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Fraud success as zombie claim lacks bite

  • Market Insight 12 août 2022 12 août 2022
  • Royaume-Uni & Europe

  • Casualty claims

Our fraud team have successfully defended a fraudulent personal injury claim involving the fabrication of evidence and false reports of the claimant's death on the eve of trial.

Fraud success as zombie claim lacks bite

The claimant alleged that as he was passing the insured's mobile food van (which was situated in a supermarket car park) he slipped on a puddle of oil and fell to the floor, hitting his head on a bollard and losing some teeth.

The claim was initially referred into the fraud team on the basis the insured had absolutely no knowledge of any incident.

This seemed strange given the fact the claimant appeared to have sustained quite severe injuries, that he (on his own sketch plan) fell right outside the mobile food van and that he stated that he remonstrated with the insured.

Further investigation revealed various other concerns:

  • The matter was not reported until 10 days after the event, despite the fact the claimant stated it was reported on the day of the event and the day after that.
  • The claimant was a regular attender at his GP yet despite attending his GP six days post-accident he did not mention any injuries or accident at all (a fact one might consider surprising bearing in mind the significant nature of the alleged injuries).
  • He re-attended his GP the day after his first post-accident attendance stating he had "forgot" to mention the accident and injuries (it could happen we suppose) and wanted these recording in his notes.
  • The Claim Notification Form was also dated the same day as this attendance, at which point a cynical person may have suspected he was simply getting a record with his GP with an intention of making a claim.
  • Clyde & Co investigations noted that he had a prior accident in 2016 where he stated he had lost some teeth. The claim was repudiated by the Local Authority involved and the claimant went to his local paper where he provided a photograph of what appeared to be remarkably similar injuries.
  • When examined by the medical expert for the Council claim, the medical expert essentially stated the claimant was exaggerating / malingering.
  • When his medical records were reviewed, the claimant was found to have given inconsistent evidence regarding his alleged injuries and lied about / failed to tell his medical expert about relevant pre-existing conditions.
  • The claimant also fabricated an email regarding supposed physiotherapy charges allegedly incurred as a result of this incident.
  • Investigations determined that it would be physically impossible for the claimant to fall and strike his head on a bollard given where the van was, as it was over 7m to the nearest bollard.

We amended our Defence to plead fraud and the Trial was initially scheduled for June 2021. Shortly prior to the Trial, the claimant's solicitors came off record and ceased to act.  

A call was received a few days before Trial, purportedly from the claimant's son, stating that the claimant had died suddenly and so would not be at Trial.

In truth, we were somewhat sceptical, and asked for both further information and a death certificate to show to the court.

Miraculously, we were then told that there had been a mistake, the claimant was actually fine and would be at Trial, much to our relief.

The matter eventually proceeded to Trial on the 26 July. The court found that the claimant had been fundamentally dishonest and awarded us costs in the sum of GBP 13,000.00, with a fraud saving on top of GBP 17,000.00.

As a side note, the court was also confident the claimant was very much alive.

Fin

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