VIC Insurance Claim Investigation

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DMLegal

Well-Known Member
28 May 2018
187
33
514
How obvious is it that the information was false? Did it entail damage to an item that didn’t happen or a lost item that was never owed? Either way in my three years working for an insurer I never seen a claim referred to Police. It is just policy that claims cannot be withdrawn by claims managers while they are with investigations. Nothing unusually really
 

Sam45

Active Member
21 June 2018
7
0
31
How obvious is it that the information was false? Did it entail damage to an item that didn’t happen or a lost item that was never owed? Either way in my three years working for an insurer I never seen a claim referred to Police. It is just policy that claims cannot be withdrawn by claims managers while they are with investigations. Nothing unusually really

It is very obvious, but it was actually lodged not for the intention of proceeding with a claim. Without going into huge amounts of detail, it was research for a new technology solution for the insurance industry. Unfortunately I was unaware that a request to withdraw can be rejected and this may end up affecting me personally, which is my concern. May I ask if you work for an Australian insurer?
 

DMLegal

Well-Known Member
28 May 2018
187
33
514
Ah, was the Policy less than 1 month old when you lodged the claim? Yes I did work for an Australian insurer, two of them actually.
 

DMLegal

Well-Known Member
28 May 2018
187
33
514
Any claim lodged within 1 month of a policy being taken out is always, no if's, but's about it, referred to investigations for review. Its automatically done by the system and no claims manager can change it or touch the claim after it has been referred. You cannot, and neither can the claims managers, speak with investigations unless they contact you first and they typically take about 1-2 weeks just to look at it. To prove any criminal charge part of the offence is that they need to prove you attempted to obtain a benefit, that would be a stretch if the claim is only at lodgement. Don't stress about it, either investigations will contact you (don't reply to them, they will give up eventually and withdraw the claim) or the claims manager will contact you once it is released from investigations (you can speak with them to withdraw the claim). There is nothing you can do at this stage to have the claim withdrawn, just wait, even though I know its stressful.
 
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