05/31/2019

The things fraudsters do

Sometimes claims fraud is obvious, indisputable evidence lands on your desk and defeating the claim becomes just a matter of time. 

However, the majority of claims fraud is not obvious and a focused investigation is required. Those committing and those enabling claims fraud, be it organised or opportunistic, put up a fight to try and convince you that a compensation payment is deserving.

Securing indisputable evidence of fraud may be rare, but it makes all of the effort put into the investigation worthwhile. 

Here are a few of our favourite ‘gotcha!’ moments from the past few months:

1.  The claimant who alleged his holiday was entirely ruined due to holiday sickness but forgot he had documented the entire (illness free) holiday on social media.

2.  The claimant who alleged she was unable to work following an accident at work was caught out when the agency she registered with sent her CV to her employer as available to cover her own shifts.

3.  The claimant who denied having any relevant photographs to support her claim despite having a number of images available on Facebook. The claimant later deleted the images to try and bolster her claim, but sadly for the claimant, the photographs and subsequent deletions were all captured.

4.  The claimant who alleged he was unable work or return to his hobbies caught cage fighting.

5.  The claimant who was proven to be in a different country when the accident at work was said to have happened.

6.  The claimant who denied knowing the driver of the other vehicle or having seen the vehicle before. The claimant was the previous keeper of the other vehicle.

7.  The claimant who lied about sustaining a back injury at work was caught out when his medical and ambulance records were obtained which confirmed his back pain had started spontaneously.

8.  The claimant who falsely claimed her back pain was whiplash following the RTA was undermined by her social media posts about the injury she had sustained as part of an intensive fitness exercise regime.

9.  The claimant who alleged he was struck on the head and sustained injury when the pub shutter closed unexpectedly. The CCTV footage however confirmed he was nowhere near the shutter door when it closed.

10.  The claimant who claimed that she tripped on flooring, supported by evidence from her son-in-law. However, the 999 call recording captured the son in law stating she'd fallen from a stool while adjusting net curtains.

11.  The claimant who alleged her vehicle was damaged in a RTA, however when the vehicle was inspected at the storage facility, it was found parked next to a JCB which had bucket claws that perfectly matched the damage sustained to the vehicle. There was no other damage.

Conclusion

These claimants all failed in their attempts to defraud a compensator. This was achieved by detecting the fraud at an early stage, setting a robust defence strategy and thorough investigation. It remains to be seen if these claimants will try again one day. 

Fundamentally Honest blog