Doubling down on discontinuance
12/19/2022
Background
At first glance, two personal injury claims received by the London Borough of Havering (“the Council”) appeared fairly straightforward. The first Claimant asserted that he suffered injuries to his neck, shoulder, lower back and swelling and grazing to the head, when, as he was taking washing out of the washing machine, the kitchen ceiling collapsed onto his head at a property owned by the Council of which his partner, The second Claimant, was the tenant/occupier of the property. The second Claimant alleged that she was standing at the sink when she was also struck by falling debris receiving injuries to her neck. Breach of duty was conceded but causation in respect of the injury, loss and damage alleged was disputed.
The claims
Concerns about the veracity of the claim arose for a number of reasons not least that the Claimants instructed different solicitors and gave differing accounts of where in the kitchen the second Claimant was allegedly standing at the time of the purported ceiling collapse. Neither of the claimants sought immediate medical attention, citing the Covid pandemic as the reason. The first Claimant’s solicitors later advised that he thought an independent medical assessment would be arranged by his solicitors and the second Claimant went to see a doctor only after submitting a Claims Notification Form (“CNF”).
The concerns led to a decision being taken in conjunction with the Council and their insurers, Zurich, to reject the claims and defend any proceedings that were issued in line with DAC Beachcroft’s organised casualty fraud strategy.
Following service of two separate sets of proceedings, robust defences were entered and a submission made that both claims be heard together.
As part of the case strategy, a Part 18 Request for Further Information was made to the first Claimant. The response to the request provided what proved to be a telling statement. It had been the second Claimant’s case throughout that she had been standing at the sink when injured by falling debris. However, the first Claimant in his reply to the Part 18 Request provided a very different version of events, stating that his partner was stood in the doorway holding her son. There was also a 5½ hour disparity between the times that the Claimants claimed that the incident had occurred.
Bringing matters to a head
Raising the various concerns in relation to the claim with her solicitors, the second Claimant was invited to discontinue her claim, an invitation which she accepted.
On the day of acceptance a similar invitation to discontinue was made to the first Claimant. After a short extension that too was accepted.
The outcome is that both cases were discontinued at the pre-directions stage with a considerable saving, delighting both the Council and its insurer, Zurich.
On reflection
This result showcased Zurich’s claims expertise throughout. From the initial fraud detection from their expert handling teams; to a robust approach being adopted within their fraud investigation team. The early fraud identification allowed Zurich to adopt a proactive approach to both intelligence and investigation.
The outcome of these cases shows the value of working closely with our clients on our organised casualty fraud strategy. Judged alone and separately the weaknesses in the two claims were evident but combining the two, bringing together a catalogue of inconsistencies and then obtaining a response to a Part 18 Request for Further Information which served to reinforce those inconsistencies, put the claimants in what was considered to be an untenable position.
Focussing first on the case perceived to be the weakest and obtaining an agreement to discontinue that claim strengthened the Defendant’s position when it came to inviting discontinuance of the other claim.
The result achieved for our client was an excellent one, potentially saving it a sum approaching £30,000.
Speaking on behalf of DAC Beachcroft, Natalie Randall, Organised Fraud & Financial Crime Lead, said “This case provides yet another example of how organised casualty fraud can present itself. We develop bespoke organised fraud strategies tailored specifically to each investigation we face and this result goes some way in demonstrating the value that approach brings for our clients and their customers”.
Speaking on behalf of Zurich Insurance, Catherine Luke, Claims Fraud Investigator, who handled the case said “Cases such as this illustrate the importance of early fraud identification, in this case, it resulted in the ability to implement a bespoke fraud strategy and proactively investigate. Collaboration was key, working closely with our internal handling teams, DAC Beachcroft and our customer to achieve an excellent outcome”.
