Fraud policy

Mutual trust is important. You trust us to process your claim properly and we trust you to supply us with correct information. We deal with fraud severely. This way we are able to keep the premiums affordable for everyone.

Fraud is when deliberate deception is used to attain (or attempt to attain) an achievement, payment or insurance cover for which there is no right. The interests of OOM Verzekeringen can be damaged by fraud. Examples of insurance fraud are:

• Dishonest answers when applying for insurance
• Altering amounts on invoices
• Exaggerating or claiming double losses
• Resubmitting a dismissed claim with a different explanation

We have an active policy in place for signalling, avoiding and fighting fraud. This is how we prevent you and other clients from becoming victims of dishonest behaviour.

If we think something is not right about your claim, we will investigate it. To do this, we may collect, record and check your data. We may ask you for additional information and an explanation. We may also use an investigation agency to investigate suspected fraud.

If we establish that fraud has been committed, we may, for example, decide to:

•  Not refund all or part of the claim, or to reclaim costs which have already been refunded
• Alter the insurance contract         
• Not accept insurance, or to cancel current insurance
• Take civil measures such as liability
• Reclaim investigation costs
• Issue a warning (including stricter checks)
• File a complaint, such as the police
• Register the incident in internal or external fraud records

We only take measures in accordance with the Insurance and Criminality Protocol (only dutch, pdf). The person involved will be notified of our position and which measures we will be taking. In such cases, the person involved may request access to the files or challenge the decision by sending an email. In order to check the identity of those involved and to prevent unauthorised parties from accessing the data, we will ask you to attach a copy of your ID to your request. Please make sure the social security number and the photo on the copy of your ID are illegible and unrecognisable. After checking your identity, we will delete the copy of your ID.

To counteract fraud, we can record and obtain information from the Dutch Central Information System(CIS). The CIS Foundation administers details for insurance companies working in the Netherlands. We only consult and record details if there is a reason to do so.

OOM Verzekeringen adheres to the privacy rules in the context of fraud and crime management. The General Data Processing Regulation, the Protocol for Insurers & Criminality, the Code of Conduct for Processing Personal Data by Financial Institutions, the Protocol for the Incident Warning System for Financial Institutions and the Code of Conduct for Personal Investigations are important in this.

It is important for our mutual trust that you and OOM Verzekeringen communicate properly, clearly and on time. If you feel we have created expectations we are not honouring, please send an email with ‘Special Cases’ in the subject line. You can also contact us if you have suggestions for improving our fraud policy or if you would like further information on how we deal with fraud.