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Guide launched to help claims professionals spot fraud

Claims handlers are advised to treat the customer fairly

The Society of Claims Professionals has released a good practice guide to spotting fraud.

It aims to help claims professionals to distinguish between fraud and the misinterpretation of policies.

The guide encourages claims handlers to take the time to build a full picture for every claim, which considers the specific circumstances. According to the guide, this requires an allowance for the possibility that a claimant has misinterpreted their cover. 

The guide states that unless there is sufficient evidence to the contrary, a claims handler should approach with the mindset of wanting to retain the customer once their claim has been properly managed.

Claims handlers are advised to treat the customer fairly, maintain high quality data, understand the fundamental dishonesty rules, and keep up to date with new types of fraud. 

According to statistics from the Association of British Insurers, more than 112,000 cases of attempted claims fraud were detected in 2017 worth nearly £1.3bn.

Jeremy Trott, non-executive director of the Society of Claims Professionals, said although fraud is a timely and costly drain on the insurance sector, claims should still be considered carefully so that fraud is recognised where it genuinely occurs and clients have access to protection when it is warranted.