What consequences can scam insurance have?

The economic difficulties that many families have gone through in recent years, together with the greater detection facilitated by artificial intelligence, have increased the number of attempted insurance frauds, which represent close to 9% of auto parts, almost five times more.

Oliver Thansan
Oliver Thansan
06 February 2024 Tuesday 09:26
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What consequences can scam insurance have?

The economic difficulties that many families have gone through in recent years, together with the greater detection facilitated by artificial intelligence, have increased the number of attempted insurance frauds, which represent close to 9% of auto parts, almost five times more. than in 2009, and more than 2% of home accident reports.

This is clear from the VII Barometer of fraud in car and home insurance carried out by Línea Directa, in which more than 110,000 scam attempts are analyzed between 2021 and 2022. The company attributes the increase to the economic situation. , marked by the sharp increase in inflation, and also the use of fraud detection means based on Artificial Intelligence (AI), which allows identifying parameters, pointing out possible connections between those involved in accidents and uncovering inconsistencies in their statements.

The aspect of the phenomenon that is most worrying is the rise of criminal organizations that make a living by deceiving insurance companies, according to the data collected in the report. "The organized insurance networks are not simply 'picaresque': they are very dangerous organized clans and are normally linked to other types of serious crimes," indicate Línea Directa, which in less than a decade has detected the activity of 911 networks of this type. , which have increased by 11% compared to the previous barometer, published at the end of 2022.

In addition, they remember the importance of fighting against this type of crime, since "they significantly increase the price of policies." Networks of insurance fraudsters commit "carousel fraud" on different companies with the aim of collecting compensation for false injuries. When they manage to get their way, the average compensation amounts to 8,300 euros, compared to the 790 euros that private drivers receive. The frauds of these gangs usually consist of simulating incidents that have never existed or causing them, sometimes involving innocent people.

One of the accidents that these organizations sometimes report are collisions that turn out to be "phantoms", that is, they have never existed. Several victims in different accidents report the same version: that a vehicle has invaded the opposite lane and, when trying to avoid it, the collision or run-over occurred. "There is never any data on that other vehicle, which always flees," they add from the insurer. Added to this is that all those involved are represented by the same lawyer, who ends up renouncing the defense of the supposedly injured parties.

Another of the most frequent deceptions are collisions in which priority signals are not respected. In this fraud, the identity of the injured usually coincides with that found in other similar accidents and the morphology of the damage does not match the version given by the victims. Another relevant point is that 90% of this type of scams are for bodily harm, since the amount of compensation that false victims can receive for this concept is on average higher.

Industry sources point out that it is common for several people to be in cahoots in car insurance scams to be credible. However, when the fraud is committed by an individual, the most common scam "is trying to include in the report damages unrelated to the accident, being more common in an old car - 11 to 14 years old -, on the right side of the vehicle and, generally, because they do not have coverage in their insurance to repair the declared damages," the insurer details.

On the other hand, the most common profile of an insurance fraudster is a young man, under 30 years old, unemployed or with a precarious job. However, in recent years there has been an increase in the number of men over 40 years of age who decide to scam to avoid having to pay for repairs or to earn extra money.

Regarding home insurance, the study indicates that at least 2.4% of reports are fraudulent. The most common deception is to declare damages prior to taking out the policy, followed by the simulation of claims that have never occurred, as well as including damages from another accident or overestimating the damages. In this sense, the insurer calculates that the average cost of this fraud per party amounts to 556 euros.

The direct consequence of fraud, it is noted, is that "the higher the accident rate, the more expensive the premiums are for everyone." In addition, it can lead to criminal consequences, since the crime of fraud is punishable by fines ranging from 6 months to 6 years. Despite this, 40% of drivers "justify" these practices, while 3.6 million acknowledge that they have been offered to participate in them at some point.