Crawford mpany: Equine fraud stopped dead by Crawford Legal Services
This was a claim relating to the health of an insured horse. Suspicion increased given the timing of the claim, compared to when the insurance policy began.
The policy began on July 28. The date of the loss under the policy was only a few days later, August 12 of the same year. Crawford Legal Services (CLS) became involved in the case following concerns from insurers about the timing.
The insured had already changed her story in relation to the claim and had filed complaints before CLS intervened. The policy owner also failed to provide the insurers with proof of purchase demonstrating that the inception of the policy coincided with when she purchased the horse.
Our investigator Crawford obtained a detailed statement from the policyholder, as well as separate statements from the horse instructor and veterinarian.
During our investigations, it turned out that an animal physiotherapist had treated the horse on August 12 (the first day of the insured’s insurance cover for the horse after the reference period) but, according to the ‘assured, it was simply a treat / massage for the animal.
We obtained the medical notes from the animal physiotherapist which referred to the horse having been “stressed / cranky”.
The insured’s statement provided to our investigator was also inconsistent with the information she had initially and previously provided to insurers regarding the onset of symptoms. In addition, the veterinarian’s comments contradicted the insured’s version of the facts.
Despite requests from CLS, the policyholder never provided proof of purchase to demonstrate when the horse was purchased. The policyholder would also not provide messages exchanged with the physiotherapist, before the physiotherapist treats the horse.
At this point, concerns remained about the legitimacy of the claim. The insurers sent a letter of dispute to the insured in view of all the discrepancies, to which an unsatisfactory response was received.
On our advice, the insurers then denied the claim on the grounds that the condition had occurred before the start of the policy, or at least during the first 14 days of coverage.
A claim savings of Â£ 5,000 was achieved for our client.
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