Horwich Farrelly secures sixth fundamental dishonesty finding under section 57 of the Criminal Justice & Courts Act

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Horwich Farrelly has secured its sixth fundamental dishonesty finding under section 57 of the Criminal Justice & Courts Act (CJCA) after an exaggerated PI claim saw a motorist miss out on £5,000 in genuine compensation and have to pay nearly £3,500 in costs.

The defendant firm has now clawed back £60,000 in related costs orders since securing its first ever fundamental dishonesty finding under section 57 of CJCA in April 2016.

The finding came after a motorist who had a genuine right to compensation grossly exaggerating her claim. Katherine Andrews gave inconsistent accounts of her injuries in seven separate medical reports in her attempt to win £20,000 worth of compensation following a collision in East London.

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 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 her 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.

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.

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, 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.

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.

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.

Matthew Paterson of Admiral Insurance said: “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, said that the case sent 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.”

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Marek Handzel

Marek Handzel is the editor of Claims Magazine. Marek welcomes articles, letters, or feedback from readers and can be reached by emailing marek.handzel@barkerbrooks.co.uk