horwich farrelly

Fraudulent Large Loss and Exaggerated Claims

insurance

Large Loss Fraud

Horwich Farrelly operates a dedicated team who deal with suspect high value personal injury cases.

This area has been significantly impacted by the fundamental dishonesty provisions contained within the Criminal Justice and Courts Act 2015. In the right circumstances, a fraudulently exaggerated claim can be dismissed in its entirety, denying a claimant both the “dishonest” and “genuine” elements of his claim.

A two pronged approach to building a case for dishonesty is applied, identifying the suspect elements of the claim whilst maintaining an overview of the “genuine” elements so that tactical considerations relating to settling/fighting the claim remain at the forefront of our thinking.

Other firms will appoint large loss practitioners to deal with suspicious large loss files. We appoint seasoned fraud lawyers to deal with these cases, ensuring all the investigative tools available to our clients are deployed at the most opportune moments.

Fraudulent Exaggeration

Exaggerated damages are often a key feature of suspect large loss claims.  Exaggeration and fabrication of special damages on the other hand is far more widespread, often driven by the close financial and business relationships that exist between organisations in the claimant supply chain.

Our analysis into claims exaggeration has identified a number of trends including:

  • Rehabilitation services being quoted and provided at above average market rates
  • Physiotherapy or CBT commencing without medical prescription
  • “Rehabilitation invoice fraud” i.e. quotations or pro-forma invoices for future medical treatment made to look like invoices for past treatment.
  • Add-ons e.g. claims for rental of TENS machines, where no such services have been provided.
  • Spurious charges for medico-legal agency administration fees

Our teams are fully aware of this increasing trend and we are equipped to challenge such claims. We create bespoke strategies based on our own and industry intelligence.

CF Large Loss Emphasis 2

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