Insurance Fraud, but not.
Discussion
The scuba diving I wouldn't worry too much about, except that there is always a risk of the bends with an injury.
I used to have back pain. I also scuba dive. I discovered (by being bloody minded and insisting I dove while in agony with a stiff back) that the pressure (I assume it was the pressure) eased the pain.
Hence the scuba diving would not be something I would make too much issue about.
As for the rest, well I guess we can all form an opinion.
I used to have back pain. I also scuba dive. I discovered (by being bloody minded and insisting I dove while in agony with a stiff back) that the pressure (I assume it was the pressure) eased the pain.
Hence the scuba diving would not be something I would make too much issue about.
As for the rest, well I guess we can all form an opinion.
Another instance of people just being nice to get out of a situation, then fleecing you when they've gotten home and have been convinced by some smart alec or themselves that you only get a few chances in life to get a load of money for free.
And yet even with your evidence they don't want to know? If so take it to the ombudsman or something, tell them that you were never happy with ti being 50/50 and that they suggested it was your best option as nobody was there.
It's horrible how someone can do that to you isn't it. You were on the bike...if you weren't hurt then how on earth could she be hurt? I know it's possible but the chances are low considering it was a low speed corner of a residential area.
I see people cutting over the lines all the time and I have to swerve in my car to avoid them, a beep of the horn and they swear at you. They even do it at T-junctions you are appraoching where they are turning from the major road (as to cut across your lane).
And yet even with your evidence they don't want to know? If so take it to the ombudsman or something, tell them that you were never happy with ti being 50/50 and that they suggested it was your best option as nobody was there.
It's horrible how someone can do that to you isn't it. You were on the bike...if you weren't hurt then how on earth could she be hurt? I know it's possible but the chances are low considering it was a low speed corner of a residential area.
I see people cutting over the lines all the time and I have to swerve in my car to avoid them, a beep of the horn and they swear at you. They even do it at T-junctions you are appraoching where they are turning from the major road (as to cut across your lane).
Purity14 said:
However, she did claim.
Has her claim been paid? What happens with personal injury claims if it's 50/50 - presumeably her insurer doesn't pay, so yours is asked to pay half? Maybe they'll tell her to sod off?I don't know really, it's nothing personal, people just see an opportunity to make money out of a situation.
Purity14 said:
No one will stand up and say she is lying, she has been to the doctor according to her notes on 4 occasions since the accident, and according to the notes, advises her to take pain killers.
The solicitors and my insurance company told me that they are not medical experts, so are unable to ascertain what she can or cannot be capable of whilst trying to recover from the alleged injury.
From my point of view, and anyone else who looks at the damage of her car, then activities that she partakes in, and the pictures of her flailing her arms around on holiday going down water slides... Whilst in pain, unable to lift her arms over her head, unable to clothe herself, wash herself, and declaring that she is too injured to swim. Just doesn't add up - the industry say they are cracking down on insurance fraud. - They are not.
So it was the insurance company's interest, not yours - hence you were processed to do so under duress perhaps (not saying stretch the chances but it sounds like thats the case to me). I would take it to the ombudsman (you can't use her in any of the points as reasons for why it's wrong what the insurance company did) and say that you have suffered financially because of their financial interest counteracting the progress of good practice (i.e. we'll save our money even if it costs you because we don't want to take an almost obvious fraudster to court).The solicitors and my insurance company told me that they are not medical experts, so are unable to ascertain what she can or cannot be capable of whilst trying to recover from the alleged injury.
From my point of view, and anyone else who looks at the damage of her car, then activities that she partakes in, and the pictures of her flailing her arms around on holiday going down water slides... Whilst in pain, unable to lift her arms over her head, unable to clothe herself, wash herself, and declaring that she is too injured to swim. Just doesn't add up - the industry say they are cracking down on insurance fraud. - They are not.
I wouldn't use the car damage as a reason to prove to her lying - it would always be subjective. The fact that she's been blazé on holidays and activities totally counteracting her claim description would surely hit home true to any self respecting law enforcer/service provider??
All I can say is, I hope you've saved every picture you've seen ebfore she realises or is advised by her lawyers/friends/family to remove any chance of it. Stating the obvious, but still!! For your own sake.
PS - A doctor advising to take painkillers does not create a foundation for medical cause to her claim. He probably told her that to shut her up and could either see what she was pulling or decided it was the best way to get a psychosomatic "patient" out of his office.
Edited by CarsGoVroom on Tuesday 10th April 11:33
Purity14 said:
CarsGoVroom said:
And yet even with your evidence they don't want to know? If so take it to the ombudsman or something, tell them that you were never happy with ti being 50/50 and that they suggested it was your best option as nobody was there.
They said that it is not in their best interests as a company to go to court, as it will cost them money, it is a financial decision.CarsGoVroom said:
It's horrible how someone can do that to you isn't it. You were on the bike...if you weren't hurt then how on earth could she be hurt? I know it's possible but the chances are low considering it was a low speed corner of a residential area.
No one will stand up and say she is lying, she has been to the doctor according to her notes on 4 occasions since the accident, and according to the notes, advises her to take pain killers.The solicitors and my insurance company told me that they are not medical experts, so are unable to ascertain what she can or cannot be capable of whilst trying to recover from the alleged injury.
From my point of view, and anyone else who looks at the damage of her car, then activities that she partakes in, and the pictures of her flailing her arms around on holiday going down water slides... Whilst in pain, unable to lift her arms over her head, unable to clothe herself, wash herself, and declaring that she is too injured to swim. Just doesn't add up - the industry say they are cracking down on insurance fraud. - They are not.
If they actually bothered their arse and looked at things it would be so much better and they would clearly see, in both cases, yours and mine, that it was not our fault at all.
spunky-mon said:
The small bit highlighted is also the main reason my insurance are being utter ***** at the moment. It will cost them to much to sort out and investigate so they are just going to blame me 100%
If they actually bothered their arse and looked at things it would be so much better and they would clearly see, in both cases, yours and mine, that it was not our fault at all.
I'm sure I remember from my claim going into the back of a car 7 years ago I had to agree with the company's approach, that they only "strongly advised" that I admit fault due to highway code etc etc.If they actually bothered their arse and looked at things it would be so much better and they would clearly see, in both cases, yours and mine, that it was not our fault at all.
If the law's changed to that effect, it's definitely for the worse. If not, try standing your ground and tell them you have just cause and evidence to back up your firm belief it was not your fault. Tell them that you are not in possession of insurance to provide them with financial gain, they are providing you with a service you legally require and do so by risk of their own financial gains.
This is what I hate about insurance companies and the "total loss" section of some agreements/policies. They are insurers by nature with risk. Yet even something that cannot be applied as anything other than risk, they try to legally mitigate their way out of it.
CarsGoVroom said:
spunky-mon said:
The small bit highlighted is also the main reason my insurance are being utter ***** at the moment. It will cost them to much to sort out and investigate so they are just going to blame me 100%
If they actually bothered their arse and looked at things it would be so much better and they would clearly see, in both cases, yours and mine, that it was not our fault at all.
I'm sure I remember from my claim going into the back of a car 7 years ago I had to agree with the company's approach, that they only "strongly advised" that I admit fault due to highway code etc etc.If they actually bothered their arse and looked at things it would be so much better and they would clearly see, in both cases, yours and mine, that it was not our fault at all.
If the law's changed to that effect, it's definitely for the worse. If not, try standing your ground and tell them you have just cause and evidence to back up your firm belief it was not your fault. Tell them that you are not in possession of insurance to provide them with financial gain, they are providing you with a service you legally require and do so by risk of their own financial gains.
This is what I hate about insurance companies and the "total loss" section of some agreements/policies. They are insurers by nature with risk. Yet even something that cannot be applied as anything other than risk, they try to legally mitigate their way out of it.
I am, and will be, fighting this as far as I can go. I pay rather alot a year to drive the car I want and fully expect my insurance to do the best they can do when I need to use them, not just bend over and take the easy route.....
Purity14 said:
CarsGoVroom said:
I'm sure I remember from my claim going into the back of a car 7 years ago I had to agree with the company's approach, that they only "strongly advised" that I admit fault due to highway code etc etc.
If the law's changed to that effect, it's definitely for the worse. If not, try standing your ground and tell them you have just cause and evidence to back up your firm belief it was not your fault. Tell them that you are not in possession of insurance to provide them with financial gain, they are providing you with a service you legally require and do so by risk of their own financial gains.
This is what I hate about insurance companies and the "total loss" section of some agreements/policies. They are insurers by nature with risk. Yet even something that cannot be applied as anything other than risk, they try to legally mitigate their way out of it.
She was the one taking ME to court for the accident, not the other way around, she reported the accident before I did, as she was actually driving her boyfriends car on a third party basis.If the law's changed to that effect, it's definitely for the worse. If not, try standing your ground and tell them you have just cause and evidence to back up your firm belief it was not your fault. Tell them that you are not in possession of insurance to provide them with financial gain, they are providing you with a service you legally require and do so by risk of their own financial gains.
This is what I hate about insurance companies and the "total loss" section of some agreements/policies. They are insurers by nature with risk. Yet even something that cannot be applied as anything other than risk, they try to legally mitigate their way out of it.
They pleaded 50/50 in light of my evidence (facebook(fraud) and Skidmarks(shows direction of travel)), and my insurance company accepted - I asked, begged and pleaded. but my insurance company just said No, No, NO.
Purity14 said:
No, its the insurance company, they told me, and said there is nothing I can do about it, due to it being a business decision - verbally over the phone.
I wanted it to go to court because it would have been perjury for the girl then! So I said and did as much as i could to get my case to court - but my insurance company wouldn't allow it and settled 50/50.
I'm sure they would say it considering it is in their interest.I wanted it to go to court because it would have been perjury for the girl then! So I said and did as much as i could to get my case to court - but my insurance company wouldn't allow it and settled 50/50.
Honestly mate I'd suggest you contact the ombudsman and explain. At the worst of it, they will explain exactly why the insurance company could legally refuse your plea. But I really don't think they can do that.
Obviously we only have the OP’s side of events here to go on but as written yet another example of how utterly unfit for purpose insurance companies often are. They only think about to day and forget about the implications of their actions on tomorrow. Yet this is not a problem for them as it is a legal requirement to have insurance if you wish to drive a car.
It is nothing short of legalised extortion, and most insurance companies are milking it for all it is worth.
OP, if you are as sure of your grounds as you first post suggests then why not collate the evidence and take it to court yourself?
It is nothing short of legalised extortion, and most insurance companies are milking it for all it is worth.
OP, if you are as sure of your grounds as you first post suggests then why not collate the evidence and take it to court yourself?
I can see that insurance companies take the cheapest option and pay the claim, but I have seen people prosecuted for fraud for falsely claiming disability benefit and this I assume done by the CPS using video evidence collected by the LA. Therefore I can imagine that it should be possible for a public prosecution rather than at the expense of the insurance company.
herewego said:
I can see that insurance companies take the cheapest option and pay the claim, but I have seen people prosecuted for fraud for falsely claiming disability benefit and this I assume done by the CPS using video evidence collected by the LA. Therefore I can imagine that it should be possible for a public prosecution rather than at the expense of the insurance company.
The issue there is, it looks like she's technically suing his insurance company for damages, and they are paying the fees/costs of car repair of course anyway. If they refuse to co-operate against her claims, is it one of those things where it isn't a crime unless the "victim" pursues it?As your premiums have increased you could try to sue her personally for the increase through the small claims court (maybe 5 years x the increase).
It doesn't matter what the insurance company has decided. If you have the evidence that she was at fault and you dont mind losing the small claim fee and/or not be able to collect on any judgement then why not proceed.
(There may be questions over how you accessed her facebook account)
Maybe a letter written to the CEO of the company explaining your situation will also help. I think you need to explain clearly how you obtained the evidence against her as no company wants to go to court with evidence that has not been obtained legally.
It doesn't matter what the insurance company has decided. If you have the evidence that she was at fault and you dont mind losing the small claim fee and/or not be able to collect on any judgement then why not proceed.
(There may be questions over how you accessed her facebook account)
Maybe a letter written to the CEO of the company explaining your situation will also help. I think you need to explain clearly how you obtained the evidence against her as no company wants to go to court with evidence that has not been obtained legally.
sugerbear said:
(There may be questions over how you accessed her facebook account)
Oh I hope, just for irony's sake...that she's one of those numpties who posts anything and everything 15 times a day and has not bothered to set privacy rules?I know of some people who even "check-in" at their "cosy bed"....the exact location of your home address and where you sleep,...? why share that to the world!
Purity14 said:
She was the one taking ME to court for the accident, not the other way around, she reported the accident before I did, as she was actually driving her boyfriends car on a third party basis.
They pleaded 50/50 in light of my evidence (facebook(fraud) and Skidmarks(shows direction of travel)), and my insurance company accepted - I asked, begged and pleaded. but my insurance company just said No, No, NO.
You have run into the brick wall which is subrogation. The insurer has chosen to deal with it differently from the way you might have done. Unfortunately your contract of insurance almost certainly allows them to do this.They pleaded 50/50 in light of my evidence (facebook(fraud) and Skidmarks(shows direction of travel)), and my insurance company accepted - I asked, begged and pleaded. but my insurance company just said No, No, NO.
It is a charter for unscrupulous third parties who know full well that insurers are reluctant to litigate. It sucks. The question I would ask is how far up the food chain have you gone with the insurer? A polite letter to the CEO about TCF might be worth a shot.
Another insurance thread and another load of PH nonsense replies again.
First off people need to learn to separate liability decisions from payouts. The first thing to assess in any incident is liability. In this case 50/50 does seem harsh but we don't have the story from both sides as always.
Secondly if it has been assessed as 50/50 then the other side can claim for injury. She will get 50 percent of any payout. So if she would have got £10000 in a non fault then she'll only get £5000 for this claim.
Whether you believe there is fraud or not proving it along with the cost is very expensive and costs are rarely recoverable even if you win. A judge recently ruled that a claimant who deliberately claimed excessive injury was still entitled to the basic compo. The insurer lost tens of thousands on that claim.
Your premium is calculated on the basis that you had a claim. The cost of that claim is irrelevant in most Personal Lines business as it's NCD rated not experience rated.
Suing her for the increase is too remote and will not work. If you were on your way to buy a lottery ticket and your numbers would have won you could not successfully sue for that either
Your premium could have risen for any number of unrelated reasons.
Sec
First off people need to learn to separate liability decisions from payouts. The first thing to assess in any incident is liability. In this case 50/50 does seem harsh but we don't have the story from both sides as always.
Secondly if it has been assessed as 50/50 then the other side can claim for injury. She will get 50 percent of any payout. So if she would have got £10000 in a non fault then she'll only get £5000 for this claim.
Whether you believe there is fraud or not proving it along with the cost is very expensive and costs are rarely recoverable even if you win. A judge recently ruled that a claimant who deliberately claimed excessive injury was still entitled to the basic compo. The insurer lost tens of thousands on that claim.
Your premium is calculated on the basis that you had a claim. The cost of that claim is irrelevant in most Personal Lines business as it's NCD rated not experience rated.
Suing her for the increase is too remote and will not work. If you were on your way to buy a lottery ticket and your numbers would have won you could not successfully sue for that either
Your premium could have risen for any number of unrelated reasons.
Sec
LoonR1 said:
Whether you believe there is fraud or not proving it along with the cost is very expensive and costs are rarely recoverable even if you win. A judge recently ruled that a claimant who deliberately claimed excessive injury was still entitled to the basic compo. The insurer lost tens of thousands on that claim.
Out of interest, which court was that decision handed down in? It is my contention that the insurance companies will fight the odd case here and there but will walk away very early in the day due to the fear of rising costs. We have been saddled with a lot of bad law in many areas over the years as a result of parties being unable to fund further litigation when faced with a bad judgement in a lower court, Obviously this is not an issue for the ins. co.s as they do have the ability to fund a fight, but appear to have little taste for it.
Personally I feel that the industry has gone entirely the wrong way about furthering its interest and those of their customers by failing to make more of the £millions it pays out based on very shaky grounds. I can see why it would not want to publicise that it will roll over almost every time that it receives a half arse attempt at a PI claim but a targeted and concerted effort to bring the inequity of it all to the attention of the general public in such a way as to engender support for a tightening up in the law relating to such claims would surely be beneficial to all honest parties involved.
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