Record keeping

Refer to this summary of the records you will need and other important information after an incident.

A claim can be submitted up to three years after an incident, so you will need to retain all relevant documentation alongside the accident investigation. The documentation you will need to disclose in order to defend a claim will vary dependant on the type of incident. As a standard you are usually required to disclose from the following:

Parties involved

  • Details of parties involved
  • Training records
  • Self-certification form or GP medical notes
  • The involvement of any contractors or sub contractors

Documentation required

  • Policy number
  • Accident book entry/incident report form
  • RIDDOR documentation
  • Copy risk assessment – details for the working practice/equipment involved
  • Any information that would assist in investigating and assessing the claim
  • Accident Investigation reports

Statements

  • Details of what happened, where it happened and who was involved
  • Views on liability and whether the accident caused the injury
  • Any information that would assist in investigating and assessing the claim
  • Any witness statements, including ‘negative’ statements
  • Relevant information e.g. injury details and whether the employee is still absent

Photos and CCTV

  • Any photos of the accident scene
  • Any photos of injuries
  • Any CCTV footage capturing the incident

Guidance on how to make a claim

Visit our main claims sections webpages for claims guidance and the best way to get in touch.

The importance of early notification

There are many reasons to notify early and complete correctly.

You should investigate incidents that cause injury in accordance with internal procedures having nominated a direct contact for this. The insured must immediately notify Zurich upon receipt of any formal letter of claim or proceedings.

Reasons to ensure that you complete correctly

There's no guarantee that any individual claim can be defended successfully, since each case is considered on its own merits and will ultimately be decided by the court if it cannot be settled between the parties/ their representatives.

Taking health and safety seriously

However, you can significantly improve your organisation's ability to defend personal injury claims by reducing the scope to be found in breach of your duty to employees and to others by demonstrating that health and safety matters are taken very seriously. In particular that they're supported by relevant documentation, adequate resources, appropriate training and that you have an effective safety management regime, all of which is kept up to date.

Keeping costs stable

On all employers' liability claims a claims inspector will be instructed to investigate liability.

On all other cases where feasible, a ‘desk-top’ decision on liability will be made by Zurich, subject to all relevant documentation being made available. We will undertake the necessary investigations and if we consider it appropriate, one of our claims inspectors will conduct investigations on site.

In circumstances where we deem it necessary to appoint a loss adjustor, e.g. a property damage claim to specialist equipment, a panel loss adjuster will be instructed.

Response times in the United Kingdom

England and Wales

To keep a matter within the personal injury portal and benefit from fixed costs, response to employer liability claims must be within 30 working days, and Public Liability within 40 working days. If the response cannot be made in this time, it reverts to the protocol timescale of 3 months, but fixed costs application is lost.

Scotland

There is no portal system, and the response on liability should be made within 12 weeks.

Northern Ireland

There is no portal system, and the response on liability should be made within three months.

Claims inspectors

We have in-house ISO certified experienced claims inspectors so we can rapidly respond with expert advice and hands on practical support.

Certain claims require beyond desktop investigation – either onsite or remotely enabled by technology. Many competitors outsource this function in its entirety, but at Zurich we believe that by having an in-house team we're able to rapidly respond with hands on practical advice and support, being there when you need us and keeping costs down.

Fraud awareness

Learn how to spot different types of fraud.

SME Brochure preview

Our counter fraud strategy

Zurich defines fraud as 'The deliberate and dishonest withholding or misrepresentation of material information to gain financial advantage'. We have a zero tolerance fraud philosophy which means that:

  • We will not pay fraudulent claims - where we hold sufficient evidence, we will take appropriate action
  • We are not afraid to defend strong cases in the civil courts
  • We will look to take punitive action against fraudsters to include recoveries of money and criminal prosecution
  • At a strategic level we are investing in the right people, tools and technology to maximise detection

Red flag indicators

Important details may indicate fraud. See our list of possible red flags.

Claimant

  • Known disciplinary problems which are relevant and recent
  • Disproportionate history of similar claims or multiple claims history
  • Refusal to sign mandates for records, attend medical examinations or sign a Statement of Truth, excluding for ill health or reasonable justification
  • Undue knowledge of insurance procedures and terminology
  • Delays, e.g., reporting the accident, submitting claim or seeking medical attention

Injury

  • Injury type inconsistent with the nature of the accident (e.g., whiplash type injury from tripping)
  • Ongoing treatment is inconsistent with the injury that has been sustained
  • Injury appears more consistent with a sporting injury, claimant linked to a sporting activity (e.g., Football)
  • Lack of medical attendance
  • Minor incident however there are significant injuries
  • No absence from work

Location and circumstances

  • Conflicting or changing accident circumstances such as a gap in detail, no elaboration or seemingly implausible circumstances
  • Injury circumstances different from circumstances in medical records or noted in the claims notification form (CNF)
  • Significant changes to the account, time, location or witness details
  • Busy location yet no witnesses or no-one is aware of incident
  • Claimant was not authorised to be in location at time of incident

Witnesses and agents

  • An agent is instructed within five days of the incident
  • Informant raises concerns
  • Witness known to claimant or there are fabricated witnesses
  • Unexplained involvement of a 'friend' or family member, particularly when the individual appears to have claims or legal knowledge
  • Claimant representative exhibits unreasonable behaviour (such as a refusal to provide documentation when valid concerns are raised)

Case study: A clear message to would-be fraudsters

The claim

When a claimant suffered a serious foot fracture after slipping off a trailer due to a build-up of oil, we accepted liability on behalf of our customer. After surgery, the claimant appeared to make a good recovery. However, he said he was unable to return to work because of the pain.

Zurich’s response

After obtaining surveillance, he was seen on a number of occasions wearing work clothes and carrying tools from a van to a private dwelling. On speaking to him, he claimed he was visiting the properties for 'company' and was still unable to work due to pain and disability. He was therefore claiming £284,000 for future loss of earnings. Zurich investigated. It was clear from his bank statements and eBay records that he was still receiving regular money and buying tools. The case was heard over 2 days in court, judgment was given and we were successful on all our arguments. Fraud savings for damages and claimant's costs were in the region of £340,000.

Total savings

In another case for the same customer, when faced with Zurich's evidenced view that the claim was fraudulent, it was withdrawn. This resulted in savings in the region of £500,000. Total Savings: £830,000