We have a deep understanding of the issues facing the insurance industry from criminal activity, especially business crime and fraud. The impact of both on reputation and cost can be significant. Financial crime comes in many forms in the commercial setting, from direct cyber-attacks from malware to ransomware leading to business email compromise and business interruption to property theft. Whether it affects policyholders directly, from dishonest employees or though their supply chain, or is due to false first party or exaggerated and fraudulent third-party claims (including personal injury), our experienced team has an in-depth knowledge of investigations, advising on coverage and defending false or fraudulent claims, sanctions and pursuing recoveries.
We offer a comprehensive service from First Notification to the claim’s ultimate conclusion. Collaborating closely with policyholders across a wide variety of industries, liaising with brokers, loss adjusters, forensic experts and investigators, with our intelligence team we conduct discrete confidential and privileged investigations.
We work closely with our counter fraud team to validate claims. We take great care to understand and reflect our clients’ policy coverage and claims handling philosophy. We adopt a flexible approach to working with all clients, brokers and suppliers; using our technical expertise, using the best approach for the particular individuals and the specific facts of each case. We work with our insurer clients to carefully assess and agree the right, bespoke approach for each claim. Our team has extensive experience of investigation and claims analysis, helping to assess, validate, repudiate or robustly challenge claims presented.
When insurers’ decisions are challenged, we manage the Financial Ombudsman complaint process ensuring that where matters are subject to police investigation there is no prejudice.
Where dishonesty, be it fraud or gross exaggeration, is present we deploy the full armoury of litigation weapons as required, including disclosure orders, interim injunctions and positive fraud-based pleadings to secure avoidance or discontinuance and, where possible, costs recovery. Strategy and timing are central to our thinking, paying particular attention to avoiding tipping off, to ensure the best outcome for clients.
Our experience has allowed us to develop specialism in new and emerging risks, including cyber and data breaches, with recent secondment and integration with a crisis management team offering us unrivalled understanding of crypto-assets in high-value denial of service and ransomware attacks.
Advising insurers on the declinature of a suspicious theft of a high-performance vehicle only to establish that the policyholder had arranged for it to be stolen.
Advising insurers on FOS complaint following declinature of claim for theft of classic car on grounds of fraud. Insurer’s decision upheld and complaint dismissed.
Six-month custodial sentence on successful prosecution for contempt of claimant who had been found fundamentally dishonest on false highway claim.
Investigation and recovery following cyber breach and push payment fraud. Norwich Pharmacal application identification of perpetrators leading to recovery of £80k and Met police investigation.