A theft victim has had his claim scrubbed out – including the legitimate part of it worth almost $35,000 – after he created fake invoices to inflate its value.

The man had a claim for fire damage to his home and contents accepted by insurer QBE in 2018, but he later submitted another for theft of contents from the damaged property. He told police at the time the value of the missing items was $44,655.

QBE denied the theft claim initially, but in 2021 the Australian Financial Complaints Authority ordered it to accept and assess it.

The insurer offered to settle for $34,263 in June 2022, but the customer rejected this. He later said the value of stolen items totalled $132,693 and he should be paid the sum insured of $100,000.

He submitted eight tax invoices in support of the claim, but QBE investigated and established the invoices were created using “an online tool”.

By analysing metadata, it could show the invoices were all created on just two occasions and “well after their purported issue dates”.  

The complainant denied fraud and said the invoices were “duplicate copies”.

However, AFCA says it is satisfied “it is more likely than not that the complainant knowingly falsified documents with the intention of obtaining financial gain from the insurer”.

Referring to section 56 of the Insurance Contracts Act, the ombudsman says the insurer can decline the entire claim, despite the fact “there was some underlying loss that falls within the policy’s coverage”.

“The complainant knowingly provided falsified invoices to the insurer to derive a financial benefit,” its latest ruling says.

“It is established by case law that even if an insured has a valid claim, the making of the claim fraudulently may entitle the insurer to refuse payment of the entire claim.

“The eight invoices total $80,410.85. That is a large sum of money. 

“In the circumstances, it is clearly not the case that only a minimal or insignificant part of the claim has been made fraudulently. Further, I am not satisfied that non-payment of the legitimate aspect of the theft claim would be harsh or unfair.

“Given the matters outlined above and taking into account the need to deter fraudulent conduct in relation to insurance, I am satisfied that the insurer is entitled to deny the theft claim in full.”

Click here for the full ruling.