Serving you better
Tips for claims professionals to identify fraud
Press release
Publication date:
02 December 2019
Last updated:
25 February 2025
Author(s):
Society of Claims Professionals
Claims professionals have been advised how to approach distinguishing between fraud and the misinterpretation of policies.
In accordance with the FCA’s definition of insurance fraud being: “when someone invents or exaggerates a claim or does not tell the truth in order to obtain cheaper cover", the Society of Claims Professionals (SOCP) has released a good practice guide to spotting fraud.
The guide contains four key recommendations to avoid conflating attempted fraud with a misunderstanding of cover.
The guide encourages claims handlers to take the time to build a full picture for every claim, one which considers the specific circumstances, so as to treat clients fairly.
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.
- Keep up to date with new types of fraud.
Jeremy Trott, non-executive director of the Society of Claims Professionals, said: “It is important to note that, 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”
“However, while fraud is still a timely and costly drain on the insurance sector, claims should still be considered carefully so that, not only fraud is recognised where it genuinely occurs, but also that clients have access to protection when it is warranted.”
ENDS
Contacts
Helen Moore, Communications and Engagement Manager
T: +44(0)20 7397 1121
M: +44(0)7464 521 213
Reace Novello, Public Relations Executive, Personal Finance Society
T: +44(0)20 7397 1113
M: +44(0)78 6732 4170
Notes to editors
The Society of Claims Professionals (SoCP) is a professional body dedicated to those working in the insurance claims sector.
Established to promote high standards, the Society works closely with key industry stakeholders, including the Government, and regulatory bodies, to engender consumer confidence and public trust.
The Society is governed by an Advisory Board made up of senior market practitioners who, chosen for their technical expertise and valued guidance, promote and champion examples of good practice within the profession.
In alignment with the Royal Charter mission of its parent organisation, the Chartered Insurance Institute, the Society of Claims Professionals supports its more than 8,000 members with a code of ethics, good practice guidance, thought leadership, and a programme of topical and dedicated continuing professional development.
For more information visit the Society of Claims Professionals.
This document is believed to be accurate but is not intended as a basis of knowledge upon which advice can be given. Neither the author (personal or corporate), the CII group, local institute or Society, or any of the officers or employees of those organisations accept any responsibility for any loss occasioned to any person acting or refraining from action as a result of the data or opinions included in this material. Opinions expressed are those of the author or authors and not necessarily those of the CII group, local institutes, or Societies.