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The importance of detecting fraud – case study

With insurance fraud continuing to grow, insurers are doing all they can to detect and prevent fraud, in order to protect customers. Simply declining a claim when it has been proven to be fraudulent is not enough – insurance fraud is a serious criminal offence and is not victimless.

RSA have a customer whose employee was injured at work. He claimed that his arm was immobile, he would need 24/7 care and would never be able to work again . He was claiming £1.9 million as a result. Routine investigations uncovered interesting and useful information. Surveillance footage showed the claimant lifting a table and pushing a wheelbarrow without any apparent pain. The claim was soon discontinued upon disclosure of the footage. RSA then brought Contempt of  Court proceedings against the claimant for deliberately exaggerating the extent of his injuries in order to gain financially. He pleaded guilty in court and was sentenced to six months in prison.

Whilst it may be difficult to stop determined or even opportunist fraudsters from making false or exaggerated claims it is possible to put effective measures in place that will help to defend your business. For help and advice contact ProAktive on 01302 341 344.


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