Claimant who boosted injuries claim over £1m withdraws in face of fundamental dishonesty plea


Perkins: Wise decision

An injured motorcyclist who went through what turned out to be unnecessary operations to bolster his £1m-plus claim has dropped his case altogether after the defendant insurer found that he was not as badly hurt as he portrayed.

Keoghs, which acted for esure, said the case highlighted the impact of the ‘fundamental dishonesty’ provision in section 57 of the Criminal Justice and Courts Act 2015.

It comes on the heels of the LOCOG case, the first authoritative guidance from the High Court on what amounts to fundamental dishonesty.

According to Keoghs, motorcyclist Samuel Mervin was seriously injured in an accident in August 2014, with the 23-year-old sustaining severe lower limb fractures leading to compartment syndrome and numerous surgeries.

Liability was admitted early in the claim and esure funded extensive rehabilitation to supplement Mr Mervin’s NHS care.

During the course of the claim, however, suspicions arose regarding Mr Mervin’s credibility as he continued to report disproportionate limitations, sufficient to render him almost immobile, in need of substantial care, and completely unable to work.

As a result esure commissioned a number of periods of surveillance, which found that he was actually fully mobile, capable of riding and working on a motorcycle, and even engaging in home removal activities.

Mr Mervin continued to insist that he was unable to walk without aids and “even went through further unnecessary and painful surgeries to perpetuate his fraud”, eventually serving proceedings which provisionally claimed around £825,000, with a likely fully particularised claim in the region of £1.5m.

The insurer then pled that Mr Mervin was fundamentally dishonest. “When confronted with the pleadings, surveillance and expert evidence Mr Mervin took the decision to withdraw his claim with immediate effect, with no damages or costs being paid.”

Keoghs partner Matthew Perkins said: “This case has a number of important features which are of considerable significance for insurers when considering their approach in potential section 57 cases involving exaggeration.

“In particular, despite his serious injuries and his decision to undergo unnecessary further surgery to perpetuate his fraud, the claimant was still prepared to drop his claim, rather than allowing his dishonesty to be further scrutinised via the court process.

“This decision is likely to have been a wise one in light of the guidance issued by the High Court in LOCOG, which reflects the hardening legislative and judicial attitudes to fraud.”




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