What to Know About Personal Injury Claim Fraud
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What to Know About Personal Injury Claim Fraud

Personal Injury ClaimPersonal injury claim fraud can result in significant consequences. Not only might your insurance carrier refuse your claim, but you may have to pay back any money awarded to you, and you  might even be charged with a crime.

Continue reading to learn about personal injury claim fraud and how working with experienced injury lawyers can help ensure your claim is properly filed and pursued.

What Is Personal Injury Claim Fraud?

Personal injury insurance fraud is generally described as any conduct meant to cause an insurance provider to reward you for an injury that is fictitious, misrepresented, or unconnected to any accident covered by your insurance policy.

You do not have to lie or make material misrepresentations in your claim to still be held accountable for personal injury insurance fraud in some circumstances. For example, you could be responsible for filing a false personal injury claim if you forget to disclose certain facts of your case that are legally mandated to include. The law pertaining to personal injury insurance fraud in Massachusetts and New Hampshire does not make concessions for a lack of intent to defraud your insurance company.

Types of Personal Injury Claim Fraud

There are generally two types of personal injury insurance claim fraud:

Soft Fraud

Soft insurance fraud, also called soft fraud or opportunistic fraud, is generally considered the most common type of personal injury claim fraud. Soft fraud occurs when a covered individual has a legitimate accident or injury but exaggerates their condition or otherwise makes an inflated claim. Claiming damages beyond what losses you’ve actually incurred is a form of soft insurance fraud.

Hard Fraud

When a policyholder fabricates a means to file an insurance claim entirely, this is known as hard insurance fraud, sometimes known as hard fraud or premeditated fraud. This form of personal injury insurance fraud generally requires advanced planning, like staging an accident and faking an injury on purpose.

Consequences of Personal Injury Claim Fraud

The consequences associated with personal injury claim fraud can be severe and life-changing. You could face one or more of the following:

  • Claim denial. The best-case scenario after submitting a falsified injury claim is the denial of the claim. In this case, your insurer will not reimburse you for any damages you incurred that are related to the fraudulent claim.
  • Policy cancellation. Your insurance company may choose to drop your coverage if you file a fraudulent personal injury claim. Even insurers who you did not make the false claim against can deny you coverage if they find out you made a fraudulent claim with another insurance provider. This information is readily available to insurers in every state and most companies regularly check for changes in this information for their policyholders. The majority of insurance contracts allow the carrier to cancel coverage with no notice if it is determined that you were involved in a fraudulent personal injury claim. Once this information is on your driving record, you will likely have extreme difficulty finding an insurer who will cover you in the future.
  • Revocation of settlement award. If you were awarded a settlement from a fraudulent personal injury insurance claim, the insurer may require you to pay back the money you were given. If you are not able to pay the money back, your insurer can sue you for what they paid you, plus the cost of investigating the fraud and court costs. A judge may also decide to award the insurance company punitive damages, which are extra fees to punish particularly egregious behavior. Punitive damages can be excessive, sometimes doubling or even tripling the overall settlement you will have to pay the insurance company. If you lose in court and cannot pay, the insurer may request that a lien be placed against you. This means you may not be able to sell or profit from some of your assets without first settling your debt with the insurance company. Your employment wages may also be garnished if your insurer obtains a lien against you.
  • Criminal charges. Filing a false personal injury insurance claim is a crime that can be punished as a misdemeanor or a felony depending on where you reside. The majority of false personal injury claims are considered misdemeanors. This is frequently the case if you only exaggerated your injuries or lied on your claim. Insurance fraud that results in the damage of real property or assets can lead to a felony charge.

Get Help With Your Personal Injury Claim From Experienced Lawyers Mazow | McCullough, PC

The cost of being flagged for personal injury claim fraud is high. Ensure your claim is filed properly with the help of an experienced personal injury lawyer.  Call today for your consultation by dialing our Salem, MA office at (978) 744-8000 or toll-free at (855) 693-9084.

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