Not upheld: claim decline based on suspected fraud; claim handling; disposal of vehicle complaint against Haven Insurance Company Limited

Decision detail

Summary

Mr M claimed on his motor insurance policy following a fire that damaged his car. Haven declined the claim, suspecting fraud based on significant inconsistencies between Mr M's initial account (that he was driving when the fire started at 40mph) and his later signed statement (that his brother was driving and the car caught fire while parked). Haven also noted that Mr M was disqualified from driving at the time of the incident. An independent engineer concluded the car was a Category A write-off with fire damage consistent with an electrical fault. The ombudsman found Haven had sufficient evidence to reasonably conclude Mr M acted fraudulently, acted fairly in relying on the engineer's assessment, and properly disposed of the car given outstanding finance. The complaint was not upheld.

The Ombudsman's reasoning

The ombudsman found that Haven had sufficient evidence to reasonably conclude Mr M acted fraudulently based on the significant inconsistencies between his initial account (that he was driving when the fire started at 40mph) and his later statement (that his brother was driving and the car caught fire while parked). The ombudsman noted that Mr M's explanations for the discrepancies (anger, bereavement, drinking, poor mental health, stress) were not persuasive given the material nature of the differences. The fact that Mr M was disqualified from driving made the identity of the driver particularly relevant. The ombudsman found Haven acted fairly in relying on the qualified engineer's assessment of the Category A write-off, in disposing of the car given outstanding finance, and in maintaining communication despite Mr M's hospitalization and address changes.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website