Help Accused of making a frudlent claim on home insurance

Help Accused of making a frudlent claim on home insurance

Author
Discussion

Gecko1978

Original Poster:

9,603 posts

156 months

Tuesday 24th September 2013
quotequote all
Any one work in insurance can help here wife is really worried.

Ok two weeks my wife tripped over in our front room with her Ipad in her hand fell onto the floor and the ipad damaged the laminate floor (gouge in it) and the glass shattered and it looks like it was bent in two.

I was in corner of the room saw her fall and saw damage to the Ipad etc. Basically just a accident.

So called the home insurance firm (whos logo is like an umberella) and made a claim the sent a guy out to look at the floor agreed it could not be patched up an agreed a price and sent us a cheque...so no news on the Ipad till today when my wife phones up and speaks to a chap for an house who says. He has never seen an Ipad damage a floor before or get in such a state from a fall and that a 6lb hammer could not damage laminate floor etc (I broke through a steal reinforced concreate floor at a property I am renovating with a hammer of similar weight it was hard but not immposible) and that my wife may be making a frudelent claim,

He goes onto say they will be using a forensic team if we wish to pursure this who are very good at spotting false clamins (Hawkins and Hawkins) and that if my wife pursues this he will advise the firm the claim is frudlent and they will cancel our cover and we will not be able to get insurance going forward.

He said he would send a lertter out and she had 14 days to think again about the claim. if she did not respond claim would be dropped but she would have to pay back thwe £500 for the floor they had already agreed.


OK so what can we do, I saw her fall I say the otherwise pristine Ipad shater and bend I saw gouge appear in laminate floor but how can I prove this other than what my wife has already said. They say its immpossible yet I saw it happen!!!!!


So do I drop it pay them cash back and forget about it. We have never made a claim in nine years of owning a home and first time we do we are accused of fraud how can this be right that insurance firm can threaten this and ask for cash back when claim is truthful.

Not that it makes a difference but I can easily afford to buy an ipad but why pay for one when you have insurance its not like there is a new model out or I have "lost it" but really sold it on ebay etc

hedgefinder

3,418 posts

169 months

Tuesday 24th September 2013
quotequote all
If its a genuine claim , whats to worry about, just stand your ground.

Gecko1978

Original Poster:

9,603 posts

156 months

Tuesday 24th September 2013
quotequote all
hedgefinder said:
If its a genuine claim , whats to worry about, just stand your ground.
The implication was that the insurance firm would require us to prove this when they felt all the evidence poited to a false claim.

So what more can I do, not being a expert in Quntum Physics I can't build a time machine and go back and film it. I can only reiterate what happened. One would hope a forensic team would find a fragment of the ipad in the floor etc (even though we hovered up the glass as we have 11 month old baby)

Seems to me the insurance firm are trying to get out of paying

roofer

5,136 posts

210 months

Tuesday 24th September 2013
quotequote all
I'd be hitting the roof being accused of that. I would pursue the oiks identity and go through all channels to make sure he was reprimanded. Cocky little bd.

randlemarcus

13,507 posts

230 months

Tuesday 24th September 2013
quotequote all
Erm, pursue the claim. If you have an offcut of the flooring handy, try dropping an angled bit of steel on it, and see how much damage a right angle can do.

Simpo Two

85,147 posts

264 months

Tuesday 24th September 2013
quotequote all
Can't advise, but I don't like their threatening nature; I might say 'Go ahead, and I'll lodge an official complaint with the Insurance Ombudsman'.

In fact do that now, and try to get their official response quickly so you can include it in your reply to the insurance company.

Rude-boy

22,227 posts

232 months

Tuesday 24th September 2013
quotequote all
randlemarcus said:
Erm, pursue the claim. If you have an offcut of the flooring handy, try dropping an angled bit of steel on it, and see how much damage a right angle can do.
This.

I dropped a wall tile on mine and the size of the dent is unreal.

If you are 100% sure, which it sounds you are, then you have to persue this further. Right now this is already about to cause you issues as you have had an insured decline to pay out on a claim and iirc that is one of the questions you have to answer.

If it were me i would also be going for the chancer expecting a personal appology.

Honestly there are few things that get me properly wound up and this would be a personal mission for me if i were in your shoes.

mickk

28,769 posts

241 months

Tuesday 24th September 2013
quotequote all
roofer said:
I'd be hitting the roof being accused of that. I would pursue the oiks identity and go through all channels to make sure he was reprimanded. Cocky little bd.
This, they are accusing you and your wife of trying to rip them off. If like you say you're telling the truth I'd be straight on the phone giving them hell.

The problem you have now is if you drop the case you'll be on some list of attempted frauds even if they say they'll drop the case.

Rude-boy

22,227 posts

232 months

Tuesday 24th September 2013
quotequote all
mickk said:
The problem you have now is if you drop the case you'll be on some list of attempted frauds even if they say they'll drop the case.
yes

We did have some great insurance people in SP&L who you could have brought this to the attention of and who might have been able to help you out a little but sadly the trolls have driven them away at the minute.

hedgefinder

3,418 posts

169 months

Tuesday 24th September 2013
quotequote all
Rude-boy said:
yes

We did have some great insurance people in SP&L who you could have brought this to the attention of and who might have been able to help you out a little but sadly the trolls have driven them away at the minute.
doesnt even deserve a response.. playing the baiting game isnt my hobby I am afraid...

V8RX7

26,763 posts

262 months

Tuesday 24th September 2013
quotequote all
THEY have to prove fraud.

Simply put they will examine the damage and the item that caused it and see if it is possible.

If that is how it happened then you have nothing to worry about.


hedgefinder

3,418 posts

169 months

Tuesday 24th September 2013
quotequote all
^^ this

Rude-boy

22,227 posts

232 months

Tuesday 24th September 2013
quotequote all
hedgefinder said:
doesnt even deserve a response.. playing the baiting game isnt my hobby I am afraid...
Sorry, I didn't realise I'd asked you a question confused

amancalledrob

1,248 posts

133 months

Tuesday 24th September 2013
quotequote all
Simpo Two said:
Can't advise, but I don't like their threatening nature; I might say 'Go ahead, and I'll lodge an official complaint with the Insurance Ombudsman'.

In fact do that now, and try to get their official response quickly so you can include it in your reply to the insurance company.
Do bear in mind that the Financial Services Ombudsman would normally require you to have followed your insurer's complaints procedure first, so it's best to do that.

Remember also that the Ombudsman will charge a fairly hefty fee to the insurer even if they find in the insurer's favour, so if you want a bit of financial revenge then that's a good way to get it.

Rude-boy

22,227 posts

232 months

Tuesday 24th September 2013
quotequote all
amancalledrob said:
Remember also that the Ombudsman will charge a fairly hefty fee to the insurer even if they find in the insurer's favour, so if you want a bit of financial revenge then that's a good way to get it.
Really? how come? Please educate us as i had no idea about such a thing!

WinstonWolf

72,857 posts

238 months

Tuesday 24th September 2013
quotequote all
Gecko1978 said:
hedgefinder said:
If its a genuine claim , whats to worry about, just stand your ground.
The implication was that the insurance firm would require us to prove this when they felt all the evidence poited to a false claim.

So what more can I do, not being a expert in Quntum Physics I can't build a time machine and go back and film it. I can only reiterate what happened. One would hope a forensic team would find a fragment of the ipad in the floor etc (even though we hovered up the glass as we have 11 month old baby)

Seems to me the insurance firm are trying to get out of paying
Get them to put the accusation in writing.

Simpo Two

85,147 posts

264 months

Tuesday 24th September 2013
quotequote all
amancalledrob said:
Simpo Two said:
Can't advise, but I don't like their threatening nature; I might say 'Go ahead, and I'll lodge an official complaint with the Insurance Ombudsman'.

In fact do that now, and try to get their official response quickly so you can include it in your reply to the insurance company.
Do bear in mind that the Financial Services Ombudsman would normally require you to have followed your insurer's complaints procedure first, so it's best to do that.

Remember also that the Ombudsman will charge a fairly hefty fee to the insurer even if they find in the insurer's favour, so if you want a bit of financial revenge then that's a good way to get it.
Fair point, you have to follow and exhaust the insurance company's complaint's procedure's first. But they will not want to be reported for the reason stated, so it would be a handy counter-threat to wield in the this game of sabre-rattling and let them know you are not simply a schmuck trying it on.

skeeterm5

3,328 posts

187 months

Tuesday 24th September 2013
quotequote all
A couple of thoughts;

1) If the claim is genuine then you should absolutely follow it up

2) I would ask for a copy of the call recording and raise a formal complaint about attitude.

S

Paul Drawmer

4,864 posts

266 months

Tuesday 24th September 2013
quotequote all
hedgefinder said:
If its a genuine claim , whats to worry about, just stand your ground.
This was the first response, and it is the correct one. Pursue the claim in the normal way, you have nothing to be frightened of.

Keep all documentation relating to the claim and do not communicate by phone. Keep it all in writing or email.

If your claim is refused, follow their complaints procedure until you are sent the the final letter which gives you the right to take the problem to the ombudsman.

Don't get wound up by bullying tactics, just record them. If you receive phone calls from them, ask them to put it in writing, but still take notes of the call (Date and time the notes to prove that they are contemporaneous.

Insurance companies do use methods of sifting claims to try and identify fraud, it would appear that your claim is failing on some of the simple tests. However, NOT pursuing the claim will make you look a fraud. Just be patient, be clear in your communication, and when it is all over, ask them to explain why they called you a liar.

R8Steve

4,150 posts

174 months

Tuesday 24th September 2013
quotequote all
Rude-boy said:
amancalledrob said:
Remember also that the Ombudsman will charge a fairly hefty fee to the insurer even if they find in the insurer's favour, so if you want a bit of financial revenge then that's a good way to get it.
Really? how come? Please educate us as i had no idea about such a thing!
It's a standard flat fee of £500 to the company if a case is opened against them, win or lose. At least it is in banking, I'm not sure if insurance is the same right enough. It's hardly hefty to these big companies right enough but there is a fee.