Catching Fraud: Relatively Coincidental
- It is becoming increasingly clear that insurance fraudsters will go to extreme lengths to make fraudulent claims to insurers
- Burglaries are an all too common occurrence, and as 1 in 5 of the UK’s 27 million homes aren’t covered by a home insurance policy, a break-in could prove to be very costly for the victim
- Our latest story looks at a break-in which saw thousands of pounds worth of designer items taken.
It is becoming increasingly clear that insurance fraudsters will go to extreme lengths to make fraudulent claims to insurers. According to the ABI, the average insurance scam is now worth £12,000, and the number of claims exposed as fraudulent has reached 1,300 per day.
Scott Clayton, Claims, Fraud & Investigation Manger at Zurich, has been featured on the BBC series ‘Claimed and Shamed’, in which he recalls the stories of a number of fraudulent claims.
Burglaries are an all too common occurrence, and as 1 in 5 of the UK’s 27 million homes aren’t covered by a home insurance policy, a break-in could prove to be very costly for the victim. Our latest story looks at a break-in which saw thousands of pounds worth of designer items taken.
The claimant returned to their home and found that a break-in had occurred. Amongst the supposed stolen items were jewellery, designer clothes, iPads and bags. The caller, who called the police straight away, did the right thing and received a crime reference number – which is later provided to the insurer.
When asked for a complete list of items that were stolen, the caller replied “A Gucci watch, four Swarovski earrings, Marc Jacobs watch, Rotary watch, Michael Kors necklace and watch, iPad mini, two Prada coats, Louis Vuitton handbag, Porsche car key, Tommy Hilfiger coat”. As Scott Clayton summarises, the total cost of items claimed to be stolen was “in the region of £14,000, so quite a significant burglary”.
Determining the damage
“When we’re looking at designer items, we would normally expect somebody to be able to provide purchase receipts or even tell us where and when they bought them to validate the claim”, Clayton continues. Proof of items can take different forms, from purchase receipts to photographs, anything that demonstrates the policyholder owns the items they are claiming for.
The policyholder sent an array of photographs in an attempt to prove the items belonged to him. However, as Clayton explains, a lot of investigation will go into photographs sent in, “we’ll validate and check all documents and photographs that are sent to us, and photographs in particular have a digital footprint behind them, called metadata. We’ll always look at the metadata to find out whether it corroborates with what is being told in terms of the time and date these photographs were taken”.
Breaking down the evidence
When the metadata reports came back, something stood out. “Strangely in this case, they were actually taken after the burglary, they were taken on the same day as we had asked for these photographs. So clearly these weren’t of items that were stolen during that break-in”.
Whilst it was looking like the claim was fraudulent, as photographs had been proven to be taken after the burglary took place, Zurich’s investigators wanted to see if there may have been a plausible explanation. When challenged on the photographs of two jackets that were taken after the burglary, the claimant after some deliberation said that the photographs that he had taken were actually of his brother’s jackets which happened to be identical to the ones that he had stolen.
“He maintained that it was still a genuine claim and that these were his brother’s jackets and not the ones that were stolen – so we asked for his brothers details so we could speak to him about the purchase of the jackets”. Unfortunately however, there was no reply to any of Zurich’s attempts and therefore a decision needed to be made based on the evidence available.
As Clayton explains, the claim was rejected, “Because of the exaggeration, and therefore the fraud, this claim was declined – we didn’t pay anything”. In addition to the claim being rejected, the claimant was added to the insurance fraud register, which will have an impact on any future insurance policies taken out.
“This claim was worth £14,000, but we had no proof that the burglary didn’t occur, so the policyholder would have received something in settlement, but as a result of his dishonesty, we pay nothing. So any genuine items that he lost in this burglary, he wasn’t compensated for and he ended up with nothing”
To learn more about the topics discussed in this article, please speak to your local Zurich contact.
BBC’s Claimed and Shamed is a documentary series that highlights the ever-growing problem of insurance fraud, and follows the stories of claimants who were caught out. To watch this episode, or to watch past episodes, please click here.