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Fraud management

Zavarovalnica Triglav, d.d., introduced a zero tolerance of fraud and thus clearly expressed its commitment to fair, responsible and legitimate business operations. The fraud management policy is based on three pillars: prevention, detection and investigation of fraud. These three pillars of anti-fraud defence are integrated in all business processes in our insurance company and enable fraud management across the entire range of its operations.

Insurance deception is any unlawful or unfair conduct by a party to an insurance contract with the aim of acquiring a pecuniary benefit from an insurer for themselves or for someone else. Deception includes various groups of unfair and criminal conduct, such the forging of documents, corruption and the unlawful appropriation of assets (e.g. insurance fraud and theft).

The most common form of deception in the insurance business, insurance fraud is when an individual engages in the following conduct with the aim of receiving compensation from an insurer:

  • deliberately damages or destroys objects;
  • enters into an insurance contract after a loss event has occurred;
  • enters into an insurance contract using inaccurate or false information;
  • presents false or forged documents;
  • presents a false picture of or invents the circumstances surrounding a loss event.

By managing insurance fraud and other criminal offences we will lower our costs and the costs of our clients. Help us be more effective in preventing, detecting and investigating fraud by telling us about attempted or committed cases of fraud.

Involvement of employees in the prevention of insurance fraud

Triglav employees are trained to prevent and detect insurance fraud. A training course includes more than 1,500 employees involved in underwriting and claims settlement. Training is of crucial importance for raising employee awareness regarding the negative consequences of fraud as well as for creating and promoting an anti-fraud zero tolerance culture.

Service for the prevention, detection and investigation of fraud

Zavarovalnica Triglav, d.d., has a Fraud Prevention, Detection and Investigation Department (SPORP), directly accountable to the Management Board. In this area, Zavarovalnica Triglav, d.d., follows the best practices of modern global companies and operates in accordance with the guidelines of global organisations, such as the ACFE and the IAIS. SPORP deals with the prevention, detection and investigation of other types of criminal offences, where external players could cause damage to the insurance company. They are divided in the following areas:

  • illegal appropriation of property (fraud, tax evasion, abuse of power, disclosure of trade secrets ...),
  • corrupt practices (unjustified gift-giving and receiving, bribes, abusing the property of another ...),
  • false accounting (falsification or destruction of business documents, tax evasion ...).

Advanced computer system for detecting and investigating all types of criminal offences

In order to effectively combat insurance fraud and any other crime Zavarovalnica Triglav, d.d., is faced with, we have implemented an advanced computer solution. It helps us prevent, investigate and research fraud. Software elements (such as i2) are standard products in global industrial sectors used by more than 4,500 organisations worldwide (insurance companies, banks, intelligence services, police, army, authorities in charge of money laundering prevention etc.).


Fraud awareness-raising campaign

Insurance fraud causes damage not only to the insurance company, but also to the policyholders since it raises premiums. Therefore, we decided to inform Triglav’s clients about this problem and show them how they can help us fight insurance fraud.

The aim of the campaign is to draw attention to the harmful effects of insurance fraud and encourage Triglav’s policyholders and employees to help prevent them for the common good. Insurance fraud is a criminal offence.

Objectives of the campaign:

  • inform people about the problem of fraud,
  • present the negative consequences of insurance fraud,
  • show how Zavarovalnica Triglav, d.d., is successful in insurance fraud detection.

Most fraud attempts combine vivid imagination and quirky plans to commit fraud, sometimes involving employees in insurance companies. Loss assessors are also faced with imaginative stories, such as presented in the video below with Severina.

More information

Everything about frauds

Zavarovalnica Triglav, d.d., has prepared a white paper on the theme of insurance fraud entitled "Careful, Looks Can Be Deceiving".

The purpose of the document is to raise awareness and to leave a lasting mark on the public awareness about insurance fraud, which is the general problem of the insurance industry, not only in Slovenia but also worldwide.