Pathetic Aviva Scrape the Barrel

PDAH

At last, Insurers taking a stance against opportunism! It's just a shame that
they only do it with 6 figure claims rather than all of the frivolous £1200
"whiplash" claims that we all subsidise...

Rudekid48
Is that the same insurers that sell the whiplash claims and data...they are not backwards at going forwards when it comes to opportunism.

dacouch

I had a customer who was with Aviva, his very expensive car £70k was stolen and ended up in the local river.

The Insurers did not believe him and the police were also suspicious.

The arguments went on for months, eventually the Insurers tested the car key (The car had no signs of being stolen) The car key showed that it had been used when the car was stolen. The Insurers told me they knew he had done it and asked the client tell the truth as he was probably covered anyway.

Eventually he told the truth (after assurances the Insurers would not ell his wife). He had been out driving with his mistress and whilst driving he became "distracted" and drove through a fence and into the Thames. He panicked and came up with the story.

Aviva accepted the claim and excuse and paid out £70k which most companies would have refused to pay

PDAH

1. Mr David Pliener, who has appeared pro bono for Mr <a title="Previous Hit" href="http://www.bailii.org/cgi-bin/markup.cgi?doc=/ew/cases/EWCA/Civ/2012/634.html&query=yeates+and+v+and+aviva&method=boolean#disp28&quot; name="disp29"> Yeates (since his solicitors at the summary judgment hearing have come off the record) and to whom the court is considerably indebted for his clear and forceful submissions on Mr Yeates ' behalf, submitted in relation to the merits of any appeal:-
   
   
   i) it was no lie for Mr Yeates to
   incorporate a company rendering services to himself or for that company either
   to refer to Mr Yeates as a client
   or to charge a management fee for its services;
   
   
   ii) the judge did not ask himself whether Mr Yeates ' actions were
   knowingly dishonest but only whether Mr Yeates was open
   with insurers about his relationship with PMR which was the wrong question;
   
   
   iii) the question whether Mr Yeates intended to
   deceive the insurers should not be decided on an application for summary
   judgment; if it could in theory be decided, then the only permissible
   conclusion was that dishonesty had not been shown to the requisite Derry v Peek
   standards;
   
   
   iv) there was no evidence that insurers had actually been misled; the fact
   that they had paid a sum on account was attributable to the fact that there was
   a genuine claim;
   
   
   v ) the claim
   for a project management fee (which was in fact never paid) was for only 3% of
   the claim and should be treated as immaterial.

The above was the claimant's submissions...the fee seemingly was not paid. It was claimed but not paid.

Tirian

Dog with bone springs to mind.

Unfortunately for Mr Yeates, the claimant's submissions are not the determinant of the outcome of the case. The judges' decision is.

The judges clearly and unambiguously held that (a) the original judgement against the claimant was justified and (b) that the claimant had furthermore acted deceitfully in maintaining that he was unaware for the deadline for appeal, despite have been informed of it by his solicitors.

As for Aviva's actions being "harsh" - I'm not so sure. An arrangement by which the succesful fraudsters are rewarded and the unsuccessful fraudsters were not penalised would be gigantic moral hazard. You would be encouraging fraud, since there would be everything to gain and nothing to lose for trying it on. Insurance simply wouldn't be possible under such a regime.

raskazz

Mr Yeates tried it on.

Mr Yeates got caught.

No sympathy here. Life's a b!tch isn't it.

whitegoods_engineer

So the claimant had his claim paid, then got greedy and tried to screw another £9k out of the insurance company which backfired and he lost the lot!

Fantastic, I am laughing my head off at this. Glad the greedy chancer lost it all! Bit of good news for once!

PDAH

Think most of you are getting carried away with the tabloidesque headline of fraud etc. What Yeates did was, completely stupidly, was try to recover additional monies for work he did. Its akin to doing your own decorating or repairs and submitting the bill to the insurers. The work was project management not repairs but the attempt was entirely stupid. The work if invoiced by an at arms length company would be recoverable. So would you call that fraud, certainly not in the sense of claiming for an non existent loss? I also think that the juvenile attempt by Yeates was easily detectable and shouldnt have caused any problem to the insurer. They may have played along with it so they could cry foul. As far as the case went the insurers did an application for judgement was sucessful although the judge gave leave for appeal which the claimant did not do in time....but judgement allowed the insurers argument to succeed without a full hearing which was a shame because you would have got both sides of the argument.

Directline v Fox is similar but the claimant at least got to present his argument.

It appears if you want to do fraud on a large scale and go about it properly you have to be an insurer!

https://forums.moneysavingexpert.com/discussion/3620279

RobertoMoir

No normal honest person thinks "My house got flooded, quick, lets form a limited company."

The claimant got caught with their hand in the cookie jar. I don't blame the insurer for not paying out on this one. I don't think its the same as invalidating an entire £1000 claim over a dispute about a £30 item, as that's one of the OP's examples.

vaio

Tirian wrote: »

......You would be encouraging fraud, since there would be everything to gain and nothing to lose for trying it on. Insurance simply wouldn't be possible under such a regime.

but isn't that the inequality of it?

punter tries it on and if caught loses the whole claim

insurance company tries it on and if dragged to the FOS/court just has to pay what they should have paid in the first place

RobertoMoir

vaio wrote: »

but isn't that the inequality of it?

punter tries it on and if caught loses the whole claim

insurance company tries it on and if dragged to the FOS/court just has to pay what they should have paid in the first place

Why is that not equal? It sounds to me like both sides are betting the total cost of the claim against the outcome there.