Not upheld: claim decline on grounds of suspected fraud complaint against Aviva Insurance Limited

Decision detail

Summary

Mr F claimed under his contents insurance policy for items stolen in a burglary, including a watch he stated was gifted in 2011. Aviva identified significant discrepancies: the watch model was not released until 2019, the photograph was sourced from a public Australian website with 2012 metadata, and the receipt appeared altered. After Mr F failed to provide plausible explanations despite multiple opportunities, Aviva declined the claim citing suspected fraud and cancelled the policy. The ombudsman found Aviva acted fairly and reasonably in relying on the fraud condition in the policy terms and did not uphold the complaint.

The Ombudsman's reasoning

The ombudsman considered whether Aviva acted fairly and reasonably in declining the claim based on the fraud condition in the policy terms. Aviva identified material discrepancies: the watch model was not released until 2019 despite being claimed as a 2011 gift, the photograph metadata showed 2012 dating, the photograph was sourced from a public Australian website, and the receipt appeared altered. Mr F failed to provide plausible explanations for these discrepancies despite multiple opportunities. The ombudsman was satisfied that Aviva's reliance on the fraud condition was fair and reasonable, and therefore the policy cancellation was justified.

How this compares

Source

Read the original decision on the Financial Ombudsman Service website