Thursday, March 17, 2011

Direct Line loses court battle over claimant's 'faked injuries'

Direct Line accused a critically injured victim of a motorcycle crash of lying about the extent of his injuries, which were worth �3.4m in compensation

A critically injured man has won his battle to retain �3.4m in compensation after he was accused of lying about his disabilities following a traffic accident.

In what is believed to be the first case of its kind, Mark Noble of Wareham in Dorset was accused of lying about the extent of his disabilities at an initial trial to determine compensation. Normally, awards are contested on the grounds of who is responsible for an accident rather than whether the resulting disabilities are genuine or not.

Noble sustained an "open book" broken pelvis, a spinal fracture, and injuries to his left leg, both wrists and head after a driver pulled out in front of his motorbike in September 2003. After 11 operations and subsequent associated problems, including MRSA, he continues to suffer chronic pain, incontinence and is essentially wheelchair dependent while outdoors.

He was awarded �3.4m in damages including significant sums to meet the costs of care and assistance, but soon after the initial trial the driver's insurer, Direct Line, was tipped off by one of Noble's neighbours that he was not as seriously disabled as he had claimed in court.

After carrying out undercover surveillance of Noble for a second time, Direct Line obtained an injunction freezing �2.25m of the award pending appeal. The surveillance showed Noble carrying out several activities unaided, including operating a dumper truck while standing on it, driving a mechanical digger and using a chainsaw. Direct Line also said Noble had failed to use the damages to pay for full-time care or make adaptations to his home ? the purpose for which they were awarded.

But experts in pelvic injury giving evidence for Noble told the appeal court that although it was unusual for people with such injuries as displayed by Noble at the first court to recover, they had seen previous examples.

Mr Justic Field said he could see how an injured claimant might decide to "forgo some or most of the aids and assistance for which he claimed and spend the money instead on other things, which in his mind compensated him for his loss of amenity".

He also accepted Noble's argument that the fact he had done better than expected following the conclusion of the first trial did not mean he had lied, or that he was able to do more at the time of the first trial. "At the time of the [initial] trial, Mr Noble was determined to try to walk unaided and may have been confident that somehow he would succeed in doing so, but he did not dishonestly conceal from the court or the expert witnesses his then true state of disability, or dishonestly emphasise his disability. The claim that he dishonestly misled the court at the [initial] trial is accordingly dismissed."

David Williams of solicitors RDPS Law, who represented Noble, said he thought the appeal by Direct Line was partly initiated by the size of the damages, but added: "I think it was also an opportunity to take a headline case to court and make an example of someone. It's backfired on them."

Williams was critical of Direct Line's decision to proceed with an appeal without first discussing developments with Noble and his solicitors. "Direct Line chose not to notify us of their concerns. They simply hand-delivered a box to Mr Noble notifying him of the court order and the video surveillance."

Allan Clare, director of risk, financial crime and security for Direct Line, defended the insurer's decison to pursue an appeal. "Direct Line was provided with information via the Insurance Fraud Bureau's Cheatline about a claim that we had paid," Clare said. "As we take all allegations of fraud seriously, whether pre or post payment, we commenced an investigation. We gathered evidence and when we felt we had a strong case, we presented this to the court. Unfortunately, the judge disagreed with our argument.

"We feel that we had a robust case and we would not hesitate to act in the same manner again, if presented with similar evidence. Insurance fraud is a serious crime, and one which adds around �40 to the cost of every insurance policy. We are grateful to the person who gave us the information and would encourage anyone who has concerns about someone committing insurance fraud to contact Cheatline."


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Source: http://www.guardian.co.uk/money/2011/mar/16/direct-line-loses-court-battle-faked-injuries

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