Accused of insurance fraud?
Request the investigation report and the conclusions the insurer relies on.
- Respond to the findings before the insurer takes a final decision.
- A registration in the incident register, the EVR or with Stichting CIS must be proportionate and has a set duration.
- Have investigation costs and any claim against you assessed separately; they do not follow automatically from the investigation.
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The first consultation is free of charge and confidential. Six offices in the Netherlands. We also speak Turkish, Polish and English.
What is insurance fraud?
Insurance fraud occurs when someone deliberately misleads an insurer to obtain a payout. Examples:
- causing damage intentionally;
- exaggerating the extent of the damage;
- making a false report, for example in the event of theft or burglary;
- submitting forged invoices;
- withholding important information when taking out a policy.
This varies from a minor inaccuracy to organized fraud. Even “exaggerating a little” can count as fraud.
Civil or criminal law: what is the difference?
In less serious cases, the insurer keeps it civil: rejecting the claim, terminating policies and recovering costs. In the case of high amounts or repetition, the insurer can also take criminal law steps and file a report. Then a criminal record threatens.
The consequences of (suspicion of) fraud
- EVR registration: inclusion in the External Referral Register (Extern Verwijzingsregister) of the CIS Foundation. Other insurers see this and often refuse new policies. See also Remove EVR registration.
- Termination of policies: multiple current insurances can stop at the same time. Sometimes this is not simply allowed; legal review is necessary.
- Recovery and costs: paid amounts and investigation costs (often via SODA) are recovered.
- Procedures: civil and sometimes criminal law.
When is an EVR registration allowed?
Registration cannot be based on a “feeling”. There must be sufficient, concrete evidence of deliberate deception at the time of registration. A vague suspicion is insufficient. In addition, the institution weighs the interests: your interest against the interest of the sector.
How long does an EVR registration last?
The maximum duration is eight years. That is not automatic. The duration must suit the case. In lighter cases, a shorter period may suffice. In the event of an unjustified registration, removal is possible.
Partial inaccuracy: all or nothing?
If there is an incorrect part in your claim, insurers often reject the entire claim. Yet exceptions exist. If you have multiple policies or separate damage items, a partial payment can sometimes be appropriate. This depends on the facts and the conditions.
When do insurers file a report?
Not every suspicion leads to a report. With significant amounts, document forgery, repetition or organized fraud, a report is obvious. In other cases, internal measures suffice, such as rejection and registration.
Who sees an EVR registration?
All participating insurers can view the EVR. In practice, often only a “difficult risks” insurer remains, with higher premiums and restrictions. Also within one insurance group, labels share information in internal registers.
Investigation costs (SODA) and other costs
In the event of fraud, insurers standardly charge investigation costs (often via SODA). If they engage external experts, the costs increase further. These items come on top of the rejection or recovery.
Report to CBV or consequences for work
A report to the Centre for Combating Insurance Crime (Centrum Bestrijding Verzekeringscriminaliteit, CBV) can affect your position in the sector for a long time. If you work in the financial sector yourself, a report to the regulator may also follow in specific cases.
Suspected of fraud: what do you do now? (step-by-step plan)
- Request the file. Request all documents on which the suspicion or decision is based.
- Read the reasoning. Are the facts correct? Is the reason stated in the conditions?
- Respond carefully. Only provide correct and complete information. No assumptions.
- Collect evidence. Invoices, photos, statements, log files.
- Have your position reviewed. We assess lawfulness, proportionality and registration risk.
- Object or file a complaint. If you cannot resolve it, go to the KiFiD or start a procedure.
Victim of insurance fraud by someone else?
You can also be a victim yourself, for example in the case of staged theft or unjustified liability. We recover your damages and ensure that you do not pay for someone else’s behavior.
What does Arslan Advocaten do for you?
- We take control: requesting the file, organizing facts, building a defense.
- We combat unjustified suspicions and unlawful registrations.
- We litigate where necessary and request removal or shortening of EVR.
- We recover our costs from the insurer where possible.
Suspected of insurance fraud or faced with an EVR registration?
Contact Arslan Advocaten immediately. We ensure a strong response and protect your rights.
