WA Fraudulent Car Accident - Car Insurance Claim against Us

[Andre]

Last year, my partner went to a flea market as a seller. When she was parking her car into a sellers bay, she lightly bumped into the back of another vehicle. Rear bumper to bumper. The owner of the vehicle was a metre away, beside her car on her knees arranging her goods for sale. She got up and inspected the bumper and both parties agreed there was no damage. No names or car insurance details were asked for or exchanged. The other party stayed for another 4 hours, from 6AM to 10.30 AM selling goods and then departed. We thought nothing of it, until 3 weeks later we received a letter from the police that we had failed to report a car accident where an injury had been incurred.

We were interviewed by the insurance commission and told that the other party maintained they had been crushed at the knee between the two vehicles. We understand the other party is making a substantial claim of injury and disability. Unfortunately, my partner had an overseas drivers licence and it had expired so she is technically, not covered by 3rd Party insurance, so any payout by the government agency could be recovered by the government from us.

We have had the interviews with the insurers private investigators and I'm concerned from what I hear, that the insurance commission will pay out too easily. So I am thinking of challenging the other party's claim on the basis of a fraudulent report. This would allow me to test their case on the legal standards rather than the insurance commissions standards.

My question is, under what area of law would I bring the claim against the other party and what is the relevant standard of proof for myself and the other party? Any other comments would also be welcome.

 

[Sarah J]

Hi Andre,

The other side is essentially claiming money (damages) for personal injury as a result of the accident. If they are seeking compensation, they become the Plaintiff and you will be defending their case. This means that they bear the burden of proving on the balance of probability that they were (i) injured; and (ii) the injury was caused by your partner.

You will need to discredit their evidence on these two points. This means poking holes or raising doubt as to any medical reports they've provided or the reliability of their oral (or other) evidence and the credibility of their witnesses (or themselves). Personal injury is always difficult to show and defend. Hence, best to contact a personal injury lawyer who can undertake an investigation on the matter and identify inconsistencies in their story (e.g. damage claimed is not consistent with car marks, medical reports, car accident etc.)

 

[Andre]

Thank you for the post Sarah,
The injury claim is against the 3rd party "Insurance Commission", not my partner. I'm not sure what the commission's criteria is for paying on the claim. My complaint against the other party is based on a fraudulant statement made by them, with damage being the amount of stress it has caused us. I believe I can make a statement to the police but I doubt they will pursue a criminal charge. So in a civil case I would base my complaint on fraud.

regards,
Andre.

 

[Sarah J]

Hi Andre,

In that case, it is best to call your insurer and ask about their procedure and criteria for assessing payouts. You should inform your insurer that you dispute their claim. Note that your insurance policy has a clause that allows them to subrogate you in any actions and initiate/defend an action on your behalf.

This means, if you wish to dispute this claim in court, you should contact your insurance company, initiate action against the claim, ask if your insurer wishes to be party to the claim on your side. However, you should do all of this after enquiring about what the insurance company plans to do themselves in relation to the claim first.

 

[Andre]

Thanks Sarah,
I will ask. The insurer is the government insurance commission as this is 3rd Party injury insurance.
I'll ask what their criteria is. They already know that we are dead against any payout, but I believe we have no say in that.
I'm assuming the clause you refer to would be normally in a contract with a commercial insurance firm.

Either way they have statements from my partner (the driver) that no such physical contact took place at all.
In other words it is a total fraud according to us.

I will enquire as to their plans and criteria, as per your advice.

regards,
Andre.

 

[Sarah J]

Hi Andre,

i'm sure the company is taking your partner's statement into consideration and doing their own investigation. They will also be doing a risk/cost analysis (i.e. how much evidence the other driver has in favour of the claim, how much it would cost to defend the claim etc.)

The clause I mentioned is a standard clause in commercial insurance agreements, however, I suspect it might also be in your insurance agreement as well. Have a read of the policy. The policy is always the best place to start in understanding what your rights and obligations are.

 

[Andre]

Hi Sarah,
I'm not sure whether we are thinking of two different things. The 3rd Party injury insurance that I am talking about is part of a vehicles registration.
When I pay my registration on the vehicle it is automatically included. I don't get any documentation with it.

regards,
Andre.

 

[Sarah J]

Hi Andre,

You're right, we weren't on the same page. In relation to the third-party insurance with the WA Government, I'm not too familiar with their scheme. Are you disputing the claim purely out of principle or because you're concerned your premiums for next year's registration/insurance will go up due to the claim?

How did you go with contacting the Insurance Commission of WA? Were you successful in your enquiries? Perhaps you could also try contacting the Department of Transport WA?

 

[Andre]

Thanks Sarah,
Well I am, in a sense disputing the claim on principle because the other person has just made a completely fraudulent statement. But also, there is a small chance that the insurance commission will come back to my partner and demand re-imbursement. This is because my partner didn't have an Australian drivers licence at the time.

Premiums do not increase regardless of any claims made. The premium is a standard one, built into the price of vehicle registration. Registration price is determined by vehicle type, tare etc.

Dept of Transport WA have no hand in the insurance side, that is solely determined by the commission.

The insurance commission of WA said, in our last conversation, that they are unlikely to chase my partner for the money. This is quite different to what we have heard from them previously.
In some way, this is re-assuring and I am considering finalising the matter by sending a letter to indicate, firmly, our claim of fraud by the other party.

regards
Andre.

 

[Sarah J]

Hi Andre,

Thanks for the update.

Who did you speak with when you enquired with the Insurance Commission? Best to get their name, time of call etc. down so that you have evidence of the call and contents said. If you further want reassurance, you can make the same enquiry in writing. A written response on the Insurance Commission's letterhead or email is always more credible than a verbal conversation from a staff member working at the Commission.

Whatever you do, just record it down in writing (and keep a copy) to show that you have made reasonable attempts to fight the matter.

Hope the outcome is favourable!