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The hard problem of soft fraud

Identifying fraud poses some complex issues for insurers.

By Joseph Bracken | Updated on September 30, 2015
Identifying soft fraud without offending policyholders involves a delicate balance. Photo: Sergey Nivens/Shutterstock

In the world of insurance, “hard fraud” is committed by sophisticated professional criminals who find ways to manipulate the insurance system and reap monies fraudulently on a more than occasional basis. “Soft fraud” on the other hand, is committed by consumers who see the opportunity to either “pad” a legitimate insurance claim or submit a fraudulent household claim on a one-time basis.

In the United Kingdom, for example, researchers at the University of Portsmouth examined some 40,000 claims handled by fraud investigators and found that the majority of cases tended to involve usually honest people indulging in an opportunistic low-value crime. The typical opportunistic fraud committed was making a claim for the equivalent of less than $1,000 for accidental damage to a computer, television or mobile phone. The research found that 82% of fraudsters submitted claims for accidental damages, since such claims do not require official documentation.

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