The Polish Insurance Association prepared a report on insurance crimes revealed in 2020. The analysis shows that last year in Poland over 23 thousand cases of fraudulent claims were detected and undue payments of nearly 401 million PLN were thwarted.
Most cases are detected at the stage of attempting to commit a crime. The major part, over 16 thousand, are the cases concerning property insurance, mainly motor insurance. Nearly 7 thousand cases of fraud, amounting to nearly PLN 47 million, were revealed in life insurance. In more than half of the cases, the applicants wanted to extort undue benefits for surgeries and hospital treatment. Using false medical documentation, bills confirming allegedly performed operations or false death certificates are frequent practices used by criminals.
In the area of property insurance, in 2020, attempts to defraud were stopped for the amount of 354 million PLN, out of which 281 million PLN were cases related to motor insurance.
The Polish Insurance Association cites among the examples of stopped scams an attempt to obtain compensation for a damaged TV set. The victim claimed that the TV set fell because a dog had pulled on the cable. This caused the matrix to fail. The incident, according to the claim, was alleged to have occurred during the first month of insurance coverage. However, already at the initial stage of the claim assessment by the adjuster, the extent of the damage did not correspond with the described circumstances. The investigation showed that the claimant had accidentally damaged the TV set himself. In fact, it had happened two weeks earlier than stated in the application to the insurer and was the result of moving a chair. The television fell and hit the corner of the bed. Ultimately, the alleged injured party withdrew the claim.
Another embezzler wanted to claim damages for a drowned vehicle. The driver thought that an animal had run into the road, and in an attempt to avoid a collision he skidded, rushed against a tree trunk and slid down an embankment, then landed in the water. He allegedly swam approximately three to five feet to shore after extricating himself from the vehicle. A roadside assistance worker testified that the victim was only slightly damp, furthermore, there was no damage to the tree and no skid or brake marks on the road.
The authors of the report note that the COVID pandemic situation and the need to operate in the virtual sphere were quickly exploited by criminals. Insurers were faced with new phishing schemes. Among the ways they had to deal with them were avoiding contact with the adjuster and obstructing the inspection under the pretext of a strong fear of contagion, refusing to send claim documentation under the pretext of lack of Internet access, or lack of skills in using e-mail and smartphones.
As the Polish Insurance Association underlines, each case of successful fraud is a cost that honest customers also bear in insurance premiums. According to estimates, the actual value of crimes is 10 times higher than the value of detected scams.
