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| Below are a selection of stories from
various other publications that have featured Carmichaels: |
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By
increasing anti-fraud measures insurers are making it difficult
to succeed with a genuine claim
by Emma Simon - The Sunday Telegraph |
Making a claim on an insurance policy
is becoming increasingly difficult as insurance companies become
ever more zealous in chasing fraudsters. Consumer bodies and
other informed observers fear that this crackdown on crime is
impinging on the rights of genuine claimants as well as those
intent on defrauding insurers.
Some have even voiced suspicions that insurers may also be
blocking legitimate claims simply to reduce costs and boost
their profits.
John Wagstaff from the Association of British Insurers admits
that policyholders have “more hoops to jump through”
nowadays if they want to make a claim. It stands to reason,
however, that the more rigorous and arduous this process becomes,
the more likely it is that genuine claimants will suffer unfairly.
Anyone who has ever tried to claim a significant amount of
money on their household, travel or motor insurance policy
will probably have found it a disheartening experience. Not
only are there endless forms to complete, but the chances
are that they will also have been visited by a representative
of a firm of loss adjusters, appointed by the insurance company
to “manage” the claim. According to one reader
of The Sunday Telegraph, “all the loss adjusters were
interested in was knocking down the value of my clam.”
He felt that his insurer had treated him “with suspicion”,
despite the fact that he had paid premiums for 15 years without
making a single claim.
Hardly the profile of a typical conman.Although the burglary
took place in December he is still waiting for the claim to
be settled.
The wrangles have included arguments over the value of his
CD collection and the cost of a replacement leather briefcase.
“They insisted I list every CD I own. As I probably
has in excess of 300 CDs, this is no mean feat. Then they
suggested that, as I could buy many of these at “discount”
prices now, I wasn't entitled to the full replacement cost.
“I work full-time. When am I going to have time to
shop around for discounts? In the end you just feel like giving
up and just accepting whatever they want to pay you. I'm sure
many people get a lot less than they are entitled to.”
The checklist of “fraud tips” below, provided
by Carmichaels, a leading loss adjuster, shows how easy it
would be for paranoid insurance companies, eager to weed out
dodgy claims, to make life very difficult for innocent people
along the way.
As the list shows, you could set alarm bills ringing simply
by not having the right receipts, or for appearing defensive.
Many insurance claims are the result of extremely stressful
incidents, such as a flood, a burglary or a car accident.
The last thing most people need is a barrage of questions
implying that they are swindling their insurer. No wonder
customers sometimes appear defensive!
A spokes-woman for the ABI adds: “In the past, insurers
took more on trust. But now they want documentation and proof
before they start paying claims. If this reduces fraudulent
claims, it will obviously reduce the cost of insurance for
everyone.” However, despite the industry's blitzkrieg
on fraud in recent years, premiums show no signs of coming
down. In fact they may have risen steeply over the past 12
months.
Income replacement policies are also subject to tougher claims
procedures. One insurance insider reports that too many companies
have doubled claims staff in recent years in an effort to
crack down on claims. He says: Insurers are putting all their
efforts into 'weeding out the malingerers', even though these
account for just a fraction of policy-holders.
“Very often, it is a subjective decision whether someone
is well enough to return to work, particularly with 'modern'
ailments like stress and depression. Some genuine claimants
are almost certainly losing out.”
Even customers who manage to make a successful claim may
also be penalised. Alison Hartley, a London PR executive,
suffered a massive increase in premiums merely because she
made a couple of claims. She says: "My contents insurance
started off at £200. But this year the renewal notice
came in for £631.96. I simply cannot afford that. I
have tried to get cover with other insurers but, because I
have made three claims in the past four years, it appears
that I am uninsurable.”
She first claimed when a bolt of lightning hit her house,
causing her TV to explode. Since then she has had two bicycles
stolen – hardly uncommon in London. She adds: “I
haven't even received the money for the last bicycle that
was stolen. I've asked for the claim to be scratched –
I would rather buy a cheap second hand bike and still be able
to afford the insurance. But apparently this is not possible.
“Neither am I allowed to insure my home contents and
exclude the cycle. And, if I refuse to pay the £600,
I then have to say that I have been 'declined insurance' next
time I apply. This seems completely ridiculous, I thought
the whole point of having the insurance was that it would
pay out if you need to make a claim. But once you do, you
can no longer afford cover. So much for peace of mind.”
Insurers become suspicious when:
| a) |
The
policy has only recently been taken out of
levels of cover have recently been increased. |
| b) |
The policyholder
has appointed a certain assessor (who work
on behalf of claimants) – presumably
because some loss assessors are better at
beefing up pay outs than others. |
| c) |
A claimant has
a detailed knowledge of claims procedure –
asking for an interim payment, for example
– it might indicate that the policyholder
is no stranger to making claims. |
| d) |
Claimants who
lose their tempers or behave unreasonably
and in an abusive manner at an early stage
in the process. |
| e) |
Claimants who
threaten the loss adjuster by intimating that
they will make accusations about them to the
insurance company and/or press. |
| f) |
Claims whose value
and content is inconsistent with the policyholders
lifestyle – for example a person on
state benefits claiming for a Rolex watch. |
| g) |
Inconsistencies
in the policyholder's story: telling one version
of events to the insurer, and then another
to either the loss adjuster or police. Also
family members telling different stories. |
| h) |
Unusual circumstances
of loss where facts are difficult to pin down
and verify. |
| i) |
There is no original
documentation or photographs of any missing
articles. |
| j) |
The policyholder
becomes over-defensive when routine questions
are asked about how business is going, or
whether they have a criminal record or have
made previous claims. |
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