Background

The policyholder reported a traffic incident in which the third-party vehicle braked suddenly due to an oncoming vehicle, causing the insured vehicle to rear end them. Liability was admitted, and the third-party vehicle repairs were settled for just over £1,000.

Approximately two and a half years after the incident, both the driver and the passenger of the third-party vehicle submitted personal injury claims. Due to the delayed notification and minimal damage involved, we referred the claim to our Special Investigations Unit for further review.

How we helped

Our Special Investigations Unit conducted a thorough investigation into the late-reported personal injury claims. Both claimants had attended medico-legal examinations over three years after the incident, and both asserted that they were still suffering from worsening symptoms. However, medical record reviews revealed that neither claimant had sought any treatment for RTA-related injuries since the day of the collision.

Further scrutiny of the case showed that one claimant had been receiving chiropractic treatment for sports-related injuries, while the other had ongoing issues stemming from a previous back fracture caused by a fall. It is important to note that both individuals failed to disclose this relevant medical history to the medico-legal experts and instead attributed these unrelated injuries to the collision.

Despite the discrepancies, the claimants both proceeded with their cases and underwent MRI examinations. In response, we filed a fundamental dishonesty defence against them.

Outcome

When faced with the clear evidence of deliberate misrepresentation of their symptoms and non-disclosure, both claimants agreed to discontinue their claims on a drop hands basis. This resolution led to a total cost and damages saving of £30,910.53. Not only did this outcome successfully protect our client from an unjustified payout, but also shows the value of the involvement of the Special Investigations Unit and the thorough analysis of medical records when detecting and defending against fraudulent claims.

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