Insurance giant Zurich gets to save more than £100,000 after a dishonest substantial care claim fell short in court.     

Bagging a win in the Edwards v 99p Stores Limited case was defendant law firm Keoghs, whose probe found “flagrant exaggerations” in the fall claim put forward by a customer who apparently had longstanding and significant medical problems even prior to the supposed discount store accident. According to Department of Work and Pensions (DWP) records, the claimant had been receiving the same rate of mobility allowance as a paraplegic.

While it was admitted that there were pre-existing symptoms, the claimant blamed as much as 60% of her ongoing issues on the incident in question. There were several other complaints related to decreased mobility, including the supposed need for patio relaying at the claimant’s residence.

The claimant also alleged that her employment prospects had been impacted, but it was found that she had not worked for more than two decades.

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The substantial care claim, a fundamental part of the overall claim, was deemed dishonest. It resulted to the claim being dismissed and the claimant’s QOCS (qualified one-way costs shifting) protection being lifted. She was also ordered to pay the defendant’s costs on an indemnity basis.

“This was a great result for Zurich and serves as a warning to any claimants who try to exaggerate their claims for damages,” commented Chris Henson, the Keoghs associate who handled the claim. “It proves the value of obtaining relevant disclosure documents and painstaking examination of the records.

“This claimant could have abandoned her care claim at any point prior to trial but proceeded all the way through and presented witness evidence from her daughter which was substantially inconsistent with evidence presented to the DWP over time.”

Meanwhile Keoghs partner Nina Dayal, citing a rise in the overall trend for slip and trip claims, said the industry should act wherever possible to stamp out this area of insurance fraud.


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