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Insured loses dispute over 'fraudulent' theft claim

A theft victim who claimed for contents allegedly stolen from his home will not be reimbursed after a dispute ruling determined that the items were taken before an insurance policy had been incepted. 

The insured purchased the home policy on June 29 last year before lodging a claim on July 11 alleging that his rented property had been burgled a few days earlier. 

The claimant told the insurer that he visited the home early on July 9, where he found the laundry door broken into and several expensive electronics missing, including a camera and PlayStation 5. 

QBE declined the claim after uncovering emails between the homeowner and his real estate agent from June 24, in which the complainant informed the agent about a list of items stolen from the property in May, including the same electronics.

The insurer also notes that the policyholder included items that he reported to be stolen in the email as part of the policy’s itemised property sheet.

QBE says the insured breached his duty not to make a misrepresentation and that the claim was fraudulent. 

The Australian Financial Complaints Authority (AFCA) agreed with the insurer’s assessment regarding the emails and cast doubts on the claim's validity.

AFCA also received confirmation from the police that it executed a search warrant on the complainant’s home in April via the external laundry door, which caused it to be damaged.

“I am satisfied that the complainant’s inclusion of what appears to be the same items said to have been stolen in May 2022, in the list of items said to have been stolen on 8 or 9 July 2022, significantly challenges the credibility of the complainant’s claim,” AFCA said.

“Further, I am satisfied that the statement from the police confirms not only that the damage to the external wooden laundry door occurred on a different date to that alleged by the complainant, but also on a date prior to policy inception and therefore prior to when the insurer was obliged to provide cover.

“Given the exchanged material I am not satisfied that the complainant has met his onus to establish a claim which is covered by the terms and conditions of the policy as he has not established a loss occurring as he describes or within the period of policy coverage.”

Click here for the ruling.