Samuel Mervin, who had been seriously injured in a 2014 motorcycle accident with an esure policyholder, found himself withdrawing his claim when “irrefutable evidence” of fraudulent exaggeration came to light.
While liability was admitted early in the claim and extensive rehabilitation was funded by esure – supplementing Mervin’s NHS care – several periods of surveillance had to be commissioned amid credibility concerns. The motorcyclist continued reporting what were described as “disproportionate” limitations related to his mobility and ability to work.
The surveillance, however, revealed that Mervin – the same person who persistently claimed he was unable to ambulate without walking aids – was fully mobile and capable of riding and working on a motorcycle. According to law firm Keoghs, the claimant even went through further unnecessary surgeries to perpetuate the fraud, which would have seen him receive around £1.5 million.
The insurer then decided to plead that Mervin’s claim was fundamentally dishonest under Section 57 of the Criminal Justice and Courts Act (2015), disclosing the surveillance and medical evidence obtained. This resulted in the claimant’s immediate withdrawal, and no damages or costs were paid.
“While fraud in serious injury cases is thankfully unusual, this is a great example of how to approach a claim when there are suspicions of fraudulent exaggeration by a claimant and an excellent outcome for our premium-paying customers,” said technical claims head Steve Morrison, who stressed that esure operates a zero tolerance policy on any type of fraud.
Matthew Perkins, Keoghs complex injury partner, said the case has important features which are of considerable significance for insurers faced with potential Section 57 cases involving exaggeration.
