This piece is from DAC Beachcroft and Aviva;
A decade-long partnership with one of the UK’s leading defenders against fraud claims has delivered £111m in fraud savings. Over 10 years, Aviva and international law firm DAC Beachcroft (DACB) have combined their legal, intelligence and litigation expertise to deter fraud and protect genuine customers.
In 2015, section 57 of the Criminal Justice and Courts Act 2015 introduced the concept of “fundamental dishonesty”. Since then, we have collaborated with Aviva on strategies aligned with legislation and built powerful case law precedent to protect Aviva’s customers from professional fraudsters and opportunists.
Our jointly devised approaches have delivered High Court and County Court successes and been recognised with awards. We have worked together, delivering training, mock trials, strategic insight, secondments and sharing structured knowledge. We continue to develop and test new ways to detect and defeat emerging fraud behaviours.
HOW WE ACHIEVED IT?
Aviva has consistently been willing to test innovative counter-fraud approaches, particularly in relation to organised and enabler-led fraud. In the wake of Official Injury Claim (OIC) reforms and the resulting “layering” and exaggeration risks, Aviva adopted a novel approach to tackling medical enablers. Its specialist BIKYO (Bodily Injury Know Your Opponent) Team uses intelligence and targeted strategies to address thematic behaviours of concern.
This approach reflects years of joint evolution, focus and experience investigating and defending organised fraud. To date, we have helped disrupt dozens of concerning medical experts, many of whom have now exited the medico-legal market. We have defeated 98% of the ring-fenced bodily injury claims and delivered £1.5m in savings.
Aviva’s work on non-injury fraud has also been successful: together, we developed a pre-litigation strategy to defeat “damage only” fraud, piloting a discrete approach across 300 claims. The pilot achieved a 67% repudiation rate, £1.5m in savings and cycle times of under six months.
Examples of successes include:
• A claim for alleged chronic pain, PTSD and other psychological injuries arising from a low-speed impact was defeated following a finding of fundamental dishonesty after a robust investigative and litigation strategy combining complex injury, fraud and intelligence expertise, saving £130,000.
• The claimant, a postman, alleged he was injured after stepping into an open manhole. Intelligence confirmed he had driven 16,000 miles in the three years following the alleged accident, despite claiming he was unable to drive. Intelligence gathered in this claim led to a £600,000 saving.
• A claim was struck out and an enforceable costs order of £83,000 was secured, resulting in a charging order being placed over the claimant’s property.
• A public liability claim arising from an alleged slipping accident while the claimant was viewing a property to buy was found to be fundamentally dishonest. The claimant was ordered to pay £8,000 in costs.
• 200 organised motor bodily injury claims were defeated as part of 47 operations. Accurate data and new investigative and litigation strategies helped identify shallow faked documents and clipped video footage, which led to our motto: “validate the validation”.
• Molodi v Cambridge Vibration Maintenance Service [2018] EWHC 1288 (QB) is a High Court decision that defined the approach courts should take when hearing whiplash claims, endorsing judicial caution, suggesting that there should be a degree of caution, if not suspicion, where a claimant has been demonstrably untruthful or where their account is so hopelessly inconsistent that their evidence would not be regarded as reliable.
• Operation Loope focussed on fake documents used in an attempt to validate staged/contrived accidents and highjacked policies. Having secured a confession from the policyholder and forensic engineers reporting inconsistent damage between the vehicles, we also secured a witness statement from the DVLA affirming the claimant’s V5c was a shallow fake counterfeit. This claim discontinued two days before trial saving £47,000.
THE IMPACT
Alongside the commercial outcomes sit wider benefits: meeting the moral and legal duty to prevent fraud, and ensuring genuine customers and claimants are not disadvantaged by those who abuse the system. Engaging with key stakeholders across counsel, regulators, industry bodies and law enforcement agencies has allowed Aviva and DACB to pursue many forms of deterrent, resulting in multiple criminal convictions and custodial sentences to drive home the message that committing insurance fraud does not pay.
WHAT’S NEXT?
We remain committed to working together to tackle claims and policy fraud, and to developing joint projects and strategies that respond quickly to emerging risks and deliver sustained results. Together, we secured excellent outcomes in the last year, demonstrating our joint resolve to investigate and defend fraudulent claims. But the nature of fraud is changing, and we need to be able to react quickly to new trends and adopt new approaches swiftly, so as to protect Aviva’s genuine customers.
The success of our longstanding partnership demonstrates both the power of collaboration and the importance of a willingness to innovate in tackling fraud. Had new strategies not been tested to defeat policy and claims fraud, the fraudsters would have got away with much, much more.
Pete Ward is Head of Claims Counter Fraud at Aviva and Claire Laver is a partner and head of counter fraud at DAC Beachcroft’s CSG.
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