This case highlights the success of our ‘One Crawford’ integrated solutions that see Crawford lawyers working seamlessly alongside seasoned Crawford adjusters.
The domestic theft claim was initially handled by one of our Crawford adjuster colleagues on a desktop basis.
It is related to a home contents-only policy (under Housing Association scheme).
Insurers authorised Crawford Legal Services’ (CLS) involvement due to the following concerns identified by our Crawford adjuster colleague:
- the claim included high value luxury (designer) items with very little evidence of purchase/ownership. This was potentially not consistent with the income/lifestyle of the residents;
- one receipt was provided for a Bulova watch (£350) but the receipt indicated that the item was actually returned to the store and refunded; plus
- there was unusual damage (candle wax) being claimed which was not mentioned when the claim was first notified (the reason why this is curious is explained below).
After interviewing the policyholder, CLS was generally satisfied the burglary was genuine/fortuitous, but shared the concerns raised by the original adjuster surrounding potential exaggeration.
The policyholder was extremely vague when asked to explain the provision of a refund receipt for the Bulova watch. She conceded this must have been provided in error and asked it to be removed from the claim.
There were also concerns over the inclusion of several high-value designer items belonging to her adult son, none of which were evidenced (beyond photos). Photos alone do not demonstrate the items depicted are authentic (ie not replicas/”fakes”) or indeed owned by the policyholder.
CLS obtained the Crime Report which revealed a significant disparity in terms of stolen items, when compared with the items being claimed. None of the son’s items were mentioned anywhere in the Crime Report. Neither was the candle wax damage to the stairs/landing carpet and a G-Tech vacuum cleaner, which was curious considering this was the first thing the policyholder informed our investigator that she saw when returning home on the day of the theft (even before discovering she’d been burgled).
A detailed challenge letter was issued to the policyholder seeking her comments and explanations, and a request for further substantiation. Only very brief (one sentence) answers were returned, several of which did not answer the questions posed and no further documentation was provided.
Ultimately it was concluded there was insufficient evidence to decline the claim in full. However, insurers did decline the items that could not be substantiated.
Total savings in the region of £4,000 were achieved, which equated to 75% of the total claim presented.
If you see indications of property claim fraud, it pays (literally) to get expert investigators on the case to ensure money doesn’t escape your bottom line unnecessarily. For help with these types of matters, please contact:
Head of Property Fraud, Crawford Legal Services