Image via: Adobe Stock
Image via: Adobe Stock
In 2020, life insurers in South Africa noted a 12% increase in fraudulent and dishonest claims, according to the Association for Savings and Investment South Africa (ASISA). The association said the 2020 statistics represented a significant increase – for example in 2019, there were 2387 fraudulent claims reported at a value of R537.1 million. Last year, however, those figures increased to 3186 cases and R587.3 million.
The highest incidence of fraud and dishonesty was in the funeral insurance space, according to ASISA, where enterprising individuals tried to con insurance companies with all sorts of tricks. A total of 2282 claims in this space were found to be fraudulent or dishonest.
ASISA was not surprised by the increase in fraudulent activity and dishonesty given the tough economic climate, which has been worsened by the COVID-19 pandemic. Megan Govender, the convenor of the ASISA Forensics Standing Committee, said dishonest policyholders and criminal syndicates – who typically view funeral insurance as a soft target – were egged on by conditions at hand and hoped to score “sizeable insurance payouts.”
Govender said the pandemic resulted in a significant increase in death, which made it easier to source dead bodies from mortuaries for fraudulent claims. “Since funeral insurance policies do not require blood tests and medical examinations and are designed to pay out quickly and without hassle when an insured family member dies, criminals and dishonest individuals most commonly try their luck in this space.”
Govender said ASISA made a special note of “several shocking” incidents in recent months that show just how far some people will go to scam insurers and access money from a funeral policy payout illegally.
‘HIT AND RUN’
Most funeral policies impose a waiting period of between 6 and 12 months on deaths due to natural causes in order to discourage people from attempting to take out a policy when they are sick and know that they will probably die soon.
Govender said that some desperate families have orchestrated “unnatural deaths” after their family members passed away from natural causes within the waiting period.
“One family collected the body from the mortuary before the death was registered. The body was then purposefully placed in the road where it could be hit by a car,” according to ASISA. The family then reported the incident as a hit and run and submitted a claim.
PURCHASING DEAD BODIES
Funeral insurance fraud often involves corrupt mortuary employees that sell dead bodies to criminal syndicates, according to ASISA. The syndicates then use the bodies to make claims against policies they took out months earlier.
“If funeral cover is taken out on someone who does not exist by submitting fraudulent documentation, the criminal will have to commit a further crime by either buying a dead body or murdering someone to enable them to claim. Buying an unclaimed dead body is usually the easier option,” said Govender.
EXPLOITING ADDICTS THAT ARE POOR
The life insurance industry has picked up on a syndicate that targets drug addicts and alcoholics from poor communities, according to ASISA. The victims are usually enticed with a job offer that requires them to part with their personal details including banking information. The information is then used to submit fraudulent funeral policy applications.
One such case stands out. Govender said the syndicate attempted to murder the victim after entrapping them in this way but the victim managed to escape. The syndicate was undeterred and moved “to plan B” and bought a dead body before submitting a claim.
“The claim was marked suspicious by the life company’s claims department and submitted to the forensic department for further investigation.”
Investigators discovered that the person who was covered by the insurance policy was alive and well, according to ASISA. Govender also said that the same syndicate has been involved in other fraud cases and suspicious deaths.