Fraud Policy
1. OOM's fraud policy
Trust is the foundation of our service. You trust us to process your claim honestly and we trust you to supply us with correct information. This is why we’re decisive in our fight against fraud. This not only helps us keep premiums affordable.
2. What is fraud?
Fraud involves a person deliberately trying to obtain payment, remuneration or insurance cover which they’re not entitled to. This can have severe consequences for OOM Verzekeringen and our clients. Examples of fraud include:
- Providing dishonest answers when applying for insurance.
- Adjusting amounts on invoices.
- Exaggerating a claim or claiming twice for the same incident.
- Resubmitting a rejected claim with a different explanation.
3. We take action against fraud
At OOM Verzekeringen, we have an active company policy to signal, prevent and fight fraud. We don’t want you and our other clients to be negatively affected by dishonest behaviour.
If we suspect that something is not right, we will investigate it. This may involve collecting, recording and analysing your data. We may ask you for additional information or further details. We may also engage an investigator to investigate suspected fraud.
If we determine fraud has been committed, the following measures may be taken:
- Not refund all or part of the claim, or to reclaim costs which have already been refunded.
- Alter the insurance contract.
- Not accept the insurance application or terminate insurance that has already been taken out.
- Take civil legal action, such as a claim for liability
Reclaim investigation costs. - Issue a warning, including heightened checks.
- The matter will be reported to the authorities, such as the police.
- Register the incident on the internal or external fraud registers.
Before taking any measures, we always make a careful assessment in accordance with the Protocol Insurers & Crime (pdf, only in Dutch). The person involved will be notified of our position and which measures have been taken. If the person involved disagrees with our decision, they may request access to the files or oppose the decision by sending an email. In order to verify the identity of the person involved and to prevent unauthorised access to the data, we request a copy of their ID for verification. We request that the social security number and the passport photo on the copy of the ID be rendered illegible in the process. After verifying their identity, we will delete the copy.
4. Exchange of information
To effectively counteract fraud, we can record and obtain information from the Central Information System (CIS). This system administers data for insurance companies in the Netherlands. We only consult and record data when there is a reason to do so.
OOM Verzekeringen adheres to privacy rules as part of fraud and crime control. Important rules include: the General Data Protection Regulation, the Insurers & Crime Protocol, the Code of Conduct for the Processing of Personal Data by Financial Institutions, the Protocol Incident Warning System Financial Institutions and Code of Conduct Personal Investigation.
5. Do you need more information?
It is important for our mutual trust that you and OOM Verzekeringen communicate clearly and on time. If you feel we have created expectations we are not honouring, please contact us by sending an email attn. ‘Special Cases’. We would also like to hear any suggestions for improving our fraud policy or if you would like further information on how we deal with fraud.