STAGED ACCIDENTS: INSURANCE FRAUD

The police chief of Hackensack, NJ was recently striped of his 15 year position after being charged with insurance fraud–he filed a false insurance report. An upstate New York man was recently also charged with the same crime: all he did (!) was take out an automobile insurance policy AFTER the date of his car accident and then made a claim under the policy changing the date of the accident so that the policy would cover it.

People in all walks of life, for a variety of reasons, but virtually always grounded in the desire to reap rewards to which they are not legally entitled, participate in what is almost a national pastime: insurance fraud. There are numerous forms that insurance fraud takes, but perhaps the most insidious is the scheme involving staged accidents. (See the instructive video: https://www.nicb.org/multimedia/staged-videos/staged-accident-videos ).

The staged accident phenomena is becoming more prevalent. It involves claims under a state’s no-fault provisions relating to medical costs, where medical providers of all sorts have been found to participate in these schemes.

It also involves claims for bodily injury that find their way into court cases, reaping enrichment for unscrupulous lawyers and thieves acting as clients. The two states with the highest rates of staged accident fraud are, in order, Florida and New York..

While the claim may be that “only” insurance companies are hurt, in reality it is everyone that owns a car that is hurt. Fraud has a significant effect on insurance premiums, which affects every car owner in his or her pocketbook.  And make no mistake about it, engaging in any type of insurance fraud changes what would normally be a civil matter involving claims for money damages, into a criminal matter, where the penalties faced by those engaging in this nefarious practice will include incarceration!

ACT  OF  GOD: NATURAL DISASTERS

If, today, a tornado were to destroy your home, “who ya gonna sue?”  Hope that you had enough, and appropriate,  insurance  coverage?

Just recently a fierce winter  storm caused ice to fall onto, and break through, a glass atrium of a New York office building.  Several people were injured, though thankfully, only slightly.   In Washington, D.C., the impact of that same winter storm that wracked almost the entire East Coast, created winds gusting up to 60 mph that shook scaffolding, causing two workers to lose their footing and fall.  Though seriously injured, both survived.   “Act of God”?    Certainly.   End  of  story?  Not at all !

There are certainly certain natural events that occur that result in damage to individuals, and for which there will be no recourse, by way of a lawsuit.  God is not a viable litigant !

Before you jump to the conclusion, however, that any given event–any “Act of God”–even a hurricane, a  blizzard, a raging flood or a tsunami–may not lend themselves to seeking compensation from a source other than, or over and above, insurance, it would be wise to consult with an experienced Personal Injury Attorney.

Most common in the winter months are cases involving falls on ice and snow.  Without going into details in this area of law, which can be difficult, the experienced attorney will examine the existence of local ordinances regarding snow removal.  The attorney will also look at any acts by a property owner that aggravated what nature may have created, had there been no human interference.

With the examples of the glass atrium and the scaffold, we enter into areas of law that also lend themselves to imposing responsibility upon third parties.  In both instances, laws exist that will govern the imposition of liability on certain third parties (building codes, labor law).  And even in addition to those grounds for a lawsuit, there are many instances where the concept of “foreseeability” is applicable which will subject certain third parties to liability for what otherwise seem to be an “Act of God”.

“Foreseeability”, the facility to perceive, know in advance, or reasonably anticipate that damage or injury will probably ensue from acts or omissions (legal dictionary definition) will be dealt with in another posting.

Auto Insurance Facts that No One Will Tell You That you SHOULD Know!

Uninsured Motorist Coverage * Underinsured Motorist Coverage * Spousal Insurance

In New York State, as in every other state, it is illegal to drive a vehicle without proper insurance coverage.  Insurance serves to protect you, and those driving with you, as well as strangers with whom you may be in an accident at some time.

New York State requires a minimum “liability” coverage of $25,000 for privately used passenger vehicles.  This is the coverage you have in case you are sued by others because of an automobile accident.In purchasing automobile insurance, you will also automatically receive “No-Fault” coverage for certain expenses you may incur in any car accident.

These include payments for medical treatment and lost wages.   It is referred to as “No-Fault” payments because the “victim” in an car accident will be paid these benefits regardless of whether that person was or was not at fault for the accident.  Those benefits are paid regardless of  fault, and for an injured vehicle occupant, the insurance company of the vehicle in which that person was riding is the company that pays those benefits.

There are other coverages available when you order automobile insurance that you should know about.   These are most often not explained to you when you order your insurance and may be the most important of all.

First of all, you should be aware of the fact that you have the option of raising the limits of both your “liability” coverage and your “No-Fault” coverage.   If you can afford to do so, you probably should .   First, it will protect you and your assets to a greater extent if you are unfortunately involved in an auto accident and are sued.   Second, it will cover your medical expenses and lost wages to a much greater degree if you are seriously injured in that accident.

Most importantly, greater liability coverage will allow you to purchase greater amounts of both “Uninsured Motorist” insurance and “Supplemental Underinsured Motorist” insurance, the importance of both of which cannot be stressed strongly enough.

“Uninsured Motorist” insurance will cover you, or the occupants of your vehicle, up to the limit of your coverage, in the event the automobile with which you had an accident had NO insurance at all.  Accidents with uninsured vehicles happen with some frequency, and then “Uninsured Motorist” coverage on your own vehicle compensates you and the occupants of your vehicle for “pain and suffering” which would not otherwise be available.   “Uninsured Motorist” coverage is part of every auto policy, but increased amounts over the basic $25,000 offered is only available if you first purchase “liability” coverage over the required $25,000 minimum.

“Supplemental Underinsured” motorist coverage may be the most important of all.  It is rarely mentioned by insurance salespeople–it is surprisingly cheap and they do not realize much profit from its sale.   This coverage becomes vital when you are unfortunately involved in a serious accident and you or the occupants of your vehicle are very seriously injured–and the accident was not your fault.   If the other vehicle, which was at fault, has insurance, BUT it is only a modest amount, it will probably not be nearly enough to adequately compensate you, or any other seriously injured person in your vehicle, for the pain and suffering they have gone through.   In that event, you and the other injured party or parties can simply turn to the “Supplemental Underinsured Motorist” coverage of your own auto policy to make up some or all of the  difference.

One last very recent addition to available insurance coverage in New York is “Spousal Insurance”.   This is important when you realize that, if you are married, there is no one with whom you drive more often than your spouse.   The rule has always been that one spouse may not sue the other.  While you could sue a parent, a child, a sibling, you could not sue a spouse.  If you were driving with your spouse and the driving spouse caused an accident, there was no available way to seek an award for pain and suffering.  That has now changed.  You can request “Spousal Insurance”.  This, too, is not very costly, and could be invaluable.   It should certainly be looked into and seriously considered.

Unfortunately, most people do not realize the shortcomings of the car insurance coverage they have until it is too late–until after they are involved in an accident.  Everyone would be well advised to review, very carefully, with a knowledgeable person, either a trusted insurance broker or an injury attorney well versed in automobile matters, the coverage they currently have to determine its adequacy.