Casualty

With increasingly sophisticated techniques, organized fraud rings target both commercial trucking fleets and private passenger vehicles in schemes designed to fabricate accidents and exploit the insurance claims process. These fraudulent activities have led to significant financial losses for insurance carriers and businesses, driving up premiums and creating unnecessary litigation. However, recent advancements in technology and legal strategies have given businesses and insurers powerful tools to combat these criminal enterprises.

This article examines common fraud tactics involving fabricated motor vehicle losses, outlines key preventive measures, and explores proactive legal strategies that businesses and insurers can implement to mitigate risk and deter fraudulent claims.

The Mechanics of Staged Accidents
Staged automobile accidents follow a common set of patterns, often orchestrated by multiple vehicles acting in concert to create the illusion of a legitimate collision. These schemes typically include:

• Forced Merging Collisions: A fraudster vehicle double-parks or obstructs traffic, compelling the insured driver to maneuver around it. At that moment, another vehicle initiates a low-speed collision, making it appear as though the insured driver was at fault. 
• Sudden Braking Scenarios: A fraudulent actor abruptly stops in front of a truck, forcing a rear-end collision. In some cases, an accomplice vehicle blocks the truck from changing lanes, thereby preventing the driver from avoiding an impact with the claimant vehicle.
• Phantom Accidents: No actual collision occurs, but claimants submit fabricated police reports and medical documentation alleging significant injuries. In many such instances, an accomplice driver will pose as a “Good Samaritan” who slows in traffic in order to allow the claimant vehicle (with unrelated damages) to pull along side the target vehicle and allege that an accident has occurred. 
• Multiple Passenger Injury Claims: Fraudulent claims often involve multiple occupants in the claimant vehicle, each alleging injuries that require extensive (and often unnecessary) medical treatment, including surgeries, to inflate the value of their claims.

Leveraging Technology to Prevent Fraud
One of the most effective defenses against staged accidents is the strategic use of technology to document incidents and provide irrefutable evidence of their occurrence. Businesses and insurers should consider implementing the following:

• Front and Rear-facing Dashboard Cameras (dashcams): Dashcams capture real-time footage of roadway conditions, vehicle movements, and collisions. These devices have dropped dramatically in price in recent years and can provide indispensable video evidence which can immediately refute fraudulent claims by demonstrating how the alleged accident was intentionally caused.
• Event Data Recorders (EDRs): Also known as vehicle “black boxes,” EDRs track speed, braking, and other driving metrics. EDR data can be used to challenge fraudulent claims by showing that no impact occurred, that an incident was intentionally caused, or that the insured vehicle was not at fault. 
• Rapid-Response Investigations: In the aftermath of a suspicious accident, investigators should promptly collect available video evidence from nearby traffic cameras and businesses. Likewise, investigators should waste no time in performing background checks of the claimants, which can reveal patterns of prior fraudulent claims, potential connections to known fraud rings through usage of common telephone numbers and addresses, and past criminal convictions.

Legal Strategies to Combat Fraudulent Claims
While technology provides a strong deterrent against fraud, businesses and insurers must also adopt an assertive legal approach to prevent fraudulent claims from resulting in costly settlements. The following strategies can be particularly effective:

• Declaratory Judgment Actions: If evidence suggests that a claim is fraudulent, businesses and insurers should consider filing a declaratory judgment action seeking a court ruling that no liability exists. This preemptive legal maneuver places the burden on fraudsters to justify their claims and can prevent the case from escalating into protracted litigation. 
• Counterclaims for Fraud: When a lawsuit based on a fraudulent claim is filed, defendants should consider asserting counterclaims for fraud, misrepresentation, and conspiracy. A well-documented counterclaim can serve as a deterrent, signaling that fraudulent actors will face legal consequences rather than quick settlements. 
• Vigorous Litigation Defense: Fraudsters often rely on the assumption that insurers will settle rather than incur the costs of litigation. By aggressively defending against fraudulent claims and utilizing video and EDR evidence, businesses and insurers can shift this calculation.

Where appropriate, defense counsel should seek early dismissal of claims based on fraudulent allegations and request sanctions against claimants who engage in bad-faith litigation.

Conclusion
Staged accidents and fraudulent insurance claims pose a substantial threat to insurance carriers, commercial enterprises, and private individuals. However, by leveraging advanced technology, conducting thorough investigations, and taking an aggressive legal approach, the insurance industry can effectively combat these criminal schemes.

*Michael is a shareholder in our Mount Laurel, NJ office and a member of the Insurance Fraud/SIU Practice Group. (856) 675-3614 | MJSweeney@mdwcg.com 

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