Employers’ liability claimant in £700k fraud

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A man who exaggerated a £700,000 employers’ liability claim after falling through a roof has received a suspended two-year custodial sentence.

Following a trial at Liverpool Crown Court, Liam Jones was found guilty of fraud and recently received the two-year custodial sentence, which was suspended for two years.

Jones suffered injuries when he fell from a roof while employed by an insured of QBE in 2011. But an investigation by QBE’s counter fraud unit revealed evidence that the employers’ liability claimant was exaggerating the extent of his injuries.

After an assessment of liability and the extent of injuries, QBE made an early offer to settle the claim, which was not accepted. Following submission of several medical reports, legal proceedings were received that valued the claim for damages at approximately £700,000.

Jones reported that he was unable to work, required help in washing and dressing, found it difficult to negotiate stairs because of pain and breathlessness, and could not stand for a length of time. He claimed that he could only walk with the assistance of a crutch in his left hand and reported that he was unable to carry a light bag of shopping or bend over.

But surveillance footage showed Jones walking freely without a crutch on one occasion for approximately five miles. In other instances, footage showed he walked with a crutch, but only to and from expert medical appointments. Evidence also showed him ascending and descending ladders while working as a roofer.

After taking into consideration the evidence, QBE, supported by law firm BLM, decided to pursue Jones by way of a private criminal prosecution for fraud. Jones received no money for his employers’ liability claim.

At the hearing at Liverpool Crown Court, the judge told Jones: “Your offences are not victimless offences. Fraud causes losses that affect society at large.”

Mike East, claims director for QBE Business Insurance, said “Fraud, including exaggerated claims, remains a major issue in our industry and we are pleased with the sentencing of Mr Jones. His prosecution is another in a long line of fraud cases in which our counter fraud team have been alert to fraudulent activity and have tirelessly pursued perpetrators in defence of our customers’ interests.”

Stuart Furniss, partner at BLM, which acted for QBE and its insured in relation to both the defence of the civil claim and private prosecution, said “This case demonstrates how important it is to take a hard line when faced with a claim tainted by fraud or exaggeration. The sentence should also act as a clear deterrent to those seeking to defraud insurers and their customers and hopefully help to reduce the number of similarly fraudulent claims which continue to drive up premiums for others.”

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Mark Dugdale is the editor of Claims Media. Mark welcomes articles, letters or feedback from readers and can be reached via mark.dugdale@barkerbrooks.co.uk