Work Injury Claim

TheLoser

Free Member
Aug 20, 2024
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3
Good Afternoon Everyone,

Looking for a third opinion whilst waiting for insurers solicitors to review. We have recieved a claim in March from a No Win No Fee solicitors firm using the claim portal and the Disease claim forms rather than injury forms.

Commercial roofing company (ltd co) completed a large project late last year. We paid another company (ltd co) for use of their labour to complete.

The working week was Mon-Fri with no weekend working owing to strict site rules.

One of their workers developed a rash on the lower leg during normal operations. The claimed 'exposure period' was Mon to Thursday of a particular week. The IP claims they were exposed to something in that window that produced a chemical burn to their leg. The IP worked the full 5 day week so worked the Friday with no inference of an injury or burn.

We were notified by text on the following Sunday night of a rash on a leg and the IP will not be in work Monday. I believe they went to Hospital and had it checked out.

Monday and Tuesday an investigation was initiated by ourselves and the building owner (Multi national corporation) and their qualified H&S Staff. Long story short - no chemicals present in the process, photos were handed over by supervisors showing the IP in the middle of the alleged exposure period wearing correct PPE and in fact wearing two layers of leg protection (Pants and plastic waterproof overpants) as it was light rain all week.

One of his colleagues saw fit to approach the clients H&S staff and claim the IP removed his work pants under the waterproof pants and the rash was caused by bad hygiene and sweating. This was recorded on the Clients internal H&S reporting system and is on the record.

The Tuesday afternoon of that week the IP was called by a director of the company for a welfare check and was asked two questions: Have you worked anywhere else Saturday and Sunday that would give rise to a rash on your leg as you did not report anything Friday and left site normally... He refused to answer. He was asked if he removed his pants from under the waterproofs at any time that week and refused to answer. The IP sent a series of voice memo's by text stating he was feverish and clammy, lethargic but believed it was not a chemical burn and that no chemicals were present and was a odds as to what it could be.

On the friday the Director received a text from the IP saying legs a lot better, I can walk good now I'll be back in work Monday. He never came in Monday and despite calls he never answered.

As this self certifying text was received stating he was fit to return Monday by his own declaration - it was deemed not required to file a RIDDOR report with HSE as any absence after the claimed return to work would be a different event.

The accident book was filled out on site as per normal procedure by our director with what details we had, and the dual investigations were closed NFA as we could not find a cause or any ongoing risk to the remaining workforce.

Several of the workforce joked about the IP working elsewhere on other jobs hence why he was not in work. He never answered his phone and the manager of his firm claimed he didnt know either.

Three weeks later out of the blue on the very last day of the project after word broke everyone would be getting a small bonus for their effort - the IP arrived for his shift with no prior warning from himself. He made no mention of any injury or disease and was happy working back on site in the very conditions he has now claimed caused injury. When asked where has he been - he declined to answer.

The project ended early December. Late Feb 26 and we decided to pay all our bills and close the company down as we had no more contracts. A DS01 strike off was filed.

However now I am led to believe due to this claim we have to file a DS02 to suspend the strike off as the claimant could become a debt of the company...

We believe the claim as detailed by his solicitor in the claim forms to be fundamentally dishonest and fraudulent on the following points (Correct me if you think otherwise):

No chemicals used in the process - Causation is denied? By his own voice notes as well he admitted no chemicals so why claim for a chemical burn? He was photographed dated and time stamped wearing the correct PPE, dual layer so contact with the leg almost impossible. Did he take his work pants off underneath and sweat causing a rash in breach of the signed risk assessment - a point he refused to answer.

Refusal to disclose his wherabouts on the Saturday or Sunday?

21 days of incapacity is disputed as he sent the text dated and time stamped saying he was fit to return on the Monday but didnt. His colleague on condition of anonymity disclosed a FB post by the IP's partner of him at a christmas event bang in the middle of the alleged period of incapacity showing him walking smiling and carrying his son on his shoulders at the event...

On his return on the last day he was reminded on more than one occasion to read the accident report in the accident book and sign but he chose not to.

The solicitor has stated in the claim forms where asked has the IP recieved treatment and rehabilitation for the injuries/disease they selected yes but then when asked for details of the treatment and rehab wrote TBC... How can you select yes but put TBC and not have the details from the IP - looks like a blatent attempt to inflate the claim.

The solicitor claims future rehab is required and will be assessed by their medical expert but put TBC for this as well when asked what is required.

There are more points found in this claim but this is the crux of it. I do believe there is more than enough to make the IP's solicitor close the claim.

What do you think? TIA
 

JEREMY HAWKE

Business Member
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    Mar 4, 2008
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    www.jeremyhawkecourier.co.uk
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    WaveJumper

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    Actual I agree with the above you need to leave this to your insurance / solicitors - adding and pretty sure you probably have when sitting down with them make sure they have all the facts every little nugget of information. Only they can decide if ititss worth fighting or not.

    From experience I would make sure they keep you fully up to date so there are no surprises ie they have decided to settle on a pay out rather than fight the case, which unfortunately happens more times than I care to remember
     
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    Ozzy

    Founder of UKBF
    UKBF Staff
  • Feb 9, 2003
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    I agree with the above you need to leave this to your insurance / solicitors
    Also adding another agree to this comment. The insurance company will need to lead on this, otherwise if you interfere it could invalidate your insurance and them not covering you. Give them all and every piece of information, as you laid out above, and let them make the call and decide on the route.

    As @WaveJumper states, sometimes the insurance company will decide to settle as it will be more cost effective than defending - which will really stick in the throat, but that is the insurance business we can all complain about - but is the way it is.
     
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    Frank the Insurance guy

    Business Member
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    Hi @TheLoser,

    I am Insurance Broker so feel qualified in providing advice on this.

    1. I suspect the IP's solicitors are pursuing a claim against both their employer and yourselves (No win no fee companies very often use a scattergun approach and claim against everyone hoping one sticks!).

    2. You say the IP was provided as labour by another Ltd co. Once provided to you, I assume he was acting under your control, supervision etc. If so, this generally creates a "master/servant" relationship and the IP is more likely to be considered your Employer for the purposes of the Employers Liability Act.

    3. You paid for Public and Employers Liability (I assume) - You bought this for exactly this scenario. As advised above by others, let your insurers deal with this. They sort these things out every day. They will take all the evidence and decide how best to deal with the situation - this could be a full denial of liability, full acceptance or somewhere in between!

    4. Dissolving co - at the time of submitting the DS01 was everything correct or were you aware of this claim? I would suggest getting some legal advice on this - is the claim considered a debt at this time? If so, it may prevent the strike off.

    I assume the reason for your post is more to do with dissolving the company than the injury claim? Unfortunately you can do little about the injury claim other than to leave it in the hands of the Insurers.
     
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    pentel

    Free Member
  • Mar 12, 2011
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    We have had 2 claims over the 45 years i have owned businesses. In both cases the employee used a no win, no fee solicitor. Both were referred straight to our insurers along with a timeline and all supporting documentation. At subsequent reviews we found that neither of the claims were successful.

    Insurers are usually very reluctant to pay out if they don't need to and with them having in house legal teams they are usually quite robust in weeding out spurious claims.
     
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    TheLoser

    Free Member
    Aug 20, 2024
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    We have had 2 claims over the 45 years i have owned businesses. In both cases the employee used a no win, no fee solicitor. Both were referred straight to our insurers along with a timeline and all supporting documentation. At subsequent reviews we found that neither of the claims were successful.

    Insurers are usually very reluctant to pay out if they don't need to and with them having in house legal teams they are usually quite robust in weeding out spurious claims.
    We input every last detail into Claude Ai earlier today using the version of Opus widely regarded as the best Ai for legal matters. Every last detail was put in, text messages, voice memos, documents the lot and it found 16 points consistent with both fundamental dishonesty and in some respects fraud based on the information claimed for. It believes there would be a 96.5% chance any competent solicitor would discontinue the claim but obviously there is always the variable they will always push forward…
     
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    TheLoser

    Free Member
    Aug 20, 2024
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    3
    We input every last detail into Claude Ai earlier today using the version of Opus widely regarded as the best Ai for legal matters. Every last detail was put in, text messages, voice memos, documents the lot and it found 16 points consistent with both fundamental dishonesty and in some respects fraud based on the information claimed for. It believes there would be a 96.5% chance any competent solicitor would discontinue the claim but obviously there is always the variable they will always push forward…
    I should also point out it is with the insurers and we are awaiting to hear from them to give them all the evidence and talk through. We just wanted to hear from anyone with similar experiences as this is new to us
     
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    Newchodge

    Moderator
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    We input every last detail into Claude Ai earlier today using the version of Opus widely regarded as the best Ai for legal matters. Every last detail was put in, text messages, voice memos, documents the lot and it found 16 points consistent with both fundamental dishonesty and in some respects fraud based on the information claimed for. It believes there would be a 96.5% chance any competent solicitor would discontinue the claim but obviously there is always the variable they will always push forward…
    What do you feel you have achieved by doing this?
     
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    JEREMY HAWKE

    Business Member
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    We are not solicitors nor are we legal experts and do not pretend to be. It is interesting to see what Ai thinks before we speak with the insurers, invariably they will do what they do but nevertheless interesting to compare the different approaches
    Dont trust that bollocks on something this serious .
    Its OK to ask it who sang "When I'm cleaning Windows" ! but asking it about commercial law is not wise
     
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    WaveJumper

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    Its all be said really now but reading this again this morning reminded me of one very serious incident we had and someone trying to make a very large claim and I really did have to smile as once due process had been done by HSE and they held the member of staff completely at fault.

    Have said it many times on threads, paper work can be key, signed training records, on site rules, the list goes on, blah blah, but its a good feeling to be able to slide that file out the cabinet and know you got your backside covered.

    Best of luck with your outcome and do let the forum know how it goes
     
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