QBE prosecutes Liverpool man, who fell from roof in 2011, after an exaggerated employers’ liability claim

A man from Liverpool has been sentenced for fraud after exaggerating an employers’ liability claim after he fell off a roof.

QBE Business Insurance successfully prosecuted Liam Jones, who was handed a two year custodial sentence, suspended for two years.

The claim

Jones fell of a roof when working for a QBE insured in 2011. 

An investigation by QBE’s counter fraud unit found evidence Jones was exaggerating the entent of his injuries.

After an assessment of liability and the extent of injuries QBE made an early offer to settle the claim, which was denied. Then following the submission of medical reports and legal proceedings, the total value of the claim and damages reached approximately £700,000.

Jones claimed that the injuy left him unable to walk excpet with the aid of a crutch in his left hand, he needed assistance to dress and wash every morning, became breathles and struggled to navigate stairs.

But surveillance footage showed him walking freely for five miles on one occasion, using the crutch but only when travelling to and from medical appointments, and climbing ladders while continuing to work aas a roofer.

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

At the hearing, Her Honour Judge Smith said to Jones: “Your offences are not victimless offences. Fraud causes losses that affect society at large”.

Another victory

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”.