How common are fraudulent claims?
Probably quite common, going by the number of claims received by local authorities for tripping on the pavement, for example. If they were all genuine, it should mean you would see someone falling down on the pavement nearly every time you went out!
Are only fraudulent claims not paid?
No! Claims are turned down because, on balance, the evidence does not indicate that the defendant was at fault, whether the claimant believed that to be the case or not.
Often there are a number of factors affecting the decision whether or not to pay a claim.
So when a claim is not paid it does not always mean that fraud was suspected, and so no offence need be taken by an unsuccessful claimant.
However, fraud is a possibility that claims-handlers always have to bear in mind.
What is a fraudulent claim?
There are four main kinds:
1. The claimant’s story is made up: the accident never happened.
2. The accident did occur but important facts have been left out, added in, or changed.
3. The story is basically true but the claimant’s injuries or other losses did not occur as a result of the accident.
4. The story is basically true, but the claimant’s injuries or losses are greatly
What can I do about it?
It is the claims-handler’s job to try to detect fraudulent claims, but the client can help by passing on information, for example:
• About the claimant, including previous examples of dishonesty,
• Any motive behind the claim,
• Any connection between the claimant and a witness,
• About the character of any witness,
• About the accident circumstances or location, which might raise questions as to the probability or even possibility of the accident occurring as claimed,
• About other factors causing the injury or loss,
• About the timing of key events, such as the claim being received a long time after the accident, or a short time after any defect or hazard was repaired.
Even before you receive a claim – take defensive action!
If you know someone has had an accident, and you think they may blame you or your business:
• Make detailed notes of what happened,
• Get statements from as many witnesses as possible,
• Take photos and measurements of the scene,
• Make sure any CCTV footage is kept secure,
• Keep any relevant documents such as inspections and repairs of any buildings or machinery involved,
• Get advice from your insurers, claims-handlers or solicitors,
• Give evidence to help someone else who is being wrongly blamed for an accident.
Finally, do try to be objective.
You may dislike a claimant, or have reasons to be suspicious, but the claim might be genuine! Whether it is or not, however, you may find the claimant is successful if there is not enough real evidence on your side. So do not be too unkind about your insurers, solicitors or the Courts if things don’t go your way, but see if there are any lessons to be learnt.