Accused of fraud by travel insurance company

Sandtree

FTB_crossed said:

The woman at the insurance company dealt with another one of my travel insurance claims before and it didn't go well for me where I had no evidence of loss of mobile phone reported within 24hrs and hence lost the claim but I gave a runaround to Financial Ombudsman for few months and SAR took more of her time etc. I think she's taken it personally and causing this aggravation on baseless accusations. 

Do you know how many claims a handler deals with? As someone in one of the more complex teams we had a light case load typically of around 300 open claims at any one time each. Look at the volume roles and they were probably double that  with a much shorter turn around time.

Sure, occasionally you will look back through a customers claim history and see you've personally dealt with them before but actually remembering anything about the customer is rare... in all my years I only "remembered" one of our customers and thats because he was in his 90s, lived in my home town, had one accident where he confused the accelerator with the brake and hit 6 parked cars and then 4 months later did the same again but this time to 8 parked cars. I didnt remember him at all, I remembered the accident and it was the similarity and identical location that made me look back and see it was the same guy. 

CKhalvashi

FTB_crossed said:

I thought without evidence they won't believe any BS that's comes out but it turned out that's not the case. I am now going to report the matter to local police and going to the country again in next week or two. I will also gather more evidence in terms of statements from all parties involved namely landlord, travel agent and hospital. 

The woman at the insurance company dealt with another one of my travel insurance claims before and it didn't go well for me where I had no evidence of loss of mobile phone reported within 24hrs and hence lost the claim but I gave a runaround to Financial Ombudsman for few months and SAR took more of her time etc. I think she's taken it personally and causing this aggravation on baseless accusations. 

Thanks for all of your suggestions and I will feed my solicitors anything extra I can get to facilitate the case.

No, if anything smells wrong, you speak to the claim handler straight away and ask their advice if you're not sure what to do.

Whether you've dealt with the person at all in the past and the outcome of that is completely irrelevant to this fact. If you didn't know you need to speak to the police, you should have spoken to the insurer.

You appear to have put yourself at a complete disadvantage here in your lack of doing this.

FTB_crossed

The other thing is that it wasn’t me who investigator wanted money from, it was my brother who he insisted to come and visit him in the office the next day.
I came back to the UK couple of months before the investigator was arranged to go and visit.
Right now with their investigative costs, why should I pay when investigator is making contradictory statements on his own where he saying something about the property in question to be my brother’s by checking with the said neighbours and then suddenly after my challenge to their report, he sent insurance company another statement which apparently confirms that address doesn’t exist at all. How will he or insurance can justify me paying for this investigative report and to make it worse, the address was supposed to be the tenancy address but according to my tenancy agreement, they had been checking this address which was Landlord’s address. They got it wrong to start with and made case difficult for themselves.
My worry and dilemma is that no one is able to pick this up from insurance company, claim handler or the complaints team and they are adamant that claim is fraudulent and want their costs paid. 

One other thing they picked up was that the money exchange receipt was not being able to be verified because the business no longer exists. It’s because the country was in lockdown for over 4 months from the transaction date and investigator said, he could not see any business there although it still exists on google business but says it’s closed. Receipts have one letter wrong in spelling in the heading and they and they have picked up on that saying we have serious doubts on its validity but “serious doubts in validity” won’t win case in court.

Do you think it’s worth reporting to police now? Shall I tell solicitor to start a small claims court or wait for insurance to chase me and then defend?

Sandtree

What are you intending to issue proceedings over?

If you are talking about settlement of your claim then you are better to go down the cost free route of complaint and then FOS than spend money on solicitors that you won't get back even if you win.

TELLIT01

The OP seems to be missing the point about financial loss.  The fact that the insurer believes they have prevented a fraudulent claim of £4k+ doesn't mean they can't claim other costs back from the person who lodged the claim.  The fact that the amount being claimed is less than the amount of potential loss is irrelevant.

Thrugelmir

FTB_crossed said:

What do you mean by that. I didn't get it?

You've covertly approached the investigator. Well you think you have. Perhaps they've put two and two together and reported back to your insurer. 

k12479

FTB_crossed said:

The woman at the insurance company dealt with another one of my travel insurance claims before....saying something about the property in question to be my brother’s....my tenancy agreement....Landlord’s address...

OP, as a neutral observer some the things you've written do come across as red flags.

FTB_crossed

It would appear as being that way but the investigator has messed up with investigation and I can see those red flags onto the report submitted by insurance twice. 

jonesMUFCforever

This thread is like something out of the 'Twilight zone' - I can't fathom out what the heck is going on and why?

FTB_crossed

   The thing is that I called up the consumer help on BBC radio and a barrister advised me to make a claim in small claims court online and not wait for insurance to do anything further