Alternative facts

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CEGA, a provider of global medical assistance, repatriation, travel risk management and claims services, has found that more and more travel insurance customers are lying about the circumstances of claims in a bid to get them paid.

According to CEGA’s Special Investigations Unit, customers who have claims turned down are then citing different circumstances that are more likely to be accepted. “In the last year we’ve seen a rise in the number of customers submitting alternative, fabricated evidence to back up a claim,” confirmed CEGA’s head of technical claims, Simon Cook. “For example, we’ve seen missed flights blamed first on something not covered by a policy, such as poor time-keeping, and then on something that’s more likely to be covered, such as a puncture en route to the airport. We’ve had cancelled holidays attributed first to passports not being renewed in time and then to illness. We’ve been told that bags have been stolen from the beach when policyholders left them to go swimming and then – once they realise that unwatched possessions aren’t covered – that the bags weren’t left unattended after all. The list goes on.”

Cook also said that claimants often produce ‘false evidence’, such as retrospective sick notes and breakdown reports, to back up their second attempts at claiming. “Some policyholders aren’t aware that lying about the circumstances of a claim is fraudulent and that the penalties can be severe,” he said. “But we ensure that our claims processes quickly pick up these scams and that claims handlers are trained to use sophisticated conversation management techniques to make sure that genuine claims are paid quickly and fraud trends are exposed.”