No possum, no payout as AFCA backs fraud decision
A driver who said he skidded into a tree after braking to avoid a possum has had his motor claim rejected as fraudulent by the complaints authority.
The man told RACQ Insurance he was travelling to a grocery store 25km away, having avoided the shorter motorway route due to heavy rain, when he crashed on a steep, unlit street.
The smash on the night of September 24 2023 left his Jeep – which was insured for $20,540 – a total loss.
The insurer declined the claim after its forensic expert said the car appeared to have accelerated while on a gravel section next to the road immediately before crashing at about 43km/h.
The expert said evidence showed the vehicle travelled in a straight line and the “circumstances of the collision are consistent with an intentional act”.
The insurer also pointed to weather bureau data showing there was no rainfall in the region.
It said analysis of bank records provided by the driver revealed “clear signs the contents had been modified and edited”, and it alleged the car “was demonstrably and intentionally overinsured”, relying on an email from the person who sold it to the claimant stating the price was $8000-$9000.
RACQ Insurance said “major inconsistencies” with the claim suggested it was fraudulent.
The man argued his claim was legitimate and he would not have risked injury by deliberately driving into a tree.
But the Australian Financial Complaints Authority finds the insurer’s evidence persuasive, noting the claimant did not provide expert reports in response to those from the insurer.
“I am not satisfied the complainant has established that the collision was unintended or unexpected, or that the damage to the vehicle occurred in the manner alleged,” an AFCA ombudsman said.
“The level of the inconsistencies between the versions of the event ... is so significant that I am comfortably satisfied a finding of fraud is warranted.”
See the ruling here.
For in-depth analysis, features and opinion, read the latest Insurance News magazine