In Belgium, insurance fraud does not spare any player in the sector. If you are reading this article, it may be because you have been a victim yourself, or because you are looking for solutions to protect yourself from it. But to fight effectively, you generally have to find out about your opponent. Finovox has therefore unearthed, for you, practical cases of insurance fraud identified in Belgium and from the field.
In Belgium, insurance fraud is defined as any deliberate act aimed at Trick an insurance company in order to gain an unfair advantage. According to Assuralia, the professional union of insurance companies in Belgium, this fraud can take various forms:
Belgian insurance fraud would represent, every year, between 400 and 800 million euros. That is up to 10% of the total amount of benefits paid under non-life insurance, such as car insurance and fire insurance.
The consequences of insurance fraud are numerous, and the practical cases presented in this article clearly demonstrate this: increased premiums, strengthened pre-compensation checks, longer compensation periods, etc.
Not all insurance scams are the same. Some are crude, and others are particularly sophisticated. What unites them is their impact. They undermine the trust between the insurer and the insured, and increase the bill for all subscribers. If you want to avoid them, you will have to learn to recognize them.
In Belgium as elsewhere, false declarations are a particularly common type of insurance fraud. It consists of provide inaccurate or incomplete information to your insurer, whether when signing a contract or right after a disaster.
Some policyholders deliberately minimize the risks that affect their situation, while others amplify the damage caused by a disaster.
The objective of the false statement? Obtaining a cheaper rate or unjustified compensation.
The false invoice is a document fraud that is regularly used in the insurance sector. In this case, the fraudster provides a forged or manipulated document to justify a claim and thus obtain a higher reimbursement than the one originally planned.
Falsification can affect the amount of the invoice, the goods listed or the purchase dates entered.
The objective of the false invoice? Trick the insurance company for receive a higher compensation than expected.
La subscription fraud intervenes, for its part, from the first contact with the insurer. It boils down to hiding or falsifying one or more information when signing an insurance contract.
False statements may relate to The health condition of the insured, on The nature of his professional activity or even on its claims history.
The objective of subscription fraud? Benefit from advantageous subscription conditions, such as Reduced premiums Or a absence of overpayment.
In Belgium, the social fraud target mainly health insurance and disability insurance.
It includes all illegal practices that aim to obtain, maintain or increase benefits derived from Belgian social security. The processes used are numerous: false declarations, fraudulent medical certificates, fictitious medical benefits, etc.
The aim of social fraud? Receiving undue care, benefits, or reimbursements.
Insurance fraud does exist. In addition, they have concrete negative impacts, for insurers as well as for policyholders. In Belgium, the cases identified reveal various mechanisms and risks. By analyzing them closely, you will be able to understand how fraudsters operate, and above all, how to protect yourself from them.
In 2005, a Brussels coachbuilder was convicted of having organized, with the help of his family and customers, 36 fake car accidents to defraud several insurance companies.
With the complicity of his family and some customers, he falsified the names of the drivers involved and Exaggerated the amounts of reparations to obtain compensation that exceeds the real costs.
With these auto insurance scams, the bodybuilder had fraudulently obtained between 100,000 and 300,000 former Belgian francs per vehicle.
This is a practical case of health insurance fraud that has recently been talked about in Belgium.
In March 2024, theINAMI (National Institute for Health and Disability Insurance) imposed a heavy fine on a general practitioner. The practitioner was accused of invoicing medical services that he had not provided and was forced to repay more than 100,000 euros. In particular, the investigation revealed that he had invoiced fictional hospital visits for nearly 4 years.
In December 2017, a Boulanger de Houyet was sentenced to seven years in prison for deliberately set fire to his establishment in order to receive compensation from his home insurance.
The investigation revealed that the fire was deliberately started in order to obtain the sum of €384,000.
Perhaps you have noticed that? From these 3 examples, it appears that fraudsters all use the same levers:
All that remains is to explain their processes and find a way to detect them!
First of all, The lure of gain. In a tense economic context, some Belgian citizens consider insurance fraud to be a quick and effective solution to avoid certain expenses, or even to bail out their finances.
One Selvitys survey conducted for Finovox reveals, moreover, that 28% of fraudsters are motivated by financial difficulties or a lack of resources.
However, fraudsters and their main motivations are not enough to explain the phenomenon. And despite the efforts of Belgian insurance companies to limit risks, many do not have the human and technological resources necessary to detect fraud.
Companies and individuals with bad intentions can then exploit the flaws, convinced that they will never be detected. It is the combination of these two factors that creates an environment conducive to document fraud in the insurance industry.
False statements and falsified documents can be difficult to detect. The practical cases of fraud presented above illustrate this well.
To identify fraud attempts before they succeed, Belgian insurers must therefore adopt a proactive and systematic approach. An approach that is based on both traditional methods and the use of advanced technologies.
Good news: the French software for detecting fake documents Finovox is now available in Belgium!
You can already use it to:
Platform SaaS or API : Finovox can be integrated into any system and reinforces the fight against fraud in companies that are the first victims.
