Thursday 18 July 2013

When cheap prices leave you unprotected

Price seems to be the main reason for people to choose which insurance broker and policy they use. The insurers have realised that some brokers will peddle any policy if the price and the keyfacts document look good.
We have recently seen a client, who is looked after by a superficially reputable national broker, sold a policy that we would consider unacceptable in its terms.
Our audit's findings relate to the following clauses covering the Employers and Public Liability sections of the policy.

“HSE RECOMMENDATIONS CONDITION
It shall be a condition precedent to ALL Liability Sections that the Insured shall ensure that they and their Employees, and any third parties acting on the Insured's behalf, comply with all applicable statutory requirements, and Health & Safety Executive (HSE) regulations, approved codes of practice, recommendations and guidance, or those of any equivalent bodies in Northern Ireland, the Channel Islands or the Isle of Man, applicable to the operations and processes conducted in connection with the Business”
In the event of a serious injury taking place the client will have to demonstrate compliance with a moving target of HSE guidance delivered via website which changes daily.

“PERSONAL PROTECTIVE CONDITION
The policy also required suitable PPE, maintained in working order, employees trained in its use, signed off and a disciplinary regime in place for non compliance”
We believe insurance is there for the times when accidents happen and processes fail, however in this case:-
  • No safety boots - no cover
  • No goggles being worn whilst grinding - no cover
  • Workplace noise over 85db and a loss of hearing suffered - no cover 
The largest claim for personal injury in the UK is £15m - a business does not need to be fighting these claims by itself or employing a solicitor to get its claim paid by the insurer.

Castlemead Insurance Brokers offer an audit to customers who have concerns over their small print. 

Tuesday 2 July 2013

Insurance Fraud - Courts siding with insurers to stem the tide

Two recent cases show that the Courts will not accept claimants grossly exaggerating their injury.

David Ribchester from Tyne and Wear said wrist injuries from a workplace incident stopped him from carrying out basic tasks including opening jars and driving, claiming £923,000 from insurers. He was jailed for 12 months when he was secretly filmed by insurance investigators on a number of occasions between February 2008 and October 2009.

You can see the footage on YouTube here. 

He was filmed at his local rugby club where he was seen to "grab the ball with both hands and go into a hard tackle" despite claiming he was unable to tie his shoelaces. The 31-year-old, who previously admitted fraud by false representation, was sentenced at the Old Bailey in London on Thursday.

In another case James Shikell submitted an inflated £1.35m claim for damages for injuries in a car crash. He was also sentenced to one year’s imprisonment after the courts found him guilty of contempt of court. The decision came after footage of him playing football revealed that he had exaggerated his symptoms. His father Robert Shikell also received a year's imprisonment for his role in supporting his son's claim while a third man, Simon Fennell was fined for providing a false statement in Mr Shikell's personal injury claim.


If only the industry can deal with minor whiplash claims - there are new Ministry of Justice changes coming into force from the end of the month to help reduce the value and fees on less serious injury claims.

We will blog about this in a few weeks’ time and add the link to this article.