Insurer invokes ‘fundamental dishonesty’ to see off claims

By 9th September 2015 Uncategorised No Comments

An insurance firm says it has forced two claimants to drop £25,000 personal injury claims after invoking the new fundamental dishonesty defence.

An AXA customer had registered a claim explaining that their passenger had opened a door which made light contact with a neighbouring vehicle.

The driver of the third-party vehicle initially confirmed this version of events but subsequently submitted a personal claim along with his passenger. The claims for cervical spine (neck) injuries were both supported by medical evidence showing a 12-month prognosis.

AXA investigated the claim because of the minor nature of the impact, and subsequently entered a defence to the litigation pleading that both claims were fundamentally dishonest.

The defence was one of the first-known occasions that an insurer has used powers created by the Criminal Justice and Courts Act 2015, to have a claim thrown out in total if it is proven the claimant was fundamentally dishonest.

On this occasion, the claims were withdrawn and AXA was awarded costs of more than £18,000 against the claimants.

Tom Wilson, counter-fraud manager at AXA Insurance, said the firm will defend itself ‘robustly’ against all attempts to commit fraud.

‘The court’s finding that both claims were fundamentally dishonest and its decision to award costs to AXA should act as a warning of the potential repercussions for those who would commit fraud,’ he said.

‘It is often assumed that organised fraud represents the greatest threat to the industry but in fact, it is this almost casual, instinctive reaction to try to fleece insurers that costs the most.’

Last week, two individuals who colluded to defraud AXA out of £15,000 were jailed for a total of 30 months.

Scott Brough, who was involved in a road traffic accident and Carl Wilson, who came forward as a witness to support his version of events, were jailed last month at Teeside Crown Court for 21 months and nine months respectively.

Both were found guilty of perverting the course of justice, fraud by false representation and aiding and abetting fraud after it transpired that Brough had deliberately driven into the side of the insured’s van.

Via: http://www.lawgazette.co.uk/law/insurer-invokes-fundamental-dishonesty-to-see-off-claims/5050820.article

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