Casualty claims
Casualty Digest: Winter Edition 2024
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Our specialist insurance fraud investigations team advises major insurers, corporates, public bodies and private organisations on thousands of insurance fraud cases each year, including casualty, disease, motor, travel, household, property, pet and commercial policies. We help to protect our clients’ businesses and their customers from the harm of fraud.
We focus on uncovering motor fraud: bogus claims, phantom passengers, low-velocity impact, staged and induced accidents. We are proficient in disease claims, including suspicious noise-induced hearing loss claims. We also have extensive experience in property fraud, including arson, theft, burglary and stolen vehicles.
Our specialist team has resolved numerous fraud rings, fabricated incidents and exaggerated claims across all lines of business. We also advise clients on future fraud prevention strategies, providing a tailored approach which helps to ensure brand protection, maintain policyholder relationships and minimise costs.
We use our cross-border intelligence and our innovative systems to improve our counter-fraud service. We have developed a number of innovative counter-fraud products as part of our Clyde & Co Newton offering. These include Fraud Screen, a bespoke Optical Character Reading (OCR) tool including artificial intelligence (AI)functionality that provides the most advanced language model accessible today and Fraud Edge, a fraud insight tool, allowing clients to understand the potential exposure to suspicious organisations.
We have achieved a series of milestone 'firsts' for our insurance fraud clients:
Strong experience in dealing with all aspects of fraudulent insurance claims. A leading firm in this area.
Legal 500 2022
The Lawyers have detailed and long-standing knowledge of insurance fraud and the various ancillary issues that flow from this. As a team it is efficient, proactive and realistic. It gets results.
Legal 500 2022
Our market leading fraud team defends a wide range of suspicious litigated and pre-litigated claims, investigating the circumstances of the claim and providing a robust defence.
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We acted for an insurer on a large motor fraud operation. The operation focused on 367 third parties claiming against 136 fraudulently incepted policies and was complex given it involved suspected staged accidents where often individuals did not exist. The strategies resulted in savings of 3.4 million for the insurer client. Additionally, following over 500 individuals being under investigation; payments were made on just 4 claims in total (97.55% success rate).
We successfully applied for the committal of three Defendants for contempt of court. The application was made following their attempts to bring a fraudulent insurance claim, in relation to a staged road traffic accident. The first and third Defendants filed witness statements refuting our client’s allegations of fraudulent behaviour. All Defendants received custodial sentences, this ruling has important ramifications for those involved in fraudulent claims.
The claimant, attempted to claim over £55,000 for injury in a road traffic accident, he claimed that injuries to his foot meant he could neither stand nor walk for long periods. His appearance on Sky TV’s Soccer AM for scoring a goal from the halfway line, was one of the pieces of evidence we presented to the Court to prove the claimant was exaggerating the extent of his injuries. He agreed to a court order to withdraw his insurance claim and pay £5,000 costs.
Representing a large local authority on a sensitive employee-led fraud ring. We ensured that reputational damage was avoided whilst achieving maximum repudiation and an IFED referral.
We acted for a large public liability insurer following a genuine accident. The claimant alleged serious physical and psychological injuries, with his claim for damages and costs in excess of GBP 40,000. Our investigation uncovered that he was lifting heavy weights and we obtained video of him on one of the world’s highest waterslides. At trial, the claim was dismissed and the claimant was ordered to pay GBP 14,000 in costs.
Following a genuine accident at work, our insurer client contacted us as they were concerned about the extent and impact of the injuries. This claim was handled using our Project Martello strategy for exaggerated claims. Our investigation uncovered that the Claimant was much more active than he was admitting. The Court ordered that the GBP 260,000 claim be discontinued and the claimant to pay GBP 5,000 to the Defendant.
Acting for several large clients in the Preston area dealing with, what was deemed to be, the first industry-wide EL/PL fraud ring. We assisted our client by liaising with the IFB and delivered a 100% repudiation rate for all intimated claims.
Acting on behalf of a global insurer defending a staged tripping claim brought against a supermarket. After defending the original GBP 60,000 claim to a successful conclusion at trial, we then pursued a private prosecution against the claimant - who received a 21 month suspended jail sentence for her part in the scam.
We pursued contempt of court actions against three individuals who had brought claims against a top 10 UK motor insurer following a staged road traffic accident, part of a larger fraud ring investigation. While the claims had not proceeded to trial meaning the three individuals hadn't lied under oath, we pursued contempt proceedings and they each received prison sentences of between 4 and 6 months.
We successfully applied for the committal of three Defendants for contempt of court. The application was made following their attempts to bring a fraudulent insurance claim, in relation to a staged road traffic accident. The first and third Defendants filed witness statements refuting our client’s allegations of fraudulent behaviour. All Defendants received custodial sentences, this ruling has important ramifications for those involved in fraudulent claims.
We acted for an insurer on a large motor fraud operation. The operation focused on 367 third parties claiming against 136 fraudulently incepted policies and was complex given it involved suspected staged accidents where often individuals did not exist. The strategies resulted in savings of 3.4 million for the insurer client. Additionally, following over 500 individuals being under investigation; payments were made on just 4 claims in total (97.55% success rate).
The claimant, attempted to claim over £55,000 for injury in a road traffic accident, he claimed that injuries to his foot meant he could neither stand nor walk for long periods. His appearance on Sky TV’s Soccer AM for scoring a goal from the halfway line, was one of the pieces of evidence we presented to the Court to prove the claimant was exaggerating the extent of his injuries. He agreed to a court order to withdraw his insurance claim and pay £5,000 costs.
Representing a large local authority on a sensitive employee-led fraud ring. We ensured that reputational damage was avoided whilst achieving maximum repudiation and an IFED referral.
Acting for several large clients in the Preston area dealing with, what was deemed to be, the first industry-wide EL/PL fraud ring. We assisted our client by liaising with the IFB and delivered a 100% repudiation rate for all intimated claims.
We pursued contempt of court actions against three individuals who had brought claims against a top 10 UK motor insurer following a staged road traffic accident, part of a larger fraud ring investigation. While the claims had not proceeded to trial meaning the three individuals hadn't lied under oath, we pursued contempt proceedings and they each received prison sentences of between 4 and 6 months.
We acted for a large public liability insurer following a genuine accident. The claimant alleged serious physical and psychological injuries, with his claim for damages and costs in excess of GBP 40,000. Our investigation uncovered that he was lifting heavy weights and we obtained video of him on one of the world’s highest waterslides. At trial, the claim was dismissed and the claimant was ordered to pay GBP 14,000 in costs.
Following a genuine accident at work, our insurer client contacted us as they were concerned about the extent and impact of the injuries. This claim was handled using our Project Martello strategy for exaggerated claims. Our investigation uncovered that the Claimant was much more active than he was admitting. The Court ordered that the GBP 260,000 claim be discontinued and the claimant to pay GBP 5,000 to the Defendant.
Acting on behalf of a global insurer defending a staged tripping claim brought against a supermarket. After defending the original GBP 60,000 claim to a successful conclusion at trial, we then pursued a private prosecution against the claimant - who received a 21 month suspended jail sentence for her part in the scam.
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合伙人兼亚洲区执行董事
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Head of Fraud Intelligence
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