- False claims: Claiming for services that did not take place.
- Merchandising: Submitting a claim for non-healthcare items, for example, sunglasses.
- ATM scams: Receiving cash and submitting a claim for healthcare services.
- Card farming: Allowing a non-member to use the membership for treatment.
- Cosmetic surgery: Claiming for cosmetic surgery under a covered procedures code. Medical schemes generally do not cover cosmetic surgery.
- Non-disclosure: Not disclosing previous medical conditions and joins the scheme to claim for those conditions.
- Dispensing fraud: Where generic medicine is dispensed and the claim is received for the original drug at a higher cost.
- False claim – death: Claims received for a death that has not occurred.
- False claim – disability: A disability claim received where the life assured has not experienced any trauma and is not disabled according to the terms and conditions on his or her policy.
- Non-disclosure: Not disclosing previous medical conditions and then attempting to claim for these conditions while on the policy.
- Misrepresentation of unnatural death:
- Hazardous pursuits
Short term insurance
- Inflating of claims: Submission of a valid claim, however the values of the items stolen are inflated or additional items are added, which were never stolen.
- Driving a vehicle whilst under the influence of alcohol or drugs: There is a misperception about this type of loss, a person is of the opinion that a blood test needs to be done to prove that the driver was under the influence of alcohol, this is not true.
- Staging of a loss: Claiming for the loss of a specified item that the client never owned, or that was not really lost.
- Causing further damage to items: A genuine loss occurred, however the client does not want the item repaired and causes further damage to the item in order to get a replacement.
- Gym points: Swiping your card, or someone else’s, at the gym and not actually taking part in any physical activity.
- Card farming: Allowing non-Vitality members to use the membership card to access the gym.
- Hotel booking abuse: Allowing non-Vitality members to lodge at a Vitality partner hotel at discounted rates.
- Healthy Food benefit: Buying excessive amounts of healthy foods for charitable purposes or resale, to get cash back, therefore benefitting financially.
- Phishing: Criminals send emails claiming to come from a genuine company to try and trick you into disclosing personal information.
- ATM shoulder surfing: Criminals try to steal your card PIN while you use an ATM.
- Social engineering: Criminals impersonate bank employees and smooth talk you into sharing important information.
- Dumpster diving: Criminals search through your waste bins for bank statements or policy documents.
- Identity theft: Criminals steal and assume your identity, buying goods on credit in your name and leaving you in debt.