Employers Liability claimant convicted for fraud

Published 17 January 2019

A serial claimant in an Employer’s Liability action eventually pleaded guilty to two counts of fraud and sentenced to 300 hours community service, to repay £1000 to another insurer and £230 in costs and victim surcharge.

Mr Richards was prosecuted by IFED and pleaded guilty to two counts of fraud when he presented a claim for personal injury against AB Agri Limited, insured by Zurich Insurance Plc.  He alleged in civil proceedings that he had slipped on a wet floor at work and suffered injuries to his neck and back.  Breach of duty was admitted, however, the claimant submitted special damages claims for gardening work, care and assistance, lost earnings, travel, medication and loss of use of gym membership totalling £5353.18.  The fraud was identified by Zurich’s claims handler Mike Sawford who spotted irregularities with the two of the invoices submitted by Richards in support of the claims.  Statements were taken from the alleged producers of the invoices confirming that they were not in fact the makers of the documents.  Following disclosure of the evidence the claimant discontinued his action and we made an application for a finding of fundamental dishonesty. 

The matter was referred to IFED who investigated the claims and who charged him on three counts of  fraud offences though one charge relating to one of the invoices was later dropped because he had not sought to be compensated for the financial loss relating to it. During the investigation of this claim other claims for a lost ring and a lost necklace were identified as being fraudulent.  Both of these claims had been paid by the other insurers.  Mrs Richards had presented a claim for a lost ring which she was wearing when she was arrested.  She was given a caution as she returned the money to the insurer.  Mr Richards fabricated another invoice when claiming for the lost necklace in an attempt to inflate the value of it and he eventually pleaded guilty to this count as well.

Mr Richards pleaded not guilty initially even though he admitted the fraud during a police interview and changed his plea the day before the trial.  The trial was used as a sentencing hearing and he was sentenced to 300 hours community service, to repay £1000 to another insurer and £230 in costs and victim surcharge.

The civil matter being dealt with by DAC Beachcroft’s Kellie Maguire will now continue following the lifting of the stay of proceedings and the hearing of the application for a finding of fundamental dishonesty will be listed shortly.

The civil court should have no difficulty in acceding to the application given the claimant’s conviction and we will seek to recover Zurich’s costs.

Serial claimants and other categories of organised fraud in casualty claims are on the rise  and it is important to ensure that the right investigation and litigation strategy is adopted to secure the best outcomes. With 31% of all our fundamental dishonesty findings involving a serial claimant or co-conspirators there is a clear need to put in place processes for identification and management of these claims.

For more information contact Claire Laver