Keoghs and Allianz expose liability claim which is found to be ‘fundamentally dishonest’ by the court.
Discontentment at work may be nothing new for many, however, in the case of Jodie Bullock v Bella Italia Group, the claimant took her feelings a step too far.
Ms Bullock worked as a chef at Bella Italia. In 2013, she made a claim for injury at work, alleging that she had fallen down a drain.
However, Ms Bullock’s story did not ring true. A number of inconsistencies, including changing the accident date not once but three times, arose the suspicions of insurers Allianz who instructed Keoghs, the UK’s leading provider of claims-related legal services to the insurance sector, to handle the claim.
Keoghs investigated the case further and uncovered additional concerns. Following the exchange of witness statements, the claimant provided an alternative accident location, circumstances and even changed the names of people involved.
The arguments against the claimant were mounting up; along with the inconsistencies of her story, the insured confirmed that the drain in the kitchen could only be lifted by a professional company when they came to clean it, and medical records showed that the claimant hadn’t attended her GP in over eight weeks following the accident, adding to the unlikeliness of the her account.
To make matters worse for the claimant, her social media accounts were discovered, which contained complaints about her employer and colleagues. The Judge quoted from Ms Bullock’s Facebook page where she stated ‘I am going to screw the ***** over’, making her intentions quite clear.
QOCS rules applied in this case. At the trial, the Judge dismissed the claim based on the inconsistent evidence. Whilst fraud was not pleaded, the court was satisfied that there should be a finding of fundamental dishonesty and therefore costs (£5,500) could also be recovered.
Nina Dayal, Director of Liability Fraud, Keoghs commented “It is pleasing to see a successful finding of ‘fundamental dishonesty' on a liability claim rather than the usual 'crash for cash' or gross exaggeration claim, where the same outcomes can be achieved. Liability fraud cases are of increasing concern to insurers, the focus for the industry has to be in relation to the early identification, investigation and validation of each claim presented. Identifying the inconsistencies in the evidence was the key to the outcome of this claim. Whilst fraud was not pleaded, a fundamental dishonesty finding and costs recovery was achieved.'
Guy Morgan, Casualty Claims Manager, Allianz, said, “We believe that pursuing dishonest claimants through the courts if necessary is what our customers would want us to do because insurance fraud adds £50.00 to the premium of every UK policyholder which is unacceptable. This was a relatively modest liability claim so we hope this sends out a signal to anyone thinking of ‘chancing their arm’ that insurers will vigorously pursue fraudulent claims regardless of their monetary value.”
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