The liars, the ditch and the wardrobe

Sorry, I was a bit tied up

Sometimes, however reckless someone’s behaviour, it’s hard not to sympathise with a claimant’s plight, says Groupama’s director of claims, Phil Bird. In one case, a policyholder rang to report that his Ford Ka had been stolen by unknown thieves. But there was something a bit odd – he couldn’t produce a key to the vehicle. Then investigators noticed that in the police report he actually had said he knew the thief.

“It turned out that he’d met a guy in a bar and taken him home. Then things had got a bit saucy and he’d been tied to the bed for a night of fun,”

Bird says. But in the morning, there was no more fun to be had. Rather than untie him, the one-night stand had stolen all the policyholder’s belongings and made his getaway in the beleaguered man’s car. He was discovered the next morning by the cleaner.

Lying can negate a claim of course. But in this case, they were sympathetic owing to the man’s understandable embarrassment. “He was more upfront with the police, who are probably used to hearing about these kind of things. You’ve got to look at the circumstances, and this was a pretty human case of embarrassment,” Bird says.

Is that a truncheon, officer, or are you just pleased to see me?

An employee of the Garwyn Group, who wishes to remain anonymous, recalls a case in a previous job. He was working as a loss adjuster for a well-known chain of erotic underwear shops when a claim came in relating to one of its northern stores.

An off-duty policeman had gone into the shop just before closing time to buy a vibrator for his girlfriend. Clearly not wishing to spend any longer than necessary in the premises, and having made his purchase, he placed the gift under his raincoat and made a dash for the door.

But he hadn’t bargained on the roll-down grille that had already been lowered halfway. The unfortunate copper ran straight into it, knocking himself unconscious. The scene of a customer, lying unconscious, with his shiny new purchase by his side, drew a sizeable crowd and an ambulance was summoned.

The man’s public liability claim was accepted but reduced to accept that he was partly responsible for the accident. Let’s hope his girlfriend was grateful.

Not the brightest spark

Sometimes a claim comes down to sheer idiocy, says Crawford & Company senior agricultural loss adjuster Chris Smith. He remembers a claim from a farmer in Buckinghamshire at harvest time. A glider had been trying to find a suitable place to land as it was starting to get dark. A friend of the glider pilot was on the farmer’s property, trying to signal that it was safe to land. The field contained stubble and bails of straw to be used for animals, with a row of houses at one end.

The man decided to light a magnesium strip, to create an Olympic-style torch to bring his friend in to land. “He ran across the field with the torch above his head so the glider pilot could see,” Smith says. “As he ran, the strips of magnesium dropped off onto the field and set the straw alight. But he had no idea – as it was all behind him.”

The whole field went up, including boundary fences for some of the homes, and a householder called the fire brigade. Luckily, the glider managed to land a couple of fields away, but the torch bearer was not so fortunate. His insurers had to compensate the farmer £2,000 for his straw, while the homeowners claimed greater amounts for their loss.

Do you pay out if I get broody?

If a holiday maker goes to hospital in India and later claims for stomach problems, it may not be Delhi belly to blame, as group fraud manager at Cega, Simon Cook, recalls.

“We had a woman admitted to hospital in India with severe abdominal pains. She was claiming for about £1,200, but when we looked into the paperwork, we noticed from the doctor’s email address that it was an IVF clinic.”

Further research showed that the clinic advertised medical tourism – and the doctor the woman was seeing was a specialist fertility doctor. “When we then spoke to the woman’s GP, he said that she’d been trying for a baby for a year and had been given fertility drugs.”

The evidence was compelling, and when Cega sent an agent to have a look at the clinic, it established that the only kind of medicine it practised was fertility treatment. Whether the woman got the result she wanted from her treatment is not known.

But travel insurance cannot subsidise someone’s desire to procreate, Cook says.

Don’t porsche your luck

A businessman’s Porsche is found in the ditch on a treacherous country road. But something nags away at the insurers. Why had the policyholder removed his car from the company’s fleet policy with Groupama before transferring it to another firm, not long before the claim was made?

Investigators noticed that there were several stickers on the car for the Gumball 3000, an international rally for high-performance cars. They investigated and found the driver had in fact won the Spanish leg of the recent rally. Further tests on the vehicle revealed that the soil on the tyres was unique to Spain.

“We discovered that it hadn’t been driven recently in Britain,” Groupama director of claims Phil Bird says. “In fact, he’d written it off in Morocco and had it brought back to the UK and dumped in the ditch. So the accident happened when he was still on our cover. I think he moved insurer because, if he’d left it on the fleet policy, it would’ve cost him on his premium next year.”

There was real ingenuity in his plan, but like so many miscreants, he’d forgotten to remove an important bit of evidence – those Gumball 3000 stickers. Crash and burn.

A fishy tale

Keep a look-out for slightly odd behaviour and you may just find something fishy. That’s exactly what happened with a character whom loss adjusters Cunningham Lindsey have nicknamed ‘Rod’ after he claimed £3,500 for the theft of fishing equipment.

Rod told investigators how thieves had broken into his garage during the night and taken his beloved fishing gear. He’d discovered the break-in that night, and even mended the door, but didn’t inform the police until the following morning.

So the firm sent down special investigator Kathryn Midgley to interview Rod. He told her that not all his fishing equipment had been stolen – he had some stored upstairs in the house. He was evasive about why he kept it there, then uncomfortable when he showed her the room, keeping himself between her and the wardrobe. Intrigued, Midgley asked him to open the wardrobe. And lo and behold, a set of fishing equipment matching the lost items stood inside. Rod was, of course, quick to say that this was a different set.

When asked if he had any evidence for the existence of the stolen equipment, he produced a photograph on his digital camera. Midgley looked at the time and date. It had been taken two and a half hours before her visit, days after the equipment had been ‘stolen’. Midgely did not take the bait and the claim was refused.

Up a tree without a paddle

Loss adjuster Cunningham Lindsey’s head of investigating services, Chris Aplin, remembers a case with a tree surgeon who had claimed for being unable to work due to a frozen shoulder. When Aplin’s staff rang his home to conduct an interview, the man’s wife answered and said he was out. The loss adjuster asked if he could try his mobile. “No, don’t do that,” she replied, “he’s halfway up a tree.” Bingo!

The client was informed and a surveillance agent was hired. He followed the policyholder the next morning and, sure enough, the man had another date with a tree. The agent filmed him climbing all over it, providing the necessary evidence to turn down the claim. Well, you know what they say, life’s a beech. IT