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Fire Fraud

Key fraud indicators for Fire claims

Should you require any assistance or advice on fire claims, please do not hesitate to contact BLM

Do two or more of these apply to your claim?

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Are there financial problems?
Does the insured’s trading history show any financial difficulty? Due diligence should be undertaken, e.g. check Companies House for commercial policyholders.
 
Have two or more claims been made within the last 5 years?
Review previous claims made by the insured. Are there any similarities between claims? Any unusual features?
 
Has cover been incepted or has the level of cover increased recently?
If the insured has only held cover for a short time, the dates of the alleged damage should be scrutinised to ensure that the damage did not occur prior to inception. Scrutiny should also be given where the insured has increased the level of cover shortly prior to the fire which may mean the loss was not fortuitous.
 
Is the insured being difficult?
If the insured is making it unduly difficult to validate or deal with a claim, scrutinise available evidence to see whether any other fraud indicators apply.
 
Is the insured refusing an inspection?
Consider what the insured might be concealing. Scrutinise the evidence and consider whether any other fraud indicators apply.
 
Has the insured provided photographs several months after the incident or are they refusing to provide digital images?
Request digital copies of any photographs to review the timestamp and metadata to ensure it is consistent with the insured’s account. If the insured is not willing to provide digital copies it may be an indication that photographs were taken after the event.
 
Has remedial work already been completed?
Insurer’s investigators should be the first to examine the property to ensure that evidence is retained. The insured should be told at FNOL to only carry out essential remedial work, and only as agreed with insurers. If remedial work has been carried out, ask for all documentation that relates to that work. If there is suspicion, inspect that work.
 
Is the documentation suspicious or of poor quality?
Carefully scrutinise the documentation provided by the insured. Is it consistent with the alleged damage? Is the invoice from a company which exists? Is there a VAT number on the invoice? If not, it may indicate a false company. If no documentation has been provided consider whether the reasons for this are justified.
 
Has the damaged property or parts already been disposed of?
At FNOL, inform the insured not to dispose of any evidence or parts. Investigators should attend promptly to ensure that evidence is retained. If the insured has already disposed of items relevant to the claim, consider whether any other fraud indicators apply.
 
Has the insured or witnesses provided vague or conflicting accounts?
Consider whether a vague account is justified given the circumstances and dates involved. Identify and consider the number of inconsistencies in the insured’s evidence.
 
Is the insured claiming a surprising sum or for surprising items?
Close scrutiny should be given to the sum claimed by an insured in order to consider whether there has been any exaggeration of the claim. Any inconsistencies or discrepancies in supporting documents should be identified.
 
Is the insured applying pressure for an early settlement or cash payment?
This might suggest a financial motive for bringing a suspicious claim, particularly if other financial difficulties have been identified.
 
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Are there multiple seats of fire?
More than one seat of fire indicates that it may have been deliberately set. Consideration should also be given as to whether the presence of any accelerant has been detected.
 
Have any security systems or devices been bypassed?
Enquiries should be undertaken as to the security arrangements of the property. Has an alarm been turned off or entry points left unsecured?

Alarm logs should be interrogated to ascertain whether entries and exits to the property are consistent with what the insured has said.
 
Is there any evidence of CCTV equipment being tampered with?
Enquiries should be made regarding the CCTV coverage of a property and whether any footage can be obtained. Has CCTV equipment been disabled or failed to record for some reason?
 
Is the property unoccupied?
Has the property been unoccupied or awaiting development for a period of time? Searches should be undertaken of planning records and property listings.
 
Are there any indicators of an uninhabited property when the insured claims occupancy?
Is there any evidence which contradicts the insured’s account that the property was occupied? For example, utility bills, alarm records, CCTV etc.
 
Was the property in poor condition?
A derelict or poorly maintained building may indicate financial issues on the part of the insured, or a potential motive to make an insurance claim.
 
Is there any evidence of the property being used for an unusual purpose?
Consideration should be given to the use of the property. A property being used for an atypical reason, for example a residential property being used to store construction materials would be of potential concern.
 
Has the property undergone significant alterations?
The removal of walls and ceilings can allow fire to spread more quickly and cause more damage to buildings. The necessity of and timing of any alterations to the building should be scrutinised closely.
 
Has relevant evidence and/or documentation in support of the claim been destroyed by the fire?
Consider whether it would have been reasonable for the documents to have been kept where they were and therefore if their destruction in the fire was plausible or if this might be a convenient way of avoiding providing evidence in support of the claim.
 
Was the size and location of the area damaged by the fire consistent with the loss of the inventory / stock / items being claimed for?
Consider if the extent of the loss being claimed for and the number of damaged items is plausible when compared to the area of the property that was damaged .
 

 

Should you require any assistance or advice on Fire Fraud claims, please do not hesitate to contact BLM