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National Claims Advice Hotline 0818 252 800

The truth about fraudulent claims

Insurance Company’s were requested to answer questions in relation to insurance fraud to determine the Bona Fide of their allegations regarding fraudulent claims.

This is a transcript of the video

Pierce Doherty: Can I just pick up on that point in relation to fraud? You make the claim that 20% are fraudulent claims. How many claims do FBD get per month?

Jackie McMahon: We get about 60,000 to 65,000 claims a year.

Pierce Doherty: 65,000 claims a year. So your suggesting that a fifth of those are fraudulent.

Jackie McMahon: Well I have given it to you on value they’re the number, as opposed to on hard count number. But yes 20%.

Pierce Doherty: But there would be a correlation between.

Jackie McMahon: Yes absolutely.

Pierce Doherty: So you’re talking about 15,000 claims are fraudulent. On the 15,000 figures –

Jackie McMahon: 15,000 might be slightly high because the count includes damaged property, windscreen, those type of claims. Probably less fraudulent in.

Pierce Doherty: Lets say 10,000 being generous to you given that you said 20%. So 10,000 claims you think per annum. How many fraudulent claims do you think FBD get per year? Fraudulent claims. Because the real question is, how many have you reported?

Jackie McMahon: There is a couple of things in it. First of all the level of proof that we require is beyond reasonable doubt, is the criminal level of proof to convict for fraud.

Pierce Doherty: Do you not have a system where you can report fraudulent claims?

Jackie McMahon: We do yes.

Pierce Doherty: Who do you report them to?

Jackie McMahon: We report them to the Gardai.

Pierce Doherty: Ok, you don’t need a level of proof. It up to the Gardai then to investigate it, would that be correct?

Jackie McMahon: That’s correct.

Pierce Doherty: How many fraudulent claims have FBD reported to the Gardai? Because its definitely not 10,000 let me tell you. Its not 15,000 its definitely not the 20% figure that you have talked about. So I want to get to real facts here instead of the spin from the industry. Because it doesn’t add up. Because let me say this. Because the questions are going to be asked of all of you who are making these accusations. Nineteen cases by the entire industry were reported to the Gardai between October and March. Now if FBD are telling us that between 10,000 and 15,000 cases are fraudulent, and Allianz and AXA will tell us roughly the same. We had the 20% figure and all the rest. It doesn’t add up. Or if it does add up, you’s do not give a damn about it. Because you’s aren’t reporting them. So like can I ask you, how many cases of fraudulent activity have FBD reported to the Gardai? Would it be less than 5?

Jackie McMahon: I can certainly give you a few examples.

Pierce Doherty: How many number ?

Jackie McMahon: I don’t have that off the top of my head.

Pierce Doherty: Would that be less than 5 ?

Jackie McMahon: Ehm, less than five reported to the Gardai…

Pierce Doherty: Between October and March of – since last year October, November, December, January, February, March.

Fiona Muldoon: Deputy, we will have to get you the figures.

Pierce Doherty: So if there is such an issue with fraudulent claims, and I am not suggesting that there is no issue with fraudulent claims. What I am suggesting is that the industry here is completely exaggerating the issue of fraudulent claims in a way to try and justify the type of premiums that you’s are charging and the increases we are seeing in certain sectors.

Pierce Doherty: How many have you’s [Allianz] reported?

Sean McGrath: Since June 2018 we have reported 48 claimants to the Gardai.

Pierce Doherty: Since June 2018?

Sean McGrath: Yes.

Pierce Doherty: So, from June 2018 – so it’s a period of a year. How many claims do you get?

Sean McGrath: In a year we get 5,000 injury claims.

Pierce Doherty: 5,000 injury claims, so that’s what, 1%?

Sean McGrath: Yes.

Pierce Doherty: So there is a suspected fraudulent –

Sean McGrath: Number of 20% as we said yes where we have indicators that there is potential fraud where we have to investigate further.

Pierce Doherty: Why didn’t you report them to the Gardai if you believe that there is potential fraud in them?

Sean McGrath: The indicators are – we have to investigate and make sure we are not wasting Garda time. So we investigate to a certain level before we pass them.

Pierce Doherty: And then on 19% of the cases you believe that there is no fraud there so the real figure is 1%? Of where there is suspected fraud?

Sean McGrath: Not Hmm. Not totally. Depending on what happens along the way. Some of them don’t turn in to –

Pierce Doherty: Surely you aren’t accepting fraudulent claims Mr McGrath?

Sean McGrath: No we don’t accept fraudulent claims, but some of them don’t turn out to be provable or have evidence.

Pierce Doherty: You do not have to prove them, it is not for the industry to prove whether they are fraudulent. It is for the industry to report a crime, a suspected crime to the Gardai.

Pierce Doherty: Mr Bradley, fraudulent claims how many have you reported to the Gardai?

Philip Bradley: We’ve reported 50 files to the Gardai.

Pierce Doherty: What period?

Philip Bradley: That’s since 2013. And we’ve had 13 prosecutions, with 4 individuals having jail terms.

Pierce Doherty: Ok, so over a 6 year period you have reported 50 claims, which is about what 8 claims per annum. How many claims are being processed?

Philip Bradley: With injury claims, we get about 5,000 per year.

Pierce Doherty: Ok so, a fraction of a percent is the suspected fraudulent claims within you ’r sector within your insurance company, would that be correct ?

Philip Bradley: Look. We. I suppose. We think. Ah. There is sufficient proof that it can go to the Gardai and ehmm.. There are a lot of claims where we expect, where we.. I mentioned to you earlier about 4% of our claims are identified as fraudulent. So it is not the biggest issue by any means, I don’t think we are portraying it as the biggest issue. But it would be a small number that are referred to the Gardai, where we think there is a realistic or potential of being proven prosecuted.

Pierce Doherty: Should you not – If you believe that a claim is fraudulent should you not report it to the Gardai regardless? Like you’ve carried out your own internal investigation. You believe that the claim is fraudulent. You are willing to come here before this committee and suggest figures of potential fraudulent claims. But when we actually drill down to it, out of 5,000 claims per annum, you are only reporting 8.

Philip Bradley: I’ll take that point.

Pierce Doherty: Ok. Because this is the issue here. We have listened for quite a while in relation to this issue and as I said, I know there are issues in terms of fraudulent claims, and I know there are issues in terms of the exaggerated claims, but not at the scale that you’s are suggesting – and the last 10 minutes have just proven that.