Oireachtas Joint and Select Committees

Thursday, 4 July 2019

Joint Oireachtas Committee on Finance, Public Expenditure and Reform, and Taoiseach

Insurance Sector: Discussion

Mr. Jackie McMahon:

Yes, they involve fraud. The Deputy asked an interesting question on fraud versus exaggeration and where the line can be drawn between fraud, for example, staging an accident, and a case where someone is exaggerating significantly. First and foremost, we are in the job to pay claims and look after people who are injured and suffer loss or damage. The amount of exaggeration and how our system is feeding that is much more significant than what I might call the pure fraud, although I do not like to use that term. To give an example, we hardly see a soft tissue injury in a very minor accident that does not have psychological trauma associated with it. MRI scans are being widely used to look for degenerative change and beef up the claims that are coming through to us. There is much more use of pain management consultants to find the pain and then treat it. This all feeds into a very long process that can be stretched out over three, four, five, six or seven years. Essentially, what is happening is that a case is being built and that case is resulting in very exaggerated claims. One other example of exaggeration that would not have been a feature previously is the cost of care. This care cost is absolutely necessary in cases where people are badly injured, and we pay large amounts in catastrophic and very sad, tragic cases. What we now have are claims that are coming in for cost of care for people with very minor soft tissue injuries. They need people to do their gardening and domestic chores. That is not classified as fraud but to the man on the street and certainly from my perspective, that exaggeration is driving up the cost of the claim and the payouts.

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