Magazine article New Statesman (1996)

Why Fraud Goes Unpunished

Magazine article New Statesman (1996)

Why Fraud Goes Unpunished

Article excerpt

The hope of monetary compensation will worsen almost any medical symptoms. The deterioration usually occurs independently of the sufferer's will: it is an effect of which he or she is unaware. But sometimes, as any doctor who prepares medical reports for insurance companies knows, claims are entirely fraudulent, in the sense that the alleged sufferer is fully aware that his or her symptoms are not real. For example, a man who says he has been prostrated on his bed for the past three years goes to Bermuda on holiday. In such cases, the insurance company needs a private detective rather than a doctor.

You might have supposed that, when an insurance company suspects fraud, it would go to great lengths to prove it and, when proved, to prosecute it. Not so. The companies go to no great lengths to expose fraud, despite the considerable sums involved. Occasionally, they do investigate if the claim is too outrageous or the amount too large; but even then, clear evidence of fraud does not necessarily lead to prosecution.

Not long ago, I prepared a report in such a case. A woman claimed to have been laid permanently low, so that she would never recover. According to the terms of her policy, the insurance company would have to pay her an income for the rest of her life, which might easily have exceeded 50 years. The total sum involved could have been more than [pounds sterling]1m.

I was not satisfied that she was telling the truth, and the company decided to investigate. …

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