Behind the scenes of real-life
insurance fraud investigations
Every year, Insurance Europe hosts the Insurance Crime Platform, a space where professionals and experts exchange intelligence and share best practices on fraud.
This year's edition featured the testimonies of fraud investigation specialists on real-life insurance fraud cases and the modern techniques used to uncover them.
Below, we will share these cases, each one a real-life example of how fraud operates, how it gets detected, and why cross-border cooperation matters.
Case 1: Hiding in plain sight
Travel insurance fraud | Cross-border
What began as a straightforward travel insurance claim for a road traffic accident abroad — with limited reported injuries — evolved over several years into something far
more significant. By the time the claim reached close to €2 million, it was based on allegations of severe and permanent disability. The medical trajectory simply did not match the original injury, and that inconsistency prompted investigators to look further.
Using open-source intelligence (OSINT), investigators reviewed publicly available online content. What they found told a very different story: social media posts showed the claimant moving independently, attending events, and participating in everyday activities entirely at odds with the level of disability being claimed. When investigators moved to gather further evidence, the social media accounts of both the claimant and their family were deleted simultaneously — a sudden and coordinated disappearance that itself served as a signal. With the support of specialised legal counsel in France and through international cooperation, the case was successfully challenged on appeal.
Key takeaways:
OSINT can be a powerful investigative tool, surfacing important insights from information that is already publicly available. Sudden, coordinated changes in online behaviour can be a strong indicator that something is wrong. And in cross-border cases, having the right legal expertise in the right jurisdiction is not a detail, it is often what determines the outcome.
Why this matters:
Fraud does not always declare itself immediately. It can develop gradually, growing in scale and complexity over time. Left undetected, cases like this can result in significant financial losses that ripple through the system, generating costs that are ultimately passed on to honest policyholders.
Case 2: Too coincidental to be coincidence
Motor insurance fraud | Belgium and beyond
Several Belgian insurers were each handling what appeared to be routine motor claims: accidents involving luxury cars, backed by expert reports, legal representation, and in some cases even a police report. Taken individually, none of the cases looked unusual.
But when insurers began sharing information, the picture changed entirely. The same scenarios kept recurring — accidents at roundabouts or parking exits, drivers who had travelled more than 200 kilometres to reach the scene, and the same individuals appearing across multiple claims. What had looked like separate incidents was in fact a coordinated scheme: an organised criminal gang staging the same type of accident in different locations across multiple countries to file repeated claims. In total, investigators identified more than 67 linked cases spanning three countries and nine insurers.
Key takeaways:
Spotting this type of fraud depends on the ability to identify patterns across different claims and different institutions. Cross-border information sharing between insurers is not optional — it is a necessity, and it must be supported by a framework that enables such exchanges systematically.
Why this matters:
Organised fraud of this scale is not about a single false claim. It targets the system as a whole, driving up costs for insurers and ultimately pushing premiums higher for honest customers. It also makes clear how critical it is to strengthen cooperation between countries in the fight against fraud.
Case 3: Twin cars
Motor insurance fraud | Belgium
When a luxury vehicle on transit plates was brought in as a total loss following a motor liability claim in Belgium, the file initially appeared consistent. The significant side damage was visible, and nothing immediately raised a red flag. But because the vehicle was registered on transit plates — making local history untraceable — Belgian insurers decided to dig deeper.
That decision proved decisive. Cross-border checks revealed that the same vehicle had already been involved in an accident a few months earlier in Germany, with near-identical damage. The vehicle had not been newly damaged: it had been bought as a wreck after the first incident and deliberately reused to support a second claim. The claim was rejected and formally classified as fraud.
Key takeaways:
Vehicles on transit plates demand enhanced scrutiny precisely because their history is difficult to trace. This case is a reminder that the full picture often lies beyond the initial claim — and that tackling cross-border fraud requires an urgent, structured framework for information sharing between insurers, authorities and law enforcement.
Why this matters:
Insurance fraud is not a victimless act. It can result in rejected claims, financial recovery actions and legal consequences for those involved. Not only, it also puts pressure on the entire system, and the costs are ultimately borne by honest policyholders through higher premiums.
Coming soon...
Insurance fraud is not a victimless or insignificant crime
Insurance protects against significant but uncertain losses through the pooling of risk. Insurance fraud — whether organised or opportunistic — undermines this pooling system because it depletes the funds paid by honest customers, leading to higher premiums.
The insurance industry is proactive in fighting fraud. Its methods include: using technology and data analytics; cooperating with law enforcement agencies; and running information campaigns.
DID YOU KNOW?
Insurance fraud is a significant problem. According to the US Association of Certified Fraud Examiners, it is second only to tax fraud in the most common forms of fraud globally.
Source: Insurance fraud: not a victimless crime, Insurance Europe (2017)
Why insurance fraud is not a victimless or insignificant crime?
Insurance is designed to protect against significant but uncertain losses through the pooling of risk. Insurance fraud undermines this pooling system because it depletes the funds paid in by honest customers to cover genuine losses.
Insurance fraud is therefore not a victimless or insignificant crime:
What is insurance fraud?
Fraud can affect all types of insurance: non-life, life and protection or health. It occurs when at least one of these conditions is met:
What are its consequences?
Fraud has an impact not only on insurers but also on their customers, with honest consumers facing higher insurance premiums as a direct consequence of fraud.
Having to investigate fraud reduces the resources insurers have to deal with genuine claims quickly, so again has an impact on honest customers.
Certain types of fraud put human lives at risk, such as “crashes for cash” or fraud-related arson, meaning that insurance fraud also puts a strain on society’s resources.
And fraudsters are often linked to organised crime, so insurance fraud funds and facilitates other serious crime
What could help in fight against fraud?
Fraud is a systemic issue that requires a collaborative approach to reduce its impact. The various national experiences of fighting fraud suggest that the efforts of insurers and other interested parties should be focused on four key areas:
Insurance fraud myths versus reality
A little bit of fraud doesn't hurt anyone
False
Insurance fraud is often linked to serious organised crime and can fund the wider activities of criminal gangs. Many orchestrated frauds such as “crashes for cash” have implications for innocent road-users and put other people’s lives at risk.
Insurance fraud is growing
It’s more complicated than that
Insurers are using increasingly sophisticated techniques in order to successfully detect more and more fraud. At the same time, fraudsters are making use of technology, third parties and other “blind spots” to perpetrate criminal acts. Detected fraud is growing, but so too are potential blind spots. What is certain is that the problem of fraud persists.
Only fraudsters pay for insurance fraud
Incorrect
Insurers collect and administer their customers’ premiums to spread risk across the population. The bill for insurance fraud, ie, the fraudulent claims payouts and the cost of insurers’ prevention efforts, is picked up by honest customers.
Insurers are "fair game"
False
Insurance fraud is a serious crime that can result in major consequences for fraudsters, who may find their future job prospects affected, find it harder to obtain insurance and even face the prospect of imprisonment.
Nobody will find out if someone commits fraud
Untrue
Insurers are committed to doing everything they can to detect, disrupt and prosecute anyone attempting to fabricate a claim. Insurers are becoming increasingly effective at sharing intelligence and information about committed frauds to prevent them from reoccurring. This includes naming and shaming fraudsters.
Insurance fraud is easy to commit
Not true
While many frauds are committed by opportunists, the more elaborate frauds require planning, knowledge and expertise. Insurers continue to strengthen their systems and checks, as well as to collaborate with other stakeholders to fight all types of frauds.
The police don't care about insurance fraud
Wrong
Insurers cooperate with law enforcement agencies in many countries, as people who commit insurance fraud often commit other offences, such as tax fraud or defrauding social services. Fighting fraud is in the common interest of everyone except those that commit it.
Fraud stays the same
It’s more complicated than that
Cyber-enabled insurance fraud and identity fraud are two growing areas and insurers are aware of the changing nature of fraud. Insurers are increasingly making use of advanced analytical software to identify cross-industry patterns and alert the industry to fraudulent networks, for instance.