Can an Injury Claim Become Fraudulent?
Written by Shawn Diederich on December 1, 2015
Most of us agree with the notion an accident victim should be fairly compensated for his or her injuries. Even when an accident is nobody’s fault, we purchase insurance to guarantee we receive compensation for such unforeseen events. Of course, there may be cases where individuals try and take advantage of the system by claiming non-existent or exaggerated injuries in order to receive compensation. While only comprising a minority of cases, such fraud in turn leads insurance companies to take a hard line against many legitimate injury victims.
What Constitutes a Fraudulent Claim?
One thing to keep in mind is an insurance company may argue a claim is false even if there was no intent by the accident victim to deceive. An insurer may deem a claim fraudulent simply because the victim inadvertently failed to disclose information that might be legally required or otherwise material to the case. That is why it is important for any insured person to read and understand their policy, including disclosure requirements, and seek advice from a qualified Florida personal injury attorney.
Beyond accidental omissions, many cases of alleged insurance fraud involve faking injuries or over-stating symptoms following a legitimate accident. Individuals may pretend to be in more pain than they really are or claim additional phantom injuries in order to get the insurance company to pay up. Some people see this as a “victimless” crime. Insurance companies certainly do not. An “exaggerated” injury is still considered insurance fraud.
What Are the Consequences of Insurance Fraud?
The most obvious result of filing a false claim is the insurance company will deny it. This means even if you were in an accident, if you exaggerate symptoms or fail to disclose required information, the insurer can deny the entire claim as fraudulent. The insurance company can also cancel your policy and report you to Florida regulators, which may prevent you from obtaining coverage in the future. And if you already received a payment or settlement, the insurer can seek a refund and possibly file a lawsuit against you.
In severe cases of insurance fraud—i.e., where a party stages an accident to recover insurance benefits—state officials may also pursue criminal charges. For instance, during a highly publicized 2013 investigation, Florida insurance regulators uncovered a massive “personal injury insurance fraud ring.” Officials noted these types of fraud cost “the state of Florida alone $1 billion a year, a loss that is passed along to consumers in the form of rising insurance premiums.”
Avoiding Insurance Fraud for Orlando Car Accident Injuries
Even if you do not intend to commit fraud, insurance company investigators may still go looking for it. And an innocent mistake or omission on your part can cost you thousands of dollars in compensation you are rightly entitled to. That is why you should always work with a qualified Orlando personal injury lawyer who will fight to protect your interests. Contact the Diedrich Law Firm, P.A., today to speak with someone right away.