Having been a victim of a fake accident at work claim I was disgusted that I had to fight my insurer NOT to pay compensation
Having never been sued by anyone it came as a shock when a letter dropped through the door from a solicitor acting on behalf of a former employee in relation to an alleged ‘accident at work’ claim. Yes, I know we all have insurance and that’s what it’s for, but having spoken to a significant number of business owners or businesses these claims can have a huge impact on them.
Some, me included can take it personally as if it’s an attack on our business or reputation. Others who work for large organisations state that it is the time and effort involved in fighting spurious claims when their time could be used more productively on running a department or business.
In my case I contacted my insurer and forwarded them the strongly worded solicitor’s letter which set out a number of serious allegations against my company and certain employees. Considering that the solicitor involved had only one side of the story I was quite shocked at the letters context.
I was told by my broker that the alleged claim for a back injury caused at work and the subsequent claim for stress would be most likely be paid out as it would be cheaper for my insurer than fighting a claim. A figure of around £3-5,000 was mentioned which would be considerably cheaper in the long run.
Even though this may sound reasonable from a cost prospective, the case quickly took a dramatic twist. As a small business we had no recollection of any accidents, minor or significant that happened to this former employee. The solicitors letter stated it had been reported to management and put into the accident book.
As it was a year since the alleged accident we had to recover the employee records from storage. It then transpired that the alleged date of the accident at work had taken place a significant period after the employee had left the company. Also, records from sick notes showed that the employee had been put on anti-depressants prior to the alleged accident and that sick leave had been taken after the employee injured his back whilst helping a family member convert a garage.
With this new compelling evidence available to our insurer you would have thought that this would have been an ‘open and shut’ case. In fact, my insurer still wanted to payout the claim as it was ‘cheaper’ to do so than fight the claim. This really angered me as this was a case of blatant fraud for injuries and stress which had absolutely nothing to do with us.
Standing my ground I fought my insurer through our broker and demanded that they changed their approach and vigorously fought the claim. After some debate they agreed and wrote to the solicitor involved and denied liability to the whole claim. This resulted in yet another letter from the former employee solicitor making even more allegations. You could actually hear the solicitor shouting as he wrote the said letter, stating how we could deny we were liable and that they would prove us wrong and sue us for substantial compensation.
Six months past by and after the law firm representing the former employee was approached by my insurer for an update it was confirmed that no further action would be taken. The cost for my insurer…. £2,200. The cost for the former employee… Zero.
More Rolex watches get stolen or lost in hotel rooms every year than have actually been made
Whilst researching I was told numerous accounts of claims, some funny and some outrageously blatant attempts to obtain cash. There was the case where the employee put his hands into a vat every night after staff had left which was captured on covert surveillance. The result was a substantial claim for dermatitis and skin disorders against the employer who on disclosure of the footage was told that ‘they shouldn’t have trusted the employee with the keys’ to the secure storage area, even though it was his responsibility.
Or how about the used condom scam. A family booked a hotel room then tried to sue the hotel after it was claimed that their child was found with a used condom in their mouth after finding it under the bed. This is a well-known scam in the industry I am told, but in this case the hotel incurred costs to prove their case. Rather than just accuse the family of lying, they had the condom examined and was later proven to have no DNA on it and the contents were matched to the shower gel in the hotel room.
Then the claims for hearing loss. One case involved a former employee who left the company some twenty years prior to the claim. The claimant through their solicitor claimed loss of hearing was a result of driving a petrol powered forklift truck in a confined space for a decade or so. This could have been a genuine reason for hearing loss, however the company never owned a petrol or diesel powered forklift truck. On receiving this information they then claimed that it must have been a result of something else. Repeatedly, they kept coming back with reasons which were proven to be untrue, with the last attempt being that hearing loss was a result of driving a flat bed van. The claim failed and went no further, but caused the small business significant time and costs to defend a fishing case.
The worry and stress business owners are put through is unacceptable and there should be safeguards in place to ensure that solicitors acting in cases like these have to do certain checks before sending threatening letters to innocent parties. But our claim along with thousands of others could have been settled incorrectly if it wasn’t for the determination of the policyholders to stand their ground. It does raise the question: who are the insurers acting for? Itself or the policyholder.