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Pathetic Aviva Scrape the Barrel

PDAH
PDAH Posts: 44 Forumite
edited 25 May 2012 at 12:51AM in Insurance & life assurance
Aviva Scrape the Barrel

The recent case of Yeates -v- Aviva reported 15/5/2012 shows the depths an insurer will go to avoid paying out a genuine loss.

In June 2007 the claimant suffered a substantial flood loss when a river burst its banks. The claimant formed a company called Pro Man Restorations Ltd to project manage the repairs. The company was formed in September 2007 and in its paperwork it referred to Mr + Mrs Yeates as proprietors and evidently traded from the same address ie the home address of the claimant. This entity liaised with the insurers loss adjusters and payments for repairs were made in the region of £160k with a balance to be paid of £60k+. The company, however, raised a fee for itsservices which it attempted to claim in the sum of £9k. Ordinarily, an insured cannot claim costs for presenting a claim but a third party company could do.The insurers refused to pay the fee and thereafter claimed fraud, not that the claim was a fraud but that the claimant had embellished his claim by a fraudulent means. The claimant started court action to recover the balance of the claim andthe insurers defended the action and further counter claimed all the monies they had previously paid so far ie around £160k. At an early stage the insurers applied for summary judgement which they were successful although the judge gave the claimant permission to appeal as the law on fraud was not clear. The claimant fell out with his solicitors and did not appeal in time and only did so when the insurers took steps to enforce the repayment of £160k. When he did appeal the Court of Appeal said it was too late as he was 7 months out of time.

It does seem the claimant was ill-advised to present the claim as he did through the guise of a limited company. The fee concerned was 3% of the loss and was not paid by the insurers. However, it would seem pretty obvious that company and the claimant were one in the same. It would have been sufficient simply not to pay the fee but deal with the rest of what was an entirely genuine loss. As it stands, the claimant still has not had the property fully repaired and will doubtless have to sell same in its present state to repay the insurers £160k. Well done Aviva, you won but it is a testament to your patheticness.
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Comments

  • mikey72
    mikey72 Posts: 14,680 Forumite
    Creating a ltd company to manage my own claim wouldn't have been my first thought. Conflict of interest springs to mind.
  • PDAH
    PDAH Posts: 44 Forumite
    Mikey
    Conflict of interest for definite!

    Weedling your way out out of paying a genuine claim is a lot worse IMHO.

    By way of an imprecise analogy if you had a genuine theft claim and you claimed £1000 but the insurers did not pay for a £30 item you could nt prove you had and then the insurers said, after review, the £30 item was an embellishment and we are suing you for the £970 we paid.........that wouldnt be nice?
  • mynameistallulah
    mynameistallulah Posts: 2,238 Forumite
    Good on Aviva for standing up to the customer who was blatantly trying to pull a fast one.
  • VictorM_2
    VictorM_2 Posts: 150 Forumite
    Good on Aviva for standing up to the customer who was blatantly trying to pull a fast one.

    Agreed! Dodgy as hell.
  • FlameCloud
    FlameCloud Posts: 1,952 Forumite
    Part of the Furniture 1,000 Posts Name Dropper
    Avoiding a whole claim as a result of any part of the claim being fradulent is hardly suprising, other decisions (Galloway v GRE, Uddin v NU, DL v Kahn) all support the insurer in this.

    You may think it is pathetic, but there is not alot you can do about it. Given it went to court, I suspect there was far more deception in the presentation of the invoice for the fees and the services they provided throughout the claim than you are letting on.
  • FlameCloud
    FlameCloud Posts: 1,952 Forumite
    Part of the Furniture 1,000 Posts Name Dropper
    edited 25 May 2012 at 6:28AM
    Actually reading the case, paragraphs 6&7 clearly show a level of deceptive intent. You should have made it clearer who the company was in relation to the policy holder, and in fact DL v Kahn has parallels in this.

    Your statement regarding the insurers not paying the bill is outright wrong according to paragraph 6 in the judgement as well.
  • molerat
    molerat Posts: 35,020 Forumite
    Part of the Furniture 10,000 Posts Name Dropper Photogenic
    Surprised he is not in front of the beak on criminal charges as well.
  • starrystarry
    starrystarry Posts: 2,481 Forumite
    Part of the Furniture 1,000 Posts Name Dropper Combo Breaker
    Folk are quick to criticise insurance companies for paying out inflated amounts on car insurance claims due to all the fees etc that get added on. Seems fairly clear there was an element of deception here, so well done to Aviva for standing up to it and protecting the rights of all its other policyholders.
  • dunstonh
    dunstonh Posts: 120,198 Forumite
    Part of the Furniture 10,000 Posts Name Dropper Combo Breaker
    Strange that the victim of an attempted crime is called pathetic and not the perpetrator.
    I am an Independent Financial Adviser (IFA). The comments I make are just my opinion and are for discussion purposes only. They are not financial advice and you should not treat them as such. If you feel an area discussed may be relevant to you, then please seek advice from an Independent Financial Adviser local to you.
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