Mark Stefan Van Kessel, Cost Control & Counter Fraud Manager for AXA Partners, discussed the effect of the Covid-19 pandemic on fraud claims. He explained how an increase in financial pressure caused by the pandemic has led to a rise in fraudulent activity amongst customers and companies. He highlighted that in the travel insurance world, new types of fraud are emerging that are specific to situations involving Covid-19 and travel. This includes false reports from customers wanting to extend their trips by claiming they are ‘unfit’ to fly due to minor illnesses or contracting Covid-19 whilst on holiday. He added that hospitals are also trying to benefit from fraudulent claims by faking bills, overtreating patients and overcharging unnecessarily.

Stefan Van Kessel stressed the importance of teamwork and collaboration when combating fraud. He explained how companies must work together and share information with counter fraud specialists, insurers, and assistance companies to help each other prevent, detect, and stop fraud. “It’s key if we want to catch out these fraudsters,” he concluded.

Xavier Begue, Chief Compliance Officer and Lionel Donguet, Global Head of Claims Excellence, at Europ Assistance, discussed the financial impact of fraudulent activity on insurance companies.

Begue explained how they want to improve loss ratio and decrease external costs through better claims management processes. “We face an increase in fraud with a direct financial impact,” added Donuguet. “Ten per cent of total external costs are fraudulent, this is huge.”

Begue and Donguet explained that staff working in fraud detection must be professionally trained and taught how to use complicated technological systems correctly. For the process to work successfully, there must be systematic correlation between the level of sophistication of technology versus staff ability, they said. If staff do not truly understand how to use the advanced technology they are working with, fraud attempts that have been detected by the system may go unnoticed by the workforce.

Donguet highlighted a recent case where fraud was successfully stopped after a customer claimed $100,000 for hospital bills incurred treating his deceased wife before she died. Upon further investigation, it was found that the date of initiation of treatment had been falsified and the policy was taken out after the patient was admitted to hospital, therefore the cover was not valid.

Donguet concluded that “We are responsible, and we have a duty to fight against fraud”.