Not upheld: claim declined for fraud; claim handling; pre-existing damage deduction complaint against Tradex Insurance Company PLC

Decision detail

Summary

Miss D claimed on her motor insurance policy for damage to her parked car. Tradex valued it as a total loss but declined the claim after Miss D provided two screenshots of similar cars advertised at significantly higher prices. Tradex investigated and located the original adverts, which showed lower prices, and confirmed with the car owners that they had never been advertised at Miss D's stated prices. The ombudsman upheld Tradex's decision to decline the claim as Miss D had provided falsified adverts, which constituted a fraudulent document under the policy's fraud clause. The ombudsman also rejected Miss D's other complaints regarding the £82 pre-existing damage deduction, the policy excess, and claim handling procedures, finding no evidence of unfair treatment.

The Ombudsman's reasoning

The ombudsman applied the test of whether the insurer acted in line with policy terms and conditions and fairly and reasonably. Tradex's investigation substantiated that Miss D had provided falsified adverts showing higher prices than the actual advertised prices, which constituted a fraudulent document under the policy's fraud clause. The ombudsman found Tradex's reliance on this evidence to decline the claim was reasonable and in accordance with the policy terms. The ombudsman also found no evidence of unfair claim handling regarding the excess, pre-existing damage deduction, or the complaint procedure.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website