Post Blog: Stepping up to the plate

Baseball home plate

Are claimant law firms doing enough to tackle fraud? Jason Peto says more must be done.

There's a lot of discussion in the insurance sector about fraud screening, cooperation and the sharing of data.

The Association of Personal Injury Lawyers and the Motor Accident Solicitors Society, for example, are lobbying for access to industry and fraud databases for their members to demonstrate cross-industry co-operation and to limit the pursuit of fraudulent claims where the claimant law firm ultimately will not be able to recover costs.

The recent 10 point campaign by Apil to tackle whiplash fraud is void of any substance in terms of tackling fraud.

There are gestures such as a statement of truth and stopping spam texts which I have no doubt would be beneficial to society. But mainly these are sound bites of requesting change from others, without any action or responsibility on the part of the claimant solicitor.

The passivity of Apil in tackling fraud is manifested in several areas of the plan. Placing responsibility for photographic identity checks onto the medical expert could be interpreted as the claimant solicitor divesting their own responsibility for identity and residency checks.

In my experience, some claimant law firms do not always undertake a client interview following referral prior to accepting instruction and submitting a claim let alone the completion of Know Your Client, identity and residency checks to validate the claimant.

Defendant insurers and law firms frequently request proof of identity documentation as part of the claims process.

These enquiries meet with varying degrees of co-operation and support from the claimant side. In extreme cases, the response is openly hostile with allegations of defendant procrastination, threats of litigation and, in some cases, with proceedings being issued.

As part of the claim investigation process, it is defendant insurers and law firms that often have to complete the identity and residency checks often with inaccurate or missing data via the Claims Notification Form.

This frequently results in cases where the identity or residency of claimants cannot be established. Surely, it should be incumbent on the claimant firm to validate and screen every new instruction before offering to represent a claimant and submitting a claim on their behalf?

Indeed, Apil's request to access insurance fraud and claims databases is the claimant community being passive rather than proactive.

While the data sharing discussion rumbles on there are some early steps the claimant industry can take to demonstrate a real willingness to work together to combat fraud.

Claimant law firms could help the industry, and themselves, by routinely screening and validating the identity of the potential claimant as part of the new case inception process, and then sharing the outcome with the defendant insurer or law firm as part of the claim notification process.

An application for a bank account, credit card and even a young person's Oyster card requires proof of identity and residency. Surely the making of a claim, often for many thousands of pounds, should be subject to at least the same level of scrutiny?

Although there is no obligation to carry out identity checks, such screening should be part of the firm's anti money laundering processes and it would be a small additional step to share the information with the defendant insurer or law firm at the outset of a claim.

I am certain defendants would behave favourably with firms that worked in this way and it would show a real practical commitment by claimant firms.

While it may take some time for claimant law firms to achieve access to industry and fraud databases, they do have an opportunity to be proactive and start to develop their own systems.

Many of the tools used by insurers are not based on previous claims information - fraud is far more sophisticated than that.

If Apil, Mass or any other large group of claimant firms were so inclined, they could employ many of the same tools as insurers to profile potential claimants, avoiding paying a claims management company for the case and wasting time on what subsequently transpires to be a fraudulent claim.

The government has identified insurance fraud as a major concern, pledging to clamp down on fraudulent injury claims.

It is looking to the industry to put its own house in order by working together to introduce measures to control and identify potentially fraudulent claims and claimants.

Simple, quick and low cost systems could be employed by claimant firms to help prevent fraudsters from ever entering the system.

Organisations such my own, that have traditionally serviced the defendant community, would be only too willing to support the claimant community if there is a willingness to be proactive in tackling fraud.

My message to the claimant community is simple: don't ask what others can do to help you tackle fraud. Ask what you can do to help yourself.

Jason Peto, development manager, Parabis Risk Solutions

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