May 11, 2016

How Insurance Investigations Minimise Claims and Premium Increases

Insurance fraud and insurance investigations are on the increase, with claimants often overstating damages, and claiming for incidents that never happened. We become innocent victims when a third party sues us for excessive damages after a motor accident. Passing the problem to our insurer is one thing. Seeing increased premiums on our bank statements is another matter.


Major Fraud Categories We Are Up against

There seems to be no end to the imagination of the criminal mind. The following are among the major problems we face on the roads:

1     Contrived accidents in which the claimant deliberately causes a rear-end collision by stopping suddenly.

2      Fictitious accidents that did not happen, but claimants ‘prove’ using photos of staged incidents, and false statements.


3      Medical expenses that are overstated and fraudulent diagnoses for whiplash that is difficult to refute.

4     Claims for injuries to phantom passengers who were not in the vehicle at the time, but we cannot disprove.

Avoiding Staged Rear End Accidents and Minimising Claims

Maintain a safe distance. Be alert for collaborative tailgaters who distract you from what is happening ahead. Watch the brake lights immediately in front of you to see if they are working, but don’t assume they are. Take extra care in stop-start conditions in rush-hour traffic, and at roundabouts and intersections. On freeways, be alert for cars entering traffic and changing lanes.

Countering Claims with a View to Insurance Investigations

The insurance cases we prepare rest on facts, not suppositions. Try to note the severity of any injuries, whether anyone confirms they are or are not hurt, or accepts responsibility for the incident. The objective is to minimise claims and avoid increased premiums. Take photographs, and report the accident to the police. You are setting the stage for a court case that may follow.

What To Do When Claimants Begin to lie

This is a difficult situation to be in, especially if you were on your own at the time of the incident, or have no witnesses. In law, your hope is in discrediting witnesses to make your counter allegations more credible.

QLD Covert Investigations can help assemble a case, investigate things that do not seem right, brief your attorney, and appear as your expert witness in court. Call us on 1300 553 788 if you need assistance with insurance investigations.

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