The latest case report from AND-E for you;
AND-E (Aioi Nissay Dowa Insurance Europe) has recently achieved success in two cases of fraudulent claims, saving over 40,000 in the original claims and costs. Ahead of IFB Fraud Awareness Week, the cases demonstrate the importance of robust investigation, strong collaboration with legal partners and a commitment to pursue claims to trial where there is clear evidence of dishonest behaviour.
“Our Special Investigations Unit (SIU) continues to deliver outstanding results in the fight against insurance fraud,” explained Jan Martin, Head of Third Party Claims, AND-E. “Protecting honest customers and challenging exaggerated claims is vital to keep premiums fair. We remain committed to taking the right cases all the way to trial to send a clear message to the market that we have a zero-tolerance attitude to fraud.”
A personal injury claim was referred to the AND-E SIU after claims handlers identified inconsistencies in a physiotherapy invoice and questioned why the matter was incorrectly submitted through the Ministry of Justice (MOJ) portal rather than the lower-value Official Injury Claim (OIC) route. Although the collision itself was genuine, several red flags emerged: an unrealistic prognosis of 18 months for minor soft-tissue injuries, a rapid return to work and football, pressure for an early interim payment, and inconsistencies in medical evidence.
Requests for full disclosure of medical,...
The latest case report from AND-E for you; AND-E (Aioi Nissay Dowa Insurance Europe) has recently achieved success in two cases of fraudulent claims, saving over 40,000 in the original claims and ...