horwich farrelly

Exaggerated PI claim sees motorist miss out on £5,000 in genuine compensation & pay nearly £3,500 costs

May, 10, 2017

A motorist who had a genuine right to make a claim following a collision in East London scuppered her chances of receiving any compensation after grossly exaggerating her claim, and giving inconsistent accounts of her injuries in seven separate medical reports.

Challenging the claim on behalf of Admiral Insurance, Horwich Farrelly was able to achieve a ruling of Fundamental Dishonesty against the claimant under Section 57 of the Criminal Justice & Courts Act 2015. As a result, claimant Katherine Andrews, has been stripped of any genuine damages she would have ordinarily been entitled to and, instead of receiving an estimated £5,000 in compensation, has been ordered to pay Admiral’s legal costs of £3,409.

Doctor typing medical notes

Significant inconsistencies in the claimant’s seven medical reports were discovered by Horwich Farrelly.

Mrs Andrews, a 47-year-old housewife from Dagenham, was involved in a minor collision in the East London suburb in May 2012 with a driver insured by Admiral Insurance. Admiral’s policyholder admitted liability and Mrs Andrew’s claim for vehicle damage was swiftly settled. However, 22 months later, Andrews submitted an additional claim for compensation exceeding £20,000.

Horwich Farrelly’s investigations identified numerous inconsistencies in Mrs Andrews’ claim. She submitted seven different medical reports due to the alleged extent of her injuries; however there were significant inconsistencies in the reports.

For example, she told the first medical expert that her symptoms were intermittent but advised her orthopaedic expert that her symptoms were constant. She told the same expert she was suffering from migraines two out of three weeks but told the other expert that she had not suffered migraines at all.

Mrs Andrews’ claim for care and assistance was also inconsistent. She provided three different schedules for compensation, each for different durations and frequency of treatment and for amounts ranging from £1,029 to £10,810.

In hearing the case at Clerkenwell & Shoreditch County Court on 20 April, District Judge Rand described the claimant as “evasive” and “challenging”, rather than answering her questions. The judge even had to ask the claimant’s husband to leave the courtroom because, on one occasion, he was seen mouthing to her during her cross-examination and, on another, she was caught being prompted by him.

According to the judge, the inconsistencies between the three schedules for care and assistance, coupled with the claimant being unable to specify the length of her alleged injury or length of disability, meant she had fatally undermined her credibility.

Horwich Farrelly applied for the claim to be ruled as Fundamentally Dishonest under S57 of CJCA 2015, which states that where a claim made after 13 April 2015 is found to be Fundamentally Dishonest in any part the court must dismiss the whole claim – even if it includes a genuine element – unless to do so would cause ‘substantial injustice’.

While the judge considered that, on the balance of probabilities, the claimant might well have suffered some injury in the form of whiplash and liability was never contested, the lack of credible evidence and finding of Fundamental Dishonesty meant the claim had to be dismissed in full.

Woman holding her neck

Claimant, Katherine Andrews, lost her right to genuine compensation after exaggerating the nature of her injuries.

The judge recorded the amount of damages Mrs Andrews would have awarded, but for the dishonesty, at £5,000. However, given the ruling, the claimant not only lost any potential genuine compensation but also QOCS-protection, which meant she is required to pay the defendant’s costs, less the damages she would have received, at a total of £3,409.

Matthew Paterson of Admiral Insurance stated: “Insurers need to apply a zero tolerance approach to fraud in order to give honest policyholders the best possible premiums. Anyone involved in an accident should know that they will be fairly compensated for their genuine claims. But if they choose to exaggerate their claim, they need to know not only will they not receive any compensation, but they will be paying costs too. It’s simply not worth it.

Ronan McCann, Counter Fraud Partner at Horwich Farrelly believes this case sends a very strong message to anyone considering exaggerating a claim. “The message from the courts could not be clearer. If you exaggerate a potentially genuine claim, you not only face losing any compensation you could have been entitled to, but you also face substantial legal costs. We expect to see this sanction being used increasingly to further strengthen the message that insurance fraud is not acceptable.

“I’d also like to give credit to our Litigation Executive, Chloe Allport, for securing this impressive result on behalf of Admiral”.

This is the sixth such finding by Horwich Farrelly since the firm secured the first finding under S57 in April 2016.

 

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