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Hockey Player's RTA Tinnitus Claim foiled by contradiction and exaggeration

18 August 2023
The case of Claimant v Markerstudy Insurance Company Limited saw DWF secure a £23,000.00 saving by successfully defending an apparent exaggerated tinnitus claim. 

The level of fraudulent tinnitus claims are on the rise and given the subjective nature of the injury, and the fact that sensory injuried attract higher awards. It becomes the perfect opportunity for nefarious actors to layer their claims.

In December 2018, a collision occurred between the Claimant and Markerstudy's policyholder. The accident was significant with severe damage to the Claimant's vehicle causing the airbags to deploy. Airbag deployment is usually powerful evidence to prove tinnitus as an airbag creates a sound at 165 decibels on deployment which is more than enough to cause damage to ears. For this reason, there was an initial intention to settle.

Interestingly, however, the Claimant confirmed the tinnitus had a 24 hour onset and the expert confirmed that the tinnitus was actually a result of whiplash. This ruled out the airbag as the cause. It was then further noted that the Claimant engaged in Ice Hockey which is a heavy contacted sport. Additionally, the Claimant was an engineer for an aerospace company which meant there was also potential for occupation related hearing issues. These all provided valid alternate sources for the tinnitus and so investigations needed to be undertaken.

The expert gave a prognosis of 12 months for the Claimant's whiplash and tinnitus.

At the start of the investigations we asked the Claimant a set of questions related to his tinnitus, other potential sources, his current health and the current status of his injuries.

The Claimant, in answering these questions, confirmed that he in fact was aware of all his injuries immediately and that his tinnitus had actually resolved within a week! This was a major inconsistency the Claimant solicitors didn't seem to pick up on.

We investigated the Claimant's GP records which, despite such a severe collision, showed he never attended his GP for the RTA but he did attend his GP for other reasons failing to mention the RTA or his injuries, which came across as suspicious.

The Claimant also attended an occupational physiotherapy clinic where the notes also fail to mention any tinnitus and confirmed he only ever received minor whiplash. It also reiterates that his whiplash got better in just over two weeks. An Accident Report Form and his Claim Notification Form also only noted his whiplash injuries and not his tinnitus.

Upon receiving the Claimant's Witness statement, he confirmed that his injuries all resolved within five months.

At this stage we had three different versions of when his injuries recovered – twelve months, one week and five months.

We highlighted our concerns to the expert who agreed that he found the failure to report the tinnitus unusual.

At this point the Claimant solicitors noticed the issues and attempted to repair the damage to their client's credibility by stating in open correspondence that the Claimant's tinnitus symptoms were, in fact, "transient in nature" giving the Claimant four contradicting versions of his injuries.

A Howlett letter was sent at this stage, approximately a week before the trial, alleging fundamental dishonesty. It stated that either the tinnitus injury did not occur or it was exaggerated.

The Claimant discontinued thereafter which meant a saving of over £23,000.00 for Markerstudy.

This case serves to illustrate that even where a case appears to be a matter to settle, investigations can still turn up damning evidence and lead to a significant saving for your client.

Sam Lee, Fraud Risk and Technical Manager at Markerstudy commented: "Tinnitus is a hot topic in the counter fraud world as it is a subjective injury where associated claims often carry significant value. At Markerstudy, we pay close attention to any claim involving Tinnitus to ensure it is handled in an appropriate environment and where fraud is evident, that the claim can be robustly challenged. Given the discrepancies in this case, I have no doubt that had the claimant have continued to pursue this he would have been found fundamentally dishonest. His decision to discontinue speaks volumes."

Further Reading