Allianz ROSNO Life Prevents Fraud for 7 Million 840 Thousand Roubles
OREANDA-NEWS. August 13, 2009. The citizen T. had purchased an accident insurance policy from Allianz ROSNO Life for the total insurance amount of 9 million 800 thousand roubles. Two months later, the client has filed an insurance claim under the risk "Disability due to accident" for the amount of 7 million 840 thousand roubles. The investigation conducted by the company’s Security Department and Loss Settlement Department proved that the client deliberately submitted false information about the occurrence of an insured accident and unlawfully demanded payment of insurance compensation, reported the press-centre of ROSNO.
The insured citizen T. told the Loss Settlement Department of Allianz ROSNO Life that 2 weeks after conclusion of the insurance contract he slipped, fell down, lost conscience and was sent to hospital with the diagnosis "Craniocerebral injury". Based upon the sustained injury, one of the branches of the Chief Bureau of Medico-Social Expertise for the city of Moscow had issued an expert resolution assigning 2nd disability category to the citizen T., whereof the latter provided relevant certificates.
In response to the request by the Loss Settlement Department of Allianz ROSNO Life to provide medical documents evidencing the injury sustained after conclusion of the insurance contract and confirmation of subsequent hospital treatment, the citizen T. gave vague explanations, referring to his memory loss. At the same time he presented certificates issued by various medical institutions and containing reference to the injury he had allegedly sustained.
The investigation conducted by the Security Department of Allianz ROSNO Life found no objective evidence of the claimed insured accident. The 2nd disability category assigned to the citizen T does not result from the allegedly sustained craniocerebral injury. Due to the absence of evidence of an insured accident in the documents submitted by the citizen T., the company notified the latter of its refusal to pay insurance compensation. Based upon the fact of deliberate provision of false information about an insured accident and the attempt to receive insurance compensation on the basis of this information, the company has notified the law enforcement authorities about the attempted fraud.
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