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How To Dispute a False Insurance Claim

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If you don’t have car insurance, you can sue the other party for fraudulent claims with the help of an attorney. If you do have one, your insurance company must defend you by providing legal counsel.

Across the U.S., consumers file millions of auto insurance claims each day — but not all of them are legitimate. Insurance fraud is an ongoing problem across the country, and when you become caught in the crossfires of another person’s fraud attempt, you face a range of unfavorable consequences.

Has someone submitted a false insurance claim about you? With an attorney’s help, you can take a few measures to dispute the claim and clear your name.

Learn how to dispute a false insurance claim below.

Check First if You Are a Victim of Insurance Fraud

Often, false insurance claims are attempts at insurance fraud, which is a felony in the U.S. You’ll want to at least have an inkling of whether the false claim was intentional or accidental. If the claimant intended to defraud the insurance company, they could be committing insurance fraud.

What Is Insurance Fraud?

Insurance only protects against damage that is outside the policyholder’s control — whether it is due to an act of nature or another person’s negligence. When someone intentionally causes damage, exaggerates their injuries, or falsifies the details of a car accident altogether to gain money from an insurance company, they commit insurance fraud.

Insurance fraud can fall into two main categories: hard fraud and soft fraud.

Hard insurance fraud occurs when someone intentionally falsifies or stages an accident to produce real or fake injuries or other damages. For instance, a person may have intentionally pulled out in front of you at an intersection, causing an accident that looks like it was your fault. Or they may have staged an accident to make it look like you were to blame for the damage that occurred for some other reason.

Soft insurance fraud is when a person exaggerates their injuries or damages to seek more compensation from the insurance company than they are entitled to. They may claim that a pre-existing injury was caused by the accident in an attempt to increase their payout. The person committing soft insurance fraud may not have falsified an entire accident, but they’re still making their damages out to be bigger than they are.

In either case, another person’s attempt at insurance fraud can negatively impact you. If they make you look like the culprit in an accident, they can cause your insurance rates to go up or even lead an officer to wrongfully cite you for breaking traffic laws. Disputing false insurance claims and fraud attempts can help clear your name.

Things To Do if Someone Makes a False Accident Claim

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Do you suspect that the other driver involved in your accident is making a false claim against you? Whether they’re exaggerating their injuries, placing the blame on you for an accident that was completely their fault, or involving you in an accident you had nothing to do with, you can take a few proactive steps to dispute their claim.

Where To Report Insurance Fraud

The process for disputing a false insurance claim differs depending on whether you have car insurance.

If you have car insurance, trust your insurance adjuster to take care of the matter for you. The adjuster will investigate all of the accident details as part of the claims process. Just provide as many details about the accident as possible to make sure the truth comes to light.

Insurance companies don’t want to pay for accidents they don’t need to. They’re good at spotting fraud and taking action against it.

Once you provide details of the crash to your insurer, you shouldn’t need to worry about the fraudulent claim seeing the light of day. It won’t hurt to also warn them of your suspicions and provide any additional evidence they may not uncover on their own.

If you don’t have car insurance and another driver is making a claim against you, you’ll need to take matters into your own hands to dispute the fraudulent claim. Working with an attorney can significantly improve your chances of success here, as your attorney can ensure that you don’t overlook any steps that can prove the other driver’s fraudulence.

Follow these tips with the help of your attorney to dispute the false claim.

Write Down the Accident Details

While the accident is still fresh in your mind, write down as many details as you can about the crash. Record where it happened, the time of day, the people involved, anything you or the other parties said after the crash, and any injuries reported at the time of the accident.

Do Some Online Sleuthing

Your attorney can help you examine the other driver’s social media profiles to find evidence that they are faking or exaggerating their injuries. For instance, maybe the driver is claiming that they broke their leg in the accident, but you see a photo on Facebook showing that they’re still working their labor-intensive job or are training for a half marathon.

Hire an Investigator

If you aren’t finding much on social media, you can even consider hiring a private investigator to find evidence that the other driver is faking their injuries. Talk to your attorney about whether this may be a smart option for your case.

Can Your Insurance Defend on Your Behalf?

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If the other driver files a personal injury lawsuit against you, your insurance company has a duty to defend you by providing legal counsel. But this “duty to defend” may not apply to your case if:

  • You didn’t give your insurance company notice of the accident within their time limit
  • The insurer has already paid out the maximum damages under your policy limit

As long as you don’t meet these exceptions, your insurance company should help you defend against a personal injury lawsuit — especially if you have clear evidence that the claim is fraudulent.

Can You Sue the Other Party?

If you successfully dispute the other party’s fraudulent insurance claim, you may wonder how you can make up for the stress and financial losses their fraudulent behavior caused. One way is through a personal injury lawsuit against them, in which you sue for punitive damages.

Punitive damages can punish the other party for malice, fraud, or oppression. These damages would come from their own bank account, so if they don’t have many assets, your lawsuit may be unsuccessful.

Talk to your attorney about whether suing for insurance fraud would make sense in your case.

How Much Compensation Can You Secure?

If your personal injury lawsuit is successful, you could recover any financial losses from the fraudulent accident, including damage to your vehicle, time off work, and legal fees. You could also recover non-economic expenses, such as emotional distress or anguish; your attorney can help you calculate these damages.

Working With an Attorney to Dispute a False Insurance Claim

client working with attorney to dispute false insurance claim

Hiring an attorney is a good idea after learning that someone has submitted a false insurance claim against you. Your attorney can ensure that you approach the case strategically from a legal perspective and don’t make any mistakes that could hurt your case.

Having an attorney on your side is especially helpful if your insurance company decides not to defend you, whether because you did not alert them of the claim in time or because you didn’t have valid insurance coverage at the time of the accident. Your attorney can:

  • Help you gather evidence showing that the other driver has exaggerated or falsified the accident
  • Defend you in court during a personal injury lawsuit
  • Help you recover damages that have arisen from the false insurance claim
  • Appeal the insurance company’s decision not to defend you after the accident

Are you looking for an experienced attorney to help you understand how to dispute a false insurance claim? Contact Sadaka Law today by filling out the contact form. An attorney will reach out to you shortly for your free consultation.



Principal & Founder
This article was written by Mark Sadaka, a seasoned trial lawyer in nationally significant cases. He fearlessly champions clients impacted by fatal or severe injuries caused by others or corporations. Renowned for his expertise in complex litigation, he's featured in books, sought after by media for interviews, and a highly sought speaker. Notably, he exclusively represents individuals facing life-changing injuries or substantial financial losses.

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