What if my insurer accuses me of fraud?

The short answer

When your insurer accuses you of fraud, you must always dispute this in writing if you are innocent. The insurer must be able to prove that there is actually fraud. You have the right to access the file and object to registration in the CIS register. For complex cases, it is wise to consult a lawyer. Doing nothing and the accusation will remain on your name for years.

What does the law say?

The insurer must, according to the Financial Supervision Act, demonstrate that there was intent to claim damages that were not lawful. A suspicion is not enough - there must be evidence of bad faith. The Civil Code stipulates that the insurer bears the burden of proof. You have the right to be heard before being included in the fraud register. The General Data Protection Regulation (GDPR) gives you the right to access, rectify and delete inaccurate data.

What should you pay attention to?

Pay close attention to the deadlines for objections and defenses - you often only have a few weeks. Carefully keep all communication and documentation. A CIS registration remains visible to other insurers for five years. Silence is often interpreted as an admission of guilt.

Example from practice

Jan reports water damage after a pipe burst. The insurer finds it suspicious that Jan wanted to have a new floor installed just before the damage. They accuse him of having intentionally caused the damage. Jan requests the full file and has a plumber confirm that the pipe burst due to wear and tear. He disputes the fraud accusation in writing with this evidence. The insurer withdraws the accusation and pays out the damage.

What can you do?

Follow these concrete steps to defend against an accusation of fraud.