Suva: More cases of insurance fraud
Suva is taking consistent action against insurance abuse: in 2022, more than 2900 suspected cases were investigated, slightly more than in the previous year. The fight against abuse saved 24.1 million francs. The total saving since the introduction of anti-abuse measures is 239 million francs.
Insurance fraud is a serious problem that affects both the insurance industry and society as a whole. Insurance abuse leads to higher costs, reduced economic efficiency and a loss of confidence in the insurance system. In addition, premiums for honest customers may increase as they have to bear the unfair behavior of a few. That is why Suva does everything it can to combat cases of abuse.
Insurance fraud cases on the rise
However, cases of insurance abuse seem to be on the rise at Suva. Last year, the insurer investigated 2916 suspected cases out of 252,278 cases in which a daily allowance or pension was paid out following an accident or occupational illness. This is slightly more than in the previous year (2021: 2839 suspected cases, +2.7 percent). Measures to combat abuse saved a total of 24.1 million Swiss francs. This amount is made up of the prevention of unjustified benefit payments by accident victims or medical service providers such as hospitals, doctors, therapists (18.6 million francs) and the fight against abuse at insured companies (5.5 million francs). The average amount saved in benefit payments per case was 22,963 francs (2021: 24,781 francs). The total number of closed cases with confirmed suspicion was significantly higher at 810 cases (2021: 686 cases). One observation took place throughout Switzerland.
Abuse at different levels
Since the introduction of anti-abuse measures in 2007, Suva has been able to save a total of over CHF 239 million. This amount benefits the insured in the form of lower premiums.
Insurance abuse takes place at various levels: It ranges from individuals who use false or missing information to evade cash benefits such as daily allowances or pensions, to fictitious companies that evade social security premiums by moonlighting or filing for bankruptcy, to deliberately false billing by hospitals, doctors or therapists. All of these patterns have one thing in common: the damage is borne by the honest.
"The vast majority of our policyholders are honest," emphasizes Roger Bolt, Head of Combating Insurance Abuse at Suva. "In order to protect them from financial damage, to ensure risk-appropriate premiums and to contribute to a fair workplace and healthcare market in Switzerland, we take consistent action against insurance abuse. Thank you for being honest!"
Source: Suva
