What is Slip & Fall Fraud?

Slip & fall insurance fraud can be generally defined as when someone deliberately stages an accident or manipulates evidence in order to file a false claim.

A common scheme in a grocery store for example, is to throw a few grapes, or slippery foods onto the floor. When no one is looking, the fraudster will feign a fall that results in injury. Another similar scheme is executed with one person walking down a grocery store aisle and pouring liquid on the floor.  Then, he or she will pretend to slip and become injured. The accomplice will then act as a witness to the accident. This “staged” slip and fall is shown in the video below.

How Common is Slip and Fall Insurance Fraud?

The National Insurance Crime Bureau receives over two thousand questionable slip and fall claims every year.  In the United States, resulting costs of slip and fall accidents are estimated at $13-14 million per year. Slip and falls are the number one cause of accidental injury, resulting in 20.8 percent of all emergency room visits according to the National Floor Safety Institute.

If fraudsters are successful in getting a claims settlement, they typically don’t stop. Criminals tend to stick with what works – and if something works, they will repeat the staged act in various locations and try to get a payout from the business owner. Slip-and-fall rings can be found almost everywhere across the nation including Philadelphia.  In 2014, the Philadelphia District Attorney arrested 46 people in an insurance fraud scheme where the group staged slip and fall accidents and recruited new plaintiffs to participate.

Discovering and Preventing Slip and Fall Fraud as a Business Owner

Keeping the floors clean and maintaining walking surfaces in a reasonable expectation of care is also very important. Obviously this is to prevent any real accidents, but a business may become a target of a slip and fall claim if the location is not maintained properly and someone wants to take advantage of that opportunity.

Another way to prevent fraudulent claims is to have cameras installed around the premises. A fake claim will not stand up to video evidence, and if potential fraudsters see a camera nearby, they will look elsewhere to perpetrate their scheme.

Recognizing a fraudulent slip and fall accident and scam can be hard.  However, there are some red flags to look for in investigation a slip and fall fraudulent claim.  

Why a Personal Injury Lawyer is concerned with Slip and Fall Fraudulent Accidents

As a personal injury lawyer for slip and fall victims in Philadelphia and the surrounding suburbs, we are concerned with slip and fall fraud.  The problem with fraudulent claims is that they make it more difficult for truly injured victims to receive the compensation they deserve. Insurance companies and store owners can be overly suspicious of all slip and fall cases because a very small minority of perpetrators are involved in these slip and fall scams.  However, as more and more businesses have security cameras, this is weeding out the truly fraudulent claims. In fact, we will immediately contact the business and put them on notice to secure any video footage of the accident. Sometimes the best evidence is the security camera, which can be Plaintiff’s friend in a legitimate case.

What to do if you suffer a slip and fall accident

Some clients are concerned that their case will be dismissed because it might be seen as fraudulent. Our best advise is to tell the truth and do not exaggerate the situation. Do not try to make the accident into something that it is not.  However, it is important to document any accident. In other words, do the same type of investigation or documentation that an insurance company would do.

 

  • Report your accident.   Always report your accident to a manager or supervisor even if you don’t think you are severely injured.  Fill out an incident report if available. Often times an injured victim of a slip and fall does not report the accident, because they don’t feel severely injured.  Sometimes the injury is not apparent and what may be something you think you can “shake off” and treat yourself becomes a major injury.
  • Document the scene and the cause of your fall.  Ask if there are surveillance cameras.  If so, ask them to preserve the video recording.  Take a picture yourself or have a loved one take a picture of the scene.  Take a picture of the accident site if you fell because of a large crack, slippery surface, or other defect. Sometimes this can be done the next day as you most important priority is to seek medical attention.  
  • Seek Medical Treatment.  Sometimes a sore foot is really a fracture.  Sometimes head pain can be symptoms of a concussion.  Even a slightly sore back could be a herniated disc. Medical evidence is also important to have to back up your claim. Do not exaggerate injuries in an attempt to convince an insurance company to compensate you with a higher amount. If they can show proof that you are not truly injured as you say, then you risk losing the entire amount.
  • Do not give a statement to the insurance company.  Often times you will be called to give a statement to the insurance company.  While many insurance companies and employees are merely investigating your claim, they often are cynical due to fraudulent claims.  Remember, they work for the insurance company who is trying to limit any exposure or pay outs. The problem is sometimes these statements can be taken out of context and any small inconsistencies can be used against you.
  • Call a Lawyer.  A good personal injury lawyer knows how to investigate a slip and fall claim.  A lawyer will make sure any surveillance video is preserved and will put the business on notice.  Sometimes these cases can be complex or hard to prove if unwitnessed. However, if you have a legitimate claim, it is important to get a lawyer involved.  Remember, the insurance company will have a team of lawyers on their side to defeat your claim.

 

The Compensation You Deserve

We have briefly looked at slip and fall insurance fraud from both perspectives so that you have a better idea of what issues are involved. If you have been injured in an accident and you believe it could have been caused by the negligence of a third party, then give us a call. As a Philadelphia slip and fall personal injury law firm will be happy to take a look at the situation and discuss with you any possible case.