When you make an insurance claim, insurance companies usually engage a loss adjuster to report on the circumstances of the claim, and to estimate how much it would cost to fix the damage. Loss adjusters are the hands and feet of insurance companies. There is nothing unusual about having one involved in a claim.
The situation is different with a private investigator. If the insurer has engaged an investigator (either an in-house one or a private one), that indicates that the insurer has some suspicions about the claim. It might be that they suspect you have made up the claim (perhaps claimed for items that were not stolen or damaged), or they suspect you lied about the circumstances in which the loss happened (for example, who was driving the vehicle at the time of the accident).
What happens when an investigator is appointed?
The investigator will want a recorded interview with you. They will also give you a notice warning you that, based on your answers, your claim might be declined, and your policies cancelled. Naturally, this gives rise to fear and anxiety.
So, are you allowed to refuse to speak to an investigator? In theory yes, but in practice no. An insurance company is entitled to ask questions about the claim, and if you refuse to provide the information needed, they can decline the claim. So, while in theory you might be able to refuse to speak to the investigator, the insurer will simply decline the claim for lack of information.
Know your rights
However, you are entitled to a fair process. We have seen private investigators asking for information they are not entitled to or going beyond the scope of their duty. We have been engaged in cases where the private investigator omitted to inform the person prior to the interview that they are entitled to a support person or a legal representative. And when the person raised the valid question “What’s the point of you telling me now as we are about to start?” the investigator reported to the insurer that the person who was interviewed was defensive and uncooperative, which led the insurer to decline the claim. In that case, the Insurance Ombudsman found that the private investigator’s report significantly misrepresented the information received in at least five respects and this resulted in a poor decision by the insurer. So, care needs to be taken when speaking to a private investigator.
Please read our article on the importance of providing correct information when making a claim. https://gaborlaw.co.nz/2023/03/03/insurance-claims-declined-for-dishonesty-can-have-long-lasting-consequences/
If you are concerned about an investigator being appointed on your claim and you require assistance, contact us at www.gaborlaw.co.nz/contact for a discussion.
