Investigations by Keoghs resulted in a criminal conviction earlier this month as claimant, Andrea Hill, pleaded guilty to fraud by false representation.
The claimant originally stated she had tripped and fallen due to the presence of a pothole on the forecourt of ‘Gibson’s News Food Wines Limited’ in Preston, sustaining a fractured collar bone and injuries to her neck and shoulder. The reserve on this claim was approximately £26,000 (including damages and costs).
Keoghs were instructed to investigate the case by insurer, LV=, in December 2013 after suspicions were aroused due to a lack of witnesses and the claimant’s delay in reporting the incident despite the apparent severity of her injuries.
Keoghs’ liability fraud team reviewed CCTV footage which showed no evidence of a fall at the time alleged.
Following this inconsistency combined with further evidence secured and prepared, Keoghs advised LV= to refer the case to the Insurance Fraud Enforcement Department.
After being charged and pleading guilty to fraud by false representation at Blackpool Magistrates Court, Andrea Hill, aged 48 and from Anchorsholme, was given an 18 week custodial sentence (suspended for two years) and instructed to carry out 240 hours of community service. A compensation order was also secured to compensate LV= for its investigation costs and Hill was ordered to pay a victim’s surcharge.
Following the sentencing, Partner at Keoghs, Nina Dayal, commented,
“This successful outcome should be equally received by the industry as a whole which is working together to fight against liability fraud, a growing concern. Fraudsters continue to seek new opportunities and unfortunately trip and slip incidents are perceived as a simple and straight forward way to achieve financial gain. However, these claims impact on society and policyholders from the owner of a small convenience store to the Local Authority and multinational company.”
“This result should be a warning to all fraudsters, that the pursuit of dishonest claims will not go undetected and without punishment.”
“Keoghs’ counter-fraud services division develop strategies and advice on prosecutions, sanctions and recoveries, offering assistance to insurers who wish to protect its shareholders and policyholders and send out a clear message to anyone seeking to defraud them that this will not be tolerated and fraudsters will be brought to justice.”
Clare Lunn, Head of Claims Crime Prevention at LV=, commented: “This case goes to highlight the lengths some people will go to in order to fraudulently claim compensation for an alleged injury. LV= takes a hard line on fraud, investigates all suspicious claims and pushes for the toughest sentences for those who are prosecuted, in order to protect our honest customers. We hope this sends a message to other fraudsters to deter them from committing this type of crime.”
City of London Police Detective Constable Paul Kirk, who led the Insurance Fraud Enforcement Department’s investigation, said: “Hill targeted this store in the knowledge it would be fully insured and therefore, in her mind, the ideal location for her bogus personal injury claims.
“Thanks to the dedication of the Insurance Fraud Enforcement Department and the insurance industry, we are able to expose and bring to justice swindlers like Hill. Hopefully her sentence will wake her up to the fact that insurance fraud is a crime with serious consequences.”
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