Understanding insurance fraud markers

An insurance fraud marker (False Insurance Claim under CIFAS categories) is filed when an insurer believes a claim involved material falsehood, exaggeration, or false supporting information. Around 420 cases are recorded annually, but this category is growing at 60% year-on-year.

Types of insurance fraud allegations

• Exaggerated claim — the claim was genuine but the value was overstated
• Fabricated claim — the claimed event did not actually occur
• Non-disclosure — relevant information was withheld during the application
• Staged incident — the event was deliberately arranged
• False supporting documents — receipts, valuations, or reports were falsified

The exaggeration vs fabrication distinction

There is a significant legal difference between exaggerating a genuine claim and fabricating a false one. Many insurance fraud markers are filed for alleged exaggeration — where the underlying event was real but the insurer believes the claimed amount was inflated. This distinction matters because the evidence required to prove fabrication is much higher than for exaggeration.

If your claim was an honest estimate and the insurer has recharacterised it as exaggeration, the complaint should challenge this characterisation. Honest estimations are not fraud.