Trust is important in the relationship we build with our customers. We recognize that there is always a risk that some customers may abuse that trust by committing fraud. That is why we actively work to prevent and combat fraud, so that honest customers are not disadvantaged by the actions of those acting in bad faith.
What do we mean by fraud?
Fraud is defined as "deliberately (intentionally) causing financial harm to Zwitserleven (a trade name of SRLEV N.V. and Zwitserleven PPI N.V.) for the purpose of obtaining a financial benefit for oneself or another person."
Examples of fraud include:
- Providing incorrect or incomplete information.
- Failing to disclose medical information when taking out an income protection and/or life insurance policy.
- Intentionally withholding information, such as previous policy cancellations by other insurers or banking institutions.
What we do to combat fraud
Preventing fraud
We screen our employees before they join our organization. Employees involved in fraud prevention and detection receive the training and education necessary to perform their role effectively. They may also attend conferences and other professional events focused on fraud prevention. In addition, we invest in technology to help prevent fraudulent activity. This helps us avoid accepting customers acting in bad faith and reduces the risk of paying fraudulent claims. As a result, digital investigations may form part of the onboarding, policy amendment, or claims assessment process.
If we suspect fraud
If we suspect that someone is committing fraud, we will investigate the matter. During such investigations, we follow applicable codes of conduct and principles, including the right to be heard and to respond to allegations. If fraud is confirmed, we may take one or more of the following measures:
- Recover payments that have been made.
- Charge additional costs incurred as a result of the fraudulent activity.
- Cancel an insurance policy.
- Terminate the relationship with the fraudster by cancelling all insurance policies held with us.
- Register the fraud in a warning system administered by the Central Information System Foundation (Stichting CIS). This enables other insurers to be alerted and may make it more difficult for the fraudster to obtain insurance at standard premium rates.
- Report the matter to the police.
Reporting fraud to the authorities
Where appropriate, we may decide to report fraud to the Public Prosecution Service. The measures we take depend on the nature, severity, and scale of the fraud involved.
In making this assessment, we follow the applicable protocol of the Dutch Association of Insurers (Verbond van Verzekeraars). This protocol requires us to consider factors such as:
- The impact of the fraud on societal and business interests.
- Whether the fraud was organized or involved multiple individuals.
- Whether any individual has become a victim of the fraud.
- Whether accurate and complete information has been provided.
How we inform customers who commit fraud
If an investigation concludes that a customer has committed fraud, we will inform them in writing of our decision and of any measures we have taken. This communication will explain, at a minimum, what the fraud means for the customer's relationship with us, including any policy termination, and whether their details will be registered in a warning system.
What is Stichting CIS?
The Central Information System Foundation (Stichting CIS) manages a database for insurance companies operating in the Netherlands. This database contains information that may be relevant to insurers when assessing risks and preventing fraud. Under strict conditions, Stichting CIS may make certain information available to parties such as the police, judicial authorities, and participating organizations. Participants include insurers, authorised agents, and organizations approved by the Foundation's board. Naturally, individuals also have the right to access the personal data held about them by Stichting CIS by submitting a request for access.