Abstract
Fraud is a serious issue in the insurance industry, which affects both policyholders and insurance companies. Despite insurance companies being in the business of transferring risk from the insured to the insurer, they are often at risk of being victims of insurance crimes specifically in the form of fraudulent claims submitted by policyholders. Insurance fraud has been identified as a significant contributor to the global increase in insurance premiums for policyholders and has caused insurers to lose billions of Rands every year. Fraudulent claims usually occur when a claimant tries to obtain a benefit to which they are not legally entitled to. Typically, it can be said that these claims stem from greed and weaknesses in anti-fraud measures. They are often seen as a lucrative, low-risk activity, but it has been demonstrated that people are more inclined to perpetrate insurance fraud during economic hardships. The focus of this study will be on fraudulent insurance claims, which may take the form of fabricating a loss, exaggerating claim amounts, or valid claims accompanied by fraudulent means. The study will address insurance fraud at claims stage in non-life insurance policies and analyse relevant case law in order to provide a general overview of how the South African courts have dealt with matters of this nature. It will further focus on the inclusion of forfeiture clauses in insurance contracts as a means of deterring fraudulent claims by policyholders and compare the United Kingdom laws of insurance to those of South Africa.