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Short summary
I was a passenger in a rear-end collision. The other driver’s insurer accepted/paid the vehicle damage claim quickly and without any real issue.
I then used the injury claim route/link the insurer gave me because I had a cut lip/dental concern and mild shoulder/neck symptoms after the accident. I paid privately for a dental check, was honest that there was no lasting tooth damage, and attended an independent medical examination. The medical expert appeared to support mild whiplash and mentioned physio/further investigation if it did not resolve.
I did not exaggerate, push for treatment, or try to inflate the claim. I was prepared to settle modestly, mainly including the dental cost.
The insurer has now rejected/repudiated the injury claim and appears to suggest the claim may be dishonest. They have also indicated they may look to recover the vehicle damage payment already made.
I would appreciate guidance on whether this is normal, what evidence they would need to allege dishonesty, and whether they can realistically try to claw back the vehicle damage payment when the accident/damage was already accepted and paid.
Full background
Hi all,
I would be grateful for some guidance on a road traffic accident / Official Injury Claim issue. I am keeping some details deliberately general as this may become contentious.
A few months ago, I was a passenger in a car which was hit from behind while stopped at traffic lights. My partner was driving and our child was also in the car.
Liability/damage did not appear to be disputed at the time. The other driver’s insurer dealt with my partner’s vehicle damage claim quickly, approved it, and paid out without any real issue.
At the time of the accident, I was drinking from a cup and the impact caused the cup to hit my mouth, cutting my lip. I was also concerned that a front crown/tooth may have been loosened or damaged. I also had pain in my shoulder/neck area after the impact.
I did not set out looking to make a personal injury claim. The insurer themselves told me that if I wanted to claim for the dental cost and any shoulder/neck injury, I should use the relevant online claim route/link. I did that because I had incurred a dental cost and had symptoms after the accident.
I paid privately to see a dentist. The dentist checked the crown/tooth and, thankfully, confirmed there was no lasting dental damage. I was completely upfront about that and did not try to claim for damage that was not there. However, I had still incurred the dental examination cost because of the accident and the concern caused by the impact.
As part of the injury claim process I was sent for an independent medical examination. The medical expert accepted that I had mild whiplash-type symptoms. From memory, the view was that it should resolve over a number of months. The report also mentioned physiotherapy and further investigation/imaging if symptoms did not resolve.
I did not push for additional treatment or attempt to inflate the claim. I was happy to settle modestly and mainly wanted the dental cost reimbursed.
The insurer has now rejected/repudiated the injury claim and appears to be suggesting that the claim is not genuine / may be fundamentally dishonest. They have also indicated that they may look to recover the vehicle damage payment already made.
I am very concerned by this because I have not lied, exaggerated, or invented anything. The collision happened, the other driver’s insurer accepted and paid the vehicle damage claim, I had an immediate mouth injury/dental concern, I paid for a dental check, I disclosed the outcome honestly, and the independent medical expert appeared to support mild whiplash.
I have since received a letter from solicitors saying they are instructed to accept service of proceedings if the matter becomes litigated, but that the insurer will continue to deal with the matter unless/until proceedings are served.
My questions are:
- Is it normal for an insurer to reject an OIC/whiplash claim in this way despite an independent medical report supporting mild whiplash?
- If they are implying or alleging fundamental dishonesty, should they be required to identify the specific evidence they rely on?
- Can they realistically recover the vehicle damage payment that was already made, where the accident and vehicle damage were accepted, simply because they now dispute the injury claim?
- Should I respond asking them to clarify whether they are formally alleging fundamental dishonesty, or merely reserving their position?
- Would this be best dealt with as a personal injury / road traffic accident issue, or also as an insurance dispute?
I am not trying to pursue anything improper. My concern is that I followed the route I was given by the insurer, was honest about the dental outcome and symptoms, and now feel as though very serious language is being used to pressure me into dropping the matter.
Any guidance on the safest next step would be appreciated.