- Introduction
These guidelines replace the previous guidelines issued by ACPO Crime Committee back in 1978.
These guidelines are intended to complement the previous ACPO document ‘Acceptance criteria & guidelines for the reporting of suspected insurance claims to the police’.
The guidelines result from numerous meetings between the Police, Association of British Insurers (ABI), Members of the Insurance Industry and representatives of the Information Commissioner.
- General Principles
The following are general principles, which have been agreed between the Police and the Insurance Industry.
2.1 These guidelines are intended to deal with requests for information from insurance companies and loss adjusters involving property crime, although they could be applied to other crime categories.
These guidelines only apply to issues arising from the insurance claim and not queries arising from the proposal.
2.2 Previous convictions, cautions, reprimands and final warnings will not be supplied. It makes no difference if the claimant consents.
2.3 While nothing in this agreement prevents claimants from using the subject access arrangements on behalf of insurance companies, in the near future, when the Criminal Records Bureau is established it will become unlawful for insurance companies to require persons to obtain their previous convictions and cautions by means of the subject access procedure (Section 56, Data Protection Act 1998).
2.4 Every request for information will be considered on an individual basis. Reasons for agreeing or not agreeing to disclosure will be recorded. Information supplied pursuant to these Guidelines will only be used for the purposes given.
2.5 In association with the ABI each insurance company has appointed a person/position to act as a contact point for the Police (Appendix A). Each Force will establish a postal contact point for liaison with the Insurance Industry in connection with these guidelines as indicated in Appendix B.
2.6 ABI/insurance companies/loss adjusters are included in the standard notifications made by Police Forces under the Data Protection Act.
2.7 The ABI have prepared guidance for its members in respect of applying for information under this agreement and subsequent use (Appendix G).
2.8 Claimants will be advised at the proposal and claim stage that the insurance companies may exchange relevant information with the Police where any claim is believed to be fraudulent or with the consent of the claimant in cases where this is needed to validate the claim. This in itself could be regarded as a valuable crime prevention measure which could make claimants think twice before making a fraudulent insurance claim.
2.9 The release of information may be delayed. For example, there may be outstanding criminal proceedings in relation to the original offence, which gave rise to the insurance claim. The Police may, however, advise if a person has been charged (although personal information will not be released) and/or indicate that there is no suspicion about the claimant.
2.10 The insurance industry accepts that values may not be accurate when supplied at time of stress and that property lists may be incomplete. It recognises that forces keep this information for policing purposes and not the evaluation of insurance claims.
2.11 The ABI on behalf of the Insurance Industry has agreed to indemnify all participating Police Forces in respect of the information supplied under these guidelines (Appendix C).
2.12 Request forms from the Insurance Industry should be authorised by a person with sufficient seniority and experience to have satisfactory knowledge of these guidelines and be able to ensure that the set criteria are met.
2.13 The ABI will act as a central contact point to assist in the resolution of any areas of difficulty that arise.
2.14 These guidelines will be subject to review in the light of experience of their operation initially after 12 months and at three yearly intervals thereafter.
- Communication from Insurance Companies and Loss Adjusters
3.1 A considerable amount of communication takes place between the Insurance Industry and Police Service and it is in the interest of all parties that workloads are kept to a minimum.
3.2 Letters from the Insurance Industry, which merely request that an interest is noted will not be acknowledged.
3.3 Requests for information from the Insurance Industry where there is specific reason to check a claim will be dealt with in accordance with Section 4 of these guidelines.
3.4 Request for information from the Insurance Industry where there is evidence to suspect a fraudulent insurance claim will be dealt with in accordance with Section 5 of these guidelines.
3.5 Requests from the Insurance Industry for Police to investigate crime will be evaluated on the basis of the grounds for suspicion put forward and in accordance with the ACPO / ABI document (‘Acceptance criteria & guidelines for the reporting of suspected insurance claims to the police’.).
- Supply of information where there is specific reason to check a claim
4.1 Requests for information will only be received for consideration from insurance companies specified in Appendix A and loss adjusters acting on their behalf provided they are in the agreed format (Appendix D). Information requested should be factual. The Police will not give expressions of opinion.
4.2 The Insurance Industry will be charged a fee of £75 in respect of each request form submitted for information under this section. This fee will be reviewed after 12 months in the light of experience.
4.3 The insurance company will write to claimants with a list of the specific information they intend to request the Police to disclose along with their reasons for requesting its disclosure. The claimant will be requested to give written consent to the disclosure and issue of specified information / material by the Police. If any such consent is given, then it is required to be fully informed and the person consenting must be the person to whom the information relates. The Claimant will also indicate whether they wish to be sent a copy of the information / material at the same time as it is forwarded to the insurance company/loss adjusters. A copy of the claimant’s written explicit consent will be forwarded to the police prior to disclosure being made.
4.4 A general consent to disclosure at the proposal or claim stage will not be acceptable under these guidelines. This would put undue pressure on the individual to agree to disclosure. The insured would not have any idea of what disclosures were being made.
4.5 Refusal by the claimant to give consent to disclosure will not, by itself provide grounds for the Insurance Industry to revert to Section 5 of these guidelines for disclosure of information.
4.6 In exceptional cases it will be possible under this section for insurance companies and loss adjusters to seek formal interviews with Police Officers at the standard fee, (currently £84). The authority for such interviews will be at the discretion of the Force concerned and any interviews will be conducted under ACPO guidelines.
- Supply of information where there is evidence to suspect a fraudulent insurance claim
5.1 Applications for information made by insurance companies and loss adjusters under Section 29(3) of the Data Protection Act 1998 will include
Why claim is believed to be fraudulent,
What information is requested,
Why this information is requested (Appendix E).
5.2 However police will undertake to advise insurance companies when there is evidence to demonstrate that a fraudulent insurance claim has been made. They would normally be advised as part of the investigation. This would be a disclosure under powers provided by Section 29 (3) of the Data Protection Act 1998. (Appendix F may be used)
5.3 No fee will be charged under this section.
5.4 Liaison will be allowed with the investigating officer in appropriate cases.
5.5 Formal interviews will normally be allowed following the conclusion of any criminal proceedings if any. A decision will be taken by the Force concerned whether it would be appropriate to charge a fee bearing in mind that the insurance company would have been the victim of a crime.
5.6 Where Insurance Companies find any further evidence of criminal conduct they will notify the relevant police force. Assistance will be given by the Insurance company to enable the police to consider criminal proceedings.
5.7 Should a claimant be successfully prosecuted or cautioned in relation to a fraudulent insurance claim the Police will notify the individual insurance company.
6 Post claim procedures
6.1 Where the insurance company is a victim of a fraudulent claim, which results in criminal proceedings then the police, will keep the insurance company advised in order that they may claim compensation.
6.2 Having settled a claim, if in accordance with the ABI guidance the insurance company wishes to claim the return of any property, which might be recovered by Police, then notification to that effect will be sent.
6.3 The Police Force will endorse the crime report accordingly.
6.4 The insurance company and not the insured should be advised that the property is available for collection. If the insurance company is notified that the property in question is available for collection then they will undertake such collection promptly.
6.5 In the event of conflicting claims appropriate legal advice may be obtained
Appendix A & Appendix B
These appendix address the liaison points for both insurers and the police.
For Insurer liaison, details of the ABI member can be obtained for the Association of British insurers at:
For Police liaison, details of the Police contact points, enquires should be addressed tot he relevant constabulary’s Data Protection Officer, usually located at the Constabulary’s headquarters.
If difficulty is experienced locating the relevant contact, we will attempt to provide the detail. Please e-mail by clicking: ABI / ACPO liaison.
Appendix C – ABI INDEMNITY
- In consideration of the provision of information by the Police to assist insurance companies and loss adjusters which are qualifying members (as defined below) in their work, the ABI on behalf of such of its members as are notified by ABI to the ACPO from time to time (“qualifying members”), undertakes to indemnify any of the persons or any authority referred to in Para 2 below against any liability, which may be incurred by such person or authority as a direct result of the provision of such information except where liability arises out of the negligence of such a person or authority.
- Persons who can claim the benefit of this indemnity are in respect of any participating Police Force, as
follows:
a) Any Police Authority
b) The Chief Constable of any Constabulary
c) Any serving or former Police Officer of any Constabulary
d) Any serving or former staff member of any Constabulary
Appendix D
REQUEST TO THE INSURED
FOR CONSENT TO DISCLOSURE OF INFORMATION HELD BY THE POLICE
Details of Insurance Company
Claim No: ………………………………… Name ……………………………………………………..
Address: …………………………………………………………………………………………………
Details of Insured
Name:……………………………………… Address:…………………………………………………
…………………………………………………………………………………………………………..
Details of Crime
…………………………………………………………………………………………………………..
…………………………………………………………………………………………………………..
…………………………………………………………………………………………………………..
Date and location of crime ……………………………………………………………………………
In order to assist with the progress of your claim, we would ask for your consent as reporting
individual to enable us to obtain the following information from the
……………………………………………………………………………….. Police / Constabulary.
The information requested and the reason for seeking it is set out below
_________________________________________________________________________________________
Information Requested
1 …………………………………………………………………………………………………………..
Reasons ……………………………………………………………………………………………………
Consent: I consent / do not consent to the release of this information*
2 …………………………………………………………………………………………………………..
Reasons ……………………………………………………………………………………………………
Consent: I consent / do not consent to the release of this information*
3 …………………………………………………………………………………………………………..
Reasons ……………………………………………………………………………………………………
Consent: I consent / do not consent to the release of this information*
Do you wish the Police to send you a duplicate copy of their response to these questions? Yes/No*
*(The claimant should delete as appropriate)
Crime Reference / Incident Number (if known)………………………………………………………..
Signed ……………………………………………………………… Date………………………………
Name ………………………………………………………………………………………………………
(block capitals)
APPENDIX E
REQUEST FOR INFORMATION HELD BY THE POLICE
WHERE THERE IS EVIDENCE TO SUSPECT A FRAUDULENT INSURANCE CLAIM
From: (Insurance Company) ………………………………………………………..
Address: ………………………………………………………………………………
To: (Constabulary) ………………………………………………………………….
Data Protection Act 1998, Section 29(3)
I am making enquiries, which are concerned, with:-
* (a) the prevention or detection of crime
* (b) the apprehension or prosecution of offenders
* delete as appropriate
Ref No: ………………………………
Nature of enquiry and information requested:
……………………………………………………………………………………….
……………………………………………………………………………………….
……………………………………………………………………………………….
Summary of existing evidence (to be supplemented by copies of documentation)
……………………………………………………………………………………….
……………………………………………………………………………………….
I confirm that the personal data requested is required for that / those purpose(s) and failure to provide the information will, in my view, be likely to prejudice that / those purpose(s).
Signed ……………………………………………
Name…………………………………………….. Date ……………………………
(Block Capitals)
Department ……………. …………………………………………………………..
Signed . …………………………………………. Post ……………………………
(Supervisory signature where necessary)
Name……………….. ………………………….. Date ……………………………
Under the terms of the Information Sharing Memorandum of Understanding between the Police Service and the Insurance Industry, any further evidence of criminal conduct obtained by the Insurance Industry as a result of the disclosure requested, must be notified to the appropriate Police Force to enable that Force to consider criminal proceedings.
COPY TO BE KEPT ON FILE
APPENDIX F
DISCLOSURE OF INFORMATION TO THE INSURANCE
INDUSTRY BY THE POLICE WHERE THERE IS EVIDENCE TO
SUSPECT A FRAUDULENT INSURANCE CLAIM
PRIVATE
From: (Constabulary) …………………………………………………………………
To: (Insurance Company) ……………………………………………………………
Data Protection Act 1998, Section 29(3)
I am making this disclosure on the grounds of :-
* (a) the prevention or detection of crime
* (b) the apprehension or prosecution of offenders
* delete as appropriate
The information attached hereto is:
…………………………………………………………………………………………
…………………………………………………………………………………………
THIS INFORMATION SHOULD BE HELD IN CONFIDENCE AND ONLY USED FOR THE GROUNDS SET OUT ABOVE IT SHOULD NOT BE DISCLOSED WITHOUT THE CONSENT OF THE CONSTABULARY
I confirm that the personal data disclosed is required for that / those purpose(s) and failure to provide the information will, in my view, be likely to prejudice that / those purpose(s).
Signed ………………………………………
Name…………………………………………….. Date …………………………..
(Block Capitals)
Division / Department ………………………….
Countersigned ………………………………….. Post ………………………….
(Inspector/Data Protection Officer or identified post where necessary)
Name…………………………………………….. Date …………………………..
Under the terms of the Information Sharing Memorandum of Understanding between the Police Service and the Insurance Industry, any further evidence of criminal conduct obtained by the Insurance Industry as a result of this disclosure, must be notified to the appropriate Police Force to enable that Force to consider criminal proceedings.
COPY TO BE KEPT ON FILE
APPENDIX G
GUIDANCE NOTE FOR ABI MEMBERS
Background
- In 1978 the ACPO Crime Committee issued guidelines on the exchange of information between Police and insurers. In 1999, ABI and ACPO agreed to draft revised guidelines in recognition that the current system was not working well in practice. The joint ABI/ACPO Working Party has now agreed a set of revised guidelines. They are intended to complement the joint ABI/ACPO document ‘Acceptance criteria & guidelines for the reporting of suspected insurance claims to the police’.
- The arrangements agreed in 1978 were felt to be inadequate because the Police were overwhelmed by the volume of requests for information received from insurers and loss adjusters and the administratively burdensome way in which they were made. The Police considered that in a large number of cases it was not made clear to them whether there was suspicion of crime, namely insurance fraud, leading to the request. It is in insurers’ interests to build a workable protocol for requesting information from the Police so that cases where they have evidence or reasonable grounds to suspect fraud are dealt with.
- Paragraph 2.7 of the “ACPO/ABI Guidelines On The Exchange Of Information Between The Police And Insurance Companies And Loss Adjusters” (the Guidelines), sets out that ABI will provide additional guidance to its members in respect of applying to the Police for information under the Guidelines. This Guidance Note provides that additional material.
Complying with the Guidance Note
- ABI has agreed with ACPO that requests from insurers and loss adjusters will only be responded to by the Police if they comply with the guidance set out in this Note and the Guidelines themselves, and if requests are made by on or on behalf of the list of participating insurers at Appendix A to the Guidelines.
- This Note refers to “insurers” but the term should be read as including loss adjusters acting on behalf of insurers. As ABI members, insurers are responsible for ensuring that loss adjusters acting on their behalf comply with the terms of the Guidelines and this Note.
Basis for requesting information
- The Guidelines set out that there are two bases on which insurers should approach the Police for information:
- Where there is specific reason to check a claim (section 4);
- Where there is evidence to suspect a fraudulent insurance claim (section 5).
- Insurers – or loss adjusters working on their behalf – who make approaches to the Police which do not comply with the Guidelines or this Note risk being deleted from the list of participating insurers at Appendix A of the Guidelines with the result that the Police will not supply any information to them or their agents.
Correspondence
- All requests for information must be made according to the agreed format set out in the Appendices to the Guidelines. Other correspondence as a rule should be limited to supporting information sent with the appropriate form. The police will not acknowledge letters registering the insurer’s interest in a particular case. Insurers are asked to keep these to a minimum and not send them as a matter of routine because many forces do not have the resources to deal with large volumes.
- Loss adjusters will need to confirm to the Police that they are requesting information as an appointed agent of a named insurer who appears on the list at Appendix A to the Guidelines.
- Paragraph 21 of this Note sets out that the Police also wish to be informed about the outcome of an insurer’s investigations where information had been requested under section 5 of the Guidelines.
- This section relates to cases where the insurer has reason to check a claim but where there is not yet enough evidence to make a reasonable decision that fraud is being attempted. A crude example might be that goods reported stolen in a burglary appear to the insurer to be well beyond the means of the claimant (eg. very expensive items of jewellery belonging to someone in a modestly paid job) and the claimant has been unable to provide any proof of ownership. In these circumstances the insurer might have reasonable grounds to make further inquiries about the claim. A Police crime report could assist the insurer’s decision whether or not to settle the claim.
- Requests under this section require the explicit consent of the insured for an approach to be made to the Police. Clearly this could make the ability to request information useless because a claimant would be extremely unlikely to give consent where they were aware that a crime report would not back up an insurance claim. To deal with this the insurer should seek the insured’s consent at two stages:
- Firstly, at proposal stage, the insured should be notified that, with the consent of the insured, the insurer might exchange information with the Police where this is needed to validate a claim;
- Secondly, at the point of claim, explicit prior consent must be obtained before information can be requested from the Police but settlement of the claim can be made dependent on consent being given if the insured had been notified at proposal stage.
- The insurer must satisfy themselves that true and explicit consent has been properly and appropriately obtained.
- All requests for information must be made in the agreed format shown at Appendix D of the Guidelines. This takes the form of a “Request To The Insured For Consent To Disclosure Of Information Held By The Police”. The insured is hereby shown the Request Form which will be sent to the Police so that their consent or otherwise is explicitly obtained on the exact information about them which will be passed from the insurer to the Police. They can also indicate if they wish to see an exact duplicate of the information which is sent by the Police to the insurer in response. If the insured gives consent then the original Form D should be sent to the Police.
- Form D requires reasons to be given for why the information is requested. A short summary of the grounds for making a suitable check must be given so that the Police can understand that it is appropriate for them to respond. Using the example above, a reason might be, “Exceptionally valuable items claimed for, no proof of ownership supplied, sum insured is very modest.” The insured will see this in advance when consent is requested.
- Because requests for information under this section are not based upon firm evidence that a crime is being attempted, the Police will charge a fee of £75 for each request made to cover administrative costs.
Section 5: Supply of information where there is evidence to suspect a fraudulent insurance claim
- This section relates to cases where the insurer has evidence to support their suspicion of insurance fraud. Requests for information from the Police will be made under s29 of the Data Protection Act 1998.
- In these cases the explicit consent of the claimant is not required in order to request information from the Police.
- All requests for information must be made in the agreed format shown at Appendix E of the Guidelines. The insurer will be required to summarise the evidence that they have and supply copies of supporting documentation to the Police. Requests for information are only likely to fall under section 5 of the Guidelines where the insurer has carried out some detailed investigations into a claim.
- No fee will be charged for requests made under this section.
- The Police have asked that where they have supplied information in response to a request under section 5 of the Guidelines, the insurer should in due course inform the Police of the outcome of their investigation and the claim. Where the insurer feels they have proven a fraud the Police should be presented with the file of evidence. Where the insurer has decided not to pursue the matter they should inform the Police accordingly.