Question
You are a claims handler for a household insurer. One of the insurer's policyholders, Peter, has a home insurance policy covering buildings and contents. Peter
You are a claims handler for a household insurer. One of the insurer's policyholders, Peter, has a home insurance policy covering buildings and contents. Peter has recently submitted a claim for fire and smoke damage, following an electrical fire in his kitchen. The electrical fire occurred three months ago. Peter's claim is for a new kitchen, as well as items of contents. Peter's nominated contractor has already replaced the kitchen. The fire damaged kitchen units, worktop and appliances have been disposed of, as have items of smoke damaged contents. The newly installed kitchen has state of the art equipment and appliances. You are concerned that the claim, as presented, has potential fraudulent indicators and have referred it to the insurer's fraud department for investigation. (a) Explain, with justification, four actions the fraud department need to take to determine if this claim is valid. (12) (b) Explain two potential consequences for the insurer if the fraud investigation experiences a delay in reaching a conclusion. (8)
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