Account of the case

The lens of the Ray-Ban sunglasses, a gift given to the Customer in the summer of 2025, broke as the glasses fell on the concrete surface at the hotel swimming pool on 4 July 2025. The Customer applied for compensation for the broken sunglasses based on their luggage insurance.

The Insurance Company requested that the Customer provide additional information, including the receipt for the purchase of the sunglasses, the details of the gift giver as well as information on the store where the sunglasses had been bought. The gift giver did not want to provide the Customer with the purchase receipt or their contact details to the Insurance Company. The Insurance Company was not given information on the store where the sunglasses were bought, either. According to the claims settlement decision made by the Insurance Company, the original place and time of acquisition as well as the ownership of the sunglasses, remained unclear. According to the Insurer’s decision on the claim, the details given by the Customer do not satisfy the obligations of the Claimant as per the Insurance Contracts Act. On 21 August 2025, the Insurance Company issued a negative decision on the claim.

The Customer sought redress from the Insurance Company’s internal appeals body. As per the decision of 14 October 2025 by the internal appeals body, the negative decision on the claim was not amended.

Customer’s demands and Insurance Company’s position

The Customer was dissatisfied with the Insurance Company’s decision on the claim, requesting that the Insurer pay compensation for the sunglasses. The Customer has been unable to provide a receipt for the sunglasses received as a gift since the gift giver will not give the receipt to the Customer. According to the Customer, it is also not appropriate for the Insurance Company to ask for the gift giver’s personal details. The Customer finds that the Insurer’s negative decision on the claim is unreasonable and should the Insurer’s Policy Terms call for such information, the Terms are illegal.

In their additional writ, the Customer also refers to the fact that not all belongings of people have receipts at hand. The Customer finds that a receipt is not necessary in order to receive compensation. The Customer also pleads the fact that the Insurance Company had earlier compensated for luggage without asking for a receipt. In their second additional writ, the Customer refers to Section 69 of the Insurance Contracts Act. According to the Customer, the Law does not expressly call for the presentation of a purchase receipt if the existence and amount of the damage suffered can otherwise be proven reliably. In the case at hand, the Customer has provided a professional estimate and photos of the damaged glasses. The Customer also finds that they have, through the information given, sufficiently proven the nature of the damage and the belongings. According to the Customer, the total refusal to pay compensation solely on the basis of a lacking receipt is not in line with the principle of proportionality, should other information support the damage suffered.

In their reply, the Insurance Company refers to the fact that the Customer has been unable to specify the store where the sunglasses were bought, nor have they given any information on the time when the glasses were purchased. The estimate of the repairs by the optician, provided by the Customer, states that the sunglasses are twisted, the ends of the arms show significant wear, and the other lens has scratches. The worn parts at the ends of the sunglass arms are not, according to the Insurer, in a logical relation to the purchase time of the sunglasses given by the Customer (summer 2025) and the time of the damage (July 2025). In this case, the Customer provided the Insurance Company with photos of the damaged property as well as a written repair cost estimate, but no purchase receipt or other reliable information on the time of purchase of the object at hand. The information provided is not sufficient to prove the ownership of the damaged property nor the amount of the loss in a way to allow to establish the Insurer’s liability to pay damages. According to the Insurance Company, the decision on the claim has been made in accordance with legislation, the Policy Terms and the insurance contract.

In their additional reply, the Insurer finds that each loss event is treated as a separate loss, so the compensability of this damage has not been assessed based on the earlier damages that occurred.

Legislation and Terms and Conditions

Legislation

Under Section 69 of the Insurance Contracts Act (Claimant’s Duty of Disclosure), 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.

Insurance Terms and Conditions

The Travel Insurance Terms and Conditions, in force as of 1 January 2024, as well as the General Terms and Conditions applied to individuals, in force as of 1 January 2022, will be applied in this case.

Matkatavaravakuutuksen ehtojen kohdan 22.1 (Äkilliset ja ennalta arvaamattomat esinevahingot) mukaan matkatavaravakuutuksesta korvataan matkalla mukana olevalle omaisuudelle vakuutuksen voimassaoloaikana sattuneita suoranaisia esinevahinkoja ja ehdoissa erikseen mainittuja muita kustannuksia.

Vakuutuksesta korvataan vakuutuksen kohteelle aiheutuneet suorat esinevahingot, kun vahingon syynä on äkillinen ja ennalta arvaamaton tapahtuma. Äkillisyys ja ennalta arvaamattomuus arvioidaan objektiivisesti yleiseen elämänkokemukseen ja korvauksen hakijan toimintaan perustuen. Korvattavuus ei määräydy vahingon seurauksen perusteella.

Vakuutuksen yleisten sopimusehtojen kohdassa 10.1 (Korvauksen hakijan velvollisuudet) viitataan vakuutussopimuslain 32 §:ään, 69 §:ään ja 72§:ään. Vakuutusehdon mukaan korvauksen hakijan on annettava vakuutusyhtiölle sellaiset asiakirjat ja tiedot, jotka ovat tarpeen vakuutusyhtiön vastuun selvittämiseksi. Tällaisia asiakirjoja ja tietoja ovat esimerkiksi ne, joiden avulla voidaan todeta, onko sattunut vakuutustapahtuma, kuinka suuri vahinko on syntynyt ja kenelle korvaus on maksettava. Korvauksen hakija on velvollinen hankkimaan omalla kustannuksellaan ne selvitykset, jotka ovat parhaiten hänen saatavissaan ottaen kuitenkin huomioon myös vakuutusyhtiön mahdollisuudet hankkia selvitystä. 

Vakuutusyhtiö ei ole velvollinen maksamaan korvausta ennen kuin se on saanut edellä mainitut selvitykset. Jos korvauksen hakija on vakuutustapahtuman jälkeen vilpillisesti antanut vakuutusyhtiölle vääriä tai puutteellisia tietoja, joilla on merkitystä vakuutusyhtiön vastuun arvioimisen kannalta, voidaan korvausta alentaa tai se voidaan evätä sen mukaan, kuin olosuhteet huomioon ottaen on kohtuullista. Vakuutetun tulee mahdollisuuksiensa mukaan osallistua vahingon selvittelyyn sekä myötävaikuttaa vahingon todellisen syyn ja aiheuttajan saamiseen selville. Vakuutettu ei saa poistumalla vahinkopaikalta, nauttimalla vahingon jälkeen alkoholia tai huumausaineita taikka muulla tavoin vaikeuttaa vahingon selvittämistä. 

Vakuutusyhtiölle on varattava tilaisuus tarkastaa vaurioitunut omaisuus ennen kuin sitä ryhdytään korjaamaan tai hävittämään.

Recommended solution

This case is about the question of whether the Customer has provided sufficient proof and clarifications on the broken sunglasses in order to establish the liability of the Insurer.

Under the valid legislation, the Claimant bears the burden of proof regarding the compensable damages.

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”.

According to Clause 10.1 of the General Policy Terms, the Claimant must provide the Insurance Company with documents and information needed to establish the liabilities of the Insurance Company. Such documents and information include, for example, those that allow the establishment of whether the Insured event has taken place, the amount of the damage caused, and who is the party to be compensated. The Claimant has the obligation to acquire, at their own cost, the information that they are most likely to obtain, however, also considering the Insurer’s possibilities to seek information.

FINE finds that the clarifications proving the damaged property, such as a purchase receipt or other ownership proofs, are – as a premise – information which is best provided by precisely the Claimant to the Insurer.

In the case at hand, the Customer has provided the Insurer with travel documents, photos of the broken sunglasses and the optician’s estimate of repair cost. The repair cost estimate by the optician does not, as such, prove the age of the damaged property but is an estimate of sunglass repair costs. The estimate of the repairs states that the sunglasses are twisted, the ends of the arms show significant wear, and the other lens has scratches. Moreover, the photos available to FINE show that the ends of the sunglass arms have considerable signs of general wear. FINE finds that it is highly unlikely that the Ray-Ban sunglasses of less than a couple of months of age would have such wear marks shown in the photos. The Customer has not obtained any purchase document from the gift giver of the sunglasses, nor the permission to provide their contact details to the Insurer. Neither has the Customer given the Insurer any information requested as to the place of acquisition of the sunglasses.

Based on the documentation and clarification made available to FINE in the case at hand, FINE finds that the Customer has been unable to provide the Insurer with such necessary and reliable clarifications to allow for the determination of the Insurer’s liability to pay damages. In the case at hand, FINE finds that the Insurer’s request to obtain purchase information on the broken sunglasses from the Customer is not unreasonable.

FINE also notes that even if the Insurer has earlier paid the Customer compensation on damages without a purchase receipt, this does not mean that the Insurer would have, in case of later losses, given up their right to request clarifications to establish their obligation to pay damages.

FINE finds that the decision on the claim made by the Insurer is in line with the Policy Terms and applicable legislation, and that FINE has no grounds to recommend that the Insurer change their decision on the claim.

Final outcome

FINE does not recommend a change in the case.

FINE

The Finnish Financial Ombudsman Bureau

Head of Division Hanén                                           
Presenting Officer Lappi