Keoghs Insight

Author

Chris Henson

Pointing the finger at fraud

AWARE17/04/2013
Casualty Aware 2

Keoghs’ liability fraud team rigorously investigate suspicious employers’ liability and public liability claims and, where and whenever appropriate with the backing of insures - in this case Zurich - defends them vociferously.

A recent example of the lengths some people will go to to fraudulently claim from insurers involved a claimant who was visiting the defendant’s property; a house where his estranged wife lived. The estranged husband claimed that, in an attempt to steady himself following a trip over a defective door seal in the kitchen, he put his hands out but, instead of preventing his fall, his wedding ring got caught on the door catch - itself defective according to the claimant - causing traumatic amputation.

Upon receiving the claim however, claims handler at Zurich, Julie Fieldhouse, raised a number of concerns with Keoghs.

The incident was not reported to the defendant until two months later, nor had the tenant made any previous complaints about the door which, it was suggested, had suffered damage due to a forced entry attempt. This was despite the tenant having made previous complaints concerning problems such as kitchen drawer handles having fallen off in the months prior to the incident. Neither had any complaint been made about any burglary attempt - despite the tenant living in the property with her two young daughters. The fact the claimant was still wearing a wedding ring, after being described as separated when the property had first been let in 1999, was also an issue of concern.

Further major fraud concerns arose when the medical evidence suggested that the claimant had severed his own finger with a, “straight bladed kitchen knife.”

Demonstrating the collaborative effort needed to expose such cases, Zurich and Keoghs were also able to obtain a recording of the ambulance calls, as well as logs and a witness statement from the attending paramedic which completely undermined the claimant’s case. A reliable and credible witness, the paramedic confirmed the claimant had been intoxicated at the time of the incident and that he had heard conversations in the property describing how he had cut off his wedding ring finger so as to ‘prove’ his love for his wife.

An attempt to discontinue with no order as to costs was refused. The claimant ultimately served an unconditional Notice of Discontinuance enabling Zurich to recover their outlay.