Key facts
A GAP claim was submitted to our client as a result of an alleged accident on 24 July 2020. The alleged accident occurred toward the end of a three-year policy term. A genuine claim would have netted the policyholder a significant payment to the tune of over 拢16k. The claim was sent to Crawford Legal 麻豆区鈥� (CLS) counter fraud team for investigation and validation.
The motor insurer had paid the RTA claim. The GAP insurer鈥檚 concerns could easily have been overlooked because photographs of the accident scene confirmed there had actually been a collision between the two vehicles. But as we know, sophisticated fraudsters are prepared to place accident-damaged vehicles together in an attempt to fool insurers.
Background
Concern about fraud heightened when the policyholder鈥檚 husband, (who was the alleged driver of the vehicle at the time of the accident), was interviewed and appeared unable to recall the accident circumstances. In fact, he provided four different accounts of how the collision occurred.
The variable memory of the driver wasn鈥檛 the only red flag. 鈥楿sual suspect鈥� accident management businesses, that were well known to CLS鈥� counter-fraud team, had been involved in this claim.
Our thorough investigations ultimately revealed that the third party involved in the alleged accident had also been involved in a subsequent accident which had the exact same circumstances as our case.
As the claim progressed, the policyholder鈥檚 husband (the driver) became so confused reaching the point where he wasn鈥檛 even clear as to whether he was the driver or not. Although he finally decided he was the driver, it became apparent he could not have been travelling in the direction he claimed when the alleged accident occurred.
Our forensic motor engineer was able to establish that while the third-party vehicle had indeed hit the rear of the policyholder鈥檚 vehicle, this was a deliberate act.
It became apparent that the third-party driver was part of a wider group involved in staging accidents. The claim was declined by CLS on the grounds of fraud.
Lessons learned
The motor insurer paid the claim without considering the possibility that a claim on a GAP insurance policy might represent a significant motive for fraud.
Fraudsters are increasingly willing to simulate genuine accidents and put accident-damaged vehicles together at the scene of alleged accidents. A picture doesn鈥檛 always tell a thousand words!
Even when there are photographs of two (or more) damaged vehicles at the scene of an accident, there may be more to the story. If insurers suspect something isn鈥檛 right based on initial investigations, it pays (literally) to get counter-fraud experts on the case.
For additional information please contact:
Peter Oakes
Head of Counter-Fraud, Crawford Legal 麻豆区
E:peter.oakes@crawco.co.uk
