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Determination
Case number | 12-00-1089480 |
Financial firm | Lloyd's Australia Limited |
Case number: 12-00-1089480 23 September 2024
The complainant held a comprehensive travel insurance policy underwritten by the financial firm (insurer). The cover was for travel overseas between 12 March 2024 and 12 April 2024.
The complainant lodged a claim for the theft of various personal items on his trip. The insurer denied indemnity for the items (excluding the cash component) on the basis that the complainant did not provide sufficient proof of ownership.
The complainant disagrees and says the insurer’s decision is unfair and unreasonable given the circumstances of the claim.
No. The complainant has not provided sufficient proof of ownership for the disputed items as required by the policy.
The insurer is entitled to validate the claim and establish the extent of its liability. The insurer’s request for sufficient evidence of ownership is reasonable and aligns with the terms and conditions of the policy.
This determination is in favour of the insurer.
The insurer is entitled to deny the claim for the disputed items and is not required to take any further action.
No. The complainant has not provided sufficient proof of ownership for the disputed items as required by the policy.
The complainant lodged a claim with the insurer following a theft event at a beach overseas on 18 March 2024. The complainant says he was walking on a street at around 3pm local time and was holding his backpack with one hand. A motorcycle driving past approached from behind, grabbed his backpack and drove away in a rush.
The backpack contained several personal items which were stolen including:
The complainant reported the theft to the local police and provided a copy of the police report. The police report states that the theft event occurred on 28 March 2024 (not 18 March 2024).
The cash component of the claim was initially declined by the insurer. However, after providing evidence of his withdrawal transaction, the insurer provided a settlement of $250 for the cash.
The insurer denied indemnity for the remaining items (disputed items), on the basis that the complainant has not provided sufficient proof of ownership in the form of original receipts, proof of payment, or confirmation that the iPhone’s IMEI number has been blocked.
Under ‘Benefit 14: Luggage and Personal Effects’ of the product disclosure statement (PDS) the policy provides cover for damage, loss or theft of personal items which an insured takes with them on a trip. Cover is subject to the terms, conditions and exclusions of the policy.
Page 93 of the PDS states the following when making a claim:
What you need to do when making a claim
…
For all claims
You must give us any information, at your expense, that we reasonably ask for to support your claim. Information such as but not limited to police reports, valuations, medical reports, original receipts or alternative evidence of ownership will be required. Where it is reasonably possible to do so, you must do this within the timeframes requested. We may ask you to provide us with translations into English, if required, of such documents to enable us to carry out our assessment of your claim. If you cannot prove the ownership and/or proof of a covered event, we may not be able to process your claim or pay you…
Further, there is a condition under Benefit 14 of the policy outlining a requirement to block the International Mobile Equipment Identity (IMEI) number. The policy also excludes cover if the IMEI number has not been blocked.
The relevant policy provisions are quoted in section 3.2 of this determination.
The complainant says he purchased the iPhone in Istanbul on 30 January 2023. He is claiming $1,500 Australian dollars for the iPhone.
The complainant says he purchased the glasses in Istanbul on 2 February 2023. He is claiming $750 Australian dollars for the glasses.
The complainant says he purchased the laptop in Istanbul on 4 February 2023. He is claiming $3,000 Australian dollars for the laptop.
The complainant says the claim for the disputed items should be accepted because:
I accept the policy sets out the type of information the complainant could provide to show proof of ownership. Similarly, the claim form listed documentation that could be provided in support of the claim. I accept that these lists are not exhaustive.
I acknowledge that the complainant provided a police report. However, the existence or non-existence of a police report is merely a factor to consider when ascertaining if a theft occurred. It is not determinative or conclusive to show proof of ownership or value of the items in question.
Similarly, I am not persuaded that screenshots of online website searches for replacement items are sufficient to demonstrate ownership of the disputed items.
The existence of photos of the receipts is uncertain, given the complainant’s statement that they were ‘potentially’ stored on the stolen iPhone. The complainant was unable to provide other information such as bank statements for the cash withdrawals used to purchase the items, or any valuations.
Whilst I accept that the complainant cannot remember his login details, this does not waive the policy requirements to block the IMEI number.
I consider the insurer’s request for sufficient evidence of ownership is reasonable and aligns with the terms and conditions of the policy
Whilst I empathise with the complainant’s circumstances, the onus rested with him to provide sufficient evidence to support he owned the disputed items.
In the absence of sufficient proof of ownership and value, I am satisfied, on balance, the insurer is entitled to deny liability for the disputed items.
The insurer is entitled to validate the claim and establish the extent of its liability. The insurer’s request for sufficient evidence of ownership is reasonable and aligns with the terms and conditions of the policy.
AFCA has determined this complaint based on what is fair in all the circumstances, having regard to:
The respective parties have completed a full exchange of the relevant information, and each party has had the opportunity to address any issues raised. We have reviewed and considered all the information the parties have provided.
While the parties have raised several issues in their submissions, we have restricted this determination to the issues that are relevant to the outcome.
AFCA is not a court of law. We do not have the power to take or test evidence on oath, or to require third parties to give evidence.
When we assess complaints, we consider:
We give more weight to documents created at the time the events occurred. If there are no relevant documents, we will decide what most likely occurred based on the available information.
If there are conflicting recollections and these are evenly weighted, we may find that a claim cannot be established.
Benefit 14: Luggage and Personal Effects (page 59 of PDS)
Important Cover Conditions
…
If a claim relates to a mobile phone or device with phone capabilities, you must supply us the IMEI (International Mobile Equipment Identity) number. You must also block the IMEI number with your telecommunications provider
We will not pay (page 61 of PDS)
…
If the loss relates to a mobile phone or device with phone capabilities and you are unable to supply the IMEI (International Mobile Equipment Identity) number. You are also required to block the IMEI number with your telecommunications provider of the stolen or lost mobile phone or device. We will not pay if the IMEI has not been blocked.
