THEhe insurer cannot be satisfied with asserting that his insured has made a fraudulent declaration, to refuse to guarantee him a burglary. He still has to prove it, as the following case reminds us.
On August 18, 2015, Mme X declares to Allianz a burglary with break-in, perpetrated the same day at his home, in the 3e district of Paris. On August 19, 2015, she lodged a complaint with the police station and produced a list of 59 stolen objects (in addition to cash), which she specified was not exhaustive, because she had not yet put away all her items. business. On November 2, 2015, she provided an additional list of 37 stolen items, bringing the total to 96.
On February 16, 2016, Allianz refused to guarantee the burglary. He invokes the general conditions of his contract as well as Article L 113-1 of the Insurance Code according to which “ the insurer is not liable for losses and damages resulting from intentional or willful misconduct on the part of the insured ”. He accuses Mme X for having made a fraudulent declaration.
The insurer accuses Mme X for having presented him twice the same invoices for luxury items (Chanel shoes and Hermès scarves): the first, in 2014, after the theft of his suitcase, which he had taken care of and the second after the burglary. He also accuses him of having sent him, in November 2015, three months after the incident, an additional list of 37 objects “ allegedly Stolen. He considers that she should have noticed their disappearance much earlier. He concludes that she made a false declaration, in order to obtain compensation to which she was not entitled. Mme X seized the insurance mediator, but the latter replied, on January 31, 2017, that “ the false declaration is true “…
Mme X therefore sues Allianz before the Paris tribunal de grande instance, in order to obtain the sum of 60,000 euros, to which she considers she is entitled, by virtue of her contract. On July 9, 2019, it was dismissed, the court ruling that the establishment of the complementary list and the existence of duplicates in the declarations of stolen goods constitute a “Bundle of signs of fraudulent intent “.
“Totally false assumption”
Mme appeals, arguing that Allianz does not provide proof of this fraud. Concerning the establishment of the complementary list, the Paris Court of Appeal notes that “The tribunal started from the totally false assumption »Following: the firm Elex, mandated by Allianz to assess the compensable amount of the first 59 stolen objects, would have, on October 27, 2015, estimated that this amounted only to “7,760 euros “. Mme X, who would have taken note of her report (which she disputes), “ would have decided to (artificially) complete his list “, in November 2015, “To increase the compensation to 111,234 euros “.
You have 44.79% of this article left to read. The rest is for subscribers only.