Personal Injury Fraud and Its Consequences

Americans have a reputation for being litigious and eager to pursue personal injury lawsuits, even for seemingly minor injuries. While trigger-happy plaintiffs can be an annoyance, they are not necessarily unlawful. However, in some cases, an eagerness to sue can cross the line into fraud. Our North Carolina personal injury defense attorneys can help the targets of fraudulent personal injury lawsuits fight back. 

Types of Personal Injury Fraud 

Fraudulent personal injury claims, in most cases, involve some sort of insurance fraud, as personal injury plaintiffs tend to seek payouts from defendants’ insurers. As such, personal injury fraud involving fraudulent insurance claims can be split into two categories: soft insurance fraud and hard insurance fraud. Soft insurance fraud, the most common type of fraud, occurs when the perpetrator has been involved in a legitimate accident but exaggerates the extent of their injuries or misrepresents the events giving rise to their injuries. Hard insurance fraud occurs when the perpetrator fabricates an accident in its entirety. While the injuries may be real, the perpetrator typically lies about how they were sustained. Our North Carolina personal injury defense attorneys handle both types of personal injury fraud. 

Example Personal Injury Fraud Scenarios 

No two personal injury claims are the same and, as a result, no two incidents of personal injury fraud are the same. Personal injury fraud can arise in any type of personal injury claim. Below are just a few examples. 

• The plaintiff claims that he slipped and fell in the defendant’s parking lot when in reality, the fall occurred on a public sidewalk abutting the defendant’s property 
• The plaintiff bribes a medical professional to overstate the extent of her injuries 
• The plaintiff claims that her injury was due to a defectively designed product when in reality, she was misusing the product when the injury occurred 
• The plaintiff claims that he was bitten by the defendant’s dog when in reality, the plaintiff had provoked the dog at the time the bite occurred 
• The plaintiff claims that she suffered injuries in a car crash when in reality, the injuries were due to a hiking accident 
• The plaintiff pursues a medical malpractice claim for injuries he knows predate the medical procedure 
• The plaintiff stages a car accident or intentionally causes a car accident for the purpose of pursuing a personal injury claim against the other driver
• The plaintiff causes injuries to himself and later claims the injuries were due to an accident
• An accident victim intentionally delays seeking medical treatment or fails to follow her treatment plan for the sole purpose of obtaining a larger settlement 

Signs That a Personal Injury Claim May Be Fraudulent 

It’s not always easy to identify personal injury fraud without direct evidence that the plaintiff has been less than truthful. However, there are a few red flags that can indicate that a personal injury plaintiff may be engaged in fraud. Those red flags include: 

• Injuries that don’t fit the accident: One of the most common tell-tale signs that a plaintiff is not being truthful is injuries that do not match those that would be expected from the accident the plaintiff suffered. 
• A history of pursuing personal injury lawsuits: It’s true that some people are just unlucky and may suffer more accidents than the average person. However, a history of pursuing personal injury lawsuits can also indicate that the plaintiff is an opportunist (at best) or engaged in fraud (at worst). 
• Unusual familiarity with personal injury claims: Few personal injury plaintiffs are well-versed in personal injury law — at least at the outset of their claims. A plaintiff who appears to have unusually detailed knowledge of personal injury claims and the insurance industry can be a red flag for fraud. 
• Willingness to accept a low or early settlement offer: Plaintiffs who are willing to accept a low or early settlement offer may simply be motivated by a desire to move on with their lives. In other cases, eagerness to accept such settlement offers can indicate that the plaintiff is in financial straits or worried about getting caught in a lie. 
• Multiple versions of events: It’s not unusual for certain details of a plaintiff’s story to change slightly over the course of a personal injury claim, as they may recall new information. But major, frequent, or contradictory changes can indicate that the plaintiff is fabricating some or all of their story. 
• Medical records for the injury from multiple providers: Some injuries require visits to multiple healthcare providers for treatment. However, duplicative or voluminous medical records in some cases can indicate that the plaintiff “shopped around” for the prognosis they wanted. 

Readers should note that these red flags are merely circumstantial; they are not definitive proof that the plaintiff’s claim is fraudulent. If you’ve noticed one or more of the above red flags, you consider discussing your concerns with a North Carolina personal injury defense attorney. 

Penalties for Personal Injury Fraud in North Carolina

Personal injury fraud can have serious repercussions for those who engage in it. At the low end of the spectrum, submitting a false or frivolous claim can result in the claim being denied. Moving up the scale, submitting a fraudulent claim can result in the claimant’s insurance policy being canceled. A canceled insurance policy can have long-lasting effects, as future insurers may deny coverage to a person whose previous policy was canceled due to fraud. If the perpetrator received a settlement as part of their claim, their insurance company may require them to pay it back. And at the most severe end of the spectrum are felony criminal charges. 

Discuss Your Case With a North Carolina Personal Injury Defense Attorney 

Fraudulent personal injury claims can cause significant financial and reputational damage to its targets. If you suspect fraud in a personal injury claim being asserted against you, you should consider speaking to an attorney to weigh your options. To get started, please contact a North Carolina personal injury defense attorney at Harris, Creech, Ward & Blackerby by calling 252-638-6666 or using our online contact form.