Employee Jailed for Exaggerating Injury.

An interesting report has cropped up in the news recently which highlights what the insurance industry is doing to combat fraudulent claims. Check out the story in full from Insurance Age below.

 

A former employee of a QBE client has been jailed for three months for contempt of court after grossly exaggerating his injuries following an accident at work.

Jeremy Heffer, 53, from Ricketts Lane in St Austell, Cornwall, submitted a claim against the metal stockholder and distributor where he worked following the incident in April 2009.

The tread plate of his lorry gave way causing him to fall four feet as a result of which he sustained an injury to his lower back and leg and was allegedly unable to return to work.

Heffer asserted that he had not worked since the accident and was unable to walk without assistance preventing a return to his job or any other form of work.

Loss
His assertion was supported by a signed particulars of claim including a schedule of loss for around £450,000.

However, evidence provided by QBE’s client and surveillance footage revealed that Heffer had grossly exaggerated his level of injury and incapacity.

When the footage was disclosed to him, he withdrew his claim in its entirety. Upon full consideration of the evidence and the extent of fraud involved, QBE took the decision to proceed with an action for contempt of court against Heffer.

Matt Lacy, director of casualty at QBE, commented: “This contempt of court case is yet another example of our success in bringing perpetrators of insurance fraud to justice.

“This latest case comes on the back of other well-publicised attempts to defraud our clients and QBE of substantial amounts of money, and demonstrates how we will resolutely defend our interests and those of our clients.”

Given the disparity between QBE’s evaluation of the claim and the claimed amount the insurer undertook further investigations, led by its special investigation unit in conjunction with BLM, between 2010 and 2013.

Surveillance
It included surveillance which showed the claimant involved in gardening, fishing and DIY activities.

The claimant’s solicitor and insurer were notified that QBE believed the claim to be fraudulent and made aware of the surveillance evidence.

QBE said Heffer issued a notice of discontinuance and QBE applied to the High Court for permission to bring contempt of court proceedings.

The High Court approved the application in June and the trial was heard at Exeter Combined Court on the 14th and 15th December.

 

Source:Insurance Age