QBE wins private criminal prosecution against Employers’ Liability fraudster

QBE-wins-private-criminal-prosecution-against-Employers’-Liability-fraudster

Following trial in Liverpool Crown Court, Liam Jones was found guilty on 18th September 2018 and last week received a two years custodial sentence, which was suspended for two years.

Mr Jones suffered injuries when he fell from a roof while employed by an insured of QBE in 2011. However, an investigation by QBE’s counter fraud unit revealed evidence that the 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. Thereafter, following submission of several medical reports, legal proceedings were received which valued the claim for damages at approximately £700,000.

Mr 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.

However, surveillance footage showed Mr 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 Mr Jones ascending and descending ladders while working as a roofer.

After taking into consideration the evidence, QBE, supported by law firm BLM, made the decision to pursue Mr Jones by way of a private criminal prosecution for fraud and Mr Jones received no money for his claim.

 At the hearing, Her Honour Judge Smith told Mr Jones that “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, BLM, who acted for QBE and their 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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