Existing user? Sign in
Share your needs with us, get contacted by law firms.
Free. Takes 2 min.
Insurance fraud covers a range of dishonest acts intended to obtain insurance money or benefits to which a person is not entitled, or to avoid paying legitimate obligations. In Belfast - and across Northern Ireland - alleged insurance fraud can lead to both criminal prosecutions and civil actions. Criminal consequences can include prosecution, fines, confiscation of proceeds and imprisonment. Civil consequences can include policy avoidance, demands to repay funds, rejection of future claims and damages. Investigations may be carried out by the Police Service of Northern Ireland - PSNI - and other authorities when suspected organised or serious fraud is involved.
Insurance fraud matters can be legally and factually complex. You may need a lawyer in situations such as:
- You have been contacted by the police, interviewed under caution, arrested or charged with a fraud-related offence.
- Your insurer has accused you of making a fraudulent claim, cancelled your policy, or is seeking repayment of sums already paid.
- You are an insurer seeking to recover funds, pursue civil remedies, or refer an allegation for criminal investigation.
- You face a regulatory inquiry by a body such as the Financial Conduct Authority about your conduct as an insurance professional or intermediary.
- You are an employee or former employee accused of dishonesty, or you suspect colleagues of fraudulent activity and need to manage an internal investigation while protecting your legal position.
A lawyer experienced in criminal and insurance law can explain the likely consequences, represent you at interviews, craft a defence strategy, negotiate with insurers or prosecutors, and handle related civil claims and regulatory matters.
Insurance fraud in Belfast sits at the intersection of criminal law, contract law and regulatory rules. Key legal themes to understand include:
- Criminal offences - Conduct that is dishonest and intended to make a gain or cause a loss can give rise to criminal charges. Offences may include false representation, making a false claim, conspiracy to defraud, fraud by failing to disclose material facts, arson where fire is used to support a false claim, money laundering and related offences. Conviction can lead to imprisonment, fines and confiscation orders.
- Civil remedies - Insurers may avoid or rescind policies, refuse claims, recover sums paid, and seek damages if a claim is dishonest. Remedies depend on policy wording, the nature of the misrepresentation and the timing of the insurer's response.
- Regulatory obligations - Insurance firms, brokers and intermediaries must comply with financial services rules and conduct standards. The Financial Conduct Authority sets conduct requirements that affect how firms prevent and respond to fraud, and breaches can lead to regulatory action, including fines and restrictions.
- Disclosure, misrepresentation and the Insurance Act - Contractual duties around disclosure and misrepresentation influence whether a policy can be avoided or varied. Commercial and consumer insurance have different rules and protections. If you are involved in a dispute with an insurer, the specific policy terms and applicable statutory rules will be central.
- Investigation powers and court process - Police and prosecuting authorities can gather evidence, execute search warrants and bring prosecutions. Civil proceedings for recovery or enforcement may run parallel to criminal investigations. Legal privilege, disclosure obligations and the right to silence are important rights to protect early on.
Insurance fraud includes knowingly making false statements on an application, exaggerating or fabricating claims, staging accidents or losses, submitting false documents or invoices, and any other dishonest act intended to obtain money or benefits from an insurer unlawfully.
If the police contact you, remain calm and do not volunteer information before getting legal advice. You have the right to legal representation during interview. Ask for a solicitor and do not sign any statements until you have spoken with your lawyer.
Yes. If an insurer has reasonable grounds to suspect fraud, it can refuse a claim, cancel the policy and refer the matter to the police for investigation. Insurers may also seek civil recovery of amounts they have paid.
No. A police referral will be assessed by investigators and prosecutors. Prosecution decisions depend on the sufficiency of evidence and whether prosecution is in the public interest. Nevertheless, a referral can lead to significant stress and disruption, so early legal advice is important.
Technically you can represent yourself, but fraud prosecutions and civil recovery claims are often legally technical and evidence-heavy. A qualified criminal solicitor or barrister can assess evidence, advise on pleas, represent you at court and negotiate with prosecutors or insurers.
Investigators may use policy documents, claim forms, medical records, CCTV, phone records, vehicle telematics, witness statements, expert reports, forensic accounting and electronic evidence. Both direct and circumstantial evidence can be important.
Provide clear, contemporaneous evidence supporting your claim - for example receipts, photographs, witness details and medical reports. Cooperate with legitimate verification requests, but seek legal advice before responding to allegations or signing statements that could be used against you.
Yes. Insurers can pursue civil remedies such as withholding payment, demanding repayment, cancelling the policy and pursuing a civil claim for losses even if criminal charges are not brought or do not result in a conviction.
Timescales vary widely. Police inquiries and regulatory investigations can take weeks to months depending on complexity. Criminal prosecutions can take longer, especially if there are extensive evidential issues or parallel civil proceedings. Early legal involvement can help manage timescales and process.
Eligibility for legal aid depends on the seriousness of the charge, your financial position and the merits of the case. Criminal legal aid may be available for serious allegations. For civil matters, legal aid is more restricted. Check eligibility with a solicitor or the Legal Services Agency in Northern Ireland.
Police Service of Northern Ireland - for reporting suspected fraud and for enquiries about criminal investigations.
Law Society of Northern Ireland - for finding and instructing a solicitor experienced in criminal and insurance law.
Financial Conduct Authority - regulator for insurers and financial services firms operating in the UK - for regulatory information and complaints about firms.
Financial Ombudsman Service - independent dispute resolution body for consumer complaints about insurance firms - for help if you cannot resolve a complaint directly with your insurer.
Insurance Fraud Bureau - industry body that analyses and helps tackle organised insurance fraud across the UK.
Citizens Advice Northern Ireland - for general guidance on consumer rights and steps to take when dealing with insurers.
Legal Services Agency Northern Ireland - for information on legal aid and eligibility for representation.
National Crime Agency - for intelligence and coordination where serious and organised crime crosses regional borders.
If you are involved in a suspected insurance fraud matter - whether as a person under investigation, a claimant whose claim is challenged, an insurer or an employee - follow these steps:
- Do not ignore the situation - acting quickly is important.
- Seek specialist legal advice - contact a solicitor experienced in criminal defence and insurance disputes as soon as possible.
- Preserve documents and evidence - keep policy papers, correspondence, photos, receipts and any records that support your position.
- Be careful in communications - do not make statements to police, insurers or third parties without your lawyer present.
- Consider your options - your lawyer can advise on representation at police interviews, negotiation with insurers, potential plea strategies, civil defence or settlement and applications for legal aid if eligible.
- Use available complaint and dispute routes - if you have a consumer dispute with an insurer that cannot be resolved, your solicitor can help you escalate to the Financial Ombudsman Service or pursue civil remedies.
Early, informed legal guidance will help protect your rights, manage the investigation or claim process and improve your chances of the best possible outcome.
