Fraud prevention

How does fraud affect you?

The biggest impact on the cost of insurance policies are the number of claims made and the market conditions that influence these costs. As a healthcare company Bupa works relentlessly to manage healthcare prices, through collaboration and partnership with medical providers.

Insurance fraud is another claim cost that can lead to increased insurance premiums for customers if it's not controlled. This could mean being priced out of the opportunity to protect you and your family with the best possible healthcare insurance for you.

What are we doing to prevent fraud?

We take the prevention, and action, of attempted fraud very seriously.

• Market leading analytic tools designed to detect suspicious activity
• Member of the Health Insurance Counter Fraud Group
• A global counter-fraud team dedicated to preventing, and investigating, fraud attempts
• A network of alliances designed to prevent fraudulent attempts and share critical information within the industry to reduce this crime
• A zero-tolerance approach to fraud. Bupa will investigate every attempt and will action any proven fraud to the maximum allowance within our rules, and the country laws in which we operate.

What can I do to help?

Insurance fraud can take many forms. Bupa treats all fraud with the same zero-tolerance approach. Examples of insurance fraud include:

• Presenting claims for services or medications not received, or altering invoices for services received
• Misrepresenting procedures performed to obtain payment for non-covered services, such as cosmetic surgery
• Submitting insufficient or falsified information to obtain an insurance policy
• Collusion between insured party and medical provider or agent

If you suspect insurance fraud, or have any concern regarding suspicious activity, we’re here to help. You can email us in confidence outlining your concern at: Email: [email protected]