As RDJ head of Insurance Fraud and in collaboration with Insurer clients I have had oversight over many successes before the courts in fighting fraudulent claims, many of which go unreported.
It can be argued that the tide is certainly turning in the ability to defend such claims with the introduction of stronger statutory provisions making fraudulent behaviour in civil claims a criminal offence. Recently the Courts have increased the armory available to defendants, allowing discovery of post-accident medical records, and awarding both costs orders and cost differential orders in the
Lastly, yet not to be underestimated, the media holds a powerful role in the fight against insurance fraud.
Last week, I acted for
The Facts
It is important to note that this was not a low velocity impact collision and whilst airbags did not deploy, the matter was proceeding by way of assessment only, as it was accepted that a credible injury could have been sustained by the Plaintiff.
In 2021, the Plaintiff's Solicitor issued a motion to transfer the Plaintiff's claim to the
The Plaintiff had trained as a Beauty Therapist prior to the accident, albeit she had never been employed as a therapist until 3 weeks post the accident. She was working over 35 hours per week in 2019, at which point she alleged her injuries became so debilitating that she had to stop work. She received Illness Benefit for a period and thereafter qualified for Disability Allowance, which she was still receiving when the matter was listed before the
Until the case opened, the Plaintiff was alleging that as a result of the accident she required 4 hours of home care per week and that she would never work again and was therefore maintaining a future loss of earning claim in excess of €500,000. Her total claim for Special Damages amounted to in excess of €700,000, a figure which the plaintiff had verified on affidavit.
The court heard that the plaintiff was a 36 year old woman who was now undergoing injections every 6 months as a result of her injuries and who had engaged a number of medical experts in support of her claim including a GP, Orthopedic Surgeon, Neurosurgeon, Radiologist, Pain Specialist, Vocational Assessor and an Actuary.
There was no doubt but this was a case where there was significant risk to the Insurer should the Plaintiff's experts and her evidence be accepted. However, evidence had been obtained of this woman undertaking a physical act that most of us could not do, even in the fullness of our health.
A photograph, published by the Irish Independent on the 8th January, 2018, had shown
Just two days later the Plaintiff had attended a medical expert at which she had said she was in constant pain in the base of her neck and thoracic spine. She reported discomfort lifting heavy shopping, reaching overhead and difficulty sleeping. She reported that she cannot play a lot with her children, cannot kick a ball or swim with her children.
Furthermore, surveillance undertaken in 2023 was shown to the court of her partaking with her Dalmatian in a dog training session for 1.5 hours. The session was physical, active and showed her having the physical capacity to grapple with the dog, bend, stretch and constantly wrestle a thick rope toy from the dog's mouth without difficulty.
In light of the evidence available to the defence team, this was undoubtedly a case we felt we had to run to trial, however to do so still took courage by
The case ran and was ultimately dismissed by Ms.
Whilst it was disappointing that the Court made no recommendation of a referral to the DPP,this is not required in order for the matter to be investigated by the Gardaí under the Civil Liability and Courts Act, 2004. Just this week, the fraud prevention provision under this Act had its teeth significantly sharpened, after Judge
The widely publicised "Christmas Tree Case" coupled with the news of this criminal prosecution must surely now serve as a significant deterrent to any of those claimants pursuing fraudulent or exaggerated claims.
A custodial sentence is not something one would like to find wrapped up underneath the Christmas Tree!
Picture: Eamon Ward Photography
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.
Ms
Cork
Tel: 214802700
Fax: 214802790
E-mail: linda.kelleher@rdj.ie
URL: www.rdj.ie/
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