Honesty the best policy
Cases that come before the Insurance Ombudsman highlight the importance of honesty and documentation,
When you head away on holiday, you want to be sure that your insurance policies are there as a back-up in case the worst happens.
But Insurance and Financial Services Ombudsman Karen Stevens says there are a few mistakes that people commonly make, which can get in the way of a smooth claim.
NOT TELLING THE TRUTH
This might seem obvious, but if you lie on your insurance claim, you may be caught out.
In one case her office dealt with, a man was turned down for a claim for jewellery, handbag, sunglasses and iPad. He said the items had been stolen over Christmas.
But the insurer then checked the metadata on photos supplied of the items and found they had been taken after the time of the claimed burglary.
The customer claimed the photos were screenshots of photos. The case manager had an independent expert look at the photos and determined the insurer was correct in its assessment.
He was also unsuccessful with the claim for the iPad which he said had been a gift for his son and in a box under the bed.
An investigator for the insurer asked him how many iPads his son had.
The customer said the one he was claiming for was the only one his son had. But the investigator pointed out that six months earlier, he had made a claim to another insurer for an iPad and was declined.
Having a claim turned down due to fraud can have wider implications because it usually makes it much harder to get insurance cover anywhere else.
HOW LONG IS TOO LONG TO BE AWAY?
If you’re planning an extended break, check how your insurance policy will treat that.
Most insurers do not want a house to be left unoccupied for more than 60 consecutive days.
In another case Stevens dealt with, a claim was made for a house damaged by fire. The insurer turned it down because there had been no one in the property for at least two months.
The ombudsman’s office did not uphold the complaint because it found that the insurer had correctly applied the terms and conditions of the policy – which said there would be no cover if the property was empty for 60 days.
TAKE CARE OF YOUR THINGS
Having insurance isn’t licence to be totally relaxed.
In another case, an insurer tried to suggest that a customer’s house was burgled because the window was left unlocked.
It said there was no physical damage to the window to indicate force had been used to open it.
In this case, the Ombudsman’s office backed the customer because the police had not concluded it was not locked and a screwdriver could have been used to open it. The onus was on the insurer to establish its argument.
PROVE YOU OWN IT
A woman who tried to claim for a US$3325 (NZ$5033) Chanel handbag and US$1000 wallet was disappointed when the insurer asked for proof she had owned them.
She argued they were gifts from family members whose relationship with her had broken down and she could not obtain any proof of purchase. She offered affidavits but the insurer said that was insufficient evidence.
The Ombudsman’s office negotiated a $500 settlement between the parties.