Turning the tables
on the fraudster
The private motor
insurance market -
a final decision
The sky’s the limit
>>> continues on page 3
The story continues...
In the last edition of fraud watch,
we provided an update on the developments
in claims and personal injury that have taken
place in 2014 and the highlights of the year
so far. However, the reform hasn’t stopped -
further developments have happened since.
Stratos Gatzouris continues his review of the
key changes to whiplash reform that affect
you and your business.
Welcome to the autumn 2014 edition of the Hill Dickinson counter fraud group’s quarterly newsletter, fraud watch. We hope that you find this both an enjoyable and informative read.
Our cover story continues our analysis of personal injury reform, with interesting developments to the concept of fundamental dishonesty and the commissioning of expert medical evidence. We take a look at what is coming next.
In addition, Michelle Reilly and Mick Lawless explain how you can turn the tables on the fraudster to pursue recoveries, sanctions and exemplary damages. Our new travel fraud database is off to a flying start and Chris Hallett explains just how big a problem travel fraud has become.
We do hope that you enjoy this latest edition of our newsletter. If you would like any more information about the areas covered, would like to discuss any of the issues featured or make suggestions for what you would like to see in future editions, please do not hesitate to get in touch with any one of the team.
We will be back with our next edition in the new year. In the meantime, we would like to take this opportunity to wish you a very merry Christmas and a happy new year.
Partner, Head of Fraud
Hill Dickinson teams up with Post magazine to consider data protection reform in the fight against fraud
Hill Dickinson counter fraud group hosted a roundtable event in collaboration with Post magazine, to discuss the proposed European Regulation on data protection expected to be passed into law next year.
The event, held on 25 September 2014, brought together experts from the insurance fraud, legal and claims communities to consider how the reforms will impact on the fight against fraud. With key changes to profiling, the right to be forgotten and the requirement to obtain explicit consent to process data, attendees held a range of views. It was, however, widely agreed that further refinement will be required to ensure that insurers retain the right to hold and store intelligence to maintain their ability to fight fraud. The event was a great opportunity for stakeholders to take a collaborative approach to consider the needs of the industry.
Left to right:
Back row: Stratos Gatzouris (Hill Dickinson), Richard Davies (Axa), Steve Jackson (Covea), John Martini (CIS), Ben Fletcher (IFB), Glen Marr (First Central), Andy Pagett (Ageas)
Front row: Ursula Jallow (LV), Steve Evans (Accident Exchange), Peter Oakes (Hill Dickinson), Mike Brown (Direct Line)
Photography: Steve Daszko
fraud watch autumn 2014
>>> continued from page 1
The Government is considering stakeholders’ responses
to a consultation on stage two, to which Hill Dickinson
has also responded. Some of the issues raised include
how the introduction of MedCo will affect litigants
in person and how the accreditation process will
work in practice. We have raised concerns in respect
of claimant solicitors carrying out searches into
the claimant’s accident history and whether it will
undermine one of the key tools that a defendant has to
assess a claimant’s credibility. We have also suggested
a requirement for claimant representatives to perform
‘know your client’ checks in much the same way as
those requirements exist in the Money Laundering
Regulations for legal representatives dealing with
Stage two: quality
Reforms will continue next year, with the proposed
introduction of an online portal aiming to address and
remove potential conflicts of interest between firms of
solicitors and affiliated experts. The portal, preliminarily
named ‘MedCo’, will be the sole point of access for
lawyers seeking medical reports. Filters will be applied to
MedCo search results to ensure that there is no financial
link between the law firm and the appointed expert.
The MOJ has also proposed a compulsory accreditation
scheme for experts to improve the quality of reports.
Experts will be given a grace period during which they
can be listed on the portal, but, if they fail to attain the
required accreditation by a set date, they will no longer
be able to use the system, and will therefore be unable to
report in these claims.
Claimant representatives may also be required to carry
out a previous claims search on the claimant via the
Claims and Underwriting Exchange (CUE) database,
prior to accepting the claim. The Government hopes
that this will encourage claimant solicitors to be
vigilant about their client’s credibility and act as an
additional filter in respect of fraudulent claims. There
is a concern that despite being made aware of their
prospective clients’ previous accident histories, some
claimants’ representatives may continue to represent
those claimants and that this information will feature in
instructions to those medico-legal experts.
Stage one: cost
On 1 October 2014 the Civil Procedure (Amendment No.
6) Rules 2014 came into force. Amendments included
the introduction of a fixed fee for medical evidence. The
fee for a standard first report will be limited to £180 plus
VAT with fixed rates for obtaining medical records and
Part 35 questions. It is expected that a claimant will be
restricted to one medical report and will need to justify
any request for permission to rely on further evidence or
step outside of the fixed fee scheme.
There is now also an opportunity for defendants to
provide their version of events to the claimant’s medical
expert prior to examination. The defendant’s version of
events will be recorded in the portal response and the
claimant must provide this to the expert to consider in
forming a conclusion. In addition, a medical expert will
need to demonstrate that they are impartial. Experts
will not be allowed to offer or provide treatment to a
claimant, and if they do, they will forfeit their report fee.
In an effort to control ‘pre-med’ offers, any offer
made without medical evidence will have no costs
consequences until the medical report is served.
The requirement to dismiss personal injury claims
for fundamental dishonesty was inserted into the
Criminal Justice and Courts Bill in July. A disappointing
amendment to the clause is that any costs awarded
to the defendant will be reduced by the amount that
the claimant would have received in damages. In the
meantime, we are one step closer to understanding
what constitutes ‘fundamental dishonesty’, in the
context of QOCS at least. In the recent case of Andrew
Fish -v- Patrick Hillman in the county court, a judge
awarded a defendant its costs when he found a claimant
who had exaggerated a low speed impact case had
been fundamentally dishonest. While this is only a
county court decision and therefore not binding, it is
encouraging to see district judges take this approach to
low speed impact cases.
When it comes to defending fraudulent
claims, nothing rivals the satisfaction of
a costs order in your favour - whether
it results from an interim application,
a claimant’s default or a win at trial.
However, it can be disheartening when
that costs order goes unsatisfied. Often,
a fraudster will seemingly disappear or
won’t have the funds to pay. When this
happens, what can be done about it?
Recovering from a claimant
If the fraudster is the claimant, then
traditional methods of recovery - such
as instructing a High Court enforcement
officer, obtaining a charging order on
a property, an attachment of earnings
order or a third party debt order - are
all effective methods of recovery,
but can take a long time to achieve
the desired result. Issuing a statutory
demand followed by a bankruptcy
petition can be a quicker method of
recovery and has the added advantage
of potentially taking a fraudulent
claimant, who may have previously
been a company director, out of
that position until the debt is paid.
What if the claimant
isn’t the fraudster?
Often claims are run for the benefit of
an accident management company
(AMC) or credit hire company (CHO),
sometimes even without the claimant’s
knowledge. It is important to ask the
question ‘who is the true instigator of
the proceedings?’ and perhaps more
importantly ‘who is going to benefit?’
The reply to these questions will often
tell you who you need to pursue and
bring into proceedings for the purpose
of costs recovery. This can be done
during the course of the litigation or
at the end of the case, depending
on the facts. CPR 44.16(3) provides
an exception to the usual rules of
qualified one way cost shifting and
allows the court to make a costs
order against a person other than the
claimant if the claim was made for
the financial benefit of that person.
The advantage of this method of
recovery is of course that an AMC or
CHO is more likely than an individual
claimant to have funds to repay costs.
Pursuing the ATE provider
is a waste of time… isn’t it?
The failure of after the event (ATE)
insurance providers to honour claims by
resorting to self-drafted clauses in their
policies is a huge source of frustration
for insurers, but it would be a mistake
to think that recovery was not possible
in any of these cases. Commonly,
claimant solicitors acting under a
delegated authority arrangement
for the ATE provider fail to keep the
insurer updated on the progress of the
litigation. If the matter proceeds to trial
and the insurers have done nothing
to reassess the risk - despite clear
misgivings and evidence supplied by
defendants – then, increasingly, courts
are prepared to bring both the ATE
provider and the claimant’s solicitors
into proceedings for the purpose of
costs recovery. In many cases, either the
ATE provider or the claimant’s solicitors
step in to make a commercial offer for
costs before the case reaches a hearing.
Isn’t the imposition of a sanction
only appropriate for complex
fraud or higher value cases?
Often this is true, but not always.
Increasingly, insurers find themselves
repeatedly targeted by the same
ring of fraudsters, submitting many
low value claims which, when added
together, represent a very significant
loss. It is important to challenge this
practice head on, to not only act
as a deterrent, but to protect the
insurer’s brand and reputation.
Contempt of court proceedings,
actions in the tort of deceit seeking
exemplary damages and private
prosecutions are all options that can be
considered. A guilty verdict in relation
to either contempt of court or private
prosecution can result in a custodial
sentence and maximum publicity which
will serve to deter any other ‘would be’
fraudsters. While private prosecutions
are not going to be suitable in every
case, in addition to the obvious
sanction of imprisonment, they have
a number of advantages over civil
proceedings: they are often dealt with
in a relatively short time frame when
compared to civil litigation and act as
an effective system of confiscation/
compensation with the possibility of
costs recovery from the public purse.
Throwing good money after bad?
Turning the tables
Insurers are often reluctant to pursue a fraudster for recovery of costs on the basis that they
‘don’t want to throw good money after bad’, with the same concerns regarding imposition
of sanctions. Michelle Reilly considers how insurers can improve their prospects of recovery
and send a clear message to fraudsters that they do in fact have something to lose.
fraud watch autumn 2014
Chamberlain & 4
Others -v- Equity
Red Star Insurance
Mick Lawless succeeded in an
action against a fraudster in the
tort of deceit in the Newport
County Court. The parties
alleged that the claimants’ 4x4
and the defendant’s van had
collided with each other. The
defendant’s van was hired from
the insurer’s policyholder. The
defendant driver denied any
knowledge of the claimant and
could not give any explanation
as to why he needed to hire
the van. Enquiries revealed
that the claimant had provided
a credit reference on behalf
of the defendant in which he
confirmed that they had known
each other for 15 years and
worked together. On receipt
of this evidence we filed a
defence pleading fraud and
issued an additional claim
against both parties in the tort
of deceit. We sought recovery
of the interim payment for the
claimant’s vehicle damage,
the costs of defending the
claim, the pre-litigation
investigation costs, including
the costs of the insurer’s
investigations, and exemplary
damages. The judge was
highly critical of the claimant
and defendant, referring to
the claim as a ‘deliberate,
conspiratorial deceit designed
to recover damages to which
none of these claimants
was properly entitled’.
We were successful in each
head of loss and were awarded
Claims in the tort of deceit and exemplary damages
on the fraudster
Insurers may sometimes feel
frustrated when dealing with the huge
volume of fraudulent claims they face
on a daily basis. Persuading a court to
dismiss a claim may seem like enough
of a challenge, but there is more that
can be done. Mick Lawless takes a
look at what an insurer can do to
increase the pressure on a claimant.
Once a claim has been found to be fraudulent,
insurers can look to recover costs and even go
down the route of private prosecution. However,
if fraud is pleaded in the defence, then the
defendant is already satisfied there is evidence
of dishonesty on the part of the claimant. There
are steps that an insurer can take either prior to
or during proceedings, which will serve to crank
up the pressure and send a clear message to the
Tort of deceit
A claim in the tort of deceit can be made
immediately upon discovery by the insurer
that it has been the victim of a fraudulent
In order to bring a claim in the tort of deceit,
an insurer must show that the fraudster made
a representation to it that the fraudster knew
to be false or was reckless as to whether or not
it was true. The fraudster must have intended
the insurer to act on the representation and the
insurer must have been induced to act upon it,
to its detriment.
An insurer can bring a claim in the tort of deceit
before proceedings are issued, if appropriate,
and does not have to wait for the matter to
What distinguishes deceit from other torts is
that there is no requirement to prove that the
losses suffered were foreseeable. The measure
of damages under the tort of deceit is the loss
directly arising from the insurance company’s
reliance upon the fraudster’s fraudulent
Damages in the tort of deceit fall in to four
1. the costs of defending the claim;
2. repayment of sums already paid;
3. internal investigation costs incurred by the
insurer prior to the issue of proceedings; and
4. exemplary damages.
Exemplary damages are a punitive award to
accompany the tort of deceit action. Damages
are awarded as an alternative to criminal
The claimant cannot face the double jeopardy
of both civil and criminal actions. In the case
of AXA -v- Thwaites the civil court found itself
in a position to award exemplary damages
but declined to do so where such damages
would be in addition to a criminal penalty. It is
important to decide which option would be the
most appropriate in the circumstances.
The leading authority for exemplary damages
is Rookes -v- Barnard, in which Lord Devlin
noted: ‘Exemplary damages are essentially
different from ordinary damages. The objective
of damages in the usual sense of the term is to
compensate. The object of exemplary damages
is to punish and deter… exemplary damages can
properly be awarded whenever it is necessary to
teach a wrongdoer that tort does not pay.’
Exemplary damages are not awarded as a
matter of course. The court does not have an
exact method of calculation but will have regard
to outrage caused by the fraudster’s conduct
and the court’s desire to mark its disapproval.
Our experience is that the award will often
represent the value of the claim or a sum which
represents the damages claimed plus costs.
A clear message
A strike out, discontinuance or trial win with a
finding of fraud is of course a good result, but
a claim in the tort of deceit turns the tables on
the fraudster and sends a clear message that
insurers are prepared to fight back against
fraudulent claims. An additional award of
exemplary damages is not only a deterrent, but
also makes a dent in the bank balance of those
pursuing fraudulent claims.
The private motor
insurance market -
a final decision
In September 2012, the Competition Commission (now the Competition and
Markets Authority (CMA)) began its investigation into the UK private motor
insurance market. The CMA works to promote competition for the benefit of
consumers. Its aim with this investigation was to identify market features that
restrict or distort competition, and suggest ways to remedy any problems.
On 24 September 2014, the
CMA released all 288 pages of
its final report. James Bilham
concludes his series of articles
following the progress of
the CMA investigation with
a review of the final decision
and considers what effect it
will have on the private motor
The provisional findings, published in
December 2013, identified five main
issues and a provisional decision on
remedies was published in June 2014.
However, in our view the final decision
fails to address some of the issues
identified and is considerably weaker
than the provisional decision.
Cost separation versus
In its provisional decision, the CMA
proposed a radical solution to this issue
in which it identified that the at-fault
insurer, who ultimately has to foot the
bill, has little control over the level of
costs incurred. The solution was the
introduction of a two-tier rate cap for
hire vehicles depending on whether
the at-fault insurer admitted or denied
liability, along with a limit on the period
However, following publication of
the provisional decision, the CMA
acknowledged that they did not have
the powers necessary to implement this
In the final report, the CMA has said
that none of their proposed remedies
for this issue would be ‘both effective
and proportionate in addressing the
adverse effect on competition arising
from the separation of cost liability and
control, and the various practices and
conduct of the parties managing nonfault
claims... ’. They have therefore left
this issue without remedy.
Stakeholders are understandably
disappointed with this response.
While credit hire companies deny
any contribution to the distortion of
competition, insurers say that the
net detriment of £278 per credit hire
claim has a significant impact on the
insurance market and needs to be
This issue related to the lack of
information provided to consumers
regarding the true price of add-on
products such as no claims bonus and
the implied price of no claims bonus
protection. The decision requires all
insurers and brokers to provide a
breakdown of the true value of the addon
product at the time it is purchased.
A better understanding of these
products will no doubt assist the
consumer in making a more informed
choice and help drive competition,
price and innovation.
fraud watch autumn 2014
Lack of information to
consumers about their rights
The CMA identified a lack of
information being provided to
consumers about their rights after an
accident. The proposed remedy was
to ensure that clear, standardised
information is provided to
consumers, both at policy inception,
and also at first notification of loss.
However, in the final report, the
CMA has decided not to pursue
this remedy, despite having already
drafted and agreed a statement
of rights. The justification for
this is that since it was decided
that other remedies could not
be pursued, then a statement of
rights would not be needed.
It is very difficult to imagine a
downside to providing a consumer
with a clear understanding of their
rights, even if this did not support
other remedies, which make its
omission from the final package even
A disappointing outcome
Needless to say, the general feeling
across the industry is that the CMA
has failed to deliver. The Association
of British Insurers (ABI) has criticised
it for evading the difficult issues.
Maybe the answer was simple. The
CMA has said that there can never
be a ‘perfectly competitive market’,
rather a ‘well-functioning market’ is
as much as can be hoped for.
The most disappointing aspect of
the report is undoubtedly its failure
to address the issue of mitigating
the frictional cost of credit hire. The
Credit Hire Organisation has issued
an open letter to insurers asking for
further commitment to an online
portal. In response, the ABI has
described the portal as peripheral
and has written to the Transport
Select Committee in an open letter
stating that the CMA is ‘ducking the
Meanwhile, we note with interest that
the CMA has failed to address fraud
at all. Fraud costs the industry an
estimated £800 million a year, almost
ten times the estimated net adverse
effect of credit hire.
The report makes for tough, and
slow, reading which is unsurprising
given the nature of the private
motor insurance market and its
many intricacies, complexities and
acronyms. To get to a final report
has undoubtedly taken considerable
time, effort and financial input from
all interested parties which, upon
reflection, makes the lack of real
progression - notably in relation to
post accident services - all the more
disappointing. This report therefore
may be remembered more for what
the CMA has not done, rather than
what it has.
The problem (December 2013) The proposed remedy (June 2014) The final decision (September 2014)
1 Lack of information to consumers about
their rights, resulting in possible underprovision
Insurers to provide clear, standardised
information to consumers at policy
inception and first notification of loss.
The proposed remedy was agreed. This
will ensure that rights and obligations are
clearly communicated to the consumer.
2 Competition softening strategies: addon
products, such as courtesy cars or
protected no-claims discounts (NCDs).
The CMA focussed on NCDs and
recommended clearer pricing of the true
value of no claims bonus protection at
point of sale.
Other add-on products were referred to
The proposed remedy was agreed. This
remedy aims to improve consumer
understanding of the premium, the
discount ‘earned’ and the cost of
protecting that discount.
3 Price parity agreements between insurers
and price comparison websites (PCWs)
suppressing competition and leading to
higher prices overall.
Restrict price parity agreements so that
insurers are covered but other price
comparison websites/brokers are not.
The proposed remedy was agreed. It is
hoped this will encourage competition
whilst protecting PCWs from being cut
out of the loop.
4 Separation of cost liability and cost control
between service providers (such as nonfault
insurers and credit hire companies)
and at-fault insurer.
Overhaul of credit hire claims to regulate
period and introduce a two tier cap on
rate depending on the liability position.
This recommendation has been retracted.
The CMA accepted that this proposal
was beyond their powers and has since
decided to take no further action.
5 Market concentration. This was discounted in light of insufficient
No further action.
Cowboy builder lassoed…
A builder has been jailed for five
years for defrauding homeowners.
Mark Jenkins admitted taking large
deposits from customers upfront
without completing the work - duping
43 homeowners in the south west of
England and south Wales.
Out of order…
A man has been arrested on suspicion
of orchestrating a £1.6 million raid on
cash machines across the country. The
man, who is thought to be part of an
organised crime gang, is believed to
have inserted a computer virus into
cash machines which infected and
then cleared cash machines using
specially created malware. The police
investigation is ongoing.
A woman has admitted to conning
fundraisers into donating thousands of
pounds for her wedding while claiming
that she had terminal cancer. Danielle
Watson told fundraisers that she had
stage four cervical cancer and received
free or discounted deals on a wedding
dress and a wedding reception as
a result. The fraud was discovered
by fundraisers when she announced
her pregnancy on Facebook shortly
after the wedding. She is due to be
sentenced in January.
The Italian job…
Two Italian businessmen have been
arrested for a €1.7 billion corporate
fraud in which they submitted false
invoices to the state for non-existent
security, cleaning and other services.
The fraud, which dates back to 2001,
is thought to have involved 62 people
and used shell companies to house the
money. The police investigation
Attack on the public purse…
In its report, Protecting the Public
Purse, the Audit Commission has
revealed that English councils detected
nearly £200 million of fraud in
2013/2014. This is the highest amount
for a generation and ten times the
figure in 1990. Part of the increase can
be attributed to ‘Right to Buy’ fraud
which increased sixfold between 2009
and 2014, with a threefold increase in
There has also
been a 200% rise in
fraudulent slips and
trips presented to
from 74 in 2012/13
to 226 in 2013/14.
A urologist has
off the medical
of fraud for
living a double
life as a TV
two months of starting his post at
Scunthorpe General Hospital. Dr
Holloway started making sick leave
claims. Suspicions arose after he
returned from one period off with an
unseasonable suntan. Investigations
revealed that he was in fact working
as an international equestrian TV
commentator. He was convicted of
fraud by false representation, fined and
ordered to pay back salary.
What is travel insurance fraud?
The average travel insurance policy covers a range of losses including:
• baggage (accidental loss, theft, delay), personal effects, money;
• cancellations, curtailment; and
• repatriation due to illness or injury.
Opportunistic fraudsters often claim for items allegedly lost or stolen while travelling both abroad and in the UK. That loss or theft may be entirely fabricated or the customer may exaggerate the value of genuinely lost items. Alternatively, customers might claim for cancellation of a trip due to illness - whereas they are actually choosing not to make the trip for personal reasons, financial reasons or they might submit identical claims on multiple policies. A more unusual, but still prevalent, problem is medical expenses fraud which might include overcharging or overtreatment in travel clinics… or even complete fabrication of the claim.
As a product, travel insurance tends to be cost-driven and insurers tend not to benefit from as much customer loyalty as seen in other sectors. Travel fraud is also perceived to be easier to get away with as many customers take out single trip travel policies as and when needed which can leave insurers further exposed to high volume, low value fraudulent claims.
On the rise
Recent years have seen a significant increase in travel insurance claims with quotes of ‘… 140% rise in lost baggage claims and 190% rise in cancellation claims in 2013’, and ‘… 7% of 18-34 year old UK holidaymakers admitted to having inflated a previous travel claim or having fabricated a claim in its entirety’. In the past year, 23% of posts on the Insurance Fraud Investigators Group (IFIG) website relate to travel fraud cases/investigations.
With the average claim for lost luggage valued at £2000, it is easy to see how important it is that something be done.
In June 2014, the Insurance Fraud Enforcement Department (IFED) made 11 arrests as part of a nationwide travel fraud operation. Claims values ranged from £300 to £14,000 and included claims such as lost or stolen clothing and electrical items, as well as medical expenses incurred abroad. Officers seized thousands of pounds worth of clothing, jewellery and electrical items, in addition to evidence of more organised fraud by way of partially completed a travel insurance claims forms, bogus doctor’s stamps and medical certificates.
How do you fight travel insurance fraud?
Travel insurance fraud can be difficult to prove with particular pressure being placed on the relatively low financial value of any one single loss compared to the cost of investigating the case further.
Travel insurers, claims handlers and investigators - unlike their motor and household counterparts - have historically had no travel claims database or other resource to track serial claimants, making it even harder to identify patterns, linked claims or serial claimants. At Hill Dickinson, we have addressed this by developing our own market-leading database, linked to our Netfoil product and proven intelligence analytics. ‘Netfoil Travel’ provides members with a low-cost platform on which they can safely and securely share common claims data, as well as undertake searches of the database where they have concerns that a claim may be suspicious. Matching claims data is returned to the respective member who can then continue their investigations at desktop level and retain control of costs.
For more information, or a demonstration of ‘Netfoil Travel’,
fraud watch autumn 2014
Many of you will have enjoyed a relaxing holiday and well deserved break this year,
but travel insurer claims teams have never been busier. With travel insurance fraud on
the increase, Chris Hallett considers how travel insurers can identify fraudulent claims.
The sky’s the limit
Michelle worked in the insurance industry for a decade, before moving to the legal profession almost 20 years ago. She advises clients on technical and counter fraud issues and works closely with them in relation to strategy. She is committed to developing counter fraud strategies beyond simply winning the case.
Bringing expertise in the specialist areas of sanctions and recoveries in fraud cases, Michelle works with clients to recover costs via both traditional and non-traditional methods. She specialises in recovering costs from the true instigator of the claim and advises on appropriate sanctions in cases of proven fraud.
Michelle regularly presents nationally and internationally on this topic and also on cross border fraud claims.
Mark is a barrister and was in independent practice in London and Liverpool for 12 years before moving in-house in 2012. He is a seasoned and robust advocate with extensive experience of trial and appellate advocacy.
Mark is a counter fraud specialist whose skills span the civil and criminal jurisdictions. Along with drafting and advocacy, Mark has a particular interest in pursuing defence costs recoveries in fraudulent claims and in the imposition of sanctions via contempt proceedings, or private prosecution.
Whilst in independent practice, Mark dealt with civil, criminal and regulatory work. He was on the Attorney General’s list to prosecute serious criminal offences. He has detailed knowledge of civil recovery and confiscation proceedings and has been regularly instructed in such work by HM Revenue and Customs and the UK Border Agency (as was). He was junior counsel in Re K (The Times, March 15 2005), a leading authority on piercing the ‘corporate veil’ and the appointment of management receivers, and has appeared in a number of reported cases before the Court of Appeal.
Nathan is a solicitor with over 10 years’ counter fraud experience. Having previously managed a counter fraud team, he has considerable experience in handling all types of fraudulent claims including low speed impact and complex fraud, as well as sanctions and recoveries.
Nathan now focuses on client relationship management and business development, and will work with both new and existing clients to develop strategies to complement our counter fraud solutions. Nathan is especially excited to be working with clients to develop a commercial strategy for dealing with low speed impacts.
Michelle Reilly, Mark Stanger and Nathan Jones have joined the firm’s counter fraud group management team. Their arrival brings valuable experience
and industry insight to complement our existing team and market-leading business strategy.
fraud watch autumn 2014
What is your role in the counter fraud group (HDCFG)?
As a complex fraud analyst, I split my time between identifying fraud rings, and gathering sufficient evidence to combat them. I keep on top of industry intelligence and utilise the massive amount of data within the Netfoil intelligence database to data mine and explore threats. My goal is to identify a potential fraud and notify all clients at risk. Once a series of linked claims are approved as a fraud ring, I then close the blinds, make lots of coffee and set about my investigations. My report is then used by the lawyer leading the operation to develop an overall strategy to defeat the claims and pursue recovery.
How did you get into counter fraud work?
My career began in the police intelligence unit, so the move to counter fraud was fairly intuitive. HDCFG use many of the same intelligence platforms as the police and the reports also follow the same NIM (National Intelligence Model) formats and processes.
What do you enjoy most about your job?
I get great job satisfaction when I uncover a fraud ring, having started with only a hunch or a tip off. The process of carrying out proactive investigations and analysis to identify a fraud that would otherwise have gone undetected is really rewarding.
While Netfoil and desktop-based analytical tools usually form the backbone of our investigations, I always enjoy seeing a claimant incriminate themselves and others on Facebook!
What do you enjoy least about your job?
The least enjoyable part of my job has to be the report writing. After the excitement of identifying a new fraud ring and collating incriminating evidence, there is then a lengthy and detailed report to write. Although it can sometimes be a daunting task, the evidence is not going to be much use stored inside my head so report writing is a necessary evil – especially as some of my operations feature as many as 50 separate collisions!
What was your most testing case?
While all of my fraud rings present their own unique challenges there is one particular operation that sticks out as the largest and most complex – operation METS. I identified operation METS in 2013 - approximately ten collisions were initially identified by Netfoil analysis, but it soon became apparent that there was a huge amount of cross-industry exposure. Over the following months I dedicated the majority of my time to this operation and it continued to grow, culminating in the police arresting an individual who was found to be in possession of 117 detailed accident crib sheets. They included maps, collision circumstances, policy numbers and photocopies of driving licences and passports.
This information, along with the Netfoil data, allowed me to link each collision to numerous other accidents within the operation. The report and chart caused quite a headache! Although the majority of the cases have now gone away with no payments made there are a handful of claims which remain and it was only recently that a new tranche of connections was revealed via searches which identified that several of the addresses provided by claimants were all owned by the same person!
What do you think you would have done for a career if you had not been an analyst?
When I was younger, I thought about joining the emergency services, as the diversity and fast paced nature of the work appealed to me. While the notion of being baton in hand on the beat tackling crime or grappling with the hose in a burning building is exciting, in reality on a cold and wet winter’s day, I’m quite happy being in a warm office!
What are your interests outside of work?
If I had been asked this question a few years ago the answer would have been simple – rugby, having played at various levels for nearly 20 years! Things are a little different since having my two children and I now spend the majority of my time trying to juggle my family with maintaining a social life and watching re-runs of Top Gear!
Who’s who at Hill Dickinson
Find out more about our team and put faces to names.
Rob Maskew-Snell is a complex fraud analyst in our intelligence team,
based in Manchester. Here, we find out a bit more about what he does
on a daily basis and what he loves (and hates!) about his job...
On 25 September 2014, we held a passenger transport
seminar at our London office, featuring Justice Minister
Lord Faulks QC as our keynote speaker. Hosted by senior
associates David Croot and Ian Emery, the event was
attended by some of our most valued clients and provided
a fantastic opportunity to discuss the developments in
whiplash reform taking place this year.
The event included presentations by Hill Dickinson’s complex fraud
senior analyst Dan Sanzeri and senior associate David Croot on
the benefits of mass data analysis and CCTV evidence. There was
also a lively panel debate about how whiplash reform will affect
passenger transport claims. Topics covered included the involvement
of passenger transport
businesses in government
consultation, the effect that
the claims portal has had on
fraud investigations and the
impact of qualified one way
costs shifting on passenger
A highlight of the day was
undoubtedly the keynote
address, delivered by
Lord Faulks. This set out the
for whiplash reform and
included an overview of what
has been done so far, with
a promise of further action
to tackle the dysfunctional
system behind personal
We are grateful to all those
who attended the event
with special thanks to Lord
Faulks QC, along with
our panel members Anna
Blunden of trentbarton,
Martin Haukeland of 42
Bedford Row, David Mace of
Nottingham City Transport
and John Miller of The
Confederation of Passenger
Transport UK. The day was a
great success and we were
thrilled to see so many of
Panel debate (Left to right): Martin Haukeland,
John Miller, David Mace, Anna Blunden
Hill Dickinson’s David Croot presents
on surveillance evidence
Left to right: Ian Emery, Chris Hallett,
Lord Faulks and David Croot
fraud watch autumn 2014
About Hill Dickinson
The Hill Dickinson Group offers a
comprehensive range of legal services
from offices in Liverpool, Manchester,
London, Sheffield, Piraeus, Singapore
Monaco and Hong Kong. Collectively
the firms have more than 1300 people
including 180 partners.
The information and any commentary contained in this newsletter
are for general purposes only and do not constitute legal or any
other type of professional advice. We do not accept and, to the
extent permitted by law, exclude liability to any person for any
loss which may arise from relying upon or otherwise using the
information contained in this newsletter. Whilst every effort has
been made when producing this newsletter, no liability is accepted
for any error or omission. If you have a particular query or issue,
we would strongly advise you to contact a member of the counter
fraud group, who will be happy to provide specific advice, rather
than relying on the information or comments in this newsletter.
Liverpool Manchester London Sheffield Piraeus Singapore Monaco Hong Kong
Hill Dickinson has a team of 100 experienced
counter fraud lawyers and analysts. Supported
by Netfoil, Hill Dickinson’s market-leading
counter fraud database, they are able to
provide advice to insurers and corporate
clients to assist in defeating fraudulent claims,
to implement fraud prevention and detection
initiatives and, where appropriate to recover
assets and payments made to fraudsters.
If you would like to know more about us,
or any other services we provide please visit
our website or contact:
Partner, Head of Fraud
Partner, Head of Fraud Operations
Director of Intelligence and Complex Fraud
If you would like more information
about the event, please see the
full review on our website.