16.1 Introduction

Fraudulent insurance claims have been a problem for the insurance industry since insurance was first written.1 Insurance fraud wilfully violates well-established legal and moral values, perpetrates social and economic order, and is, therefore, prohibited by law. All insurance claims frauds are for the purpose of obtaining insurance payments to which the fraudsters would not be entitled; in a broad sense, it may be said that all frauds in connection with claims are fraudulent claims. To put it more clearly, it can be said that a claim is fraudulent if it can be shown that the insured intended to defraud the insurer of insurance moneys via misrepresentation or concealment of the truth or put forward false evidence and documents when, in fact, there was no loss or the loss was exaggerated.