On 27 February 2014, a search and seizure operation was conducted at the offices of Statusfin brokers in Groblersdal by the South African Police National Investigation Unit, DPCI Polokwane, The Insurance Crime Bureau and Santam.
The purpose of the operation was to seize exhibits that could be used as evidence in Court against an employee of Statusfin Insurance Brokers who was identified as a suspect of fraud through the SAS system during the proof of value stage. Upon further investigation, enquiries were made at the various insurance companies that were identified as possibly having some sort of involvement in the suspect’s elaborate scam to defraud insurers.
The modus operandi of the suspect was to submit fraudulent fast track claims on the policies of existing Statusfin clients. Before submitting the claim, the suspect would change the debit account number on the policy to that of her own bank account number. False invoices would them be submitted as well as receipts to support the false claim. As soon as the claim was settled by the insurance company, the suspect would change the debit account number back to that of the client, who, during this process, has no notion of the claim submitted.
During the search and seizure operation, the suspect was confronted about the allegations and it was arranged that she would be taken to the Groblersdal Magistrates Court on 28 February 2014, where she would confess to the above-described modus operandi. The suspect admitted that no one else was involved in the commission of these crimes.
In total, the suspect submitted 25 false claims in the time between December 2012 and February 2014, amounting to a value of R250 000. The only insurer affected by these fraudulent activities was Santam.
After the suspect’s confession, the matter will be discussed with the Commercial Crime Court Prosecutors in Pretoria. The suspect indicated to the investigation team that she intended to plead guilty in terms of Section 105 of CPA.
Claim files, false invoices and stamps used to produce the false invoices were seized and booked in to the SAP 13 as exhibits and for further investigation.
The Insurance Crime Bureau wishes to thank the SAPS members involved in the operation and for their ongoing assistance in this matter.
Further progress on the case will be reported.