Horwich Farrelly and Aviva hit record breaking fraud results

Fraud team secures ten successful findings of Fundamental Dishonesty for Aviva in five days, saving the insurer almost £100,000

Our Fraud team has hit another record in the fight against fraudulent claims after successfully securing 10 findings of Fundamental Dishonesty (FD) in just five days. Aviva initially identified fraudulent concerns on a number of third party claims which it referred to Horwich Farrelly. Further investigations by Horwich Farrelly’s Intelligence Team not only resulted in the successful convictions of the ten individuals but also saved the insurer – and their customers – over £96,000 in damages and costs and the results now allow recovery of their legal fees direct from the dishonest claimants.

The cases in the record-breaking run involved a variety of individuals and scenarios, confirming the firm’s stance that there is no such thing as a typical fraudster. They can be anyone, of any age, from anywhere, which is why we thoroughly investigate fraudulent concerns identified by insurers on every claim it receives and adopt a zero-tolerance approach to fraud.

One case, worth over £42,000 including costs, involved four claimants who were in a minor car collision, one of whom was the father to the other three minors. Two of the claimants told the courts that they were not injured in the accident, but that their father had taken them to A&E for a medical examination and told them to say they had sustained injuries. Whilst their father tried to plead to the courts that his children were ‘mistaken and confused by the extensive cross examination’ and were genuinely injured, the courts were not convinced by the evidence and an application for a finding of Fundamental Dishonesty was successful.

Another case involved two claimants who did experience some minor injuries in a motor collision, however exaggerated them so much to the point that the judge stated it was impossible to tell which injuries were actually sustained. Both individuals claimed for up to eleven months of injury to the neck, shoulders and lower back, but both failed to mention their alleged lower back pain to their GPs despite attending multiple appointments since the accident. One claimant also said she was unable to cook for this injury period and was “sweating, shaking and shivering” all night after the minor accident. They both attended their GP shortly after the incident with a full range of motion to their necks, yet when examined for the purpose of the medical report some months after their range of motion was severely restricted. As a result of the exaggerated injuries, the judge stated there was no adequate explanation as to why their conditions drastically deteriorated. Both were found Fundamentally Dishonest and ordered to pay costs of over £7,000.

Horwich Farrelly has worked closely with Aviva for the last 15 years to help the insurer defend its customers from fraudulent cases and ensure that customers benefit from the costs saved on unmerited claims.

Commenting on the record breaking FD cases, Jared Mallinson, Fraud and Aviva client account Partner, said: “We have always taken a very firm and robust approach to combatting fraud in the insurance industry, and will investigate all claims thoroughly. We push for FD findings in the right circumstances, and these cases demonstrate the success of our approach, saving one insurer over £96,000 and allowing them to recover their legal fees.

“Aviva has a clear strategy of listening to its customers and defending them where there are fraud concerns, even when it is uneconomic to do so. Challenging these cases and passing them to us once they litigated works in well with our own strategy and that is why we are able to have record breaking fraud results such as this and have obtained more FD findings than any other firm. We will continue to work closely with clients and the industry to apply a zero-tolerance approach in combatting fraud and hope the outcome of these cases will make people think twice before falsifying a claim.”

Richard Hiscocks, Casualty Claims Director at Aviva, said, “First and foremost, Aviva is here to pay claims, which we do 96% of the time. However, we also have a duty to our customers to ensure that we are not paying for fraudulent claims, which adds to the cost of insurance. Thanks to Aviva’s leading fraud detection capabilities, we saved our honest customers more than £80m last year.

“Working in partnership with law enforcement agencies and law firms like Horwich Farrelly, we successfully prosecuted 58 instances of fraud last year, securing custodial sentences of over 68 years, and challenged hundreds of cases of which resulted in findings of fundamental dishonesty. Insurance fraud is a crime, and fraudsters are more likely than ever before to be caught, facing the very real prospect of serious financial penalties as well as custodial sentences.”