What is insurance fraud? - INSURANCE CONFIDENTIAL

Motor Injury

Suspended sentences for husband and wife

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...

Discovery of fraudulent disability claim saves €2 million

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...

General Motor

Driver caught out over 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...

Fraud ring in the Midlands

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...

Personal Injury

Backdated injury creates a bigger problem

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...

Customer sets themselves up for a fall

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...

Claim for future earnings lacks foresight

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...

Home Insurance

Staged robbery between friends

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...

Fabricated goods in household claim

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...

Non-Disclosure

Three false claims in as many months

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...

Obtaining insurance by false declaration

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...