At HF, Dishonest NTI claims have been a huge problem for the insurance industry since the implementation of the whiplash reforms, with claimants now incentivised to claim for additional injuries to falsely inflate the potential value of their claim.
In the ongoing battle against fraudulent claims regarding non-tariff injuries (NTIs), HF in partnership with Hastings Direct, have seen not only a finding of fundamental dishonesty but a focus on the Claimant’s solicitor to contribute to costs – or ‘show cause’ as to why they shouldn’t.
Dishonest NTI claims have been a huge problem for the insurance industry since the implementation of the whiplash reforms, with Claimants now incentivised to claim for injuries other than whiplash with a view to falsely inflating the potential value of their claim.
In this case, the claim followed a road traffic accident on 22 April 2022. The Claimant was one of the passengers in a car struck at force by another car, insured by Hastings Direct. The accident was capable of causing injuries but there were immediately several red flags querying whether this Claimant was injured to the extent they alleged, or at all.
The first alert resulted from the submission of a CNF via the MOJ claims portal on 16 June 2022 (and not the OIC portal). In fact Hastings received three different CNFs on that day, all for occupants of the Claimant vehicle and all represented by the same solicitors. Each one reported non-tariff injuries (two knee and one elbow) as well as psychological injuries and whiplash.
Incredibly, the Claimants and their solicitors appeared able to determine, less then two months post-accident that the injuries would be protracted, with each CNF containing this same statement: ‘Due to the injuries suffered the claim will exceed the £5,000 limit, if the claim is rejected we will issue for abuse of process and have the matter listed for a Fast Track claim. Please read the circumstances before prematurely dropping this matter off as we will not re-submit this on the OIC.’
The claim was repudiated and at trial further doubt was cast on the truth of the claim. The Claimant did not attend a GP appointment when stated, in fact not until July – which was some time after he had instructed his solicitor. He claimed no previous medical history despite records showing he in fact had prior problems with his knee.
The Claimant’s solicitors refused to include the CNFs in the trial evidence and refused to include a statement drafted by HF’s intelligence analyst.
The Claimant also made a very low offer prior to trial which meant Hastings were under threat of having to pay indemnity costs of they were not successful. They were not deterred and carried onto trial.
The Judge permitted all the Defendant’s evidence and was particularly troubled by the content of the CNF. The Claimant was found to be fundamentally dishonest and ordered to pay the Defendant’s costs. As the Judge was so concerned by the conduct of the Claimant’s solicitors, he also ordered them to serve a statement to show cause as to why they should not contribute to costs.
Jared Mallinson, Partner & Head of Counter Fraud, said: “Dishonest NTI claims have been a huge problem for the insurance industry since the implementation of the whiplash reforms, with claimants now incentivised to claim for additional injuries to falsely inflate the potential value of their claim. At HF, we’re committed to achieving the best outcome for our clients and in this case, the outcome demonstrated the importance of pursuing cases where claimants and their solicitors are attempting to dishonestly circumvent the reforms, and robustly defending them through to trial if necessary.”
Kay Denyer, Head of claims Fraud, Hastings Direct added, “In the wake of the whiplash reforms we have seen a sharp rise in non-tariff injuries in the low value injury space. Whilst it remains our primary objective to ensure that innocent victims of accidents are fairly compensated, it is also crucial that we take a tough stance on those gaming the system at our customer’s expense”.
This outcome clearly demonstrates the importance of pursuing cases where Claimants and their solicitors are attempting to dishonestly circumvent the reforms, and robustly defending them through to trial if necessary.
You may also like
50 Million Reasons to Celebrate HF’s Counter-fraud Technology
Five years ago, we launched HOLT, our AI-driven counter-fraud technology designed specifically for the insurance sector. The purpose of HOLT...
Engineered to Fail – 50k Claim Dismissed
Insurer Hastings Direct and HF, have succeeded in having a £50,000 claim dismissed due to the questionable evidence of an...
Ev-olution: Insurance Companies Beware – And be Prepared!
The emergence of electric vehicles (EVs) marks a significant evolution, and one that impacts insurance companies. The unique issues surrounding...
HF’s Counter-Fraud & Costs Teams save over £64k for Admiral
The true value of cross-departmental collaboration was showcased by HF in a recent claim, saving Admiral over £64,000. Following a...