insurance


Strange Insurance Fraud Cases

By John A James Jr Platinum Quality Author


Insurance fraud is a terrible thing that costs countries billions of dollars every year, but you have to admit that some people are extremely creative about it. Below we will examine some notable insurance fraud cases and determine what type of insurance fraud it is, and whether or not it is a "hard" or "soft" fraud.
A male cyclist was struck by an automobile and suffered some serious injuries. He was compensated to the tune of $22,000, but a suspicious insurance official decided to probe further. It turned out that the would-be injured party had actually been hit by a car driven by his girlfriend. To top it all off, he had inserted a toothpick into his nose to make sure the incident caused him bodily damage. He is lucky it did not kill him. He was brought up on charges for insurance fraud and lost the case. This is clearly a case of "hard" fraud (fraud that is intentionally executed), and since the auto insurance paid his claim, it is a case of hard auto insurance fraud.
In another case, an auto mechanic had a large piece of machinery dropped on him while he was on the job, resulting in back and leg injuries that required a long recovery time. He eventually filed a claim saying he was unable to work, and drew a monthly payment from his disability insurance. As in many cases like this, the insurance company hired a private investigator to take a peek at the would-be disabled man. After only one day of surveillance, the investigator captured footage of the man changing a transmission in a car parked outside of his house. He had no trouble moving around or changing the transmission, proving that he was, in fact, able to work. While this is an extreme case, this can be considered soft fraud, since the man exaggerated a once-legitimate claim. He was truly injured and it did take time to recover, but instead of stopping the payments for his disability benefits and going back to work, he kept collecting the insurance money and did work on the side. He pretended to still be injured. He was fined and ordered to pay back a lot of the money he had received in benefits.
Back in the 1980's, a recent high school graduate, along with some friends, decided to steal the floodlight from their alma mater's gymnasium roof. The ringleader, a boy called Ricky, climbed up and removed the light, only to fall through a skylight and become seriously injured. The boy and his family sued the school for millions of dollars and won, regardless of the fact that the boy was committing a crime at the time of his accident. Is this fraud? Truth be told, the boy did not fall or become injured on purpose, nor did he fake his injuries in order to receive an insurance payout. Indeed, the law permitted that if someone was injured on school grounds, the school (and the school's insurance company) was responsible for that injury. So, no fraud here, even though it leaves a distinctly bad taste.