MOTOR INJURY
False Report
A husband and wife team were handed down suspended prison sentences after they attempted to defraud an insurance company of €250,000 by falsely pretending the husband was driving a car that was involved in an accident resulting in damage to the car and injuries to his wife. Upon Garda investigation it was found that the wife, who claimed to be the passenger, was in fact driving the car at the time of the accident.
€2 million saved following Fraudulent Disability Claim
The claimant was involved in a motor accident and, after some years, claimed that he was completely disabled and was permanently confined to a wheelchair requiring full time care. Investigations revealed that the claimant was in fact not in any way disabled and that there was no physical reason for any disorder he claimed to have. The claimant withdrew his claim on the morning of the High Court hearing, the insurance company successfully pursued an order for costs and the case was concluded with a saving of €2 million.
GENERAL MOTOR
Motor Fraud – Flood Damage
A false claim was submitted to an insurance company from a policyholder alleging his BMW X5 jeep was written off as a result of flood damage. The claim was worth €45,000. The claimant had only third party cover on the night when he drove the jeep into extensive flood water. However, the following day he took out comprehensive cover and alleged that the flood damage took place three days after he secured comprehensive cover. He was assisted with his scam by a tow truck driver. Following the insurance company’s investigations, they referred the matter to the Garda Bureau of Fraud Investigation. Both men were convicted at Dublin Circuit Criminal Court of conspiracy to defraud and were sentenced.
Fraud Ring
Between 80 and 90 motor accidents were staged in the mid-nineties in the Midlands Region. A linkage to a local garage proprietor was identified and the matter was referred to the Garda Bureau of Fraud Investigations. Following extensive investigations, a fraud ring was uncovered. Among the methods employed for the staged accidents was the use of the scenes of recent accidents to show debris and oil and the exchanging of number plates with previously written-off cars. During the course of this long and detailed investigation, 1,294 statements were taken and 100 bank accounts were examined using court orders. In total 15 people were convicted – their occupations spanned a range of professions including company directors, a garda, a farmer and a car salesman. Prison sentences ranging from five years to 18 months were handed down.
PERSONAL INJURY
Exaggerated Injuries
A claim to the value of €80,000 was lodged following a single vehicle accident. The claimant was a passenger in a friend’s car. When this case was investigated it was found that although the claimant did suffer injuries, some of the injuries he was claiming for were in fact sustained in a separate subsequent accident seven months after the incident occurred. The claimant was exposed and the judge dismissed the claim in its entirety.
Personal Injury Claim
A customer in a take away shop made a claim after alleging that he had fallen after slipping on liquid on the floor. The shopkeeper saw the claimant pouring the liquid onto the floor. This case went to Court but was subsequently thrown out on the basis of evidence provided by the shopkeeper. The saving in this case was approximately €25,000.
Employer's Liability – Loss of Earnings
An employee, on the basis of a back injury, made a claim for loss of future earnings estimated at €225,000. The claimant maintained that he could not do anything as a result of the injury, including cook, clean, coach his GAA team, drive or undertake any work. The insurance company hired a private investigator who gathered evidence, including video surveillance footage of the claimant working both as a painter and singing in a band. No claim was paid.
HOME INSURANCE
Staged Burglary
Two separate claims for burglaries in the same geographic area amounted to €103,000. It was noted that both claims were very similar. When further investigated it was dicovered that the two claimants were good friends and it was proven that together they had staged their own burglaries. These cases were successfully prosecuted. One of the claimants was made pay €12,000 to the Court, which was distributed between charities in the local area.
Household Claim – Electrical Goods
A householder submitted a fraudulent claim for the loss of property on his household insurance, stating that a burglary had taken place. With the co-operation of a shop assistant in an electrical retail store, the claimant had created invoices for goods by replacing the original name of another customer on an invoice with his own name. The householder also obtained instruction manuals for the relevant electrical goods. The forged invoice and instruction manuals were presented to the insurance company in support of the claim. Following the insurance company’s investigations, it was decided to refer the matter to the Gardai for criminal investigation. The fraudster admitted that he had exaggerated his claim by €12,000 and in addition, although he had recovered items taken from his house during a burglary in 2001, he never informed the insurance company of this. At Dublin Circuit Criminal Court he received a three year suspended sentence.
NON-DISCLOSURE
Non- Disclosure
Three claims were made in a three-month period following the inception of a motor policy. Upon investigation it was found that the insured had numerous previous convictions and outstanding charges, including road traffic offences which were not disclosed. It was also found that the incident circumstances as described by the insured did not tally. The claim was rejected and a saving of €45,000 was made.
A man obtained motor insurance with an insurance company. On the proposal form he completed to obtain the insurance, he had stated that he had no previous motor convictions. However, the insurance company received an anonymous tip off via the Insurance Confidential hotline that the man had several motor convictions. The insurer’s internal investigation team carried out further investigations, which finally resulted in the matter being passed to the Gardai. The individual was subsequently convicted for obtaining insurance by making a false declaration and driving without insurance. He received a four month suspended sentence.
