Finance: Tough Stance on Insurance Fraud pays dividends
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“We believe though that our unequivocal policy of a ‘zero-tolerance’ approach towards fraud acts as a deterrent in preventing fraud from occurring, as well as prosecuting offenders to the full extent,” says Jerry Chetty, head of Forensic Services at Santam.
“We currently have some 374 cases pending investigation at the South African Police Services. In our experience, somebody given to criminal activity is as likely to commit fraud in good times as in bad,” he says.
Chetty notes that economic circumstances is no justification for treating fraud any more leniently than would otherwise have been the case, and says that it is Santam’s policy to report all instances of fraud to the authorities, irrespective of the nature of the crime, the amount involved or whether it has been committed by an employee, client, intermediary or business partner.
“Fraudsters should not for one moment think that we will be any more lenient by virtue of economic circumstances. We will do everything in our power, not only to prevent any fraud from occurring in the first place, but to prosecute offenders to the full extent.
“Inevitably our approach has resulted in the company itself suffering no financial loss, while the person committing the offence may have to deal with criminal convictions for fraud and perjury, the obvious cancellation of his policy with us and an inability to obtain insurance cover anywhere else, as well as the shame to himself and his family,” says Chetty.
He says that the Santam model utilises deterrence, prevention, search, investigation and awareness in the fight against fraud, but assures clients that genuine claims are not prejudiced in any way by any assumption of fraud.
“Honest clients have nothing to fear. Where the claim is genuine, we honour our commitments in full. It is certainly not our policy to treat clients as criminals; on the contrary, we invite them to join us in combating crime, and have recently introduced a service that allows them to easily forward any details of suspected wrong-doing via SMS. As the service is operated independently by our service provider, who will cleanse all details if so required by the client, total anonymity is assured.”
Chetty recommends that clients who may be feeling the pinch as a result of current economic circumstances should discuss the options available to them with their brokers.
“There are a number of options for reducing the premiums payable on insurance policies. While clients in Gauteng should always ensure that they are appropriately covered, their broker is best placed to advise them on the best means of managing their risks relative to their financial circumstances.
“Under no circumstances should anybody think that they can take a chance by submitting a fraudulent claim. They are bound to get caught and will have to face the consequences,” he concludes.
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