Claims handler jailed for defrauding ex-employers out of £129k

Claims-handler-jailed-for-defrauding-ex-employers-out-of-£129k

On Thursday (23 August 2018), a man was sentenced at Stafford Crown Court after he abused his position at three different companies in the insurance industry, and lied to their clients about fictitious medical treatment costs that they were liable to pay.

Following an investigation by the City of London Police’s Insurance Fraud Enforcement Department (IFED), Iain Wishlade of Burton on Trent, was sentenced to 26 months in prison.

IFED began investigating the case after a referral by a loss adjustment and claims management company in August 2017. Wishlade confessed to the company that he’d abused his position as a liability claims handler and had stolen £8,500.

A liability claim is when the insured (person or company) receives a claim against them. The insured then notifies their insurer who engages with a loss adjustment and claims management company (such as the one Wishlade worked for) to investigate the claim and confirm the legal liability of the insured.

In his role, Wishlade would confirm whether the insured was liable for the claim and if their insurance policy would cover them for the costs involved. Once confirmed, he would then negotiate a settlement with the third party claimant or their appointed lawyers.

Wishlade admitted that he would lie to his company’s clients stating that they were liable for medical treatment used by the third party claiming against them, and would then submit a false invoice to the client for the costs.

LDK Management Services Limited (LDK) was a business set up by Wishlade in June 2015 and he used this company to submit the false invoices. He made out that LDK performed medical rehabilitation services, such as private medical treatment and physiotherapy.

In each case, Wishlade lied and told the company’s client that LDK’s services had been used by the third party claimant and he then submitted false invoices on a LDK letterhead for the costs of these services. LDK did not provide any service to any third party on the claims handled by Wishlade.

Wishlade also manipulated where the payment for these fictitious medical bills would be transferred and requested for them to be paid into a bank account he owned.

To help conceal his fraudulent activity, Wishlade admitted in an interview with IFED officers that he would attach the false claims for the fictitious medical treatment to legitimate, high value claims.

During the interview, Wishlade also admitted that he’d committed the fraud as he was heavily in debt, caused by living beyond his means for several years.

After Wishlade’s fraudulent activity had come to light with this company, two of his previous employers were contacted and they too discovered that Wishlade had defrauded them. During his time in employment, Wishlade stole £120,500 in total from both companies.

Wishlade abused his position and used similar methods to produce false invoices through LDK and submit them to his employer’s clients for processing.

City of London Police’s Detective Constable Kevin Hughes, who led the investigation for IFED, said:

“Wishlade lived a life beyond his means, slowly building up large amounts of debt, and in the end he reverted to fraud to try and save himself.

“Fraud is the never the answer and will only cause more problems and misery, as you will be found out and brought to justice. Wishlade’s case is a prime example of this.”

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