Bhopal (Madhya Pradesh): Around 700 suspected fake road accident insurance claims have surfaced across the state, allegedly causing losses to insurance companies. Police Headquarters (PHQ) has decided to take action against the suspected fraud, involving claims worth around Rs 60 crore.
According to police officials, a syndicate operates behind the scenes to facilitate fraudulent claims by manipulating medical records. They said the extent of injuries in accident cases is assessed on the basis of certificates issued by treating doctors.
A network of brokers extracts information from police stations and connects victims with doctors willing to issue fraudulent certificates. These certificates often exaggerate minor injuries, turning them into claims for higher disability percentages.
It is highlighted that even minor accidents are portrayed as severe by obtaining inflated disability certificates. For instance, a fracture is sometimes shown as 50% disability or a leg injury is exaggerated to 70-80%.
However, during cross-examination in court, the disability percentage often gets reduced. In many cases, individuals claiming permanent disability are found capable of riding bikes or walking without assistance.
While fake claims are a concern, experts also pointed out that insurance companies delay claims by making excuses. It is explained that insurance companies often delay filing responses in court, dragging cases for months.
They take 4-5 hearings to respond, which should ideally be done in one hearing. This prolongs the victim's wait for justice by 6 months or more.
Delays prolong victims' wait for justice
Insurance companies often argue that FIRs are filed late, misleading the court to avoid paying claims. They cite delays in police investigations, which sometimes take 8-10 days.
These tactics not only delay compensation but also complicate the victim's fight for justice. Experts agree that if insurance companies respond within a month, victims could receive compensation within 3 months.
