How does MS Amlin deal with fraud
For a good relationship between MS Amlin and its clients, trust is the basis. We assume that our clients are telling the truth. However, various studies show that a small group of customers abuse this trust. They commit fraud. The same surveys also show that the vast majority of customers think we should crack down on insurance fraud. That makes sense. Because the more fraud is committed, the higher the insurance premium. We would like to prevent this by checking claims and insurance applications to see if they are justified and correct.
We verify who we do business with
When applying for insurance, we check who we are doing business with. We always check the identity of the applicant. But also the identity of the beneficiary of an insurance or financial service. We do this again when we pay out a claim. We then also check whether someone is on a sanctions list.
What do we mean by fraud
At MS Amlin, we view fraud as deliberately disadvantaging of MS Amlin for the benefit of the fraudster or a third party. The fraudster then misrepresents facts in order, for example, to obtain insurance or to receive a (higher) benefit than he is entitled to. Consider, for example the following:
- Failure to give honest and/or complete information to MS Amlin, such as when applying for insurance;
- Not telling honestly what happened;
- Changing amounts on bills;
- Claiming more than the actual damage;
- Submitting a rejected claim again, with a different story;
- Intentionally causing injury and pretending it was an accident;
- Pretending a personal injury or exaggerating an injury;
Avoid misunderstanding
Avoid mistakes and unclarity. For example, when filling out a form, are you not sure what we mean by a certain question? Then contact us or your advisor. This also applies if, for example, you are unsure of how to proceed with a claim or if you don't know what information to provide to MS Amlin when filing a claim.
Fraud management coordinator
We deploy internal and external qualified specialists dedicated to preventing, detecting and combating insurance fraud. Internally, it means that MS Amlin works with fraud control coördinators who are registered as (candidate) register coördinators in the Register of Fraud Control Coordinators. This register falls under the responsibility of the Association of Insurers and is managed by the Netherlands Institute of Registered Experts (NIVRE).
How does MS Amlin detect fraud
We use various ways to find out the truth in order to detect fraud. Needles to say, we comply with applicable laws and regulations in doing so, including the General Data Protection Regulation (GDPR) and the Code of Conduct for Personal Investigations. (GPO) Examples of methods used by MS Amlin to investigate fraud or attempted fraud include the following:
- We may investigate (or cause to be investigated) a person's conduct or collect (or cause to be collected) information that may be relevant to obtain or be accepted for insurance, assess entitlement to compensation or determine the sums paid out;
- We may collect and process personal data obtained by other means and from other sources than from the individual concerned. For example, from public sources such as the license plate register of the Department of motor vehicles (RDW), the registers of the Chamber of Commerce, the Land Registry and the Internet. But also information obtained from other persons such as tip-offs or witness accounts;
- We can gather information by conducting technical, tactical and personal investigations. Examples include observing or interviewing persons (or having them observed), accident analysis, note checking, fire (technical) investigation and investigation of break-in traces;
- We use relevant information from the financial institutions’ alert system. We may exchange information with other insurance companies;
- We deploy predictive software. This software distinguishes between claims that are approved immediately and those that require investigation on account of possible fraud;
Conducting investigations
Some research we conduct ourselves, but some we do not. For some investigations MS Amlin engages external investigation bureaus. Agreements have been made with these investigation bureaus. They must comply with the laws and regulations for the proper conduct of investigations and the processing of personal data.
Our measures in case of fraud
We take a number of measures when fraud is established for example the following:
- We do not pay out or do not pay in full;
- We may recover the costs of an investigation that has been instituted and reclaim damages that have already been paid;
- We can recover direct and indirect damages (through the SODA Foundation. More information can be found on the SODA website. (www.so-da.nl/verzekeraars;)
- We can reject an application;
- We can also terminate other, existing (insurance) contracts;
- We can report to the police, for example if:
- there is considerable finacial damage;
- there is the prospect of the return of goods, e.g. stolen cars;
- this is requested / instigated by the police;
- We may include your personal data in the Incident Register and the External Referencel Register. The Incidents Register is a register in which incident data is filed. The purpose of the Incidents Register is to support activities aimed at ensuring the security and integrity of the financial sector. The CIS foundation manages this register. Find out more at www.stichtingcis.nl. The External Referral Register can also be accessed by other financial institutions and contains referral data of persons who have been involved in incidents. More information is provided in the Protocol Incident warning system Financial Institutions 2021 (PIFI);
- After a fraud investigation, our point of view and measures are communicated in writing and by registered mail.
Recovery of costs
MS Amlin makes every effort to recover the internal and external investigation costs incurred. Either MS Amlin itself may reclaim these costs and/or SODA. A standard compensation of € 532.= applies to internal investigation costs in case of fraud. This amount is recovered by SODA (Service Organization Direct Liability). In addition to the standard amount, SODA can also recover other costs incurred or wrongfully paid damages on behalf of MS Amlin. Learn more about SODA at www.so-da.nl.
How do we inform the fraudster?
We will notify the fraudster in writing of the measures we are taking.
Reporting fraud
Do you suspect that an insured or other relation of MS Amlin is committing fraud? If so, you can report it to us:
- By mail: fraudecoordinator.nl@MSAmlin.com
- By calling our Security Department during office hours 020-5031100
When reporting (suspected) fraud, it is important that we can link your information to the correct file. That is why we ask for this information:
- Claim number (if known);
- Name, address, date of birth of the person(s) involved;
- What the fraud relates to;
- How you obtained the information;
- Your contact details if you are willing to provide additional information to MS Amlin;
In this way, your information will go directly to one of the fraud control coordinators. This coordinator will handle your information with care. You can read more about this in our Data Privacy Notice.