Posted By Wayne D Schofield
Dear Colleagues,

Without going into too much detail with regards an EL claim and without contraveining any Data Protection Laws, what experiences have you had of an EL claim made by a current employee, of an incident not reported via the usual means, which resulted in an amount of 'delayed' time off work for a condition spurious to the alleged cause of the incident.

Basically, the employee alleges that whilst wearing work boots, the employee walked into a pile of floor sweepings (PVC resin, stabilisers etc, that can be an irritant), which then forced its way into his boot, though his sock and infected his big toe.
As we have had no record of the incident, nor had his recorded time off been allotted to a work related incident, he is now, from the advice of our insurance, in a strong position to win this claim to pay for next years holiday. Any advice from any of you on how we can limit our damages here and prevent a re-occurrance in the future?

Your advice is greatly appreciated.

Thanks

Posted By John A Wright
Is this employee saying he walked into the sweepings on ONE occasion, and that alone irritated, sorry infected, his big toe???

Posted By martin gray1

Hi Wayne

Annoying situation I know. I have got a case going on at the moment, he did not report any injury to anyone or ask to enter anything in the accident book. A colleague of his was working four feet away and saw nothing. Then failed to turn up for work and two days later phoned and said he hurt his back at work.

Investigated it and then went back and told him I was not treating this as a work related injury. Informed insurance company and the Loss adjuster is coming next week to look at training records risk assessments etc.

He tried to claim industrial injury benefit but I believe he was refused. Came in the office the other week walking fine and driving his car. I wrote to his doctor and they say they cannot comment as his records are still abroad with his own doctor.

I have written again to the GP asking for a report on his health at this moment in time on the information they have, but I am still awaiting an answer.
MG

Posted By Brigham
Beats me why you allow floor sweepings that include hazardous substances to be left there. Surely the routine for clearing this type of debris would be to dispose of it as soon as!
Anyway, this persons link to injury appears tenuous but your insurers might be looking at the greater picture of cost containment. However specialist opinion should be sought to determine whether the injury could have been caused by any of the substances in the pile of sweepings he allegedly kicked. Remember, he may have had a minor injury (broken skin) to his toe at the time of the alleged incident that might have made the event more credible. If they can get away with minor a settlement out of court, together with no admission of liability, insurers often take this route. Contrary to previous advice, I don't believe that you can instruct your insurer not to settle, it's their money and their claim.

Posted By Paul Duell
>>If they can get away with minor a settlement out of court, together with no admission of liability, insurers often take this route

That's certainly been my experience of at least one EL insurer - and it's a really short sighted approach. It doesn't take long for the less-scrupulous employees to realise that bunging in the occasional "dodgy claim" - as long as they keep the amount reasonably small - is a fairly easy source of free money.

If this is the first time you've experienced this, I'd strongly advise pursuing every avenue of accident investigation you can, even if the insurers aren't asking for it. A bit of "being awkward" now might save you a whole pot of trouble later.

(and before I get flamed, as happened to someone a couple of months ago - I know not everyone makes dishonest claims, and I certainly know that not every claim is dishonest. But some are)

Posted By Phil Grace
Wayne,
Previous postings are correct - it is not possible for employers to simply tell their insurers "not to settle". Insurers are not able to simply tell the claimant's solicitors to "go away". If the claimant continues to allege injury then it is possible that legal proceedings will be issued resulting in insurer having to go to court. As has been said it will be alleged that there was a dangerous situation, sweepings/trash containing hazardous substances etc... and it is for employer to prove that this was not the case, to establish that they were not negligent.
It must be remembered that if proceedings are issued and case goes to court costs rise dramatically and if insure/employer loses then they will have to pay all costs. Out of court settlements are often negotiated with each party bearing their own costs. A pragmatic but approach that is cheaper all round in the long run. On balance a very small % of cliams end up in court (less than 5%) and generally where there is a legal point to establish

I am aware of the argument that such an approach only encourages others - but each claim rests on its own facts. Each and every accident should be thoroughly investigated in case a claim is made. Insurers need information in order to mount a defence.
Phil

Posted By Barry Cooper
Wayne
Contrary to what has been said, I have to repeat that yes you can instruct your insurers not to settle. I have done it. Not many times admittedly, but have been successful on the few occasions I have.
Most insurers find it easier and cheaper to settle, without putting up a defence. They try to settle by a desk-top investigation.
Of course you have to demonstrate that you have controls in place, training, good housekeeping practices etc as previous responses have said.

Barry