The Situation Explained

A claimant insisted that his not-roadworthy vehicle failed to start after being driven through copious amounts of water. The insurance company, however, rejected the claim. After obtaining an expert's report, they found no sign of water damage to the engine.

Scrutiny by the Insurance Company

IAG, the insurer, carried out an intricate investigation, enlisting the technical skills of a mechanical and data forensic expert. The expert found no signs of water ingress in the engine bay. Instead, the overall mechanical health of the vehicle drew concern, being flagged as unroadworthy with a faulty cooling system and signs of overdue servicing. More defects were noticed, blatant ones which should have been apparent to the car owner. They found efforts had been made to fix these defects as well.

Findings Concluded

The claim was further opposed by a diagnostics and repairs expert who identified a faulty ignition switch and signs of general wear and tear, independent of water damage. On July 4th of the previous year, the claimant alleged that his vehicle encountered water on the road, causing failure. Coverage of the policy included accidents, flooding, and storms.

A Differing Narrative

Meteorology data showed heavy rainfall on July 5th, but the insurance investigator uncovered that the incident occurred on July 4th. Further contradictions arose when the claimant stated that the car was in perfect condition prior to the incident, unware of any missing parts, ruling out the possibility of oil or water leaks, or any issues with the head gasket. These opposing narratives raised questions about the legitimacy of the claim.

The Final Verdict

The AFCA upheld the investigator's conclusion that substantially refuted the claimant's account of the incident, although it didn’t side with the insurer’s claims of suspected fraud. The AFCA ruled that “The insurer provided limited information to establish its allegations of fraud or that the claimant had not been truthful and frank.” As a result, all records indicating any allegations of fraud had to be removed by the insurer.

To summarise, this cases serves as a powerful reminder for insurance policy holders, of the importance of transparency and taking proper care of their vehicles. A careful examination of the evidence and professional expert opinions allowed AFCA to validate the insurer’s determination to reject the claim for water damage to the car.