SERVICE: Contents
OUTCOME: Not upheld
Issues: Proof of loss/ ownership
Mr J held insurance on the contents of his house.
In June 2022, Mr J’s vehicle was stolen from outside the house. At the time of the theft, his vehicle had a bag inside it containing several collectible cards. The vehicle was later recovered by police, with the cards missing.
Mr J made a claim to the insurer for the loss.
The insurer accepted the claim and offered Mr J a cash settlement of $4,606 for the cards. The settlement offer included a settlement value of $500 for a card known as “X”. Mr J contested the valuation and told the insurer that the card was a first edition, and not an unlimited edition. He said a first edition was more rare and more expensive than an unlimited edition. Mr J noted on his loss schedule that a first edition “X” card was worth $24,999.
The insurer said that it was not required to adjust its settlement offer. However, in recognition of several delays in the claim, it included an ex gratia payment of $2,500, increasing its settlement offer to $7,106.
The case manager’s assessment
Because the insurer accepted the claim for the cards, the issue was whether the settlement offer was fair and reasonable in all the circumstances, considering whether the insurer could rely on the ownership condition to limit the payment for the “X” card. The ownership condition required that, when making a claim, an insured must prove they owned the property they claimed for and provide evidence of its value.
Mr J said that he had provided enough information to prove he owned a first edition “X” card, including credit card statements highlighting all transactions with possible stolen items, including the box that the “X” card came from. Mr J said that the claim included many other first edition cards which were all accepted by the insurer.
The insurer said that, even after accepting the claim, it was entitled to request proof of ownership. It said the bank statements provided by Mr J only demonstrated that he purchased various boxes of cards over a period of time and did not prove that he owned an “X” card, or that its value was $24,999. It said Mr J had only presented a loss of $5,000 to the police, and had not provided any additional forms of evidence to assist the insurer in assessing the claim, such as photographs, a valuation, or verification from family or friends that Mr J owned the “X” card.
The case manager believed that Mr J had not provided sufficient evidence that he owned the “X” card. In the circumstances of the claim, Mr J’s bank and credit card statements only proved that he owned various boxes of cards. Mr J did not provide specific evidence that he owned a first edition “X” card as a photograph or a professional valuation.
While the insurer did not dispute Mr J’s ownership of several other first edition cards, that did not prevent it from relying on the ownership condition. It was reasonable for the insurer to make further enquiries about an item which Mr J said was rarer and worth significantly more than similar items which were also part of the claim.
In all the circumstances, the settlement offer was fair and reasonable. The insurer was not required to increase its offer, because Mr J had not proved that he owned a first edition “X” card. In addition, the insurer’s ex gratia payment of $2,500 was fair compensation for the delays that Mr J experienced.
Complaint No: 00230053