for over a year. However, the claim was
not withdrawn and remained in place.
Asda then informed Sussex Police, who
charged him with fraud by making a false
representation, despite his denying any
wrong-doing in the police interview.
What can you do?
Our Insurance Team have seen a number
of clients and their insurers face claims,
which although they maybe based on an
actual event, have been exaggerated or
described as having happened in different
circumstances.
Insurance Fraud
Insurance fraud has an impact upon
businesses and the public, who end up
paying for the dishonesty of some through
higher insurance premiums.
Insurance fraud can range from
opportunists failing to disclose their full
claims history when applying for cover;
those who exaggerate their losses by
adding extra items to a genuine claim;
through to those who bring dishonest
personal injury claims, including highly
organised ‘crash for cash’ criminals who
contrive often dangerous road accidents
and then make claims for phantom
passengers and fictitious injuries.
A Recent Example
In a local case, a 35 year old Brighton
man was found guilty at Lewes Crown
Court of bringing a personal injury claim
against Asda in a fraudulent attempt to
claim £11,000 in compensation. He was
jailed in October for 9 months.
In June 2012, whilst shopping in Asda’s
Brighton Marina store, the man said that
he had slipped on a puddle which had
formed due to water dripping from the
store ceiling. As a result of his falling over,
he claimed that he suffered from back
and neck pain, headaches and emotional
distress.
If you believe that a claim is suspicious,
you should report this to your relevant
insurers as soon as possible so that they
can investigate. (If you are uninsured, then
this is an area where we can offer you
advice).
Depending upon when you are first aware
of the claim, you should also take some
practical steps as soon as possible to try
and gather any evidence which could be
helpful later on when defending the claim
and possibly alleging fraud. (Of course,
you may not be aware of the claim until
months later when you are first notified
by which time, much of the evidence may
have gone). These steps could include:
• If you are a business with CCTV, save
any footage of not just the accident if
it was caught but also of the accident
location before and after the event and
the Claimant’s movements before and
after. They may reveal s omething useful,
such as the Claimant moving normally
after the incident without any apparent
injury. The benefit of CCTV is of course
obvious when you consider the
Asda claim.
• Take photos of the alleged accident
scene and note what may be there. If
the Claimant alleges that they slipped, is
there any substance or liquid present?
Sometimes, the alleged accident
circumstances may not make sense
when you see the scene. If so, record as
much as possible.
• Were there any independent witnesses?
If so, make sure you have their name
and contact details and if possible try
and get the basics of what they saw
written down and signed. Witnesses
could be co-workers at a business,
customers in a shop or passers by.
However, there may be some reluctance
on their part to become involved. Such
contemporaneous accounts can be
invaluable if later on in proceedings,
the witness then advances a different
version of events.
• With most people having camera
phones, take pictures of the parties
involved – if possible – accident
locations, cars, surfaces and whatever
else may be relevant to the event.
The incident may come to nothing in the
end but in the event that a suspicious
claim is brought, you or your insurers will
be in a better position to defend it.
By Michael Mulcare
But, the Claimant had completely staged
the fall. How do we know this? - because
of the CCTV footage which was shown
in Court, capturing the whole incident.
The footage initially showed him walking
across the section between the aisles
where he intended to stage his fall and
looking around. Other shoppers appeared
to walk over the same spot without any
problems at all. Then, as he walked
back along the same aisle passing other
shoppers, the footage showed him
kicking one leg out in front, causing him to
deliberately fall backwards, flat onto
his back.
When the Claimant made a personal
injury claim, Asda sent the CCTV
footage to his solicitors and as a result,
nothing further was heard from them
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