Insurance Fraud

Normally when you see headings like “insurance fraud”, you think of unscrupulous plaintiffs claiming they have been in a road traffic accident when they have not. Or you think of people who have been involved in an accident and then grossly exaggerating their claims. You don’t often think of insurance fraud referring to the insurance company.

THE THREAT

Let me therefore highlight a particular case I have just finished with. This case involved a client who had been seriously injured and the insurance company made it clear that they felt that the plaintiff was grossly exaggerating his symptoms. A week before the hearing, in breach of all the regular rules, the insurance company sent a notice stating that they intended to call three private investigators. At the same time they said they were no longer prepared to settle this case in line with an offer they had previously made.

Obviously I was then very concerned that my client had misled me and that the insurance company had some damming video tape evidence that would win the case for them.

HONEST CLIENT

When the case came up for hearing, the client, incredibly bravely, stood his ground and would not accept all the legal advice about the figure he should accept and instead said he had nothing to fear and he was not exaggerating anything and they could have no evidence against him. The case went ahead and the insurance company did not call any private investigator evidence and in fact had no private investigator evidence. They will say that this was an attempt to bluff us into a settlement and that it is just part of the negotiating process.

FRAUD

I call it fraud. I call it insurance fraud. All you ever hear in the media is of the poor unfortunate insurance companies having to pay out fortunes in legal costs and of unscrupulous claimants inventing road traffic accidents so as to make money from insurance companies.

If this had happened the other way around and the plaintiff had been found to be deliberately misleading the other side, a file would probably have been sent to the DPP’s office to consider a criminal prosecution. I do not see why it should be any different where it is the insurance company who commits the fraud.

Kevin Brophy

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