Fundamental dishonesty
 fraud case study

This is another example of our true commitment to fighting insurance fraud and protecting our genuine customers’ interests. 

The claim was for a road traffic collision in which the claimant stated that his vehicle had been hit in the rear by our policyholder.  Liability was conceded at an early stage, the only remaining issues were identifying how the accident happened and what the cost of the claim was.

The claimant’s solicitors completed a Claims Notification Form in which it was alleged that the claimant had suffered shoulder and back injuries.  The claimant’s medical examination took place five weeks after the accident and he told the doctor that he was aware of pain to his right shoulder and lower back within two days of the accident, and he had suffered travel anxiety.  Although he hadn’t sought medical treatment from his GP, the claimant complained of pain during his examination and the report recorded a 10% restriction of movement to the back.  The medical expert therefore suggested the claimant had sustained a soft tissue injury which was likely to last for six months.

However, the claim as presented set alarm bells ringing due to the differences we noted in the claimant’s report compared to our own findings.

The claimant had contacted us four days after the accident, confirming that he had not suffered injury and simply wished for the repairs of his vehicle to be arranged.  The call had been recorded and couldn’t have been misinterpreted.  In addition, the claimant’s insurers confirmed that he had spoken to them five days after the accident and confirmed that he was absolutely fine.

In the light of this evidence, we instructed DAC Beachcroft to pursue alleged fundamental dishonesty on the part of the claimant, expressly referring to the contradictions in the accounts given by him.

After disclosure, the claimant’s solicitors ceased to act for him and came off record.  The claimant failed to respond to any subsequent correspondence and the claim was struck out due to their failure to pay the hearing fee.

It would have been easy to take the win but we wanted to pursue the claimant for the costs that had been incurred and instructed DAC Beachcroft to pursue the allegations of fundamental dishonesty and to seek an order that the claimant pay the costs of the action.

Having been served with the application, the claimant confirmed he would not be attending the hearing. The court made the finding of fundamental dishonesty and permission was given to enforce the costs order against the claimant which were £7,846.45.

DAC Beachcroft Partner Georgia Court said:

“This is another excellent result for our counter-fraud team.  The finding of fundamental dishonesty in this case shows the value of not just accepting the win and leaving it at that.  The determination of Allianz to press the point has brought about a significant recovery of costs.”

James Burge, Fraud Manager, Allianz Insurance said:

"This is yet another example of our true commitment to fighting insurance fraud and protecting our genuine customers’ interests.  We are thrilled to have achieved a finding of Fundamental Dishonesty against this individual.” 

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