In this era of digitisation, pandemic, and economic stress, insurance fraud is a rapidly evolving problem for the insurance sector. Overall, carriers in the UK and Ireland are performing well in their fight against fraud – but there’s still some room for improvement.
As part of our contribution to optimising claims risk management procedures, we’ve just published our 2023 Fraud Survey – UK & Ireland Life/Health Insurance Market. We want to highlight best practices, pinpoint opportunities for support, and identify potential vulnerabilities.
The survey not only serves as a means to benchmark the market as a whole, but it was designed so that Gen Re can offer individualised feedback and support to our clients.
A large number of clients from the UK and Irish markets participated, comprising group and individual carriers who offer Income Protection, Life/Terminal illness Insurance, Critical Illness, Total Permanent Disability, and Long Term Care. Anonymised responses to a multiple-choice questionnaire were analysed and used to form the basis of the report.
Participants were asked to identify the most common types of insurance fraud they experience. In ranked order, they are as follows:
- Misrepresenting physical capacity and/or working while on claim
- Falsified documentation
- Underwriting non‑disclosures
- Deaths abroad
- Individual policies with multiple insurers
- Identity theft
Most participants felt their exposure to questionable claims has increased due to these primary factors:
- Economic stressors driving questionable claim submissions (82%)
- The rise in remote/digital interactions with customers (76%)
Over 40% of participants cited other factors that increased their exposure, specifically:
- Regulatory restrictions related to information sharing (Personally Identifiable Information)
- Lack of information/data/analytic resources
- Staff lacking awareness of trends/suspicious indicators
The survey identified several areas of strength and opportunity among insurers.