Peter filed a claim with his insurance company because his home was burgled and a considerable number of items had been taken.
In order to show that Peter was indeed the owner of the stolen items, the claims handler asks him to provide proof of this in the form of, for example, purchase invoices. The invoice for the stolen television set immediately struck the claims handler as unusual. The invoice did not mention the name of the policyholder or an invoice number. When asked, the policyholder indicated that he did not know why his name was not on the invoice but that he had definitely purchased the set. A telephone call to the seller showed that the set was bought by someone else who lived at different address. This led the claims handler to transfer the case to the Special Affairs department. All invoices submitted by the policyholder were examined in detail and the sellers of the items were contacted. Article numbers proved to be incorrect, sizes of purchased shoes were found not to match the shoe size of the policyholder, addresses were incorrect, etc.
When Peter was confronted with the findings of the investigator, he stated that he had indeed been burgled and the claimed items had actually been stolen. However, he no longer had invoices for many items and, as he feared that the insurance company would would reject his claim, he had therefore ‘arranged’ the invoices. It was clear to the investigator that this statement was also incorrect, because the television set mentioned above had been purchased by a family member. The set had not been resold to the policyholder because it was still in the living room of the family member.
There was therefore a clear attempt to defraud the insurance company. The insurance company filed a report with the police against the policyholder for attempted fraud and forgery of documents. On this basis, the policyholder was arrested by the police. During his arrest at his home, the police discovered an interesting added bonus: A fully operational cannabis plantation.
The report to the police and the arrest led to criminal proceedings being brought against the policyholder. In addition, the insurance company ‘joined’ the proceedings on the basis of the investigative costs incurred. By ‘joining’ the proceedings, the investigative costs became part of the judgment by the court and it was therefore not necessary to recover these separately.