Detecting fraud

Find out how insurers identify insurance fraud.

When you sign up for an insurance policy, you agree to give complete and accurate information to your insurer at all times. Insurers have processes built into every interaction they have with customers to help them detect when someone may not be entirely truthful.

These processes can include

  • training staff to detect inconsistencies or issues with claims that may indicate the claim needs further investigation
  • requiring proof of ownership or proof of original cost for items claimed for
  • requiring proof of work done to repair or improve the value of an asset like a house or car
  • talking to witnesses to accidents
  • requiring customers to report crimes like accidents or burglaries to the police before making an insurance claim
  • asking for photos of damaged items
  • having broken technology or furniture or damaged vehicles assessed by an approved expert
  • logging claims in the Insurance Claims Register (ICR).

If an insurer requires more information, it doesn’t mean you or someone else has committed fraud. It does mean an insurer will want to spend more time investigating the claim to make sure everything is above board. Sometimes, this will involve asking for extra information and talking to extra people.

Insurers also receive fraud reports made by members of the public to either the insurer themselves or the IFB.

Making sure that only valid claims are paid keeps insurance affordable and fair for everyone else.

Insurance fraud is a cost incurred by every policyholder, so it’s important insurers fully investigate all issues and reports.

When you make an insurance claim, you’re required to cooperate with all requests made by your insurer and provide any documentation they request. One of the standard conditions of your policy is to assist and cooperate with them and their assessors, investigators, lawyers or anyone else they appoint to help with your claim.

If you’re concerned someone involved in your claim is asking for information that isn’t relevant, or you feel they’re not acting appropriately, you can make a complaint to your claims handler or through your insurer’s complaints process. Check your insurer’s website for more information about making a complaint.

Find out more about your rights on the ICNZ website.

Keep reading: Reporting fraud