Exaggeration of injuries sees claim dismissed under Section 57

Exaggeration of injuries sees claim dismissed under Section 57

Grimes v Service Insurance Company Ltd

Swansea County Court – 9 March 2017

A Claimant who suffered personal injury as a result of a road traffic accident had her claim dismissed under section 57 of the Criminal Justice and Courts Act 2015 due to fundamental dishonesty on her part and the Claimant was ordered to pay the Defendant’s costs. Whilst the Judge accepted that some injury was sustained in the collision, she found that the Claimant had exaggerated her symptoms. Liability had been admitted, but causation was placed in dispute.

Whilst Section 57 has been in force for nearly two years, there are still only a small number of examples where it has been applied.

 

Background

This claim arose from a road traffic accident on 15 April 2015. The Claimant suggested she was waiting at a roundabout when the Insured vehicle collided with the rear of her vehicle resulting in her sustaining personal injury.  Although the Claimant attended her GP some five days after the date of the accident, she only submitted a Claims Notification Form on 26 February 2016, some 10 months after the index accident. The examination with her medical expert took place on 18 March 2016, some 11 months after the date of the accident.

The Claimant had submitted a claim for vehicle damage to her own insurance company shortly after the accident, but at that time no injuries were reported. The Claimant had told her medical expert that she did not take any time off work as a result of the accident, but had been on restricted duties. She also told her medical expert at the time of his examination, some 11 months post accident, that she was suffering from ongoing travel anxiety as a result of which he recommended further review by a clinical psychologist.

Initial case management directions ordered by the Court required disclosure by the Claimant of her medical records and occupational health records, as well as requiring her to provide replies to Part 18 Questions raised by the Defendant. Although the Claimant successfully varied that order so that she did not have to answer those questions, she was invited by the Defendant to answer the questions nevertheless, which she did not do.

A review of the GP records revealed an entry which confirmed her attendance at her GP some five days post accident was disclosed. It recorded: “Whiplash injury last Wednesday.  At round about hit from behind.  Developed pain in right trapezius shoulder region since the weekend.  Not limiting activities.  Has good range of movement of neck and shoulder.  Advised typical mild whiplash injury”.

In contrast with this record, the Claimant advised her medical expert that she suffered a severe sprain/strain to the neck which resolved three months after the index accident. She complained of pain in the neck which referred into both shoulders stating the severity of the injury as severe.  She complained of feeling shocked and shaken, suffering sleep disturbance, travel anxiety and discomfort.

The psychological complications were described as severe. The Claimant also told the expert at the time of her examination that the travel anxiety/discomfort had not resolved and that symptoms had persisted at a severe level since the accident. In terms of effects on her lifestyle the Claimant told the medical expert that she was not incapable of heavy domestic chores and/or cleaning at any stage, but that she was restricted for a period of three months.  She said she was not incapable of bending, stretching and lifting at any stage, but that she was restricted in this activity for a period of three months post-accident.

The Claimant subsequently served a witness statement confirming that she intended to rely upon the contents of the medical report, but she then sought to suggest that aspects of the report were incorrect, that, despite what was recorded in the medical report she had not been restricted in her work duties at all, and she had not felt that the psychological symptoms were severe enough to require further treatment. Effectively, the Claimant sought to limit her claim to a three month whiplash injury, abandoning the claim for psychological injury.

As part of the Defendant’s case, social media evidence was served showing the Claimant to be on holiday on two occasions within the psychological injury prognosis period, which was 12 months. At the time of putting forward the stage two settlement pack the Claimant’s claim had been valued at £3,000 such value clearly taking into account a recovery period beyond only three months.

DWF represented the Defendant. Their full report of this case can be found here:

http://insurance.dwf.law/news-updates/2017/05/exaggeration-of-injuries-sees-claim-dismissed-under-section-57/

2017-05-11T06:53:10+00:00