Can you spot the damage?
Meet the ex-garda leading the f ight against insurance fraud… and look at these 10 cars where 12 people claimed payouts of €150k...
IRISH fraudsters in the UK are among a number of criminal groups targeting insurance claims here because payouts by our courts far exceed those in the rest of the EU.
But insurance groups are fighting back. In one recent case, a team from Aviva travelled to the UK to probe a claim alleging personal injuries in a crash in Ireland with an Eastern European driver.
The team was led by ‘fraud buster’ Robert Smyth, a former member of the Garda national drugs unit who now heads a team of 30 dedicated fraud investigators for Aviva. ‘The accounts of the claimants didn’t match that given by the guy who was insured with us. That set alarm bells ringing so we started to have a look at the claim. We discovered that the group making the claim were Irish but living in the UK, so some of the team travelled over to interview them. They weren’t expecting that and the claim fell apart.’
Referring to a dossier of claims relating to 10 cars, with 12 injury claims, Mr Smyth explained that in the region of €150,000 was paid out, with payments varying from €4,000 to €14,000, but one person received €20,000 and another €50,000.
Sometimes a case comes under scrutiny based on common sense. Mr Smyth recalled a scenario where ‘six people, three in each car, claimed €60,000 in personal injuries’. He said: ‘If you look at most cars on the road there is usually one person, possibly two, in each car, so on the balance of probabilities we felt it was unlikely that two cars with three people in each would somehow collide with each other. We had a look and decided to contest the claim in court. The judge dismissed the case against all six and awarded costs against five of them.’ Mr Smyth also highlighted the cost of tackling fraud. ‘If a fraudster brings a claim to court and we contest it, we have to pay our legal team. The State can pay for his and if we are awarded costs they usually haven’t got the means to pay them anyway. ‘I can recall one case in Athlone where a guy claimed he had been struck by a car at a Stop sign. The driver, however, was adamant that the man had jumped on to the bonnet of the car when it was stopped. We went to court, and discovered, prior to the hearing, that he was in jail for rape.
He was brought to court from prison and when he was in the witness box he couldn’t even remember which leg he’d claimed was injured. ‘The case was dismissed but incredibly he chose to appeal it. We won the appeal but the total legal costs involved were around €40,000. From memory, we were awarded costs, but where was he going to come up with them? So the company had to foot the bill.
‘There have been suggestions that costs can be deducted from a person’s social welfare payment, but the law states that there is a minimum basic amount that a person has to be given in order for them to live on it and that no deductions can be put in place that will bring their income below that amount. For fraudsters, it is like playing the lottery: if they win, they win big if they lose, they’ve nothing to lose.’
Mr Smyth’s squad explores all areas, especially social media which often yield a breakthrough.
‘We had one man from the Travelling community who claimed he hurt his shoulder in an accident,’ Mr Smyth said. ‘We had a trawl through YouTube and came across him knocking another man out in an organised bare knuckle fight, and he supposedly had a badly damaged shoulder. When we showed his solicitor the clip the case was quietly dropped.’
Mr Smyth believes solicitors could do more. ‘If a claim is blatantly ridiculous from the start then the solicitor should stop it at source, and there is evidence that particular law firms tend to specialise in these type of cases.’
Meanwhile, fraudsters ‘know the game’ and will often target vulnerable drivers, he said. They will, say, spot a lone female driver and jam on the brakes in front of her, forcing her to crash into the back of them. They know that she is likely to be so shocked that she may not even want to go to court, and that if she does it’s her word against maybe three or four claimants.’
Although they have had success since their formation three years ago, Aviva crew don’t always win. ‘We had one case where a guy who is an MMA cage fighter, claimed he had sustained a serious back injury at work. We obtained film of him fighting in a tournament when he was supposedly hurt and showed it in evidence. The guy admitted it was him, but told the judge that he had come second in the tournament, and that had he been fully fit he would have won the final.
‘The judge awarded him the money – and we awarded him full marks for ingenuity.’
‘Couldn’t remember which leg he’d injured’ ‘Like playing lottery… with nothing to lose’