feigning injuries for insurance companies

On my first night in Los Angeles, my friend got into a small accident. She was driving a Uhaul, going 5MPH and trying to move lanes when she hit an SUV who had pretty much ignored her. It was difficult to figure out what the SUV lady was thinking because she didn’t speak any English. We called the cops who said that they would not send anyone unless there were injuries. There were none. The SUV lady wouldn’t exchange info with us and kept calling someone and it was clear by her movements that someone who spoke English was coming. Eventually, her granddaughter showed up and explained that her grandmom didn’t speak English. Duh. The granddaughter exchanged insurance and contact information with my friend. Everything seemed fine – a dent on the SUV and a damaged bumper on the Uhaul but no one was hurt.

Today, my friend got a call from one of the insurance people who asked her to go through everything. She explained what happened in great detail. They asked why there was no police report and she explained that she’d called the cops but they only come when someone’s hurt. They asked so no one was hurt? And my friend was like no. And then it became obvious that the woman had filed injuries. WTF?

Having seen the woman and the car and having hung out with the woman for a good 20+ minutes waiting for the granddaughter, there’s *no* way that there were injuries. No possibility of whiplash and it was the passenger side. She wasn’t holding on to any part of her body and her granddaughter said nothing. Everything was normal, even if we were all a bit frazzled.

But then i started wondering, what’s the cost of reporting injuries? I mean, if she succeeds in declaring injuries, she gets money even if she’s lying, right? But what does she lose if the insurance company shows she’s lying? Are there any costs to lying when it comes to insurance? My moral fabric is horrified by the idea but then again, i return pens when i stole them from stores after signing credit card receipts. I cannot imagine lying to get more money from insurance. Of course, everyone thought that i should sue this person and that person after my neck accident. But it was an accident – i couldn’t ethically feel good about lying even if it cost me an arm and a leg. Yet, for others, is there any reason not to lie? What happens if you get caught lying to medical insurance?

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14 thoughts on “feigning injuries for insurance companies

  1. Francis Storr

    Are there any costs to lying when it comes to insurance?

    Yep – it puts the cost of everyone else’s premiums up. Sure you might have defrauded your insurance company, but everyone else suffers in the long term. If you get caught there is a very large chance you’ll be forced to pay the money back to the insurance company. Oh, and insurance companies do talk to each other, so if you get caught defrauding one, you may have issues getting covered with other companies in the future.

  2. Dare Obasanjo

    There are definitely condequences to lying on an insurance claim given that insurance fraud is a crime. Anyway, rule #1 of getting involved in an accident is to always call the cops. I’ve also learned the hard way that just because a person seems nice when during the incident doesn’t mean that there won’t be problems later on.

    PS: Is your friend a doctor and if so did he/she examine the alleged victim? If not, how does your friend know that this lady wasn’t hurt during the accident?

  3. Dossy Shiobara

    Dare’s right: even if no symptoms are obvious immediately after the accident, it doesn’t mean there isn’t an injury. That’s what makes the line between “real injuries” and “insurance fraud” so blurry.

    If you suspect the other party is exaggerating the injury claim, speak to your OWN insurance company’s representative indicating that you suspect possible insurance fraud … and try to get a medical report that identifies the injury. I’m not sure who the burden of proof lies with to show that it wasn’t a pre-existing condition (i.e., wasn’t caused by the accident), though.

    I definitely think insurance fraud might go away if it carried a mandatory prison sentence. If I have to subsidize insurance fraud, I’d rather do it by paying taxes to put people in prison than through higher auto insurance premiums, if I had the choice, you know?

  4. zephoria

    We definitely did call the cops. The other lady wouldn’t talk to the cops and the cops wouldn’t come because there were no injuries. I’m sure it will be worked out though because when their insurance called my friend, she explained the cop-calling part before they told us that the other lady was claiming injuries. The other lady never called the cops and we explained to the granddaughter that we called the cops but they wouldn’t come because there were no injuries. So the English-speaking granddaughter definitely heard us say “no injuries.”

    It just makes me frustrated because, like y’all, i hate subsidizing insurance fraud but i don’t think that’s a deterrent for people lying.

  5. Mano Marks

    I once had a minor accident that later turned into a huge hassle. Initially, neither of us wanted to work with insurance companies, but when she later told me of numbness in her fingers, I quickly called them up. I didn’t think I was going that fast, and gave my statement to the insurance company. 3 years later, after I forgot about it, I got a call from my insurance company telling me they had just settled. They thought there was probably no real injury, but it was cheaper for them to settle than go on.

  6. Si

    I’ve been the person who “looked fine” after someone opened his door into my right fender when I was going about 20mph down a narrow street. We exchanged information, and I stated and believed that I was fine right after the accident. As the evening wore on, I began having sharp shooting pains between my chest and neck. It took about 2-3 hours for the pain to manifest in then 27-year-old me – adrenaline and shock will do that – and by the morning I couldn’t turn my head. It’s quite possible something similar happened to the elder SUV lady. Even with insurance-paid therapy (chiro, massage, and acupuncture) I had neck problems for years after.

  7. Mark Federman

    Boy do I sympathize with your friend. I had an incident a few years ago in which a person jumped out of a taxi in the middle of the passing lane on a four-lane road and bolted to the sidewalk, and ended up on top of the hood of my car. My peripheral vision and reflexes happen to be fairly good (thank God) and the person merely slumped to the road, got up and continued his sprint to the sidewalk. I pulled over, called police and paramedics. The paramedics checked the bozo and confirmed there were no injuries. The bozo refused to go to hospital for any xrays or other checkout. The investigating officer said that (1) I must have exceptional reflexes, and (2) beside that, I must have been going relatively slowly, since the absence of injuries for such an accident demonstrated that I was not at all at fault. (The cop apparently was a 20-year veteran of accident reconstruction, and said that if I had been going anywhere close to the speed limit, the guy should have been dead, or at least severely injured. Great.)

    Despite witnesses, the cop, the paramedics and all, I receive a letter from some sheister lawyer accusing me of all sorts of negligent malfeasance, and claiming the most incredible recounting of injuries and consequential crap that you could imagine. I had reported the initial incident to the insurance company, with the details of all who attended and witnessed, so when the lawyer’s letter came in, I just sent it off to the insurance company. The adjuster shrugged it off, said it wasn’t unexpected, and chalked it up to the car accident “victim’s” lottery. They settled, paying the guy something, and (glory be) I wasn’t faulted on my policy.

    Call me mean-spirited, but I can envision a so-called reality show in which insurance fraudsters are forced to re-enact the accident, incurring the real injuries that they falsely claimed. Perhaps a sequel to the Rod Serling classic series: “You are now entering… The Insurance Fraud Zone!”

  8. Loaf

    This sort of thing drive me round the twist. there are costs to people doing this, but only if they are caught. What they are doing is a crime, but also an affront to a sense of fair play.

  9. Christian Toennesen

    Gosh, reading this I understand why there is one lawyer for every 35 people in the US. Sad, really, that such a culture of dishonesty and fraud seems to have emerged. Even sadder, perhaps, there appears to be no simple way of getting beyond it.

  10. ingo

    It appears that the willingness of people to lie to insurance companies is due to the (alleged) tendency of them not to pay when they should’ve (morally) because of some loophole in the contract. Sort of a “getting back at the immoral company” thing. Of course, it is quite short-sighted and often hurts other people instead.

    That aside, I always call the cops ever since someone tried to get 3.000 DM ($1,500) out of me for a scratch in the bumper. Luckily, in Germany they come regardless of whether there is an injury or not. I once called them in front of the hospital 😉

  11. Matt

    First of all, as was mentioned above, insurance fraud is a crime. And if you think frivolous lawsuits are driving up your insurance bills, just remember that insurance companies will often litigate the hell out of cases in which their clients are clearly at fault.

    Secondly, there’s no way to know whether or not that woman was truly injured barring a medical exam. I know it sounds contrary to common sense, but even a very low-speed accident can cause serious injury. And that injury is not always apparent immediately after the accident. I know it sucks to have a relative minor accident and then have to go through an ordeal with the insurance company, but if you were actually injured, you wouldn’t want people to discount your injury based on what they thought about the frequency of insurance fraud.

  12. Brody_the_Bulldog

    Yeah, well – my car recently got wrecked while it was parked outside my place. Some guy in a uHaul fell asleep and mashed into 3 parked cars.

    I called uHaul to file a claim with their insurance, and of course, they’re refusing to pay for it. One of the reasons given – you guessed it – there’s no personal injury. Apparently, dealing with property damage claims just isn’t worth their time…

    Obviously, I never thought personal injuries would be beneficial – but it seems to be the key to recovering anything at all. Sad… but (in my case) true…

  13. Kari

    On the other side, the people who file fraudulent claims make it hard for people who actually do get whiplash injuries. I was rear ended by a huge truck while sitting at a stop light. I had no health insurance, so I was sent to the insurance company doctors. The physical therapy made me mobile but it increased my pain 3 fold. Now it is four years later, I am still in incredible pain from the car accident, and there are some days I can hardly walk. The insurance company refused to pay all my medical bills, much less anything for pain and suffering. It angers me because I have not had a pain free day since that accident, yet I know people who’ve gotten in similar situations and walked out feeling fine and with $20,000 in pain and suffering money. It didn’t help me that I had a terrible lawyer either. Now hat I’ve had health insurance for the past two years, I can prove that I’m in absolutely agonizing pain, but since the accident was 4 years ago and I had to settle before the statute of limitations was up, there isn’t anything I can do.
    Because of this I absolutely hate people who get away with insurance fraud. The insurance company probably thought that’s what I was doing, but my family and friends can testify my agony continued even after my pathetic $7500 settlement to cover $12,000 in medical bills.

  14. H

    I came off my motorbike as a result of a bus driver. At the time, I didn’t feel any injuries, in fact only hours later did I get headaches. Shoulder and lower back pain came 24 hours later.

    I thought I was dying, because of the headaches (brainbleed). I asked the doctor why the pain came a day later. He said it was normal in many cases for the pain to come later. Apparently adrenaline and the fact that inflammation can take time is the reason.

    So it is quite possible that someone can suffer injury even though they seem OK at the time. Actually, someone I know died after coming off his bike from internal bleeding in the mid section. He was examined by the hospital who gave him a clean bill of health, said it was nothing to worry about.

    Also, a lot of police motorcyclists have told me that a rider can feel OK, but it is worth inisting on an ambulance. Apparently, a few bikers who feel OK will die on the way to hospital from what appear to be only superficial injuries following a minor low speed accident.

    Don’t be so quick to judge this woman. She was old as you said, so her body has lower tolerances than yours.

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