Pablo owns a courier service. On May 15th he reported to the insurance company that his delivery van had been stolen. This is annoying for Pablo because he has only owned the van for three weeks and he needs it for his work. He claimed an amount of USD 20,000 for the loss of his van.
When the claim appears on the screen of the claims handler, the system immediately gives an alarm signal: further attention is required. The system notes that relevant information was not included in the decision-making process when this insurance policy was taken out. It appears that the company of the policyholder is registered abroad. However, it is the policy of this insurance company not to accept foreign legal entities as policyholders. The insurance policy should therefore not have been concluded. Even if the company had been established domestically, the insurance policy should not have been concluded without stipulating additional conditions, since delivery vans used for courier services are subject to additional prevention conditions such as a regular driver’s check and/or a premium surcharge or (higher) own risk. It also appears that the owner of the company was registered in the general Fraud Registration System. He was apparently previously involved in fraud in the form of deliberate collisions. A manual check should have taken place at acceptance, but the first and last names were exchanged which meant that the check did not produce a result. If the name had been correctly entered it would have been clear that he was registered in the Fraud Registration System.
The insurance company rejected the claim on the basis that the policyholder had infringed his duty of disclosure. He should have reported that his company was established abroad, that the delivery van was being used for courier services and he had previously been caught committing insurance fraud.