Relevant medical history: the foundation of a dishonest claim

Author: Shoshana Mather, Litigation Assistant

Most of the claims we deal with involve a collision between vehicles. This claim arose from an incident when our client’s driver had an unfortunate event when the rear doors of the van he was driving suddenly opened, and one of the supermarket plastic delivery baskets fell onto the road.

Our client’s driver was immediately alerted to the incident as he heard the rear door slam shut so he stopped straightaway and noticed the basket in the road. He made an attempt to make the claimant aware of the debris in the road however, the claimant appeared not to notice him or the basket. As a result, the claimant’s vehicle drove over the empty basket.

The claimant’s vehicle drove for about three car lengths before coming to a complete stop with the basket still underneath his vehicle. The claimant retrieved the basket from underneath his vehicle with no difficulties and no injuries were mentioned either.

Surprisingly a claim for injuries and loss of earnings in excess of £12,000 was presented. The claimant presented as an ill man with previous injuries which allegedly were made worse by this minor incident. The claimant even saw his medical expert on two occasions. A nine-month prognosis was given.

Clearly things did not add up as the claimant’s claim seemed fictitious or exaggerated at best:

• The claimant denied a pre-existing history to the medico-legal expert but his GP records revealed a relevant history. His pre-existing history was only taken into account in the second medical report after the medical expert had reviewed his medical records.
• Despite alleging that the index incident prevented him from working for about five months, he did not seek medical attention from his GP following the incident. In fact, his first GP attendance was seven months after the accident. What was more telling was that even at this GP appointment, he only went for medication review; an appointment which was scheduled by his GP. The index accident was not mentioned at all!
• The medical expert recommended a nine months prognosis but the claimant only commenced physiotherapy treatment one year after the accident; outside the prognosis period.
• By the time the claimant had the physiotherapy treatment he had forgotten what injuries he had actually sustained; the treatment notes did not mention some of the injuries in his medical report.
• Despite alleging that he was off work from October 2016 until March 2017, his medical records revealed that he was working in November 2016.
• The claimant’s alleged absence from work only commenced 11 months after the accident, again after the nine month prognosis.

  Surprisingly a claim for injuries and loss of earnings in excess of £12,000 was presented. The claimant presented as an ill man with previous injuries which allegedly were made worse by this minor incident. The claimant even saw his medical expert on two occasions. A nine-month prognosis was given.

  Clearly things did not add up as the claimant’s claim seemed fictitious or exaggerated at best:

  • The claimant denied a pre-existing history to the medico-legal expert but his GP records revealed a relevant history. His pre-existing history was only taken into account in the second medical report after the medical expert had reviewed his medical records.
  • Despite alleging that the index incident prevented him from working for about five months, he did not seek medical attention from his GP following the incident. In fact, his first GP attendance was seven months after the accident. What was more telling was that even at this GP appointment, he only went for medication review; an appointment which was scheduled by his GP. The index accident was not mentioned at all!
  • The medical expert recommended a nine months prognosis but the claimant only commenced physiotherapy treatment one year after the accident; outside the prognosis period.
  • By the time the claimant had the physiotherapy treatment he had forgotten what injuries he had actually sustained; the treatment notes did not mention some of the injuries in his medical report.
  • Despite alleging that he was off work from October 2016 until March 2017, his medical records revealed that he was working in November 2016.
  • The claimant’s alleged absence from work only commenced 11 months after the accident, again after the nine month prognosis.

The claimant claimed that all this confusion about the medical history was from a simple lapse of memory – the claimant had simply forgotten to mention his pre-existing medical problems to the medical expert. The judge had little patience with such weak excuses finding instead that he had conveniently misremembered his medical history and was of the view that there are “...some things we do not fail to remember and this is one of them.”

At the same time the judge rejected the suggestion that the claimant’s GP failed to properly document the accident in the medical records.

As the claimant had completed a pre-medical questionnaire prior to the second medical examination where he circled ‘no’ in response to the question on whether he had pre-existing medical problems, the judge found this to be incredible evidence and was satisfied that the claimant was fundamentally dishonest as such, was ordered to pay our client’s costs.

As we continue to see what lengths claimants are willing to go to for whatever financial gain they can make, it is important to stay one step on top of these types of claimants by ensuring thorough investigations are carried out throughout the claim to defeat such claims and recover our costs. The devil is in the detail.