Auto Insurance Claims: Injury claims appears to be fraud, Injury fraud, what do I do?


Question
At night about 2 weeks ago, I was about to exit a parking space when an Suva or Indian pulled along to the rear driver side of my car and double parked waiting for the spot. I thought everything was all clear and the Suva flicked it's headlights.  I almost completely exited the parking space when the accident occurred. I pulled over exchanged insurance information.  Everything seemed simple and straightforward, cars damaged but everyone's okay.  That was until I received a letter from their attorneys claiming damages, called my insurance and was told everyone in the other vehicle is claiming the need medical assistance.  Not a limp, scrap or any signs injury or pain.  What can I do besides forwarding the documentation over to my insurance provider?

Answer
The best thing you can do is to be available for your insurance company.  I have investigated fraud for insurance companies and it is a tricky subject.  The SIU department at your insurance company may get involved, but you can't force it.  Unfortunately, the reality is that many soft tissue injuries are 1) Subjective, meaning they don't show up on an X-ray and are based on what the victim verbalizes, and 2) Possible, even in low impacts.  There are too many factors for the average SIU or adjuster to evaluate in order to argue that the injury is fraud.  And I doubt you have the ability to argue it either, no offense.  They may be hurt, they will probably get a small injury settlement, but they will not get rich over this accident, trust me.  I agree it is suspicious, but proving they did it on purpose is hard, you know?  

Most of the time, if a soft tissue settlement is pursued, it is because a chiropractor or some other health professional has provided treatment at the direction of a physician.  If somebody goes to the doctor complaining of pain, the doctor will prescribe them pain medication or muscle relaxers (if the diagnosis is soft tissue strain or sprain), and then tell the patient if the pain persists to see a therapist or chiropractor to try and speed up the healing process.  At the end of everything, they might get $500.00 for their efforts, and the attorney and chiro will get everything else.  Don't let it get to you, just tell your insurance company your side of the story and be there if they need you.  I don't think the accident will be a big factor in your rates, but if you want to get an answer to that question for sure, the underwriting department at your carrier is the only place to get the answer.

I hope this helps!  Information is always free at Petty Details, LLC.  Look us up if you need more assistance.