'A bit suss': claimant loses dispute over alleged jewellery theft

Report proposes 'self-funding' insurance model for export industries

A man who had his claim denied after he alleged thieves entered his home and stole $117,000 worth of jewellery has lost his bid to overturn the decision after a dispute ruling said he failed to establish he suffered a loss.

The complainant lodged a claim, under his contents insurance policy, on November 17 2015, a day after crooks allegedly stole the jewellery along with electronic and personal items from his home.

The man said he had returned home from work some time after 10pm on November 16 to find that it had been broken into. He says he called the police and spoke to his housemate, who had been the last person on the premises, before realising the valuables were missing.

The police report confirmed that the housemate had been the last person on the premises, who said he locked the front door but had left the rear door unlocked and open.

IAG said the complainant failed to prove that the theft had occurred and cast doubts on his claims of ownership and the alleged value of the stolen items.

The insurer also said that the complainant breached his duty to uphold good faith and that the claim was fraudulent.

The Australian Financial Complaints Authority (AFCA) sided with the insurer’s decision, saying the complainant’s version of events had several inconsistencies that raised concerns about the claim’s validity.

IAG relied on the police report and accounts from responding officers that questioned details of the theft.

The police report concluded that there was no evidence to show that anyone entered the property forcefully and noted photographs on the claimant’s phone of the jewellery dated as taken just two days before the theft.

See also  Does Pet Insurance Cover teeth extraction?

One of the responding officers said in conversations he had with his superiors that they were unsure about the allegations made by the policyholder, saying he thought “it was a bit suss”.

The attending constable said the timing and contents of the photographs “seemed quite suspicious” because they showed the jewellery to have been carried on the complainant’s hand rather than worn appropriately.

“All these photos, the suspicion started to arise for me due to the fact that all these photos were only taken two days ago but as well… if you have a piece of jewellery you have it on somebody, you know, around somebody’s neck or on your finger,” the constable said.

When asked by the insurer if the photos appeared to be orchestrated or set up, the constable responded “definitely”.

The complainant said the photographs had been taken months before the theft but provided no counterargument when the police notified him of the recorded photograph date.

The police report noted that the jewellery, which accounted for 90% of the total value of the alleged losses, had only been insured in the past couple of months despite the claimant saying he had owned some items for years. The report also commented that the emotion shown by the complainant “seemed exaggerated” and not typical for someone whose home had been robbed.

AFCA noted several inconsistencies in the man’s account of how he obtained the jewellery, which it said created doubts over his credibility.

The complainant told IAG that he purchased one of the stolen watches, a Rolex, from a person named AS for $9500, all of which was paid in cash. However, in a separate interview, the man said he purchased it from a different person.

See also  The Russian Oil Price Cap update

IAG said that when the claimant added the Rolex to his policy on September 15 2015, he said that his father had given it to him. The man later clarified that his father did not give him the watch but provided him with money to purchase the watch.

“My father gave me the chance to buy that watch, sir. If not my father, how can I buy that watch?” the complainant said.

The complainant’s housemate said he believed the Rolex was a family heirloom.

The panel also raised an issue with irregularities in accounts of the complainant’s whereabouts on the day of the theft.

The man first said he had been at his girlfriend’s house in the days prior to the event, and after leaving work around 9pm, he found the home to be ransacked and called his roommate.

However, the claimant provided the police with a statement saying he had last been at his house on November 15, one of the dates he was allegedly at her home.

The roommate said it could have been likely that he was at her house on the night of November 15, but also said he thought the complainant was out of town with his girlfriend.

IAG also raised the issue that the complainant was unaccounted for in the hours before the alleged time of the theft. The claimant’s director said he believed the man finished his shift at 6pm and called him in the evening, which the insurer says shows that he had not been at work at 9pm.

See also  TAL rolls out digital solution for super funds

AFCA noted telephone records that showed that the complainant did not call the police immediately, as he claimed, but instead that his housemate called the police around 11:25pm.

The complainant told AFCA that he could not recall all the details of the event given the time that had passed, other than to say he had felt overwhelmed at the time and that his poor English comprehension may have contributed to the confusion.

AFCA determined that IAG was entitled to deny the claim because the complainant failed to show that he suffered the losses he alleged in the claim.

The insurer was required to remove any allegations of fraud against the claimant’s record after the ruling said it was not satisfied there was enough evidence to prove that the man intentionally provided false and misleading information to receive a claim payment.

Click here for the ruling.