Health insurers want authorities to do more against fraud; Most fraudsters unpunished

The Dutch authorities need to do more against health insurance fraud, according to the health insurers. Every year, they submit over 70 major fraud files to the investigation service of the Labor Inspectorate (NLA). But the NLA only investigates about 20 of them. “This means that many perpetrators go free,” health insurers told the Telegraaf.

Health insurance fraud is not new. It typically involves incorrectly declared hours of care or requesting more care for a client than they need or receive. There is no recent research into the extent of this fraud in the Netherlands, but in 2015, the Court of Audit estimated billions of euros per year, according to the newspaper. And healthcare was much cheaper nine years ago.

Perpetrators of health insurance fraud are often a rogue care provider employee stealing a few thousand euros. But according to health insurers, they’re seeing more and more cases where networks commit millions of euros of fraud. They report these large-scale fraud cases to the NLA, which carries out the criminal investigation on behalf of the Public Prosecution Service (OM). In 2021, health insurers reported 67 major fraud cases, 73 in 2022, and 84 in 2024. But the NLA didn’t investigate the majority if those files, the health insurers said.

That is extremely frustrating, CZ director Joep de Groot told the newspaper. “We do our utmost every day to detect as much fraud as possible,” he said. “And then you hope that it will get the same priority further down the chain.”

DSW director Aad de Groot said insurers already only send the most serious cases to the NLA. “But they deserve to be arrested.” Healthcare premiums continue to rise while fraudsters who stole hundreds of thousands of euros of healthcare money go free, he said.

The NLA could not tell Telegraaf whether it investigates every case it receives from health insurers. Annual figures show that it completes 16 to 20 investigations per year, according to the newspaper. The NLA said that this number has been agreed upon with the OM and Public Health Ministry, partly based on the available capacity. There are limits to what the service can handle.