02 may 2024, 14:04

FOS recovers insurance benefit following charge-off of insured card as a result of fraudsters’ actions

A financial institution refused to pay an insurance claim in connection with the debiting of funds from the bank customer’s card as a result of fraudulent actions. The victim appealed to the Financial Ombudsman, which recovered the amount stipulated in the insurance contract in her favour.

A resident of Yoshkar-Ola applied to the financial institution with documentary evidence of an insured event after fraudsters had debited funds from her insured bank card. She requested the insurance indemnity provided for, but the payment was refused.

Financial Ombudsman Denis Novak found that an insurance contract had been concluded between the applicant and the financial institution and that the list of insured events did include the transfer of funds from the policyholder’s account(s) by the policyholder or the holder of the insured bank card as a result of unlawful actions of third parties, qualified by the competent authorities as fraud (Article 159 of the Criminal Code) or theft (Article 158 of the Criminal Code).

The victim contacted the police and reported that she had received a WhatsApp call from a number that looked like a major bank’s official number. An unidentified person introduced himself as a bank employee and said that they were trying to apply for a loan in her name. The woman was convinced that money might be withdrawn from her accounts. Further, other unidentified persons connected remotely and conducted monetary transactions with the help of the account owner.

As a result, 100,000 roubles were withdrawn via an online banking application and the account was closed. Funds were received on the woman’s card at another bank and transferred to an external account on the same day. All the write-offs were confirmed by the bank. It follows from the criminal case file that an unidentified person, in an unspecified place, committed a secret theft from the applicant’s bank account. Thus, the fact of theft has been established by law enforcement agencies.

“It did not follow from the terms of the insurance contract that the policyholder, in order to realise the relevant risk, had to directly transfer funds from the insured card to the accounts of third parties as a result of their unlawful actions (from the insured card to the unidentified person’s card). The insured event under this risk is the occurrence of losses due to transfer of funds from the insured bank card as a result of unlawful actions of third parties. Consequently, the insured risk has been realised and the claim for recovery of insurance compensation under the insurance contract is subject to satisfaction,” Denis Novak pointed out.

Copy link