Insurers and MAIC protect motorists by detecting and deterring fraud claims. 

Fraudulent claims increase premiums paid by all motorists

The CTP scheme relies on the honesty of claimants when they claim damages for injuries sustained in a motor vehicle accident. The Motor Accident Insurance Commission (MAIC) regularly undertakes prosecutions against persons who engage in dishonest conduct in the Queensland CTP scheme, with insurers playing a leading role in early detection of claim fraud. Their investigations underpin the evidentiary foundation for a successful MAIC prosecution. Members of the public can also contribute by reporting their observations and concerns about fraudulent behaviours in a claim.  

Fraud prosecutions serve as an effective enforcement tool for general deterrence in the scheme

The penalties imposed for committing a fraud offence need to reflect the seriousness of the offending to serve as a tangible deterrence for other like-minded people in the community. Importantly, the public contribute to the scheme, and without detection, the payment of fraudulent claims has the potential to lead to increased insurance premiums and diminishes public confidence in the scheme.

MAIC has secured criminal convictions and significant penalties against fraudulent claimants 

In a recent case example, the claimant’s signed claim form failed to disclose a relevant medical history that may have affected the extent of the disability, or damages claimed. When attending medical specialists for medical assessments, the claimant routinely denied having had any back or neck symptoms prior to the accident. During investigations, the insurer noted in medical records and medical attendances that the claimant had long standing neck and back pain issues.

Insurers submit quality referrals to MAIC that lead to successful prosecutions   

The insurer referred the matter to MAIC to consider a potential fraud prosecution because on evidence it was clear that the claimant knew the representations made to medical practitioners were false. MAIC, after considering sufficiency of evidence and public interest, charged the claimant with an offence against the Motor Accident Insurance Act 1994 for attempting to defraud the insurer.

Criminal convictions and penalties against offenders send a strong message

The claimant pleaded guilty to the attempted fraud charge in the Brisbane Magistrates Court and was sentenced to 12 months’ imprisonment, wholly suspended for an operational period of two years.  A conviction was recorded, and the claimant ordered to pay $30,000.00 in costs to MAIC. The Magistrate strongly criticised the dishonest conduct of the claimant and for delaying the guilty plea. His Honour, during sentencing, remarked that if it was not for the fact that the defendant had no criminal history, he would have considered an actual term of imprisonment.

Last modified 20 May 2024


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