DWFs market leading Counter Fraud team has already secured several awards for the disruption of medical expert enablers, including Counter Fraud Initiative of the Year at the Insurance Times Claims Excellence awards 2026 and Insurance Partner of the Year at the British Insurance Awards 2026.
The team continues to set the pace in this area with no less than five cases delivering adverse judicial comment in the last two weeks alone.
Back-to-back dismissals of PTSD diagnoses for three Claimants by the same expert highlight the importance of properly reasoned psychological injury evidence
Terri Collins, Senior Paralegal, adds to her impressive list of wins with two cases of hers involving psychological assessment and a failure to diagnose symptoms adequately.
A timely reminder that expert evidence must do more than simply state a diagnosis — particularly where the diagnosis advanced is post-traumatic stress disorder (PTSD). PTSD is a serious psychiatric condition with potentially significant consequences for an individual’s daily functioning. Where such a diagnosis is relied upon in litigation the court should scrutinise the reasoning leading to such conclusion, the factual material relied upon, and whether the expert has properly engaged with the applicable diagnostic criteria. Here, the expert Psychiatrist failed.
Both reports were produced by the same expert. The medical evidence was challenged on the basis that it appeared formulaic, insufficiently reasoned, and did not adequately address relevant background factors, including pre-accident symptoms, intervening life events, and alternative explanations.
The court was invited to consider whether the expert evidence amounted to little more than a bare assertion — an “ipse dixit” — rather than a properly reasoned expert opinion.
A key issue included whether the diagnostic criteria for PTSD had been properly analysed. DWF argued that it is not enough for an expert to simply recite symptoms or apply a label. The opinion must demonstrate a careful assessment of the relevant criteria, the claimant’s presentation, the chronology of symptoms, and any alternative explanations, all of which the expert failed to do.
In one case, the HHJ Sephton KC was critical of the expert’s failure to engage adequately with the relevant criteria for PTSD observing that the answers given to Part 35 questions were generic, internally inconsistent, and did not sufficiently address the specific facts of the case.
In the second matter the court considered the absence of contemporaneous psychological complaints, the failure to disclose relevant pre-existing symptoms, and concessions made by the expert in Part 35 replies. Despite those concessions, however, the expert did not alter the diagnosis or prognosis, which undermined the reliability of the opinion.
The claims for psychological injury were dismissed.
The judgments reinforce that expert evidence must be independent, objective and properly reasoned. It is not sufficient for an expert to maintain a conclusion where the factual foundation for that conclusion has been weakened or contradicted.
For defendants, these decisions underline the value of carefully testing psychological injury claims through contemporaneous records, disclosure, causation analysis and targeted Part 35 questions. Where expert evidence is unsupported, formulaic or fails to engage with material facts, it may be robustly challenged, and as in these cases, successfully undermined.
Failure to address other relevant accidents including one that the expert had reported on herself proves fatal to claim
In another case involving the same expert, Sarah Potter, Solicitor highlights the expert's failure to identify that they expert had examined this self-same Claimant previously – something the court were not impressed with!
The claimant pursued a claim for physical and psychological injury following a non-fault road traffic accident in June 2022. Liability was accepted, but causation challenged, with DWF identifying inconsistencies in the claimant's account and challenging the reliability of the medical evidence.
There were inconsistencies around time off work, the duration of symptoms, previous accidents, prior psychological issues and social media material showing activity after the accident. DDJ Bunting in the County Court at Edmonton found the claimant’s explanation to be unsatisfactory.
The psychological claim failed outright. The court was critical of the expert report, observing that it relied heavily on self-reporting, failed properly to engage with the claimant’s previous history, did not adequately explain the diagnostic criteria, and did not grapple with alternative causes. That undermined the report to the point that the court could not rely on it. Commenting on the previous examination by the same expert, DDJ Bunting stated '…but more significantly I find surprising [the Expert] had diagnosed C previously. I cannot see how a basic check did not establish that'.
The physical injury claim also failed, principally on causation. Although the accident was capable of causing whiplash-type injury, the claimant had not sought medical attention until months later and the experts had not been provided with a complete picture of earlier accidents and symptoms. The absence of a contemporaneous medical “anchor” meant the evidence remained speculative.
The claim was dismissed, with costs awarded to the defendant.
Tariff award only as PTSD claim falls away
Georgia Talbot, Specialist Lead Manager, discusses her recent success involving a Consultant Psychologist.
Liability was admitted following a road traffic accident in which the claimant’s BMW was struck by the defendant’s insured. The dispute focused on causation and quantum, with the claimant alleging physical injury, adjustment disorder and PTSD. HHJ Sephton KC accepted that the collision was capable of causing injury and that the claimant had suffered an exacerbation of pre-existing back pain, supported by contemporaneous attendance at an out-of-hours clinic. That exacerbation was assessed as lasting up to 10 months.
The most significant feature of the judgment is the consideration of the PTSD evidence. The court found the expert psychological evidence unsafe. In particular, the diagnosis was criticised for reciting DSM-5 criteria and simply asserting that they were met, without any proper analysis. There were also difficulties around whether the accident met the trauma threshold for PTSD and whether there was reliable evidence of avoidance behaviour.
Another important reminder that just because an accident may be capable of causing injury does not mean that an award will be made where the medical evidence relied upon is unsatisfactory. A point overlooked by many claimant practitioners and medical experts alike.
Expert evidence on trial: Disclosure failures prove fatal
DWFs Nathan Jones, counter fraud specialist in tinnitus and NIHL cases, discusses his recent success involving an ENT expert.
In a clear reminder of the high bar imposed on expert witnesses, the court struck out medical expert evidence for failure to disclose GMC practice restrictions that were in force when the claimant was examined.
The ENT surgeon was subject to a supervision order and conditions requiring GMC approval for non-NHS work. None of this appeared in the report or his CV, despite the court’s reliance on experts to provide impartial, objective assistance on matters outside judicial expertise.
The judgment underlines a simple but powerful point: an expert’s overriding duty to the court includes transparency about anything that may affect independence, competence or reliability. If a doctor cannot practise unsupervised without regulatory oversight, the court is entitled to ask why their litigation evidence should be accepted without disclosure of that restriction.
District Judge Sheldon stated as follows: "To put in simple terms if GMC are not satisfied this medic in his practice as ENT Surgeon cannot practice w/o a supervisor, why should the Court accept this evidence when that evidence does not state there has been any supervision or declare the conditions on his licence".
This follows neatly on from the decision of Mr Justice Trower in JSC Commercial Bank Privatbank v Kolomoisky & Ors [2025], where he effectively bridged a major gap between criminal and civil procedure by holding that expert witnesses have a duty of candour to disclose prior adverse judicial criticisms.
Another useful reminder to scrutinise expert credentials carefully, including regulatory history. Non-disclosure of professional restrictions may not be a technical defect — it can go directly to admissibility.
