Woman’s €760,000 injury claim dismissed after she admits she won Christmas tree-throwing competition

Boggles

It would nearly be worth setting up a PI company to get these investigation contracts off the insurance companies.

The days of sitting in a car for hours or days with a camera are long gone.

This one like so many others were rumbled by a simple google search and a look at her social media.

Field east

https://www.boards.ie/discussion/comment/121826749#Comment_121826749

When AND WHErE did this happen.? The whole situation re physical/mental claims like this is that it is assumed by almost all that the claims are genuine. And therefor there is little or no effort made to DOUBLE CHECK did the accident actually happen, was it as severe as was stated, etc, etc.

I am aware of a situation of someone walking into the front of a truck that was parked and was back playing hurling, golf and cycling the following week. Won €150,000=She claimed that the truck was morning and drove into her.

another case where another individual imported an expensive machine that went on fire under very suspicious circumstances- it being only two weeks in his possession. The guy told a neighbour that he was not happy with the machine because of its performance. Insurance paid out again

no wonder insurance premiums are so high with this kind of carryon

Boggles

https://www.boards.ie/discussion/comment/121826641#Comment_121826641

The vast majority of claims don't end up in court.

In a lot of circumstances people have no choice but to get their solicitor involved because the insurance company is acting the complete bollíx.

Lets not be going down the route of pretending the insurance companies and their billion euro monopoly are the good guys here.

SouthWesterly

https://www.boards.ie/discussion/comment/121826749#Comment_121826749

Which may be true as she was seen lifting a tree not a bag 😁

jbv

https://www.boards.ie/discussion/comment/121807364#Comment_121807364

Doctors are still getting paid for the reports.

Nermal

https://www.boards.ie/discussion/comment/121808721#Comment_121808721

Insurers operate within the bounds of what judges do. If judges start throwing out claims for unprovable injuries, insurers will stop paying them.

Boggles

https://www.boards.ie/discussion/comment/121826973#Comment_121826973

The vast vast majority of cases don't get near a Judge. Roughly 5% of claims do.

Insurance companies operate in the bounds of what gives them the highest profit margin. They choose to pay out on 75% of claims, the details of this is a guarded secret.

You always hear the stories of people getting high pay outs but never the 1000s who get low balled.

I'm not defending solicitors that are playing the game, but the insurance are fully committed and togged out too.

They blame each other whilst the vast vast majority of people who don't make any sort of fraudulent claim or claim at all have no choice but to pay for the gravy train.

El Gato De Negocios

https://www.boards.ie/discussion/comment/121826815#Comment_121826815

https://www.piab.ie/eng/

Nonsense also re people needing to get solicitors involved, the majority of time it's to try and get more money from insurance companies, not because insurance companies are acting the bollix.

Boggles

https://www.boards.ie/discussion/comment/121827132#Comment_121827132

That's not a court. 😕

Nermal

https://www.boards.ie/discussion/comment/121827020#Comment_121827020

The cases that make it in front of judges set the framework for settlement for those that don't.

Boggles

https://www.boards.ie/discussion/comment/121827256#Comment_121827256

How could you possibly know that given the insurance company do not publish their pay outs?

Also more claims are resolved at the PIAB than the courts.

boardlady

https://www.boards.ie/discussion/comment/121826597#Comment_121826597

The 750k relates to a future loss of earnings claim - reduced working capacity into the future.

Clo-Clo

https://www.boards.ie/discussion/2058337566/woman-s-760-000-injury-claim-dismissed-after-she-admits-she-won-christmas-tree-throwing-competition

All over the UK now as well, she is making herself famous

She also won the competition.

The insurance company should sue her, the disability benefit should now be forced to be repaid in full etc etc

2smiggy

https://www.boards.ie/discussion/comment/121807256#Comment_121807256

<admin snip> user warned.

Boggles

Her name is Polish, why would Polish people be on Welfare for a "long long time"?

Also having been to Poland many times, it's far from a "shité hole".

Nermal

https://www.boards.ie/discussion/comment/121827262#Comment_121827262

Because as you said, insurers profit-maximise.

Even where they consider a claim spurious, exaggerated or just unprovable they will settle it if the alternative is taking it to court and ending up paying it anyway with legal costs on top.

When judges start consistently throwing out such claims, insurers will stop settling them, because it will finally become cost-effective to do so.

Boggles

https://www.boards.ie/discussion/comment/121827889#Comment_121827889

If a claim is fraudulent it is incumbent on them to fight the case. Like we saw in this case.

But they don't, I was told before the fee is either 39k or 42K or below at which they will liberally settle at. But again we do not know for sure because it is a guarded secret.

Then they just tack it onto all our premiums, they cannot lose.

If it were indeed true we would see far more than less than 5% claims make into court.

Also the vast vast majority of claims that make it to the courts are not fraudulent.

It's myth by the insurance industry that 1 in 5 claims are fraud, they have absolutely no figures to back up this claim.

Nermal

https://www.boards.ie/discussion/comment/121827916#Comment_121827916

What if the insurer suspects it's fraudulent or exaggerrated, but has no proof?

What if there's no objective evidence of the claimant's injuries, but the court will accept at face value the claimant's self-reported symptoms?

What option does an insurer then have other than settling?

Yes, in the long run the insurer will not lose and society pays through higher premiums.

Until the courts correct their behaviour, that's the only possible outcome - we can have high payouts and high premiums, or low payouts and low premiums. We can't have high payouts and low premiums.

griffin100

https://www.boards.ie/discussion/comment/121826770#Comment_121826770

I can assure you that the days of sitting in a car, following claimants and taking photos are not long gone. Not everyone has an open social media presence or is a stupid as this claimant. It is still very common to have a claimant who claims incapacity of some sort and / or an inability to work due to an injury followed by a PI.

Boggles

https://www.boards.ie/discussion/comment/121827952#Comment_121827952

There is no such thing as self reporting in court.

You need to provide medical evidence, the insurance company also as an opportunity to do this.

Nermal

https://www.boards.ie/discussion/comment/121828119#Comment_121828119

As discussed earlier in the thread, in many PI claims the 'medical evidence' is simply self-reported symptoms with a doctor's signature at the bottom.

As long as the courts accept this 'evidence' as fact, we will have high premiums.

Seth Brundle

https://www.boards.ie/discussion/comment/121828166#Comment_121828166

I have ongoing neck pain from an incident years ago. Can't show any evidence of it though.

2smiggy

https://www.boards.ie/discussion/comment/121827734#Comment_121827734

<admin snip> User warned.

Seth Brundle

have had a number of polish workers who found that going on welfare for 'a long long time' with a practically free council house is preferable to returning to Poland, or returning to work.

There are plenty of Irish people defrauding both the welfare and tax systems so shut up with the bigoted crap!

Boggles

Would be the polar opposite of my experience.

All hard working all own their own homes.

It's usually the Irish lads who wouldn't work to warm their arsé would be the most vocal about the foddeners.

2smiggy

https://www.boards.ie/discussion/comment/121828273#Comment_121828273

<admin snip> User warned.

brokenbad

Most expensive Christmas Tree she ever picked up.....

Potatoeman

Which got thrown further? The case or the tree?

Norrie Rugger Head

https://www.boards.ie/discussion/comment/121807306#Comment_121807306

I've bad intermittent sciatica. I could play a rugby match today, run 10k tomorrow, and be fine. Could try to get out of a chair tomorrow evening, feel a twinge, and be absolutely crocked for a week or more.

If I were working a trade I'd be unemployable. As it is I have to make sure to have strong medication on hand, for days installing servers etc (just in case)

Not saying that people cheating the system should not get exposed but this idea that pain injuries always have to mean constant pain is false.

Norrie Rugger Head

https://www.boards.ie/discussion/comment/121828188#Comment_121828188

I've bad soft tissue damage from coming off a motor bike, 20 years ago. Long haul flights are a nightmare, standing over an average height counter where I have to bend over the same.

Zero evidence of anything on scans

Uncle Pierre

https://www.boards.ie/discussion/comment/121829067#Comment_121829067

Sorry to hear about your own circumstances.

However, I'd like to think that if you were the one making a claim, you'd be honest enough to say "sometimes I'm fine and can lead an active lifestyle, but other times I'm in pain and unable to do anything much".

But according to the news report on this case that's linked all the way back in OP, this woman "told the High Court sitting in Limerick that she suffers constant pain in her back, neck and thoracic spine".

I'm not a medical expert but I find it hard to believe she suffers such bad constant pain if she's able to throw a Christmas tree and wrestle with a Dalmatian.

Patrick2010

https://www.boards.ie/discussion/comment/121827916#Comment_121827916

"It's myth by the insurance industry that 1 in 5 claims are fraud, they have absolutely no figures to back up this claim."

Do you have any figures to refute it?

Boggles

https://www.boards.ie/discussion/comment/121831732#Comment_121831732

The number of recorded insurance fraud cases in 2022 amounts to half of one percent (0.53%) of claims, Mr Magner said.

This contrasts with estimates from insurers that “approximately 20pc of the personal injury claims they receive could be fraudulent or exaggerated”.

Alliance Board member and CEO of the Federation of Irish Sport, Mary O’Connor said: “We regularly hear from insurers about fraudulent and exaggerated claims being as high as 20pc and yet those reported to the Gardaí are less than half of one percent. Something doesn’t add up.”

Norrie Rugger Head

https://www.boards.ie/discussion/comment/121831544#Comment_121831544

Not saying it looking for sympathy but thank you nonetheless

Apologies, I mistyped. I am in constant pain but I am not in constant DEBILITATING pain. That was a big omission, on my part. As I sit here, currently, I am "fine" yet leaning to one side to keep pressure off. If I was to be asked "are you OK?" would immediately say "Yeah, why?". It's the default for me and I don't pay too much attention to it anymore.

Yeah; were this an injury from, say a crash, my testimony would be that I am in daily pain with often happening yet random and lasting bouts of debilitating pain.

Again, in a daily physical job I WOULD be unemployable but, at the same time I could enter a Christmas Tree throwing contest and be fine.

I'm not saying that she was an honest or dishonest person, not my place, but the insurance industry has done a fantastic job of trying to paint any normality of life as proving that someone is not injured permanently

Large bottle small glass

This Plaintiff was pretty much braindead to do what she did.

In cases like this the use of PIs is pretty much run of the mill. The PI firms will have boots on the ground and will also have dedicated online personnel. No of it is rocket science but mainly tedious boring work I would think. If they know what they are doing and you have done something stupid on your social media accounts they are going to find it.

In situation were insurance companies suspect there is a large "ring" of claimants the investigation methods by some insurers are quite a few steps up from just an online search. Suffice to say that once you are using Instagram, twitter, tik tok or whatever they you have just given them a location tracker and a list of who your friends are, are where they go gyms, cafes etc etc.

All completely illegal but as an insurer if you play by the rules you get fcuked. You can never show the information you got that way, but you can use the photos you took of some dipsh1t lifting weight because he was posting photos on his Instagram at the same time every other week..

Norrie Rugger Head

https://www.boards.ie/discussion/comment/121832018#Comment_121832018

So, read my above.

I go to the gym regularly but that does not mean that I don't suffer debilitating bouts of crippling back/leg pain.

It means nothing to see people live their lives around long term illness/injury but the insurance industry has painted it as such

Again not saying this person was or was not genuine.

El Gato De Negocios

https://www.boards.ie/discussion/comment/121831813#Comment_121831813

You are displaying your ignorance here tbh.

Here's 2 scenarios.

1) Im driving along, travelling approximately 20 km per hour. Coming up to a set of lights I slow down, stop my car but the driver behind me isn't paying attention and crashes into the back of me. No major damage done but one of my brake lights gets broken and my bumper if cracked. I was wearing my seat belt and got a bit of a sudden jolt forward but no major injuries. I wake up in the morning and my neck is feeling a bit stiff, i take a few ibuprofen and it settles down after a few days. I get occasional, residual pain but nothing that impacts me in any meaningful way. On the advice of my friend, I ring a solicitor that specialises in personal injury claims, explain the incident and they advise me to go immediately to my GP. Before I go to my GP, another friend tells me there might be a few quid in it for me if I play my cards right. So i go to my GP, i tell them that I am having trouble sleeping with the pain, Im getting flashbacks to the incident, Im too nervous to get behind the wheel of the car again. They do me up a cert for work, I take a few days off, meet with the solicitor and have them lodge a PI claim on my behalf, presenting the embellished symptoms outlined above. Ultimately, I end up getting €20k compensation for my injuries.

2) Myself and my friend arrange to stage an accident. I tell him to meet me at a particular place at a particular time and he will ram into the back of my car and flee the scene, obviously Im not going to be sitting in the car as I could get seriously hurt. This plan goes off without a hitch, I ring the guards and tell them Ive been involved in a hit and run incident. They arrive with an ambulance, Im carted off to hospital due to my serious whiplash and the car is towed to a garage. I contact a solicitor, explain the details, they bring a claim on my behalf to the MIBI and I end up getting paid €40k compensation for my injuries.

Which of these above scenarios would you consider to be fraudulent?

Uncle Pierre

https://www.boards.ie/discussion/comment/121831813#Comment_121831813

Am not going to get hugely involved with this one and will let @El Gato De Negocios lead any discussion on it, if they want to.

But I googled that quote you put up, to see where it came from, and look what I found: https://www.independent.ie/business/personal-finance/reform-group-queries-how-seriously-insurers-are-taking-fraudulent-claims/a875862582.html

i.e. the speaker wasn't saying insurance fraud mustn't be a problem because only 0.5% of cases end up as a recorded fraud.

He was instead saying insurance companies don't seem to be doing enough to tackle fraud, because it's widely believed that the true percentage is much higher.

Boggles

https://www.boards.ie/discussion/comment/121832807#Comment_121832807

The OP wanted statistics, they are the statistics.

Every thing else is unfounded opinion.

If you have other actual stats, by all means fire them up.

El Gato De Negocios

https://www.boards.ie/discussion/comment/121833023#Comment_121833023

Since you've elected to skirt my last post, the statistics you posted said

This contrasts with estimates from insurers that “approximately 20pc of the personal injury claims they receive could be fraudulent or exaggerated”.

Theres a couple of key words in the above.

Estimates

Could be

Fraudulent OR exaggerated

You know damn well that both scenarios I posted are examples of fraudulent claims. As scenario 1 is for all intents and purposes impossible to prove beyond reasonable doubt, AGS would never entertain it. Even with scenario 2, in the absence of actual footage, AGS would likely also never entertain it.

Another one that you'll likely avoid answering but ill ask your opinion anyway, do you think scenario 1 would occur in many claims in this country?

You know, people seeing the € symbol, solicitors operating on a no win no fee basis, would there be little, a few, many claimants, that might over egg their symptoms to try and get a few extra quid?

Boggles

https://www.boards.ie/discussion/comment/121833590#Comment_121833590

Insurers operate a zero tolerance policy on claims they believe to be fraudulent or exaggerated. It's in their charter.

The published figure is around half a percent. Again, only the vast vast minority of cases make it in front of a Judge. Less than 5%.

If you have other figures I will gladly take a look at them.

Makkey Uppy scenarios or your feelings are pretty much irrelevant to the facts.

El Gato De Negocios

https://www.boards.ie/discussion/comment/121833644#Comment_121833644

🤣🤣🤣

As I suspected, an utterly ill-informed barstooler, good luck.🫡

Boggles

https://www.boards.ie/discussion/comment/121833771#Comment_121833771

So absolutely no tangible evidence to refute the published statistics, just insults.

Good for you.

👍️

ejmaztec

This is the first time that I've seen anyone prosecuted for making a fraudulent claim, and every chancer should end up in court if their "accident" claim is fraudulent.

Tralee man jailed for fraudulent claim over pub toilet fall (irishexaminer.com)

downtheroad

I previously worked at a law firm that defended a supermarket chain. The settlements that were paid out, long before ever seeing a courtroom, were astounding. Often for trivial matters, because it was cheaper to settle for 10s of thousands than to go to court.

Like him or loath him, Pat McDonagh called out a particular law firm for taking a number of very similar cases against his company. The legal letters appeared to be a template, with the dates and names differing.

https://supermacs.ie/open-letter-to-tracey-solicitors-in-relation-to-insurance-claims/

No foal no fee needs to be stamped out of the legal profession. The lawyers who take these cases on are throwing sh!t at the wall to see what sticks.

And unfortunately it is the ordinary Joe paying for all this through savage insurance premiums, not to mention businesses ceasing to trade because they can't get requisitie insurance cover at affordable prices.

downtheroad

https://www.boards.ie/discussion/comment/121834266#Comment_121834266

This was a good one

https://m.independent.ie/irish-news/courts/woman-accused-of-taking-glass-out-of-her-bra-and-putting-it-in-her-food-in-restaurant-court-hears/39476723.html

https://www.joe.ie/news/674306-674306

Uncle Pierre

https://www.boards.ie/discussion/comment/121834196#Comment_121834196

In response to this and a couple of other replies from you above:

No, there are no statistics to prove that the true proportion of fraudulent or exaggerated claims is in the region of 20%.

But the point is that the 0.5% figure you refer to doesn't prove that only 0.5% of claims are fraudulent or exaggerated. It merely states that only 0.5% of cases end up as recorded fraud.

Take the two hypothetical cases outlined by the other poster above. The insurers may strongly suspect that they're fraudulent or exaggerated, but are unable to prove it. Therefore, they don't end up as recorded fraud.

Basically, what your statistic says is that 0.5% of cases end in people being caught making fraudulent or exaggerated claims. It's highly likely that many others also make such claims, but get away with it. Therefore, the true rate of fraudulent or exaggerated claims is above 0.5%. Maybe not as high as 20%, but not as low as 0.5% either.

This is basically the point the speaker was making in the report that you referred to yourself.

Boggles

https://www.boards.ie/discussion/comment/121836033#Comment_121836033

No, there are no statistics to prove that the true proportion of fraudulent or exaggerated claims is in the region of 20%.

So we agree.

Uncle Pierre

https://www.boards.ie/discussion/comment/121836073#Comment_121836073

Lol. You're very selective in the things you quote, and I'm not convinced you pay much attention to the context in which they were said.

Yes, we agree that there are no statistics to prove that the true proportion of fraudulent or exaggerated claims is in the region of 20%. That's an irrefutable fact.

Hopefully you also agree that a statistic which says only 0.5% of cases end up as recorded fraud doesn't mean that only 0.5% have at least some element of fraud or exaggeration in the first place. That too is an irrefutable fact.

Boggles

https://www.boards.ie/discussion/comment/121836309#Comment_121836309

Context is moot, the OP asked for the statistic.

This has already been pointed out to you.