Claims, Scams and Compensation

[Davros]

Grrr, did anyone else watch this on C4 @ 9pm last night. I had a feeling it would be one of them shows that would make me angry, and it did.

The amount of lazy greed portrayed in the show really grated me, as did the slimey claim lawyers and there slimey nature.

 

[MrB]

Glad I didn't see this!! Being a liability underwriter I get to see first hand the things people try to claim for, often successfully in our current culture of blame. Got this report through the other day, it really beggars belief:

Below is a recap of the claim in question which originated from the Southern Region of QBERI in 2005.

Our insured, JT Davenport, was a trucking company from NC that had a contract to deliver groceries to Go Mart convenience stores, including those located in West Virginia. On the night of the occurrence (6/13/05), our insured was making a delivery at a Go Mart store in Charleston, NC at 2AM. While the insured was completing his delivery, an intoxicated man left a nearby tavern and laid down underneath the tractor trailer, placing one of his legs between the rear wheels of the trailer.

When the insured driver pulled away from the c-store, the intoxicated man, who had passed out under the trailer, was run over. Ultimately his left leg was amputated at the knee as a result of the occurrence. It was subsequently learned that the claimant was severely intoxicated at the time of the occurrence and had actually told individuals at the tavern across from the c-store that he was going to go lay down under the tractor trailer in the c-store parking lot. Investigation also revealed that claimant had a lengthy criminal history and meager employment history.

Almost immediately after the accident, a lawsuit was filed against our insured and Go Mart. The allegations against our insured were essentially that our insured driver should have looked under the trailer for intoxicated adults before driving away. The allegations against Go Mart included inadequate lighting in the parking lot and inadequate security. The contract between our insured and Go Mart required our insured to indemnify Go Mart for liability arising from the insured's negligence.

Go Mart tendered their defense and indemnity to us shortly after suit was filed. The tender was accepted and a defense provided subject to a reservation of rights on the grounds that Go Mart could not be indemnified for its own negligence. Prior to trial, the plaintiff's demand was in excess of $5M.

Due to the significant comparative negligence of the plaintiff, the joint defense offer to settle was significantly less at $200K. At trial, there were no college graduates in the jury pool and only two of the jurors were high school graduates. None of the jurors were employed. The trial judge demonstrated a pro plaintiff bias in a majority of his rulings during the trial as well.

The underlying trial took place in 2008 and the jury awarded a total verdict of $3M and allocated fault equally among all parties.(1/3 each). Thus the net verdict was $2M. We tendered $1M on behalf of our insured, but refused to pay the $1M allocated to Go Mart since the jury specifically attributed 33% fault to the Go Mart based upon the evidence of their independent negligence introduced at trial. Our refusal to indemnify Go Mart for their own negligence ultimately resulted in insurance coverage litigation and allegations of unfair claims handling practices.

Despite evidence supporting our position, the court ultimately ruled against us on all aspects of the coverage litigation. As a result we required to fund the Go Mart's portion of the underlying verdict. Additionally we were required to pay extra contractual damages of $500K. This aspect of the claim was resolved in January of 2010.

West Virginia is a venue known for extremely plaintiff biased juries and judges, and this notion certainly proved true in the above referenced claim. A claimant who significantly contributed to, if not entirely caused his injuries, was awarded $2M by a jury of his peers. Additionally a valid coverage position was completely ignored and ultimately dismissed by the trial court judge. As a result we were required to fund the co defendant's portion of the verdict and subjected us to extra contractual damages. We do not write insurance in W Virginia, but we do in the surrounding states of MD, NC, OH, PA, and VA. Thus the potential exists to be drawn into litigation in W. Virginia.

When this occurs, we must remember it is not a venue where we can expect a fair shake from the juries or judges in most if not all instances. In short the deck is stacked against insurers in this state and we must remain cognizant of this fact.

 

[Matt the Shrimp]

All I can say is: thank heavens we don't have civil juries in the UK. They really don't have a bloody clue.

 

[Manchester Shrimper]

I saw this. I was incensed but not particularly surprised.

I always thought health and safety regulation had got a bit stupid recently but this program gave an insight as to why this has happened.

Case and point was the lady who sued Lambeth Council after being hit by a falling branch while reading in the park (despite not being seriously injured) and this leading to the Council spending their Council Tax-payers money on a tree-inspection regime to make sure it didn't happen again.

Also, even though the Mum who broke her ankle in the parents' race at sports day was outsmarted when she tried to sue the school, the school caretaker said it would spell the end of that particular tradition.

Often the media makes local councils out to be jobsworth spoil-sports but this program showed that a lot of the time, they're just protecting their backs against the ambulance-chasers.