Robust medical evidence and detailed investigations lead to evidence of an inconsistent presentation of symptoms, saving insurers over £800,000

The claimant’spleaded case was that he had suffered Hand Arm Vibration Syndrome (HAVS) with associated bilateral hand and upper limb pain, together with numbness, pallor, deficits in motor function and severe vascular symptoms. He further alleged that his symptoms also affected his lower limbs, with pain and numbness being experienced.

The claimant further pleaded that as a result of his injuries, he suffered low mood.

The claimant worked for the insured as a bodywork engineer and supervisor between November 2009 and January 2021. He says he was exposed to excessive levels of vibration during his time working for the defendant. The job itself was the manufacturing of refrigerated trucks. He alleged that he was exposed to vibration from using hand tools, drills, sanders, grinders and circular saws.

He states he worked between five and seven days a week and for eight to 10 hours a day. It was alleged that he used tools for around eight hours a day which, on face value, seems a significant amount of time.

While breach of duty was not our strongest argument, it became clear very early on that the claimant’s evidence was not consistent and his description of symptoms throughout his evidence varied significantly.

The claimant sought to rely upon evidence from six separate experts, including a Consultant Vascular Surgeon, a Pain Management Specialist, a Consultant Rheumatologist, an Occupational Physician, a Consultant Hand Surgeon, and a Consultant Psychiatrist.

The defendant was granted permission to rely upon evidence of a Consultant Hand Surgeon, a Pain Management Specialist, a Consultant Rheumatologist, and a Consultant Psychiatrist.

It was established that the claimant’s symptoms were not Raynaud’s Phenomenon, however,  the claimant’s Consultant Vascular Surgeon suggested that the claimant was suffering with Complex Regional Pain Syndrome (CRPS), as such the claimant obtained a report from a Pain Management Specialist whose conclusion was rather uncompelling, but he remained of the view that the claimant was suffering from CRPS.

Further medical evidence was sought, and the conclusion was that there could be a possible diagnosis of CRPS, however whether this was vibration-related remained in question between the claimant’s experts.

Following yet further medical evidence, it was concluded that the claimant did not suffer with CRPS, but he did have Chronic Primary Pain.

The experts agreed that the claimant’s symptom presentation was “highly unusual” with the defendant’s experts concluding that the claimant likely has some undiagnosed condition unrelated to his work. The claimant’s experts attempted to keep causation alive by suggesting his symptoms could be linked to vibration exposure, despite there being no causal link.

Throughout the claim, the claimant suggested that his symptoms were so severe that he could no longer work, he was unable to write, unable to pick up a kettle or hold a cup, unable to do the washing up, unable to hold the steering wheel of his car, and unable to lift his child, lift loads of shopping, washing or use the vacuum.

Following social media investigations, it was established that the claimant was not being honest about the effect of his injuries in his day-to-day life as various social media posts suggested that he was able to ride a motorbike, lift weights at the gym, play basketball and go on bike rides, and there was evidence of him holding his child.

It was clear that there was an element of fundamental dishonesty and the claimant’s credibility was diminished.

The parties proceeded to obtain joint statements from the medical experts and they referred, on numerous occasions, to the claimant having exaggerated his symptoms, there being inconsistencies between what he had told his own experts and what he had told the defendant’s experts; one expert described the claimant’s symptoms as being exaggerated and due to malingering.

The evidence stacked up against the claimant’s claim being genuine, however as a last-ditch attempt to obtain supportive evidence the claimant made an application to rely upon a report from a Consultant Neurologist. This application was refused by the court.

The claimant had submitted a Schedule of Loss valued in excess of £1 million and while we did not agree to this valuation, the overall claim had been valued in excess of £800,000.

Perseverance, a robust strategy, and investigations, together with strong medical evidence, led to a successful defence and a saving of more than £800,000 for the insurers.

Author: Emma Simm - Associate

Email: emmasimm@keoghs.co.uk