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It is very possible for individuals to
unwittingly commit insurance fraud, or at least to be accused of it. Insurance
companies cannot reject claims unless they can prove that there has been intent
on the part of the claimant to perpetrate a fraud. This is difficult, but with
such an enormous sum of fraudulent claims being made every year the insurance
companies have to do all that they can to protect themselves, and their
customers from the impact of fraud.
One
particular problem is that, according to the Financial Ombudsman, a body that
offers a type of high court in regards to insurance claims, documents that have
been forged do not necessarily mean that a claim is fraudulent. Whilst this
might seem rather peculiar, there are, in fact, good reasons for it.
Firstly the customer may not necessarily
know that the document they have obtained and are using to support their claim
is fraudulent. More relevantly though, insurance firms often insist that
customers produce receipts for the items that they claim for, thus putting
customers in a position where they may be tempted to create substitutes for
lost receipts. Thus the Ombudsman has to determine what led a customer to
create a false receipt, whether it was solely to substantiate transactions that
actually took place, or whether intent was there for the individual to claim
more than they were due.
In some recent cases involving claims for
written-off vehicles, firms appear to have asked customers to substantiate the
original purchase price of their vehicle. As a result, some customers who had
lost the original sales material (or perhaps purchased the car through other
routes) have sent in false documents.
Other
customers have produced false documents to try and substantiate a higher price than
they actually paid. This is clearly wrong, but it does not justify the firm
voiding the policy. The customer's claim is for the present market price, not
the original purchase price. As long as there is no doubt about ownership and
no suggestion of fraud, the firm is not allowed to meet such claims on the
basis of the normal market value.
It is, therefore, quite possible to
accidentally commit insurance fraud, and it is also very possible to do it
trying to validate a claim that you fear may otherwise be rejected. Ultimately,
though, the Ombudsman is set up to support the claimants, as it should do, and
if you fear that a claim might be rejected the Ombudsman will support you even
if the information that you have provided is not as comprehensive as perhaps it
should be.
The easiest way of ensuring that your
claims are paid is to fill in your application form as comprehensively as
possible when you make the initial application. This way the insurance company
is most likely to accept that you have done everything you can to make them
aware of all the details, and you can never submit too much information. If you
do your research properly you will get a good value policy, whatever cover you
require.
The Co-operative Bank offer a range of home
insurance products.
For details of proper industry practice,
visit the Association of British Insurers.
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