False Personal Injury Claim Arrests Following Nationwide Operation

Posted: October 10, 2014

Posted in: Personal Injury 

The City of London’s Insurance Fraud Enforcement Department (IFED) arrested 11 people across England last month in an operation targeting suspected false personal injury claims. 

The arrests come in relation to a ‘trip and slip’ day of action by the department, with over 60 officers involved in the operation. The largest claim under investigation is £200,000 for on-going medical treatment from a bus crash in Pakistan several years ago. 

Seven men and four women were arrested at homes in: Cleveland, Essex, Greater Manchester, Lancashire, Leicestershire, West Midlands and West Yorkshire. Additionally, a further four people attended police stations in London and West Yorkshire for interviews regarding allegations of fraud.

The police action was taken following referrals from insurers and the Insurance Fraud Bureau. The IFED now have 29 detectives working with 10 support staff and investigates around 300 cases per year, usually referred through the same insurance industry system. 

DCI Dave Wood, head of IFED, said: “[The] ‘trip and slip’ day of action marks a major step forward in our nationwide investigation targeting people suspected of trying to con insurers with bogus insurance claims”.

What is a Fraud in a personal Injury Claim?

Personal Injury Fraud is typically defined as any act or omission that is intended to result in a financial insurance benefit for an injury that is (or is now) non-existent, exaggerated, or unrelated to any accident covered by the policy. 

Claimants may be guilty of fraudulently filing a personal injury claim even if you do not lie or make false representations; if you simply fail to disclose information which you have a legal obligation to disclose, or which you should reasonably be expected to disclose. 

Common examples include faking or exaggerating injuries from an accident, or planning or facilitating destruction of property through theft of arson. 

What are the Consequences?

If you file a fraudulent claim for personal injury there may be significant consequences both in terms of financial repayment and criminal charges being brought. These include:

• Denial of award of Claim: There will be no financial benefit for a fraudulently filed claim and the party will need to bear the burden for the extent of the damage, exaggerated or not.
• Cancellation of Insurance Coverage: The financial institution may drop the claimant as a customer regardless of whether the claim was filed against the company. If a claim is held to be fraudulent most contracts permit the insurance company to cancel the policy without notice and the police holder is unlikely to obtain future insurance policies with a finding of fraud against them.
• Revocation of Settlement: Should an award have been made on a fraudulent claim, the financial institution will request the money be revoked. If this sum cannot be returned in full then civil action may be raised against the fraudulent party in excess of the costs accrued during the legal action and the investigation period on the case. Additionally, the insurance company may seek punitive damages, which are a financial consequence intended to punish the claimant. 
• Criminal Consequences: Depending on the extent of the fraud there may be criminal consequences, which may result in a substantial fine or, in extreme cases, jail time. A conviction of a crime would result in this being detailed on a criminal record under the name of the claimant. 

Since personal injury often occurs in a number of contexts, injury fraud can also have other negative consequences, such as the loss of a job, loss of employment benefits, and/or loss of additional insurance coverage.

With such wide ranging consequences that personal injury claims are completely true and without omissions, particularly with organisations like IFED stepping up investigations of fraud. 

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