Investigation and research shows a claim to be fundamentally dishonest

North East Lincolnshire Council successfully secured a finding of fundamental dishonesty against a claimant who exaggerated her accident-related…

Summary

North East Lincolnshire Council successfully secured a finding of fundamental dishonesty against a claimant who exaggerated her accident-related injuries.

Facts

The claimant presented a personal injury claim following an alleged accident on the highway. The council properly admitted that there was a highway defect but the circumstances of the accident and the alleged injury and losses remained in dispute.

The claimant commenced court proceedings seeking in excess of £100,000. Her schedule of loss included a significant claim for care (over £70,000) and a claim for future loss of earnings (£30,000) based on an alleged substantial reduction of function in her right arm. She contended that she required assistance from family members with basic household tasks, shopping and gardening and was unable to lift her grandchildren or lead a normal active life.

Inconsistencies emerged and intelligence enquiries showed the claimant participating in an ice bucket challenge without any apparent difficulty. A period of surveillance was commissioned to include footage of the claimant travelling to and from an appointment with her own medical expert.

This footage suggested the claimant had full use of her right arm. She was seen lifting a pushchair onto a train, carrying her grandchild and using her arm in a completely normal way. By contrast, on the same day she informed the orthopaedic expert that she was unable to move her right shoulder or elbow. The expert was unable to explain the reported symptoms from an orthopaedic perspective and, when subsequently presented with the surveillance footage, he confirmed that it was wholly inconsistent with the claimant’s presentation to him.

Following an application by the council to amend its defence to plead fundamental dishonesty, the claimant immediately (and without explanation) discontinued her claim. The council nonetheless applied to the court for a finding of fundamental dishonesty in order to secure an enforceable costs order.

Judgment

In finding fundamental dishonesty, the judge found that it was a deliberate choice by the claimant to give a false and misleading perception of ongoing symptoms.

Comment

North East Lincolnshire Council was represented by national law firm Weightmans LLP in conjunction with their insurers, Zurich Municipal. Suzanne Milne, casualty fraud partner at Weightmans, said:

“This case demonstrates the commitment of local authorities and their insurers to protect public funds by robustly investigating and defending suspected fraudulent claims.
“It also highlights the increasing willingness of the courts to make findings of fundamental dishonesty, even where breach of duty has been admitted and the claimant may have suffered a genuine injury. We hope this outcome sends a message – dishonest claims for compensation are not victimless crimes, they are incredibly costly to the wider community and will be treated accordingly.”

North East Lincolnshire Councillor Dave Watson, portfolio holder for finance, said:

“Dishonestly claiming thousands of pounds from a council is an offence and if the evidence proves that you have done that, you will face the consequences. We, like all local authorities, are required to protect public funds and this sends out the message that we will challenge any claims that we feel are fraudulent.”

Scott Clayton, Head of Claims Fraud at Zurich, commented on this case:

“This was a straightforward attempt of mindless extortion of the public money. The claimant did suffer some injuries as a result of the accident but the extent of exaggeration of the damage was such that our customer, the council, had to pursue the fundamental dishonesty charge to demonstrate the zero tolerance to fraud approach.
“Councils are really struggling to deliver vital services to their communities due to ever-decreasing public sector funding so anyone trying to defraud them should be brought to justice.”

Martin Brown, Solicitor and Suzanne Milne, Partner, in the Manchester Casualty Team at Weightmans LLP acted for North East Lincolnshire Council in this case in conjunction with their insurers, Zurich Municipal. David Callow of 12KBW was counsel in the case.

For further information about Weightmans LLP or to discuss any of the issues in this update, please contact Suzanne Milne (Partner) or Martin Brown (Solicitor) on 0121 200 7571 or martin.brown@weightmans.com.

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