Fraud against NHS Resolution

Fraud relating to the serious exaggeration of a legitimate claim for damages under NHS Resolution-administered insurance schemes, or the falsification of circumstances supporting a claim.

NHS Resolution maintain overview of their own localised risks, threats, vulnerabilities and enablers.

Fraudulent claims against NHS Resolution administered schemes broadly fall into two categories; the serious exaggeration of legitimate claims for damages (i.e. the claim does not reflect the harm actually suffered) and the falsification of the circumstances which led to a claim for damages being made (i.e. the incident did not occur as described).

Claims under the Liabilities to Third Parties Scheme (LTPS) where payments in compensation to claimants totalled £28.5 million in 2019-20 are likely to represent the most prevalent fraud risk encountered by NHS Resolution.

In 2019-20 new LTPS claims rose slightly from 3,585 received in 2018-19 to 3,744 an increase of 159 (4.4%).

The majority of LTPS claims under investigation for fraud are below the value of £50,000. NHS Resolution expenditure for all claims amount to approximately £2.44bn for 2019-20.

Liability to Third Parties Scheme

Types of claims against the Liability to Third Parties Scheme that were investigated for fraud in 2019-20 (as a percentage of the total)


increase in LTPS claims compared to 2018-19

Assault 21%
Defective equipment 15%
Manual handling 8%
Needlestick 8%
Occupiers liability 4%
Slip/ trip 36%
Unsafe system of work 4%
Aggregated other causes 4%