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Protecting Our Customers

WPA has committed itself not to tolerate fraud or corruption. We recognise that we have an absolute duty to our customers to identify and prevent financial crime. WPA also has statutory responsibilities, set out by our regulator the Financial Services Authority (FSA), to reduce the extent to which our products may be used as vehicles for financial crime. As a result of these responsibilities we operate strict controls to prevent and detect fraud, and we promote a strong anti-fraud culture which is supported throughout the organisation.

What is Fraud?

"A fraud is an intentional deception perpetrated to secure an unfair gain."

In the health insurance context fraud is an intentional act of deceiving or, concealing, or misrepresenting information which results in healthcare benefits being paid.

WPA prevents fraud by working closely with a number of bodies:

• Health Insurers Counter Fraud Group (HICFG)
• Association of British Insurers (ABI)
• Insurance Fraud Investigators Group (IFIG)
• The NHS Counter Fraud Security Management Service (CFSMS)
• UK Police forces

Please note: Where fraud is identified or suspected, WPA will record & investigate this. We will share data with other organisations under S29(3) of the Data Protection Act 1998, for the prevention/detection of crime and/or the apprehension/prosecution of offenders.

What actions does WPA take when fraud is identified?

When insurance fraud is identified, WPA follows a procedure which is designed to prevent further fraud losses, to recover payments made, and to bring the culprit(s) to justice.

• Wherever possible WPA will always seek to support criminal prosecution.
• In addition WPA will instigate civil recoveries for recovery of all losses to us, the interest on these sums and all associated costs. This will involve recovery of any claims we have paid. We reserve the right to make the policy void from the date it started and will not refund any premiums paid to us.
• Where a medical provider is involved we will formally report the matter to the appropriate regulatory or professional body.
• WPA will work with other insurers, and other anti-fraud organisations to circulate the offenders details to prevent similar crimes being perpetrated elsewhere.

What should you do if you suspect Fraud?

If you have information relating to potential fraudulent activity, please contact our Risk Review Team:

Email: Risk.Review@wpa.org.uk

Telephone: 01823 625 250