Common Factors that Elicit Suspicion of Fraud in Personal Injury Claims

Here are some circumstances that might lead the insurance company to suspect a personal injury claimant of fraud.

Hearing from an Orange County Personal Injury Attorney “Too Quickly”

If the insurance company hears from the claimant’s personal injury attorney too quickly, the claims adjuster’s suspicious may be raised. The insurance companies teaches its adjusters to watch out for claimants who are “claims conscious” and suspect their familiarity with the system may be a result of their trying to game the system.

Contact from Union Leaders

Similarly, adjusters become suspicious if they hear from the claimant’s union leader inquiring after the claim. Even if the union leader does not pressure the adjuster to accept the claim, the adjuster will be quick to jump to conspiracy theories about premeditation.

Disappearing Symptoms

If the adjuster sees you limping when you collect your check but then sees you walking normally in the parking lot, he will immediately suspect fraud. This is part of why experienced Orange County personal injury attorneys tell their clients never to exaggerate their symptoms.

Failing to Answer Phone Calls

If the adjuster is consistently finding his calls unanswered during the day, he may begin to wonder what the claimant could be doing all day if he is truly disabled. And if the claimant is capable of being out and about, is he truly injured?

Inconsistency between Injury and Described Symptoms

Insurance adjusters consider it a major red flag if the symptoms the claimant describes are not consistent with their medical records.

Reputation of the Treating Physician

If the claimant’s doctor has a history of treating personal injury claimants, the insurance adjuster may suspect him of running a “claims mill” trying to pump the insurance industry full of fraudulent claims.

Valuable Cases

The claimant stands to gain a large amount of money for his claim, above and beyond what he might have earned working, the insurance adjuster tend to be warier than usual, even if it isn’t an immediate red flag.

There are plenty of reasonable explanations for any of these situations, but you will need an experienced Orange County personal injury attorney on your side to get the money you deserve. Call Orange County personal injury attorney Samer Habbas at  (888) 848-5084 today for a free consultation.