What Happens If ICBC Accuses Me of Filing a False Insurance Claim?

What Happens If ICBC Accuses Me of Filing a False Insurance Claim?

Dealing with the Insurance Corporation of British Columbia (ICBC) is never as easy as you might hope. Although the crown corporation is supposed to pay no-fault benefits in the majority of car accident cases, ICBC frequently looks for any reason to deny a claim.

Even though you paid for your insurance coverage, ICBC adjusters will scrutinize every statement you make, looking for any inconsistency that undermines your claim.

Indeed, there are some situations in which ICBC will pay out a claim and then later try to reclaim the money by accusing the policyholder of having made a false insurance claim. To put it another way, if the ICBC suspects you made any false statements or misrepresentations in support of your claim for no-fault benefits, you may find yourself the defendant in a civil lawsuit.

Fortunately, an accusation is not evidence, and ICBC must still prove any insurance fraud charges against you in a court of law.

Insurance Corporation of British Columbia v. Mehat: Insurance Fraud or Overzealous Insurer?

Consider this recent decision by the British Columbia Court of Appeal: In this case, ICBC made an extraordinary effort to charge a married couple with fraud in connection with a car accident that took place in Surrey over a decade ago. And although a three-judge appellate panel found the trial court made some mistakes in how it reached its decision in favour of the couple, the Court nevertheless dismissed ICBC’s appeal.

Briefly, the facts are as follows: On June 10, 2008, Surrey police responded to a report of a van “colliding with a house.”

One of the constables at the scene interviewed two men, a father and son, who were in the van at the time of the accident. According to the constable, the men “gave contradictory accounts of who was sitting where in the vehicle.” At one point, the constable looked inside the van and saw a child safety seat in the back row.

A second constable interviewed a woman, who was identified as the wife and mother of the other two passengers. She told the constable she was driving the van when it hit the house. She said she “got dizzy and couldn’t find the brakes.”

This second constable also interviewed one of the tenants in the house, who said she “only saw two males and a child exit the vehicle.” The constable also said she observed the husband “had a strong odour of liquor on his breath” and other signs of possible intoxication, although the officer never conducted any formal chemical test.

The husband held an insurance policy with ICBC. He and his wife filed a claim for benefits, stating that she was the driver when the accident occurred. ICBC eventually agreed to pay approximately $37,000 for the damage to the couple’s vehicle, $19,100 to the homeowners for their property damage, and $15,000 to the tenant, who sustained personal injuries in the accident.

ICBC also incurred about $3,800 in legal costs related to the tenant’s personal injury claim. Altogether, ICBC paid out around $73,500 under the husband’s policy.

ICBC Failed to Meet its Burden of Proof

About three years after the accident, ICBC filed a civil claim against the husband and wife. The insurer said it believed the couple lied about the circumstances of the accident. More specifically, ICBC alleged the husband was actually driving the van, and the wife was not even in the vehicle when it struck the house.

ICBC speculated the husband was driving while intoxicated, and that his wife rushed to the scene afterwards to try and cover for him.

After ICBC presented its case in British Columbia Supreme Court, the couple submitted there was “insufficient evidence” to support the insurer’s claims. The judge initially disagreed, saying that there was some evidence to suggest the couple was lying.

But following the completion of the trial, the judge ruled in favour of the defence, noting that “there was no direct evidence that [the husband] was driving the car.”

The Court of Appeal said the trial judge “applied the wrong test on the insufficient evidence application,” but notwithstanding that error, the Supreme Court’s ultimate conclusion was correct–namely, that “ICBC had failed to meet its burden of proof.”

Where ICBC Went Wrong

In fact, ICBC’s case at trial was largely based on perceived inconsistencies in the wife’s statements to the police. For example, ICBC pointed to the wife’s claim that she never saw the tenant “lying on the floor” following the collision as proof she did not arrive at the scene until after the fact.

But the trial judge said the evidence did not support ICBC’s speculation. Not only was the tenant “lying on the floor below the level of the van’s hood,” which would explain why the driver did not see her, but the wife herself testified that she had “trouble focusing on her surroundings” after the crash and her immediate focus was on caring for her child who was in the back seat.

ICBC also made a big deal out of the fact neither the husband nor the wife testified at trial. The couple actually presented no witnesses in their defence, instead relying on the ICBC’s lack of evidence to make their case for them. In any event, ICBC demanded the trial judge “draw an adverse inference” against the couple over their decision not to testify. The judge declined to do so.

The Court of Appeal said this was not a legal error on the judge’s part. For one thing, ICBC could still rely on the discovery testimony of the husband and wife. And ICBC itself could have called and cross-examined either spouse at trial. But regardless of whether or not the spouses testified, it was well within the trial judge’s discretion to decide whether or not to hold their decision against them.

Has the ICBC Accused You of Filing a False Insurance Claim? Call Us Today for Help

Let’s make one thing clear: You should never lie about the facts surrounding a car accident to ICBC or any other insurance company. But you should also not stand pat when falsely accused of insurance fraud.

What you should do is contact an experienced Surrey ICBC lawyer who will fight for your interests. Call Preszler Law at 778-807-0225 to schedule a free, no-obligation consultation with one of our qualified car accident lawyers today.




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