A motor policyholder who was accused of claims fraud will receive a payout after winning a dispute before the industry ombudsman.

The claimant said his wife was driving his car between 9pm and 10pm on March 20 last year when she failed to give way at an intersection and crashed into another vehicle.

His wife said she was in shock and unable to take photos of either damaged vehicle before they were towed away. The husband said he arrived at the crash site too late to take photos.

Suncorp suggested the claim was fraudulent, noting inconsistences in the claimant and wife’s recollections of the time the husband arrived at the scene.

It noted there was no police report on the incident and it could not reach the tow truck company using contact details provided by the claimant.

The insurer said its investigator found no evidence of a crash at the site, and neighbouring residents could not say if the accident occurred.

A forensic expert said the car appeared to have been stationary when hit and there were no signs seat belts were being used at the time.  

The insurer also suggested the vehicle was unroadworthy and said it earlier rejected the claimant’s attempt to raise its sum insured from $40,000 to $75,000. The car was insured for $52,000.  

But the Australian Financial Complaints Authority says there is limited evidence the claimant had a financial motive for faking a claim. He and his wife had modest savings and no outstanding debts.  

It was reasonable for the crash site to be cleaned up, given it was in a residential area, and Suncorp misinterpreted its forensic expert’s findings to suggest the car was unoccupied when hit, the authority adds.

AFCA acknowledges some inconsistencies in the versions of events but says this is not enough to reject the claim.  

See the ruling here.

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