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Angelo shanahan  
#1 Posted : 08 July 2016 07:59:21(UTC)
Rank: Forum user
Angelo shanahan

Good morning all, Currently have a claim going through for an accident at work, The IP has been supported all the way through process, full pay for six month, occupation therapy, home visit, amended duties - hours. None of the above have been deemed by the IP as enough, the actual accident at work was partially his fault, (wrong side of a cordoned off work area). The injury received was soft tissue damage. The IP has ongoing low back pain attributed to soft tissue injury. To date, no investigation has identified serious spinal pathology. As I have grown more frustrated with the individual I have taken a closer look at what he is doing he has been ding whilst off on full pay. There are gaps in his pain medication, up to 4 weeks sometimes, the IP is now off again. I have been informed he is attending the gym, socializing ie drinking during the day and generally enjoying his time off. His last Occupational Health visit, he stated 'that he is having difficulties with light household chores, sitting for long periods and some aspects of self-care in terms of dressing and putting his socks on. A claim was put in within 4 day of the accident, this is ongoing and I am awaiting what damage value is they seek. Has anyone any experience of using a private investigator?, would it be beneficial in disputing elements of the claim? anyone experience or recommendations for someone that would cover greater Manchester? Kind Regards Angelo
WatsonD  
#2 Posted : 08 July 2016 08:14:18(UTC)
Rank: Super forum user
WatsonD

Just playing devils advocate to your post here, but: Is your informer(s) information solid? Going to the gym could be medically advised as part of this therapy, sometimes the NHS even pay for membership. Drinking during the day could also be a sign of stress/ depression brought on by the accident; also, just because someone is in a pub doesn't mean they are drinking alcohol. All I am suggesting is, tread carefully. If you want to build a case you have to consider all angles.
stevie40  
#3 Posted : 08 July 2016 09:57:44(UTC)
Rank: Super forum user
stevie40

Have experience - yes, I work in insurance and did a few years in an injury litigation team. I have to ask though, why are you even considering this? You should just pass on all your concerns to your EL insurer and let them appoint an investigator if they agree with your concerns. Insurers use specialist investigation firms who know all about civil court evidence procedures and disclosure rules. There are also very strict rules about entrapment and evidence staging. In the past, it was not unknown for a PI to let down or damage a claimants car tyres and catch the claimant on film changing the wheel. Clearly this is not permitted.
alexmccreadie13  
#4 Posted : 08 July 2016 10:21:59(UTC)
Rank: Super forum user
alexmccreadie13

Being in a high risk industry I am in complete agreement with Watson D. Stevie40 gives the best advice. Do pass your concerns on if you stick to your guns your insurers will pursue the case as it means if they can prove inaccuracies then it will reduce any possible pay out. Ta Alex
Angelo shanahan  
#5 Posted : 08 July 2016 10:30:12(UTC)
Rank: Forum user
Angelo shanahan

Thanks for the responses so far, Information is pretty solid, three separate sources, three separate instances over a four week period He has been offered counselling, attended for a short while and been signed off as mentally sound / stable by both NHS and then by PMI who we use for occupational health. I meet with the IP each week to discuss physio, rehabilitation, general well being ect. NHS have stopped his treatment as as far as they are concerned there is nothing left to gain. We have offered more which has been declined. We have a list of questions to ask, can you walk 200 meters with shopping, can you reach a high cupboard etc, always answered no The pain medication he is using, can not be taken with alcohol, he took pictures of himself in a beer garden, posted on facebook then deleted them. Again I am told that he is regularly out in the city center clubbing etc More of an affect on general employees moral, Our insurance company has looked at this, and may possibly appoint someone, if I am honest they are not particularly proactive, or the adjuster I am dealing with is not. I have dealt with this individual for 6 months, expended a lot of time and energy, my gut feeling is he is he taking the Michael and abusing the situation. All responses welcome, more frustrated than anything as the situation has stagnated. Kind regards Angelo
Andrew W Walker  
#6 Posted : 08 July 2016 10:33:43(UTC)
Rank: Super forum user
Andrew W Walker

Great advice above. I have recently had doubts about the validity of a claim and passed it to our insurers to deal with. I would not advise that your company does anything other than pass on the concerns. Andy
stevie40  
#7 Posted : 08 July 2016 12:20:33(UTC)
Rank: Super forum user
stevie40

Angelo - ask the loss adjuster to undertake (with insurers permission) a Social Media Background Investigation check. It will come as no surprise to many of you that insurers and their agents do look at FB (and other social media) profiles to catch out the fraudsters. Often it is the first step and the results will then decide whether to use very costly covert surveillance methods. If you are not happy with the adjuster, express your concerns to the insurer, perhaps via your insurance broker. The broker is there to fight your corner.
HSE Chris Wright  
#8 Posted : 08 July 2016 13:53:58(UTC)
Rank: Forum user
HSE Chris Wright

Angelo, With the best intentions in the world a PI in this case would do very little in my opinion. the legal teams would just find a suitable reason for each activity. I also doubt that with the amount this claim will raise to would even be worth the legal teams time fighting. If you say it's partially his fault it would be more practical to aim for a 50% deduction in his claim for contributory negligence.
sadlass  
#9 Posted : 08 July 2016 20:48:38(UTC)
Rank: Forum user
sadlass

Angelo. Try to detach. Discuss your views with insurer if you can, but they will deal and pay out (although there may be an excess to pay by the company - but not by you!). However difficult and frustrating this may seem, it is not your problem. I am assuming you are the safety adviser, not the line manager or HR. You (presumably) helped with any investigation, and the person's line manager (presumably) has also been overseeing the absence. I don't know why you are involved in meeting this person on a weekly basis. It's time that management stepped up to the plate! It is an absence matter now, the cause is irrelevant, as is the civil action. Once pay goes down (after 6 months?) there may be a swift recovery. Also if talk turns to the future . . . Unless you are also the HR manager, step away.
Victor Meldrew  
#10 Posted : 09 July 2016 18:00:49(UTC)
Rank: Super forum user
Victor Meldrew

Plenty of good advice here Angelo & clearly something needs to be done to improve worker morale, which obviously concerns you. Issue can escalate if the IP is successful in getting a 'payout'. One experience I had whilst engaged by a client was to 'follow' a claimant who was thought to be pulling a fast one - I found that the IP was a boxer, cage fighter & bouncer when not at work - not surprisingly this was where he received his injury, which he claimed was partly due to his work. When the IP was confronted with the evidence the claim process ended. A good message sent back to the remaining workforce, which is what you want. So can your company/insurers sort accordingly? I must add however, that my aforementioned event was long ago & before Data Protection, Human Rights & other goodness knows what other legislation individuals can now use to wriggle out of the truth / facts.
Angelo shanahan  
#11 Posted : 11 July 2016 12:34:39(UTC)
Rank: Forum user
Angelo shanahan

Insurance have now appointed an investigator, I have had a cup of tea and a chocolate biccie so back in a nice happy place. thanks for all you comments, Kind regards Angelo
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