Fundamental dishonesty

Stuart Giddings, partner in Keoghs’ Complex and Catastrophic Loss team, recently succeeded in bringing a fundamentally dishonest claim to a stop, resulting in LV= costs being paid. The claimant was involved in an accident on 15 December 2013 and pursued a personal injury claim as a result. He sustained a number of nasty injuries as a result of the incident including several fractures across his body and psychological trauma.

The defendant accepted that the claimant had sustained a number of separate and distinct injuries, all of which would have given rise to some disability for a period of time. The defendant accepted that the claimant’s hip injury would have given rise to the need for replacement surgery in the future but denied that there should be any long-term consequences as a result of the other injuries. Causation was raised as an issue in respect of the longevity of symptoms the claimant complained of due to his pre-existing problems such as diabetes and diabetic neuropathy.

Despite suffering from genuine injuries, the claimant did not plead his claim, nor present at examinations, in such a way that was commensurate with the injuries sustained. The claimant’s pleaded claim at the time of filing a personally signed schedule in February 2018 was £1.5m for special damages alone – this didn’t include a claim for alternative accommodation for the claimant to move into (a four bedroom, single-storey house).

The claimant’s presentation to medical experts alleged that his level of disability gave rise to significant difficulties and his schedule and witness evidence (as supported by family members) pleaded the following issues of most significance:

• The claimant was effectively housebound and could do nothing for himself, being unable to move independently or use his right arm, which gave rise to a claim for constant care and overnight sleeping care in excess of £67,000 per annum. The claimant said he essentially spent his days and nights in the living room where he had a bed.
• He was unable to drive his car and the only time he would leave the house was if a family member went with him. He would always need someone with him as he was too nervous to drive.
• That he needed a wheelchair when mobilising outside and could barely walk from the front door of his house to his car on the driveway.
• That he was otherwise dependent on a crutch and the support of another to walk.
• Carrying a baby in his right arm, carrying papers in his right arm and opening doors with the same hand.

Suspicions about the claimant’s veracity were raised by the defendant’s orthopaedic expert in June 2017. Following receipt of his draft report, LV= obtained a number of periods of surveillance between August 2017 and March 2018.

Contrary to his many assertions, the claimant was seen on seven out of the 10 days of surveillance doing the following:

• Carrying a baby in his right arm, carrying papers in his right arm and opening doors with the same hand.
• Driving his car to the restaurant that he owned, to his accountant and to a bank on many occasions without being accompanied. He appeared to be engaged with work at least to a moderate degree.
• Mobilising outdoors with one crutch and at times walking without it. He was never sighted in a wheelchair.
• He walked around without support from another to do so.
• Practising his religion and socialising without support or attendance from family members.

Another interesting facet to the accommodation claim was the claimant presented a case for adaptation works at home being required as a result of his accident related injuries. Those adaptations cost £18,120. Through investigations it was found that the work carried out was actually applied for four months pre-accident.

The defendant applied to amend their defence in order to plead fundamental dishonesty and served medical evidence, surveillance footage and supplementary reports from all of their experts. On doing so, the claimant sought to discontinue his claim in order to circumvent a finding of fundamental dishonesty and avoid paying the defendant’s costs. After lengthy discussion with the claimant’s representatives it was eventually agreed between the parties that the claimant could discontinue his claim on the basis that (a) he repaid interim payments totalling £50,000 to LV= and (b) paid the agreed sum of £75,000 in respect of LV=’s costs and disbursements. 

Steve Clark, Technical Claims Manager, said that LV= were delighted with the outcome: “LV= is committed to providing genuine claimants with the required level of care needed, particularly in circumstances where serious injury has occurred. However, when exaggerated claims are put forward such as in this case, we will work with our lawyers to prevent such claims being pursued for personal gain.”

Stuart Giddings, Keoghs partner who worked on the case, said: “Complex claims are not exempt from fraudulent behaviour and we will work with our clients to investigate claims where concerns are raised. Thanks to our expert, LV= and Keoghs’ own investigations, we have ensured that this claimant is not rewarded for his attempt to exaggerate his claims.”

That he no longer worked or engaged in work-related activity.