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Insurance company has reject my claim on the basis of fraud…

Customer Question
Insurance company has reject...

Insurance company has reject my claim on the basis of fraud and canceled my policy not sure how to dispute it

Lawyer's Assistant: What state are you in? It matters because laws vary by location.

MI

Lawyer's Assistant: What steps have you taken so far?

Raised an internal complaint to dispute the matter.

Lawyer's Assistant: Anything else you want the lawyer to know before I connect you?

A few days after I withdrew the claim the investigation department use

Submitted: 18 days ago.Category: South Africa Law
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Customer reply replied 18 days ago
A few days after I withdrew my claim the investigation department made a decision to reject my claim and cancel my policy
Customer reply replied 17 days ago
Insurance company claims invoice for 1 of items is fraudulent even after I advised the item in question should be withdrawn as it was company supplied device and thus i was not the legal owner.
Answered in 7 hours by:
4/8/2018
Lawyer: CaseLaw, Attorney replied 17 days ago
CaseLaw
CaseLaw, Attorney
Category: South Africa Law
Satisfied Customers: 1,683
Experience: BCom; LLB; Masters in Law
Verified

Hi there and thank you for your question,

I am a practicing attorney based in South Africa and I will try to assist you with your legal question but please feel free to ask as many follow up questions in order to clarify your initial question. If you have a new question, you must please open a new thread.

The answer is going to (unfortunately) lie in your policy. One of the clauses therein should deal with disputes, and there will be a process which is set out which deals with lodging a dispute.

But, I must tell you that you will need a valid reason for thinking that you can dispute their decision.

I must also say that in my opinion the insurance company is within its rights to reject a claim, and even cancel a policy, where there has been an attempt to commit fraud. A perfect example is (unfortunately) exactly what you've set out above.

Claiming for a device that you don't own under your personal insurance policy (even though you withdraw the claim) constitutes attempted fraud. That would provide them with grounds to terminate the policy.

I'm not too sure what argument you would have to prove that you didn't intend to do that.

If my answer hasn't provided you with enough clarity regarding your initial question, please send me a REPLY with follow up questions so that I can continue to assist you in this same thread for as long as you need. Let me know if you need more advice - don't just rate my answer as "bad".

If my are HAPPY with my answer then please click one of the STAR ratings or the SMILEY FACES to rate my answer!

Good luck and best regards,

CaseLaw

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CaseLaw
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Category: South Africa Law
Satisfied Customers: 1,683
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