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Suspected fraudulent personal injury claim


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I was involved in an incident (I would not term it an "accident") last month. As I was driving into the company car park, there was this HGV parked to my left. I stopped and then started slowly, and as I was passing the HGV, this guy climbs down from the passenger side of the HGV and lands on the passenger wing mirror of my car. I go forward and stop as I see him waving in my rear-view mirror. There is a parking attendant who informs me that the chap behind is yelling that I ran over him. I then park my vehicle and ask him if he is alright. He says he has hurt his back and leg, which I could scarcely believe as I was doing as little as 5-7 mph. He then goes away muttering "you don't get run over by a car every day". I call up the police the same day informing them of this incident. The officer asked me if there was any damage to my vehicle to which I replied there wasn't any. She says there is nothing the police can do as there was no damage to my vehicle and hence technically she cannot make a note of this.

This morning, I get a letter this morning from his solicitor for a personal injury claim. This has left me dumbfounded. OP claims he was fixing something on the side of his HGV, which he clearly wasn't. He then goes onto say that my wing mirror hit him with such force that my wing mirror came off, which is a blatant lie. He then accuses me of driving without proper care and attention and driving too close to him, which is again a lie, since it was him who was climbing down from the HGV in the first instance, that too as I was passing. He says he has suffered soft tissue injury, bruising and whiplash(to neck, back, left side). I am no medical expert but I cannot fathom such injuries can be caused by a car brushing past you at less than 10mph!

In the claims letter it mentions that he has not taken time off from work nor attend hospital but that he sought medical attention. He also has not undergone any physiotherapy or rehabilitation. He also did not deem it necessary to report this to the police.

My choices are that I speak to the parking attendant (as a potential witness) and try and get hold of any CCTV footage to dispute his allegations. I will then call my insurance company and tell them I strongly suspect this is a fraudulent personal injury claim. Why did it take him four weeks to file for personal injury claim in the first place, I suspect something fishy here. Hoping for advice from forum gurus.

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Hi There

First thing to do is report this to your insurance company. They will start investigations into the supposed injured party. Tell them what you have stated on this site and they will start to defend the claim. The parking attendant if more than likely involved in this claim and it would not surprise me that this is not the first incident of this nature that has occurred in this car park. Your insurance company can check this on the many registers and data that are shared between insurers for this very purpose. Your insurance company will request any CCTV images however; don’t get your hopes up of this materialising. Over the years, Insurance companies have cottoned on to the more obvious fraudulent claims activities so the fraudsters are trying different methods. Stand your ground with this one and make sure your insurance company is doing everything they can to reject the claim.

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as Tilly says contact your insurance, tell them everything relating to the incident including the attempt to report it to the police, did you get the officers name when you tried, if so include that aswell, try to be as specific as possible. did he physically climb off the hgv or jump from the cab??? cos that will amke a big differance aswell

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btw did you get the co name off the truck, if your feeling vindictive you could send a complaint to them

 

No I did not, but massive lesson learnt, nothing is as innocuous as it seems when it involves a pedestrian and a car...

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Unfortunately I am having to investigate fraudulent claims on a more and more regular basis.

 

As mentioned by TillyGT report the incident to your insurance company ASAP. They will be able to flag any potential claim made by the third party as possibly fraudulent, and they all have their own team of in house counter fraud accident investigators doeing the same as I do (although I work in the legal sector rather than the insurance sector)

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I'm also in a "suspected fraudlent case" and would appreciate some advice as my insurance company is NOT that helpful.

Accident happened Sept 29, 10. It's still in dispute with fault but it looks like my insurance company are going to give in and claim fault! The third party sort medical attention on Oct 1 with regards to an "injury" - soft tissue damage to neck and shoulders but there is no evidence currently to supoort this. In January of this year he filed an injury claim, which he filed just after he received his insurance renewal quote - due to the fact it hasn't been settled yet he has to pay the premium till it is - of £2747!

I have evidence that since the "accident" he has continued to work - waiting tables for several hours at a time, under gone an interview with the RAF (which I believe has a fitness test - he failed on the apptitude test), managed to spend 2 hours cleaning a drive way, 2 hours single handedly putting up a marque, completed a 6 mile power walk, not to mention games of cricket and football - all this is stated on his Facebook page - which I have copies. My insurance company aren't interested and said that if a medical report comes back saying he's injured then they will have to go with that and that they can't use Facebook as a reference.

Please help as I'm not getting much response from my insurance company!!! How do I go about proving his fraudulent claim?

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I'm also in a "suspected fraudlent case" and would appreciate some advice as my insurance company is NOT that helpful.

Accident happened Sept 29, 10. It's still in dispute with fault but it looks like my insurance company are going to give in and claim fault! The third party sort medical attention on Oct 1 with regards to an "injury" - soft tissue damage to neck and shoulders but there is no evidence currently to supoort this. In January of this year he filed an injury claim, which he filed just after he received his insurance renewal quote - due to the fact it hasn't been settled yet he has to pay the premium till it is - of £2747!

I have evidence that since the "accident" he has continued to work - waiting tables for several hours at a time, under gone an interview with the RAF (which I believe has a fitness test - he failed on the apptitude test), managed to spend 2 hours cleaning a drive way, 2 hours single handedly putting up a marque, completed a 6 mile power walk, not to mention games of cricket and football - all this is stated on his Facebook page - which I have copies. My insurance company aren't interested and said that if a medical report comes back saying he's injured then they will have to go with that and that they can't use Facebook as a reference.

Please help as I'm not getting much response from my insurance company!!! How do I go about proving his fraudulent claim?

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I would suggest contacting the Financial Services Authority (FSA) who are the insurance and financial industry watchdog (http://www.fsa.gov.uk/)

 

They will listen to you concerns, and they will act. Of all the Government departments I have to deal with on a regular basis, this is the one who keeps its promises and is effecient.

 

They will even call you back at their expense.

 

Well worth making the call.

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Thanks for that T.C.

Another thing you may be able to help me with is that my inusrance company wants me to admit fault and I quote "it's my (the insurer's) view that counts" and as a driving instructor I am fully aware of the rules of the road and it's not as black and white as the Highway Code suggests (Highway Code is a "guide"). My insurers are stating that you ALWAYS take your right lane to turn right at a roundabout/lights etc regardless of the road markings stating two lanes go the same direction - I have evidence of other situations that are exactly the same as mine, that are official proceedures taken on the driving test, to back up my positioning. In essence what they're saying is, what we teach as driving instructors and what is accepted on an official DSA Practical Test are not correct. They are saying that they are not going to go to court with this and that I am at fault. Am I able to contest my insurance's admission of liability?

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My insurers are stating that you ALWAYS take your right lane to turn right at a roundabout/lights etc regardless of the road markings stating two lanes go the same direction

 

:lol: I am sure the examiners at my test centre would find that laughable also. I teach the procedure as "if you have a chouce of lanes, then select the left of that choice". i.e. if there are 3 lanes, and the middle and right lane are marked to turn right, then you pick the middle lane, (not forgetting to move back to the left lane ready for your exit). As our learners are usually travelling slower than other people this is the only sensible choice.

 

Lets hope none of your insurers staff need to take a driving test because if they apply their rule they will get into dangerous situations very quickly!

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:lol: I am sure the examiners at my test centre would find that laughable also. I teach the procedure as "if you have a chouce of lanes, then select the left of that choice". i.e. if there are 3 lanes, and the middle and right lane are marked to turn right, then you pick the middle lane, (not forgetting to move back to the left lane ready for your exit). As our learners are usually travelling slower than other people this is the only sensible choice.

 

Lets hope none of your insurers staff need to take a driving test because if they apply their rule they will get into dangerous situations very quickly!

 

The r/a in question - it's a big r/a - (from where I was approaching) has three lanesWITH arrows - left lane with left arrow, middle lane with ahead arrow and right lane with ahead arrow. There is NO right arrows marked on that section of the r/a. On other areas of the r/a there are DEFINITE right arrows - where the 3rd party came from (from my right) there are two lanes that go right and both have right arrows on them (the 3rd party took the right of the two). On test routes here we have r/a with EXACTLY the same road markings (two arrows going head, a left arrow but NO right arrows and we take the left of the two ahead arrows two to turn right - I have evidence of these r/a's used on test routes) Which is what I did and I am being penalised because I admit this. I checked my blind spots and my car is fitted with blind spot mirrors.

The 3rd party was not on the r/a as I entered - the traffic was stationary at lights on my right. I entered the r/a WITH A RIGHT SIGNAL on into the left of the two lanes, which then took me to the outer circle of the r/a. The 3rd party came on to the r/a and into the far right lane (inner circle of the r/a) bearing in mind that where he came from there were two marked lanes WITH right arrows (he took the right of the two). So he entered the r/a after me and over took me on my right. If he'd taken the left lane of the two that turned right, he would have been behind me and not next to me. My insurers are saying that I under cut him as I was going passed the exit the 3rd party wanted - depsite my right signal - and that you cannot go passed more than one exit in the left lane on a r/a (yet as above there are r/a's on test route where you CAN do this) My insurers could not give me an answer as to when and why you would use the left lane to turn right when there are two lanes going the same direction, but it was okay to use your right lane to go ahead if both lanes go ahead and kept referring back to the H/W code that it's the right lane that turns right ONLY (despite the H/W code stating you take the left to go ahead as per diagram - so now my insurers are contradicting themselves). If I had taken the inner circle I would have had to cut across three lanes to left back into the left lane off the r/a - either route then I'd be screwed as I'd have 'cut' any one who had followed me on to the r/a from my left.

 

But if they want to quote the H/W code to me...

"the rules of the H/W code do not give you the right of way in any circumstance but they advise you when you should giveway to others. Always giveway if it can be helped to avoid an incident"

"when reaching the r/a you should - watch out for all other road users already on the r/a"

"in all cases watch out for and give plenty of room to traffic crossing infront of you on the r/a"

"before overtaking you should make sure that the road is sufficiently clear up ahead"

"do not over take where you may come into conflict with other road users...when a road user is indicating right, even if you believe the signal should have been cancelled"

 

And could someone tell me where it says in the H/W code that we drive on the left side in this country? How would you know that otherwise? cause as instructors that's what we teach, along with the MANY different proceedures on r/a's!!! This is very frustrating and I am questioning what they hell and why am I teaching learners??

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Thanks for that T.C.

Another thing you may be able to help me with is that my inusrance company wants me to admit fault and I quote "it's my (the insurer's) view that counts" and as a driving instructor I am fully aware of the rules of the road and it's not as black and white as the Highway Code suggests (Highway Code is a "guide"). My insurers are stating that you ALWAYS take your right lane to turn right at a roundabout/lights etc regardless of the road markings stating two lanes go the same direction - I have evidence of other situations that are exactly the same as mine, that are official proceedures taken on the driving test, to back up my positioning. In essence what they're saying is, what we teach as driving instructors and what is accepted on an official DSA Practical Test are not correct. They are saying that they are not going to go to court with this and that I am at fault. Am I able to contest my insurance's admission of liability?

 

Do not admit liability, and your insurers are not allowed to admit liability on your behalf unless it is blatantly obvious that you were at fault. Even then they would have to contact you to explain their stance and ask you for your observations and comments before making an admission of liability.

 

What many insurers have difficulty with, particularly claims handlers is that they do not know the Highway Code and they certainly have no understanding of the Road Traffic act.

 

As an example, I get a lot of cases where a motorcyclist has filtered down a line of traffic and then been hit by an emerging vehicle, and 99% of the time the insurers will quote Powell v Moody (1966) as their statutory defence which is a case where the filtering motorcyclist was found 100% liable. They forget or don't know the case of Davis v Schroggins (2006) which found the other way.

 

Another example is where a motorcycle has undertaken on a motorway (nearside overtake) and been taken out, and the insurers willl state their case on the basis that the motorcyclist carried out an illegal undertake.

 

Nowhere in the Road Traffic Act does it say it is illegal, and in fact the speciific offence was removed from the stautie book back with the introduction of the 1972 road traffic act, and they (the insurers) fail to accept that in some circumstances a nearside overtake is actually the only option.

 

I give these two simply as an example of how we have to contend with non knowledgable people handling claims which can affect people in so many ways.

 

It is sometimes worth using your knowledge and experience by putting the key points in writing supported by official documentation and quote chapter and verse on the basis that if the insurers know better, maybe they ought to advise the DSA advanced bodies and the driver training profession generally that they (the insurers) know better.

 

I still think it would be a wise move to contact the FSA as this will get a few backsides twictching nervously and force the insurance companies to listen to what you are telling them.

 

As a by the by, there is no written regulation that states we must drive or ride on the left. If there was, then that would virtually put a complete block on all overtakes, it is a genral acceptance that we drive on the road in order to avoid crashes occuring (a sort of common law a bit like Murder which states that if someone murders they commit an offence under common law, well as an analagy, if you drive on the right and cause a crash, then common law (or maybe common sense) would make you guilty of an offence such as careless or dangerous driving) which I hope makes sennse.

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The r/a in question - it's a big r/a - (from where I was approaching) has three lanesWITH arrows - left lane with left arrow, middle lane with ahead arrow and right lane with ahead arrow. There is NO right arrows marked on that section of the r/a. On other areas of the r/a there are DEFINITE right arrows

 

This is the correct way they mark these large roundabouts. The reason for this is to ensure no "idiot" inadvertantly turns right immediately at that roundabout junction and ends up facing the wrong way on the roundabout.

 

An example on test route near me is marked Left lane - left/straight on, Centre lane = Straight on, Right lane = straight on. It is also traffic light controlled and as the green light comes on it is in fact a green left arrow, again, to remind everyone they must drive onto the roundabout in a left circle direction.

As you get onto the main part of the roundabout (having past the 1st exit), the lane markings change to Left lane = straight on, Centre lane = Straight on/Right, Right lane = Right.

As you get to the 2nd exit the left lane traffic MUST leave, centre lane traffic MAY leave, using a left signal and exiting into the "offside" lane of the new road/slip road, centre traffic MAY also continue round to the right using a right signal, then immediately after passing the 2nd exit, change signal to left and drift across to left lane (having checked blind spot) ready for their exit. Traffic in the 3rd lane MUST continue to turn right, and be showing a right signal throughout, and as they pass the 2nd exit, drift across into middle lane (having checked blind spot) and change signal to left indicator ready for their exit. They will then exit into the "offside" lane of the new road/slip road they are entering.

 

It amazes me how many supposedly "experienced" drivers cannot use these roundabouts correctly!

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Thanks so much for your help T.C.

The 3rd Party have supplied CCTV footage of the 'incident' - but my insurers are not sure where they got it from. However the CCTV footage doesn't show the road markings clearly - apparently it just shows me 'cutting' the other driver. I have requested a copy of the footage and they are 'decding' as to whether I can see that or not due to DPA. My insurers (NIG) have also admitted that the 3rd party insurers are hard to deal with and that they dig their heals in (Quinn). NIG do not deal with instructors insurance any longer so I feel like I'm am being fobbed off so they can get me to admit fault and then it's sorted without further hassle. They're saying that they can not see what the 3rd party did wrong - (depsite the fact I was on the r/a before, therefore infront of him and was signalling to turn right all the way yet he over took me) and at the end of the day ''it's their view that counts''!!

 

Crem

My problem is that there are no right arrows on my section of the r/a. As I entered the r/a there are actually 4 lanes. The two far left go left ONLY and other two go ahead ONLY. Once passed that first exit (where the two left lanes have gone) it then leaves you with the two ahead lanes. tehy saying that there's no reason why I took the lane I did and I should have taken the right lane as it was quiet. Out of the four lanes on the r/a as I entered I took the far left of the two going ahead to turn right (due to there are no right arrows) - I do this on EVERY other r/a with the exact same road markings as per the DSA test routes for the exact same situation.

 

Oh and the 3rd party (17 year old) saw medical attention shorlty after the incident (incident Sept 29, 10, sort attention Oct 30) but did not put a claim in till January 2011 - the same week he got his insurance renewal which went up from £1500 to £2747!!

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tehy saying that there's no reason why I took the lane I did and I should have taken the right lane as it was quiet.

 

Then they are wrong!

 

Driving guidance is, when they is a choice of lanes, you should use the leftmost of the choice to proceed in your chosen direction. By their same logic I should drive in the outer lane of a dual carrigeway A road "because it was quiet". This is utter nonsense and every reasonable driver knows if the 2 lanes are "quiet" you should be proceeding in the left lane.

 

Likewise, if they are 2 lanes going in your direction on a roundabout, then you use the left of the choice, which ultimately puts you back into the left lane on your chosen exit.

 

Can you tell us which roundabout you are talking about so that we can see it on google earth?

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Here is the image I supplied to NIG. I'm red arrows.

accidentsept.jpg

 

 

 

This is the view on entering the r/a - you can't see any further road markings until further round the r/a obviously - can only see the two arrows vor ahead.

RA2.jpg

 

 

 

This is the view for where the 3rd party came form - he took the far right lane to turn right (as though behind the van)

RA4.jpg

 

 

Example test route r/a - no right arrows - we take middle lane to turn right (left of the two ahead arrows)

A174-2.jpg

 

Another example - we take left lane of the two to turn right

MANDALE2.jpg

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final example - take middle lane (left of the two with ahead arrows) to turn right

MANDALE1.jpg

 

In all cases you go passed the 'straight' ahead exit to turn right. All the above are official DSA test routes and thoes are the official proceedures to go round them on test.

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Here is the image I supplied to NIG. I'm red arrows.

[ATTACH=CONFIG]25404[/ATTACH]

 

 

 

This is the view on entering the r/a - you can't see any further road markings until further round the r/a obviously - can only see the two arrows vor ahead.

[ATTACH=CONFIG]25405[/ATTACH]

 

 

 

This is the view for where the 3rd party came form - he took the far right lane to turn right (as though behind the van)

[ATTACH=CONFIG]25406[/ATTACH]

 

 

Example test route r/a - no right arrows - we take middle lane to turn right (left of the two ahead arrows)

[ATTACH=CONFIG]25408[/ATTACH]

 

Another example - we take left lane of the two to turn right

[ATTACH=CONFIG]25407[/ATTACH]

 

 

The lane markings appear purfectly clear and demonstrate the 3rd party was in the wrong.

 

The Mandale2 example probably isn't a good example as when viewed on google most people would perceive that roundabout to only have a "left" and "straight on" exit when heading out of Acklam, with no right hand turn at all. However Mandale1 does show that the left lane of the 2 with straight arrows would be correct when exiting the A19 to turn right towards Thornaby. This then splits into 2 as it passes the Acklam road, left takes you back onto A19, right continues around towards Thornaby and becomes the left lane again as you go over the A19 bridge ready for your exit into the left hand lane to Thornaby.

Edited by crem
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oh and this is my car - can hardly miss it (well he didn't 'miss' it, he hit it!!!)

[ATTACH=CONFIG]25412[/ATTACH]

 

Ahhh! This is the only bit that could have been in the 3rd party's favour. If he had argued that upon seeing your car it brought on a mild attack of epilepsy I would have believed him!!!! :lol:

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