Keoghs Insight

Author

Matthew  Ruck

Matthew Ruck

Associate

T:01204 678672

AD v Haven Insurance Company Limited

Client Alerts27/10/2021

In AD v Haven Insurance Company Limited, a claim for alleged permanent injury and significant past and future losses with a claim value of £166,000 was dismissed and found to be fundamentally dishonest resulting in the recovery of £19,600 of costs.

Background

This claim was one of a number handled by Keoghs on behalf of Haven and LV= which all involved allegations of permanent injury with reliance on the evidence of the same medical expert. A batch of his reports were reviewed and the opinions analysed. Defences were then served in each claim pleading the unusual and concerning patterns in the medical evidence, and applications for joint case management were made supported by similar fact evidence and an anonymised dataset. The applications were granted; the claims were joined and permission was given to rely on all the medical reports that had been identified from that expert.

As a consequence all claimants abandoned reliance on the evidence of that expert and sought replacement evidence from new experts. This was granted and all claims then proceeded separately.

The Claim 

The claimant was a passenger in a taxi which struck a parked vehicle and overturned. She alleged various injuries which had all resolved within six weeks, other than a lower back injury which was said to be permanent. This caused restriction on the open labour market and she would require permanent future assistance with heavier tasks and six sessions of physio per year for the foreseeable future. She sought, amongst other things, future costs in the form of £20,000 to pay her partner to undertake household chores, £17,000 to pay for a professional gardener and £11,000 for a professional painter and decorator.

After changing her medical evidence; the alleged injury was reduced to a minor head injury and bruising, a 6-week soft tissue neck injury and a 2–3 year acceleration of constitutional degenerative changes in her lower back. Her past and future loss claim totalling £75,787.55 was reduced to £3,208.00.

There remained significant inconsistencies between the claim and her medical and occupational health records and various social media posts.

The Trial 

The claim was defended to trial with a pleading that the claim was fundamentally dishonest. The judge commented that the inconsistencies were surprising and the original medical opinion was of no value. The physical tasks identified in the social media posts that were not mentioned at medical examinations were entirely contrary to the claim presented. 

He found that the back injury must have recovered within a few months and the claim had been dishonestly exaggerated. The genuine element of the claim was assessed at £4,000, but this was dismissed on the basis of fundamental dishonesty and the Claimant was ordered to pay costs of £19,600.

Comment

It can be difficult to adequately challenge extreme or otherwise unusual medical opinions in individual claims. This case shows the importance of the ability to identify all claims which feature a specific expert to facilitate the review and analysis of their evidence to identify patterns which may undermine their reliability and may possibly suggest a breach of their duties to the court. Whilst there are data protection and procedural challenges to the deployment of such evidence, such an approach may be the best way to challenge the evidence and to bring such issues to the court’s attention.

 For any further information, please contact Matthew Ruck.