WWYD?insurance fraud?a possible rant/vent

[mrFDNY]

hi all,
i got this thing on my mind and to be honest it really made my blood boil alot.here's what happened.
at work tonight we get a run for a auto extracation on the belt pkwy.dispatcher says one car possible flipped over, only one 911 call on it.so we go we get there and no car did roll over,no biggie.we get out to see if any one requires medical attention or if any car is leaking fluid of any kind.all is good and the only 2 people involved(each was the driver and alone in each car)denied injurys.so we tell the dispatcher we need highway patrol to come for a report and to secure the scene.both cars are in a bads spot and our rig is blocking them from getting hit again plus the fact the no one slows down to under 70 is'nt helping either.so a black truck pull up and over,stops a guy get's out and approaches both driver who are standing on the shoulder of the highway talking with our Lieutenant.he explains he can make them $50,000 each if they were to suddenly have neck and back pain.my Lieutenant looks at him and says "your kidding me right"you "know thats a felony what you just did"?the guy now i am there with my LT.the guy says what do you think this is russia?this is a free country!i can do what i want,when i want to. he gets back in his truck after giving these ladies a business card and pulls away.right after I, mr smartypants writes his plate number down.

one of the ladies bite's,she comes out of nowhere and say's "now that he mentions it i do have lower back pain and m,y neck hurts.two seconds ago you were fine,now your dying with pain,huh?she goes to the hospital.the police come and we tell him what happened,i know this police officer very good and thats a under statement.he used to live on my block and we were best friends as kids and still go out every now and then for a beer and just to catch up on old times.i've taken his kids to baseball games.he says there's not much he really can do,he will issue a ticket to the owner of the vechile for interfering with a fdny offical( my LT).but none can prove this ladie does not have pain,there is no pain test and she will probaly get some kind of money if she sues for pain and suffering.i have never been so angry to the point i thought of hitting someone.of course i would not hit him,but it did feel good thinking about it.i also just paid my auto insurance bill,so that does'nt help.i had to vent this to someone tonight i guess you guys are it.if i see this dirt bag at another one of my scenes i will have him arrested for interferance and obstruction of a gov't offical.maybe i get lucky and he'll assault me and that's a felony to hit a fdny , ems or nypd on duty and i have him arrested for that to.it just gets under my skin that this creep thinks in his mind we were giving him a hard time and he was not doing anything at all wrong.unreal.hope all are well and have a great day!! I'm happy again,thanks for listening or reading i guess.

 

[Lessa of Pern]

unfortunately, my friend, it's very common. I've seen it many times in the years I practiced in the city, before I weny in-house at an insurance company.

it's illegal -- it's insurance fraud -- and even though the police usually don't get involved, if our company's fraud investigation unit could find guys like this,we'd prosecute.

most of these guys will direct you to a specific medical clinic. the reason?


it's not just a question of having neck and back pain. under the no-fault law you have to be "disabled" from that pain for over three months. otherwise, all you'll get is no-fault benefits -- that is, they'll pay the doctors and they'll pay a % of your wages while you're out of work.

if you bring a law suit, you're subject to be examined by a doctor we choose. often they'll prove someone is "faking it". you also have to give a sworn depostion in pretrial proceedings, and if the lawyers have any suspcisions...well, they'll ask about the guy who was "interfering".


with luck, the fraud scheme will unravel long before trial.

 

[PneumaticTransit]

My uncle-in-law works as firefighter in Miami.

They get called to accident scenes all the time and can spot insurance fraud a mile away.

Apparently the new thing is to get a friend involved. Take insurance policies out, and then run into each other. Collect the insurance money, get new cars, now it's that previous at-fault's guy turn to get hit.... repeat cycle. I'm not sure how it all works, but he says it's a big problem down there.

 

[Arielle22]

I am an HR Mgr and I have seen quite a bit of worker's comp fraud. I have no problem with paying for people injured on the job. I have had employees cut a finger off and another who was out 3 months due to a car accident. I had a tech work 3 weeks and just quit. Out of the blue 3 months later he files a claim and says he is totally disabled. He never told me or his mgr he had been injured. Too bad that my wc insurance had an investigator catch him on video doing activities which clearly shows he is ok. His lawyer was so obnoxious on the phone to me. I gave her the info she needed, told her off and hung up on her. I figure he is suing me, what harm is there by saying what I feel?

MA has a problem of accidents for profit. There was a case where 2 young men had their grandmother in the car while it was deliberately being hit. Something went wrong and she died. They were arrested but fled the country before their trial.

 

[CharlesTD]

It is people like this that annoyu teh hell out of me I mean they are screwing with teh rest of us as it ends up increasing all of our insurance premiuims and we get stuck paying for the a name I can't say that get these people to file fraudulent claims.

 

[punkin]

Totally off topic, but regarding not having pain and suddenly developing it. This actually happens. I was hit from behind (my trunk wound up in my back seat-really bad) and had no pain at the scene. The next day I get up for work and can't move my neck and my baack is throbbing. Doctor told me this is perfectly normal.

 

[mrFDNY]

Totally off topic, but regarding not having pain and suddenly developing it. This actually happens. I was hit from behind (my trunk wound up in my back seat-really bad) and had no pain at the scene. The next day I get up for work and can't move my neck and my baack is throbbing. Doctor told me this is perfectly normal.

yes this is true the next day is normal, but 2 minutes after being handed a insurance card and told if you have neck and back pain i can make you $50,000. that's too quick for me.

 

[punkin]

yes this is true the next day is normal, but 2 minutes after being handed a insurance card and told if you have neck and back pain i can make you $50,000. that's too quick for me.

I'm not disagreeing with you. Like I said, my post was off topic.

 

[Forevryoung]

Mr.FDNY- I handle two NSP exits and a huge stretch of LIE. I was part of the crew who responded to the police officer a little over a year ago (first suffolk county police officer to die on the job in a very long time).

We call it Allstate-itis. The fenderbenders where there is NO damage to either car (going ten miles an hour for example) and we have to collar and board all four people in the two cars. That and my favorites- the pages for the prior car accidents when we cleared the scene over an hour ago. There was an accident once across the street from the station and the people felt well enough to walk across the street (it was pouring out) and then stood around chatting for awhile, filled out the forms that they didnt want to go to the hospital, had the police officer cosign these forms and 40 minutes later as the tow truck pulled up, one lady felt "dizzy" and wanted to go to the hospital. She was then stunned when I put her in triage because I didn't consider her situation an emergency (no board no collar no reason although I considered the KED )

 

[zalansky]

Unfortunately I am a claims adjuster for a large auto carrier and I handle injury claims. This does not shock me, insurance fraud is how quite a few "personal injury" attorneys make their living. (AKA: "Ambulance chasers")
You would not believe the stuff I see cross my desk. I take recorded interviews from people (something personal injury attorneys warn the public not to do) and they say on tape they are not injured. They miraculously become injured after talking with some friends and/or family members who enlighten them that they can make money off the accident, or when the attorneys solicit them. They make me sick - the attorneys, the lying "injured" people...I don't believe anyone is injured anymore because I am so jaded.
By the grace of GOD, I am quitting this job after the holidays and going back to school!!!
I will never work in insurance again, ever.

 

[christineann]

I work in the legal field - insurance defense, and every time I think I've seen it all, there is a new case that amazes me. Fortunately, the insurance companies are fighting these frivolous lawsuits - unfortunately, they have to pay legal fees to do so. We've gotten defense verdicts ( zero to the plaintiffs) in three cases in the past several months in cases that had $30,000 to $100,000 demands from the plaintiffs. What these moron, something for nothing plaintiffs don't understand is that the "no fee unless you collect" means that if you get no money from your suit, you the plaintiff will still be responsible for reimbursing your attorney for the expert fees, multiple visits to the attorney's favorite doctor, xrays, copying fees, mileage, subpoenas, telephone calls, court fees, etc. A plaintiff may not collect anything but could end up owing his attorney thousands of dollars. It's a win-win game for the plaintiff attorneys.

FWIW, a case that is valid will not go to trial 90% of the time. It will be settled out of court. We have settled cases for probably more than they are worth to avoid the expense of trial.

I hope that you will contact the state bar association and report what that attorney did. I do not believe that any state bar association allows such behavior.

 

[mrFDNY]

I hope that you will contact the state bar association and report what that attorney did. I do not believe that any state bar association allows such behavior.

he was more of a ambulance chaser.the card was two sided.one side had a chiorpratic office address and phone #,the other a lawer's info,with phone # and address.my LT is handling it and writing the paper work to whom ever for this one.

 

[JimB.]

I've had calls similar to this (although not quite so brazen). I handle it in a variety of ways.

1. If they start making the complaints after we've been on scene, they get the Whole Nine Yards (backboard, collar, straps, CID, large bore IV, EKG, & anything else I can think of that could be considered remotely appropriate). You never know. They may be suffering from acute multi-systemic trauma.

2. I make sure to tell the ER personnel (in front of the patient) exactly what happened.

3. I document EXACTLY what happened on the Patient report (i.e., patient ambulatory on scene prior to arrival, initially voiced no complaints). I also document damage (or lack thereof) to vehicle, usage of safety equipment, & I have also documented if complaints began after talking to someone else, if patient went to hospital at bystander's or family's urging, etc., etc.........

It may not make a difference, but at least I feel like I did something.

 

[Marseeya]

Totally off topic, but regarding not having pain and suddenly developing it. This actually happens. I was hit from behind (my trunk wound up in my back seat-really bad) and had no pain at the scene. The next day I get up for work and can't move my neck and my baack is throbbing. Doctor told me this is perfectly normal.

Same here. After my accident several years ago, I was up walking around and carrying my very heavy 3 yo DS. That evening I started feeling sore and the next day I was in the worst pain of my life.

But I see what the OP is saying. It's awfully convenient that the woman speaks to a shyster and all of a sudden hurts. What a witch.

 

[Lisa loves Pooh]

Dumb Question--but don't some mild injuries not rear their ugly heads until later.

I got rear ended--had a pre-existing injury that was exacerbated by the rear ending. However--no pain from the inital collision. It took a good 30 minutes before I realized the muscles were hurting and by the time I had gotten to my PT appointment that I already had the next day...the area was very hot from inflammation and the pain was just wretched. In my case with my pre-existing...it was never ever that bad.

Am I to understand that insurance will think I am "faking" it?

I am thankful that I had run 6 miles the day prior to the accident and the fact that I was unable to run for 2 weeks and that it took 4 months for me to get back up to that distance--was at least a quantitative sign that something was up even though I refused for the police to call fire/rescue--drove home and went to an event that evening.

I'm . I don't want to be calling an ambulance when it isn't necessary.

ETA: Like the preceding poster---I had one other neck problem...I jumped off of a high dive and landed funny in the water. The only thing bothering me was the pain from what felt like I belly flopped off of a mountain (landed sllightly tipped--but not technically a belly flop). Everyone--the stupid instructor...to all my friends thought I was silly for complaining b/c it isn't like the doctor can do anything about a belly flop. The next day I woke up unable to move my head. They told me I got the equivilant of whiplash--and that's how they tell the real ones from the fake ones b/c most whiplash symptoms don't show up until later.

 

[Hillbeans]

You would not believe the stuff I see cross my desk. I take recorded interviews from people (something personal injury attorneys warn the public not to do) and they say on tape they are not injured. They miraculously become injured after talking with some friends and/or family members who enlighten them that they can make money off the accident, or when the attorneys solicit them. They make me sick - the attorneys, the lying "injured" people...I don't believe anyone is injured anymore because I am so jaded.
.

Years ago, a car hit us from behind while we were at a stop (they were looking at the accident on the other side of the road). Our car had about $4,000 in damage, and our son was 5 mos at the time in the back seat. The car looked 5 times worse than it actually was b/c the bumper fell completely off. We were all fine, but the only "extra" we needed was a new car seat because our son's car seat broke from impact.

I can't tell you how many people told me to sue to get $$$ even though I wasn't hurt - I couldn't believe it. I'll never forget the people who told me to sue and their lack of honesty. What goes around comes around, and if we weren't hurt, why would I sue? So I can pay higher car insurance next year? No way.

 

[4formickey]

You can find out the guys name and try to report him that way. I work in chicago ,driving a bus and this is why they have cameras on all of our fleet. You have a broken mirror and ten people says,there back is hurting. I was involed in an accident awhile back when I was rear ended while standing still. This guy was about to get off of the bus, after he saw that the bus was hit ,he ran off the bus to tell his job(he worked in a school right there) ran back to the bus and said that his back was hurting. He doen't know that it was all on tape. When the tape is looked at his dream of a big payday are over.

 

[Forevryoung]

1. If they start making the complaints after we've been on scene, they get the Whole Nine Yards (backboard, collar, straps, CID, large bore IV, EKG, & anything else I can think of that could be considered remotely appropriate). You never know. They may be suffering from acute multi-systemic trauma.

2. I make sure to tell the ER personnel (in front of the patient) exactly what happened.

3. I document EXACTLY what happened on the Patient report (i.e., patient ambulatory on scene prior to arrival, initially voiced no complaints). I also document damage (or lack thereof) to vehicle, usage of safety equipment, & I have also documented if complaints began after talking to someone else, if patient went to hospital at bystander's or family's urging, etc., etc.........

It may not make a difference, but at least I feel like I did something.

We do the same. The best was when we start unloading equipment and they say "but I really dont NEED all that right?"