When A Personal Injury Case Becomes Insurance Fraud

No matter whether it was a car accident or a slip in a store, if you were hurt due to the negligence of another, you have the right to pursue a personal injury claim. If that negligent person can be proven to be at fault, their insurance will cover your medical bills, lost wages, and even pay you for the pain and suffering of having to go through that injury. The personal injury system was put in place to make sure that innocent people aren’t left paying for injuries that were caused on accident. However, like with any other system, there are ways to defraud it, even if you don’t mean to.


When people think of insurance fraud in terms of personal injury cases, your mind might immediately go to the TV situation where someone might fake a number of injuries in order to get more compensation. However, typically this is an unlikely scenario. Realistically, it is very difficult to find a doctor who would be willing to put their reputation on the line to attest to fake injuries. There are some injuries that are, by nature very vague to define, such as spinal injuries and the classic case of whiplash, but even then, fraud is difficult.

However, in truth the most common way that a personal injury case becomes a case of insurance fraud is when you fail to disclose information. Most people that face insurance fraud from a personal injury case don’t lie or give false information in order to get money, but rather they just fail or forget to mention something.

Situations that would be considered fraud by omission might include failing to mention something you did differently that day that you would not have done otherwise, failing to mention you were doing something illegal at the time that may have contributed to the accident (i.e. texting while driving), or in general failing to mention anything pertinent to the accident. Even if you do not believe the small detail is important, you should still at least disclose it to your attorney. This can help protect you from fraud as they will be able to advise on if it is important or not. Even if it is something condemning, like that you were texting while driving during an accident, they will still be able to help spin it so you can still receive compensation.

If it is discovered that you failed to disclose some information during the personal injury case, in most cases it would simply hurt your case. Depending on the unique circumstances, you may not be able to recovery any compensation, but in most cases, it will just mean you will recover less. However, if it is discovered after the case is concluded, the insurance company is very likely to pursue a fraud case against you.

Punishments for a conviction of insurance fraud include a likely revocation of your settlement and, in most cases, a misdemeanor-level criminal charge. For fraudulent personal injury cases, you can face a felony charge if the willful destruction of property was part of the case as well. For those who omit crucial details, the resulting misdemeanor may mean a series of fines, probation, and even jail time.


Has your personal injury case ended and the insurance company is accusing you of fraud? This is not the time to be idle. Not only is the settlement you need for your injuries in danger, but being convicted of insurance fraud could come with criminal punishments that you don’t want to have to endure. If you are looking at insurance fraud because of a personal injury case or beyond, contact us today.