Personal Injury Fraud

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 What is a Personal Injury Claim?

Personal injury law is a broad category of law which encompasses a wide variety of cases in which individuals were injured as a result of the negligence of others. Categories of personal injury law may include:

  • Automobile accidents;
  • Dangerous property or buildings;
  • Defective products; and
  • Medical malpractice.

A personal injury claim is brought when a plaintiff claims they have sustained an injury, either mental or physical in nature, or both, because of the actions of the defendant or the defendant’s failure to act. In these types of cases, courts or juries may award monetary damages to compensate for the injury and the losses associated with it.

Mental injuries may include emotional pain and anguish which is sustained due to the accident. Physical injuries may include injuries to:

  • Limbs;
  • Organs; or
  • Other parts of the body.

Injuries which are sustained by the plaintiff do not have to manifest instantly, and may develop over time.

What is a Personal Injury Award?

Personal injury awards are granted to individuals in personal injury lawsuits in order to provide them with compensation for injuries they suffered as a result of the actions of another individual. In general, the majority of personal injury lawsuits result in a monetary damages award for a plaintiff.

A monetary damages award is an amount which is paid to the injured individual, or plaintiff, by the individual or entity that is found liable for causing the injuries, known as the defendant. A plaintiff and defendant are permitted to agree on an amount of a damages award following negotiations between the parties, the parties’ insurance companies, and their attorneys.

In certain cases, a court may issue an injunction, which is a court order that prohibits conduct or requires a defendant to take certain actions. The majority of personal injury lawsuits result in a damages award which is intended to cover the losses of the plaintiff.

Monetary damages awards are common in cases including:

  • Automobile accidents;
  • Slip and fall claims;
  • Negligence lawsuits; and
  • Class action lawsuits.

What Do Personal Injury Awards Usually Cover?

There are often numerous components to a personal injury award. The amount of damage awarded and the scope of the coverage of those damages will depend upon the injuries and the losses which the plaintiff sustained.

In many cases, personal injury awards cover:

  • Compensatory damages, which are intended to compensate the plaintiff for their losses. These damages must be calculable, and directly caused by the defendant’s conduct;
  • Restitution damages, which are damages that are calculated based on the gain that was obtained by the defendant from their actions;
  • Punitive damages, which are damages that are intended to punish a defendant for their actions. These damages are usually only granted in cases of willful or intentional conduct, and compensatory damages are also issued; and
  • Pain and suffering. Compensation is sometimes granted in cases where a victim can show that they suffered additional hardships from the injury.

In the majority of personal injury cases, most of the plaintiff’s losses will be compensated through the award of compensatory damages. This award typically covers:

  • Medical bills;
  • Hospital and medication costs;
  • Lost wages; and
  • Other direct losses.

Punitive damages awards, however, may be fairly high if they are given. It is important to note, however, that many states have placed caps on the amount which can be awarded.

What is Personal Injury Fraud?

Personal injury fraud arises when an individual provides false information regarding a personal injury claim. It may also involve circumstances when an individual files a claim for an injury which never occurred or when they attempt to use false evidence to try and prove an injury did occur.

Personal injury fraud may occur in numerous different contexts as well as in many different types of situations. Similar to other types of fraud, personal injury fraud is illegal and may result in serious legal consequences.

What are Some Examples of Personal Injury Fraud?

There are many different ways in which individuals attempt to engage in personal injury fraud, including:

  • Filing false insurance claim information;
  • Filing a frivolous lawsuit, such as a lawsuit for a claim that will more than likely not succeed in court;
  • Fraud when applying for health care;
  • Hiring a physician to provide false testimony regarding an injury;
  • Applying worker’s compensation or disability using fake injury information;
  • Exaggerating the extent of a legitimate injury;
  • Using a previously sustained injury as the basis for a new injury claim; and
  • Filing for excessive amounts of damages.

Personal injury fraud may often involve other types of legal issues as well, including issues which related to insurance, employment information, and other matters. There are certain types of injuries which are commonly faked, including:

  • Whiplash;
  • Shoulder and joint injuries; and
  • Spinal injuries.

These types of injuries are often difficult to detect or measure in terms of their seriousness at the time they are caused, which is why they are often the basis for fake injury claims.

Are There Legal Consequences to Committing Personal Injury Fraud?

If an individual engages in personal injury fraud, it may lead to serious legal consequences. Similar to other types of fraud charges, it may result in criminal misdemeanor charges.

Conviction of a criminal misdemeanor may result in criminal fines as well as jail time. Personal injury fraud may also result in an insurance company taking one of more of the following actions:

  • Denying an individual an award from any claim that they filed with them;
  • Canceling the individual’s current insurance coverage;
  • Revoking a settlement or insurance lawsuit award; and
  • Filing a civil suit against the individual to collect damages.

Are There Any Defenses to Personal Injury Fraud?

In order for an individual to be liable for personal injury fraud, they must have intended to commit the fraud. In other words, they must have intended to make a fraudulent statement or present fraudulent evidence in order to cheat or defraud an individual or entity and do so while being aware they are doing it.

There are some defenses which may be used to defend a personal injury fraud charge. For example, the individual must have known that the statement they made or evidence they presented was not truthful at the time at which it was presented.

An individual is not engaging in fraud if:

  • They made honest mistake when stating the facts of the accident;
  • They had no intent when making the defrauding statement or giving fraudulent evidence; or
  • They guessed that the information was true, but were not too sure and had no intent to lie.

Do I Need a Lawyer for Assistance with Personal Injury Fraud Issues?

It is essential to have the assistance of a personal injury lawyer for any personal injury fraud issues you may be facing. Personal injury fraud cases often involve numerous legal issues and may result in extremely complex lawsuits.

Because of this, it is important to have the assistance of an attorney for help with any personal injury fraud matters, whether you are defending a charge or attempting to prove a charge. Your attorney can advise you regarding the relevant laws in your state, how they may affect your case, and represent you any time you have to appear in court.

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