Bike lane

He must repay over £150,000 for interim payments and costs.

Horwich Farrelly, alongside Admiral Insurance, successfully defended a fraudulent personal injury claim pleaded at more than £900,000.

The claim brought by Mark Bolt, a 35-year-old firefighter, from Halewood, near Liverpool, was abandoned after surveillance footage showed significant inconsistencies between his accounts to the medical experts and his true capabilities. The defendant alleged fundamental dishonesty and Bolt subsequently accepted his claim was dishonest.

On 22 October 2016, Bolt was knocked from his bicycle by the defendant’s vehicle on Speke Hall Road, Liverpool. As a result, Bolt fractured his left elbow to the extent that he needed surgical repair and radial head replacement. He also claimed significant on-going restriction of function and hypersensitivity, describing ‘exquisite pain’ if the elbow was touched.

Further, he told his medical expert in 2019 that, following the accident, he had to wear a sling when out in public to protect the arm, had to avoid crowds because of  the sensitivity of the tip of the elbow when banged or knocked, could only feed himself with his right hand, needed help when showering, was unable to get out of the bath without help, could not safely take a dish out of his oven and was unable to carry out painting and decorating.

Admiral subsequently undertook surveillance after receiving information to suggest that Bolt’s injuries were not as serious as he claimed. They identified that, amongst other things, Bolt only wore a sling when attending medical appointments relating to his claim, was able to lift heavy items with either hand easily, there did not appear to be any sign of restriction to the injured arm, and Bolt moved in crowded places (without a sling) with no difficulty.

At this point, Admiral instructed us to support the investigation. Despite giving Bolt the opportunity to reconsider his claim, Bolt denied any wrongdoing and insisted that he had been entirely honest about his injury and his recovery.  Therefore, they disclosed the surveillance highlighting Bolt’s misrepresentations to the medical experts. Shortly after he asked if he could discontinue his claim. Given Bolt had never returned to work after the incident, he received a total £50,000 in interim payments. Therefore, Admiral refused to allow the discontinuance before Bolt repaid that money, plus interest. Ultimately, once the money was repaid, Bolt discontinued and subsequently agreed to sign a declaration and admit his claim was Fundamentally Dishonest.

As a result. Admiral has no outlay on the claim for damages, with total savings, inclusive of third party costs, in the region of £1.2million. Bolt will also have to pay Admiral’s legal costs which amount to circa £100,000.

Alex Wilkinson, Partner and Head of our Large Loss Fraud Team, said: “This is a victory over a claimant who advanced a fraudulent claim for £900,000 in damages, but who ultimately walks away with nothing but a finding of dishonesty against him. It further demonstrates the savings insurers can generate by employing fraud investigations to suspected dishonesty in high value claims.”

Adding that the collaboration between the firm’s Large Loss and Fraud Teams was crucial in ensuring the fraudulent claim was discovered and then dismissed, Wilkinson, said: “Horwich Farrelly lead the market in terms of findings of Fundamental Dishonesty. In the area of Large Loss Fraud, our specialist handlers work seamlessly in tandem with each other to ensure dishonest claims are robustly defended.”

Stuart Cook, Head of Technical Claims at Admiral, said: “This is the third Admiral case where a claimant who initially suffered quite serious injuries, has gone on to admit or been found by a court to be Fundamentally Dishonest in as many months. Whilst this highlights the extent of the problem the industry faces it also emphasizes the fact that with the support of our legal partners we are able to identify such claims and ensure that the right outcome is achieved. It’s important to say that Admiral is 100% committed to paying out on genuine injury claims quickly and fairly. However, we will investigate and defend ourselves when presented with claims where we believe someone is being dishonest.

“Mr Bolt fundamentally misrepresented the nature and extent of his injuries and has now ended up in a position where he has received no financial settlement for the accident along with a Court Order to reimburse our significant legal costs in full. He has admitted to being Fundamentally Dishonest and will be paying for the price of doing so for many years to come.”