Above the Law - Business Insurance fraud.

[Sad sam]

With the car claim the insurers professional enablers tried to deceive by valuing the car at less than 1/2 what others exactly the same were for sale at. 1/2 the industry standard valuations. How is that anything other than fraud? This took about 6 months to resolve.

 

With the property, the insurance company firstly said no damage, to be very clear they repudiated the claim.

Then they said the claim was worth £200, then £1000, then £10,000 then £40,000 the £137,000, then £180,000 then £200,000 then over £200,000.

 

This has taken NINE (9) years, in a house that is uninhabitable.

 

So what is undervaluing a claim by over £200,000, or

 

Then you find that this is standard insurance practice from industry professionals, that the powers that should care or investigate don't.

[veganite]

Offers. Negotiation. Not fraud. As for the 9 years it is uninhabitable, IMO you should be seeking an additional compensatory payment in respect of the 9 years in respect of further financial losses you have incurred due to the unnecessary delay. Such losses would be perhaps your mortgage payments, any additional expenses if you have lived elsewhere etc.

 

I believe that most insurance companies are highly unfair to their customer, but it is in the name of business.

It is unfortunate that most companies / businesses seem to be unfair to their customer, but it is all in the game of making money. Such unfairness as a low settlement offer or an unreasonable time delay should result in a complaint to the insurance company and if not rectified possibly followed with legal action.

 

My recent experience with an insurance company (for a car) has taken 6 / 7 years to settle - I am still waiting as they require a letter of authorisation for payment (something which I can not arrange at this moment due to my location).

 

Insurance companies? Unfair yes, fraud no.

 

I think the insurance companies are not guilty of fraud from your original post since there is always the route of negotiation (which it appears you have successfully done on two occasions) and if negotiation fails, then it is possible for legal action although the onus would be on the customer to provide evidence as to why they believe their claim to be higher than what the insurance company offers.

[Sad sam]

If you run with your sentiment of 'name of the business' etc, why is it then when people attempt to up their claim, the insurers can null & void the contract, plus have you arrested & prosecuted for insurance fraud.

 

A valid claim should not be such a battle.

 

Paper 6 deals with this & how Insurance Law is way behind the rest of the world. But Parliament is dragging its heels.

The playing field should not be SO 1 sided.

 

Hence my concern that those empowered to redress the unfairness' are not, instead breading further issues for their own financial benefit.

[veganite]

Up their claim? You mean negotiate? In that case, I negotiated with my car insurance and upped the claim. I was not arrested and prosecuted for fraud.

[stu007]

Hi Sad sam

 

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[SuperVillain]

I don't get this. With the car total loss, the post is made on the assumption that the insurers original valuation is incorrect. Just because they offered more doesn't mean that it isn't...

 

In my insurance days I had sometimes been told to offer higher Total Loss settlements to get argumentative people to go away, even when they weren't really correct. Your insurers will have used a vehicle valuing system to come up an average value for the make model age, e.g. Glass's Guide and then made additions or deductions based on the actual circumstances (e.g. more money for lower than average mileage, less money for pre-accident damage, deduction for salvage if you keep the vehicle etc).

 

For the same of £3k its probably not worth taking up that much of a claims handlers time dealing with an argumentative customer.

 

I had one guy arguing over a difference (between our valuation and his) of £1.5k and he phoned me twice a day, wrote letters on a weekly basis coming up with ever changing reasons why our valuation was wrong, till eventually my manager was like, just give him an extra grand and get rid of him...

[BRIGADIER2JCS]

I don't get this. With the car total loss, the post is made on the assumption that the insurers original valuation is incorrect. Just because they offered more doesn't mean that it isn't...

 

In my insurance days I had sometimes been told to offer higher Total Loss settlements to get argumentative people to go away, even when they weren't really correct. Your insurers will have used a vehicle valuing system to come up an average value for the make model age, e.g. Glass's Guide and then made additions or deductions based on the actual circumstances (e.g. more money for lower than average mileage, less money for pre-accident damage, deduction for salvage if you keep the vehicle etc).

 

For the same of £3k its probably not worth taking up that much of a claims handlers time dealing with an argumentative customer.

 

I had one guy arguing over a difference (between our valuation and his) of £1.5k and he phoned me twice a day, wrote letters on a weekly basis coming up with ever changing reasons why our valuation was wrong, till eventually my manager was like, just give him an extra grand and get rid of him...

 

 

 

I think this applies in many "industries" getting rid of the serial moaners has always been a problem, they "are always right" it's the rest of the world that has a grudge against them alone.

[Sad sam]

I don't get this. With the car total loss, the post is made on the assumption that the insurers original valuation is incorrect. Just because they offered more doesn't mean that it isn't...

 

In my insurance days I had sometimes been told to offer higher Total Loss settlements to get argumentative people to go away, even when they weren't really correct. Your insurers will have used a vehicle valuing system to come up an average value for the make model age, e.g. Glass's Guide and then made additions or deductions based on the actual circumstances (e.g. more money for lower than average mileage, less money for pre-accident damage, deduction for salvage if you keep the vehicle etc).

 

For the same of £3k its probably not worth taking up that much of a claims handlers time dealing with an argumentative customer.

 

I had one guy arguing over a difference (between our valuation and his) of £1.5k and he phoned me twice a day, wrote letters on a weekly basis coming up with ever changing reasons why our valuation was wrong, till eventually my manager was like, just give him an extra grand and get rid of him...

 

Dear SV

 

In our car case after the first insurance valuation we turned to Parkers’s, Glass’s guide and CAP's of which we were able to get 2 of the 3 trade valuations.

We also found in identical car for sale ie spec & colour, but had 5000 MORE miles for £7,500.

This is when they upped their first valuation which we did not accept.

 

When we stated we would take the matter to the FOS the insurer accepted the average of the 3 industry valuations £6,700.

My point on this is that this should have been the initial valuation as the insurer employed a professional to examine the car for valuation. Why should an innocent accident victim be so out of pocket?

The vulnerable would have been duped by the insurers professional enabler into accepting a 1/2 valuation offer. I believe this is deceitful and fraudulent.

 

You pay insurance to cover your risk from loss, not to add to your misery.

Car insurance is compulsory. Insurers & the industry should not see insurance fraud as a 1 sided affair. Legislation & companies powered with consumer protections should not be turning a blind eye to such practices.

 

I do not accept 50% trade advisory valuations, clearly in the knowledge that 50% will not cover the loss as commencement for negotiations. These are professional enablers, no different that the professionals increasing loss valuations, that the insurers are fighting against.

Many of the Loss adjustor's state they are independent in introductory letters, this is clearly wrong and could easy mislead the vulnerable.

 

I hope you see my concern.

 

We should not consider just ourselves but ie consider an innocent OAP. left with 50% valuation. That is taking advantage is is clearly FRAUD.

[veganite]

i think we will have to agree to disagree re the fraud... although i can see how you think it is fraud, also i can see your concerns and your reasoning, but as the insurance companies are such a big business they have this tied up pretty neatly within their favour.

unfortunately, the insurance companies are a business operating purely to make a profit and that is why they more often than not provide a lower settlement figure, but as i've said before - it is up to the customer to negotiate. as negotiations take place then this makes it not fraud.

[ericsbrother]

you havea course of action you can follow in both of these instances and that is to sue the individual who casued the damage and name their insurer as a co-defendant. If a court agress that you are due the compensation you seek they will pay up. Often just issuing a claim against their customer is enough to focus their attention and for £200k they will certainly be sitting up taking notice.

However, if you are reliant upon their good behaviour it is the nature of the beast that they will try and avoid paying anything and will say almost anything as long as it cannot be quoted to that end.

This is not the same as fraud, it is an imbalance in the position of the parties and judges have to consider this when they make a decision and if they dont there are methods of appealing that decision (well, if you are rich or broke there is little risk in this) and the companies will have firther costs to then consider so again they often try and reach a settlement beforehand (always trying to save a few bob at the time as well).

[Ganymede]

The legal definition of fraud comes from Derry v Peek [1889] 14 AC 337:

“Fraud is proved when it is shown that a false representation has been made:

● knowingly, or

● without belief in its truth, or

● recklessly, without caring whether it be true or false.”

 

I assume Ganymede you are either an Insurance seller or Chairman or possibly a loss adjuster.

 

Insurance is taken out to transfer the possibility of a loss to an insurance company, which in turn spreads out the costs of unexpected losses to many individuals hence the premiums.

 

What you are saying is that you cannot understand that an insurance company that leaves an individual short of the required sum to ensure they do not suffer loss, by thousands or hundreds of thousands is not committing fraud?

 

Insurers & their representatives are getting away with this daily. Is it costing individuals £billions every year while the insurance industry profits soar!

 

Haha no I am not and have never been in the insurance industry in any capacity. The fact that you would think that shows your ignorance.

 

And thanks for your attempt to educate me on the law. I'll take it under advisement. ;-)

[BRIGADIER2JCS]

Haha no I am not and have never been in the insurance industry in any capacity. The fact that you would think that shows your ignorance.

 

And thanks for your attempt to educate me on the law. I'll take it under advisement. ;-)

It appears that anyone who would dare to disagree with the OP must work or has worked in the insurance industry.

[unclebulgaria67]

It appears that anyone who would dare to disagree with the OP must work or has worked in the insurance industry.

 

All relevant advice has been given.

 

If the OP thinks that the Insurance company are committing fraud, then they should go to Magistrates to lay information that the CEO of the Insurance company is head of a criminal enterprise engaging in systematic fraud and Magistrates should issue a warrant for the Police to arrest the CEO. Of course Magistrates would want sufficient evidence of this and not just a couple of cases where the Insurers had made low offers, which were subject to negotiated settlement.

 

As I said earlier, if the OP really wants to register their concerns about the Insurance companies behaviour, they should persevere with the FCA.