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Personal Injury Claims Fraud – The Other Side of the Story

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Personal Injury Fraud

One of the many self-serving arguments trotted out by insurance companies to attempt to justify their recent astronomical round of hikes in motor insurance premiums is that we have a serious problem in this country with fraudulent personal injury claims and that the tab for this criminal behaviour has to be picked up by innocent road users.

A Case of an Innocent Accident Victim

Whatever about fraud perpetrated by personal injury claimants, a recent case which we concluded shows that insurance companies are more than willing to engage in morally reprehensible behaviour when they perceive that they’ll get away with it.

Mary* was involved in a serious two-car collision in which the driver of the other vehicle quite properly accepted full liability from the start, so the only question to be resolved was the level of compensation to which Mary was entitled for the injuries she had suffered.

Enter the “Friendly” Claims Handler

Within days of the car accident, while Mary was still very much in shock and distressed, as well as being seriously physically injured, she received a phone call from a claims handler employed by the other driver’s insurance company. The tone was one of friendship and concern – he really wanted Mary to get sorted out as quickly as possible with the minimum of fuss.

This initial phone call was followed up by several more, with all the traffic being one way. He then invited himself around to Mary’s home on no less than three occasions within a short number of weeks after the accident, at a time when Mary’s injuries were nowhere near having settled.

The brainwashing technique used was two-pronged. On the one hand, he impressed upon Mary how desirable it would be to get her payout as soon as possible so that she would have access to cash and could draw a line under the whole thing and move on. In tandem with this, he repeatedly told her that the driver of the other vehicle was an elderly gentleman who wouldn’t know peace until the claim had been settled (a shameful lie, of course – the other driver was entitled to a full indemnity from his insurer so it didn’t matter a jot to him when the claim was settled or whether the insurance company paid out one euro or a million of them).

Mary explained to the claims handler that she had a history of mental health issues and that this, coupled with the shock and trauma of the accident, meant that she had no confidence in her decision-making abilities and that she really didn’t know what she was doing.

Quick and Easy Money – “Let’s Get You Sorted”

Did this revelation prick the claims handler’s conscience? Au contraire: it appears to have galvanised him to move in for the kill. Within a few short weeks, Mary found herself with a settlement cheque for €12,000 in her hand and the claims handler’s assurances that she had done the right thing and had been well looked after ringing in her ears.

Fast-forward twelve months later to when Mary first contacted us in a sense of desperation. Still in significant ongoing pain from her injuries, it had become clear to her that she had been badly hoodwinked.

Hopeless Case – “Full and Final Settlement”

On the face of it, Mary’s case was hopeless: she had accepted a sum of money in full and final settlement of her personal injury claim. That the sum she had received fell well wide of the mark was unfortunate but immaterial to the enforceability of the settlement.

But when we heard the egregious circumstances involved in Mary’s case we felt that there were serious issues around her capacity at the time of accepting the settlement that made her situation different. More importantly, we predicted (quite rightly as it turned out) that the last thing that the insurance company would want was for a judge to get wind of what had gone on and that they would therefore quietly consent to Mary’s case being assessed by the Injuries Board (a completely illogical position for them to adopt where the case had ostensibly been fully settled a year previously).

Insurance Company Pay Up Full Value When Caught

The Injuries Board eventually assessed Mary’s personal injuries claim at €37,725, meaning that she ended up receiving more than €25,000 over and above the €12,000 sum that was supposedly meant to represent fair compensation in the eyes of the insurance company. The insurance company promptly paid over the balance without so much as a whimper of protest.

While this kind of behaviour by insurance companies is widespread, Mary’s story is extremely unusual in that it has a happy ending. In the vast majority of cases where unrepresented accident victims deal directly with insurance companies, they have absolutely no comeback when they eventually find out that they’ve settled their personal injury claim for well below its true value.

If you have questions about a personal injury claim as a result of this article, please visit our personal injury claims page for more information or call us on 1890 390 555.

* Mary (which is not our client’s real name) has approved the publishing of her story in the hope that it may prevent other accident victims from being taken advantage of by insurers.

John McCarthy

John McCarthy is a seasoned solicitor with almost 20 years of experience, specialises in personal injury and medical negligence claims, focusing particularly on high-value compensation cases. His extensive litigation experience spans Circuit Court, High Court and Supreme Court levels. John's practice involves a diverse range of cases, from personal injury and wrongful death to property damage, defective products, professional negligence and judicial reviews.


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