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Ombudsman rejects crash claim after insurer’s fraud allegation

The industry ombudsman has backed Suncorp’s rejection of a car crash claim, saying it is “not persuaded” the damage was accidental.

The Australian Financial Complaints Authority says it prefers the insurer’s forensic expert report to that of the policyholder’s mechanic.

The driver – who Suncorp accused of fraud – said she was travelling through an intersection when she hit the side of another car crossing her path. She said a trailer and boat had obstructed her view.

But Suncorp’s forensic specialist concluded the other car was stationary when hit and had been for several seconds. Crash data indicated its engine was idling, the transmission was in park and there was no accelerator or brake input.

The specialist added the damage and the vehicles’ positions after the crash were inconsistent with the struck car having been moving.

The driver’s mechanic disputed the crash data and suggested the other vehicle could have been travelling at between 10km/h and 25km/h.

Related article: Insurer, driver share legal bill after stalling on claim

But AFCA notes the mechanic did not attend the scene and has no apparent qualifications in accident reconstruction.

The ombudsman says the absence of horizontal scrapes on the hit vehicle suggests it was stationary. Its position after impact, only two metres from and almost directly opposite the insured vehicle, was inconsistent with both vehicles having been moving.

The authority finds the policyholder’s account incompatible with the forensic evidence.

“I am ... not satisfied the loss occurred in the manner alleged by the complainant and I am not persuaded it was accidental,” an AFCA member said.

AFCA finds the driver has not established a claimable loss, so it does not need to consider the insurer’s other allegations, including fraud and a failure to act with utmost good faith.

See the ruling here.


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