Account of the case
On 28 August 2016, the Policyholder informed the Insurance Company that his camera, of the value of euro 1,100, had been stolen on 27 August 2015 in Portugal during his holiday. A claim for compensation from the travel insurance had been filed. The Insurance Company had asked the Policyholder to provide them with an original receipt for the purchase or information regarding the date and place of the purchase. The Policyholder provided the Insurance Company with a handwritten receipt, dated 23 May 2016, indicating the place of purchase as the store called MP Brothers located in Pakistan, at the Jhelumin Shabbir Plaza marketplace. Moreover, the Policyholder had given the Insurance Company the name and telephone number of the seller.
In its email of 30 September 2017, the Insurance Company communicated that the store could not be contacted as the telephone number given by the Policyholder was not operative. The Policyholder was asked to provide the full address and telephone number of the store.
The same day, the Policyholder responded that he did not remember the address of the store. The Policyholder told that he had bought the camera from an unknown person who, presumably, worked in the store called MP Brothers. According to the Policyholder, it should have been possible to locate the store at the Shabbir Plaza market unless it has been closed.
The Insurance Company communicated to the Policyholder that its contact in Pakistan was not able to find the store, indicated by the Policyholder as the place of purchase, at the Shabbir Plaza marketplace. Other storeowners had not heard about a store called MP Brothers. There were various stores and offices at the Shabbir Plaza but not one single store selling cameras.
The contact person had not found the address indicated by the Policyholder. The persons residing in the area had not heard about a person indicated as the seller although they told they knew everybody living in the area. According to the contact, the phone number given by the Policyholder was not in use.
In its decision dated 10 October 2016, the Insurance Company found that the Policyholder had not provided them with sufficient information concerning his ownership of the allegedly stolen camera.
Customer’s complaint
The Policyholder told that it is usual in Pakistan not to receive proper digital receipts. The receipt given to the Policyholder was mainly an account of the camera not being stolen or not having any defects. According to the Policyholder, this mode of operation corresponded to the usual procedure in second-hand trade.
According to the Policyholder, he had asked his own contacts to find the seller. The Policyholder had sent the Insurance Company another receipt dated 23 December 2015.
The Policyholder told that during a telephone conversation, the Insurance Company representative had mentioned that based on the travel insurance, three compensation claims had been filed in a year. The Policyholder believes that this fact has had a bearing on the negative decision on the claim.
Reply by the Insurance Company
In their reply, the Insurer refers to their decision on the claim.
Recommended solution
Formulation of question
The case is about assessing whether the Policyholder has provided the Insurance Company with sufficient proof on his ownership of the allegedly stolen camera.
The applicable norms of law and policy terms
Under Section 69 of the Insurance Contracts Act, the claimant shall provide the insurer with such documentation and information as is required for assessing the insurer's liability and as the claimant can be reasonably required to provide, with due consideration of the opportunities available to the insurer to obtain such information.
17.6 Indemnification procedure
17.6.1 Obligations of a claimant
The claimant shall comply with the instructions for claiming indemnity given in the terms and conditions of the personal or non-life insurance and provide AIG with the documentation mentioned therein.
The claimant shall provide (insurance company) with documents and information necessary for the assessment of (insurance company)'s liability. The claimant is required to acquire the documentation which he/she is best equipped to acquire, while taking into account that (insurance company) may also acquire such documentation. (insurance company) is not obliged to pay indemnity before it has acquired the said documentation.
Evaluation of the case
The Insurance Complaints Board notes that under the valid Finnish law, the Policyholder is obliged to provide the information regarding the insured event to be compensated. According to the Insurance Company, it has not been shown in this case that the Policyholder was the owner of the camera reported stolen.
According to the Policyholder, his contacts in Pakistan had found the seller and provided a new receipt dated in December. The Insurance Complaints Board finds that is remains unclear how the Policyholder’s contact had been able to find the seller, considering the fact that the contacts of the Insurance Company had not found the person indicated as the seller by the Policyholder, nor the seller's store or address, and that the telephone number given by the Policyholder was not operative. Moreover, the Insurance Complaints Board adds that the Policyholder had first communicated that he had bought the camera at a store called MP Brothers but had later told that the seller was a private individual, presumably working at the store in question. The Insurance Complaints Board finds that the changes in the description impair the reliability of the account given.
The Insurance Complaints Board finds that in the case at hand, it has not been reliably proven that the Policyholder was the owner of the camera reported stolen and therefore the Insurance Company is not liable to pay any compensation for the loss.
Final outcome
The Insurance Complaints Board does not recommend any change in the case.
The Insurance Complaints Board’s decision is unanimous.
INSURANCE COMPLAINTS BOARD
Chairman Norros
Secretary Nikunlassi
Members:
Karimäki
Korpiola
Rusanen
Toimi