For policyholders subjected to a personal injury claim they believe to be fraudulent, it often feels like the system is rigged in favour of the claimsters. Solicitors are happy to take cases on a no-win, no-fee basis.
The level of fraudulent and exaggerated insurance claims in Ireland has been the subject of much debate in recent times.
We have never really bought the insurance industry estimates which suggested that 20% of all claims were fraudulent.
Likewise we have never bought the suggestion that the real level of fraud is less than 1% and an issue that can be ignored.
The experience of our members would back up the claims of a Limerick barrister who in 2018 indicated that the level of fraudulent and exaggerated claims was around 8%.
This is a scandalous level – it costs every one of us, clogs up the medical and judicial systems, criminalises genuine claimants and damages the reputations of the legal and medical professions.
It also damages the reputation of the insurers who are complicit in the situation when they settle claims policyholders believe are 100% fraudulent. Although we can sympathise with them to an extent given that they know the Gardaí are not resourced to habitually deal with such cases and that even if they take a case all the way to court, they are relying on a judge to take a critical look at the case and almost never see a case referred to the Gardaí by a judge, even when he or she acknowledges that it is fraudulent.
Insurance fraud also creates a fog through which it is difficult to analyse or debate other more complex reforms that need to be put in place.
The issue was recognised as one that needed to be addressed right from the start of the Government’s Cost of Insurance Working Group process in January 2017, which considered “the establishment of a dedicated team within An Garda Síochána or a partnership to tackle insurance fraud”.
As it stands, there is no ongoing formal coordination of insurance fraud cases, no straightforward route for policyholders to make complaints to An Garda Síochána and not a red cent has been committed to combating insurance fraud, in a force with enormous demands on a finite budget.
We acknowledge the one-off value of ‘Operation Coatee’, which has targeted three insurance fraud gangs, as well as the Garda Commissioner’s plans to roll out general fraud units within the new divisional structure. But as it stands, we understand that there are only four such units on trial and no firm timeline for the roll-out to the rest of the divisions. And even when they are in place, they will deal with all fraud, such as social media fraud, invoice redirection and credit card fraud.
We cannot wait any longer for the scourge of insurance fraud to be addressed. It must be made very clear to scammers that it is not a victimless crime and the money does not come out of some big pot owned by the insurers. If you make a fraudulent or exaggerated claim, you are scamming your neighbour, your local club, your local employer. As a key element in doing this, we need a fully-funded, specialised Garda unit to coordinate the specialised offence of insurance fraud and we need it now.
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