Uninsured losses ... and No Fault insurance increases

vaio

I guess the statute for benefits recovery is needed to allow the state to recover directly from the at fault party rather then via the injured party whereas in tort they would be regarded as too remote.

As a matter of public policy it can only be a good thing that the at fault party picks up the costs rather than transferring them to the state/employer.

I'll get OH to dig out her T&C and post the exact wording for you to pick the bones out of it.

im-lost

Mine were as below, I'd assume they've had it checked over, one of the largest brewery companies in the South West employing thousands of people.

Still a bunch of !!!!!! though after dropping me like a hot potato after my accident, when they could have easily paid ssp instead of making me jump through the benefits hoops, who may I add are equally a bunch of shysters because I haven't even fully recovered and they are sniffing after their pound of repayment flesh, but they are just letting my ESA claim roll on without all the atos interviews etc, well, for the time being at least

"If your absence is occasioned by the actionable negligence of a third party in respect of which damages are recoverable and you receive any payments from a third party (including your own insurance company) in respect of damages for absence from employment due to incapacity, then any sum/s paid by the company to you in respect of the same period of absence shall constitute a loan to you and shall be recoverable by the company out of the amount of damages recovered by you under any compromise, settlement or judgement. You must notify the company of all the relevant circumstances and any such claim, compromise, settlement or judgement made or awarded"

vaio

InsideInsurance wrote: »

.........In all my days of claims handling I never once had a case where the TP claimed their contract of employment converted sick pay to a loan in any circumstances.....

I've never been a claims handler but I can't see why a loan (from my employer or anyone else) would need to be discussed as part of a loss of earnings claim.

I earn £50k a year, I've been unable to work for six months as a result of the accident so here is my loss of earnings claim for £25k. If asked "does your employer pay sick pay?" then the answer would be "no" as my contract of employment is clear that it's a loan from my employer along the lines of im-lost's version.

I'll give the OH a nag so we can see the LA version which would, I guess, be pretty wide spread.

InsideInsurance

vaio wrote: »

I've never been a claims handler but I can't see why a loan (from my employer or anyone else) would need to be discussed as part of a loss of earnings claim.

I earn £50k a year, I've been unable to work for six months as a result of the accident so here is my loss of earnings claim for £25k.

Typically I wouldn't be asking how much you earn or if you have sick pay or not. Depending on the length of the claim of LoE then typically I'd be asking for payslips or P60s covering the period both before the incident and during the claim.

From that I see you were averaging 3k a month take home before the accident, during the period of not working you took home a total of 6k so for your claim of 6months it would be 3k * 6 months - 6k received and so you get a cheque for 12k


Obv self employed is different especially as every taxi driver that ever claims has only been doing it for 9 months so have never done a tax return or anything else that gives an audited income but all are earning 150k a year working 8 days a week


Seeing the wording of the contract would be interesting as its not something I've come across and would be curious as to how enforcable it is. Eg have an accident whilst on holiday, TP is liable but has insufficient insurance (which in countries like the US is legal), does the employer really then claim the money back from the employee? If they receive a global settlement that is below the total claimed due to limited insurance who decides if what was received was for PSLA or LoE? If it is just a "friendly agreement" between employee and employer is it enforcable? Certainly with other things that have gone through the courts (eg IR35, masked employees etc) it has been deemed that a contract of convenience isnt necessarily binding - ie HMRC has recovered employers NI when the contract stated the relationship was not one of employee/ employer

InsideInsurance

im-lost wrote: »

"If your absence is occasioned by the actionable negligence of a third party in respect of which damages are recoverable and you receive any payments from a third party (including your own insurance company) in respect of damages for absence from employment due to incapacity, then any sum/s paid by the company to you in respect of the same period of absence shall constitute a loan to you and shall be recoverable by the company out of the amount of damages recovered by you under any compromise, settlement or judgement. You must notify the company of all the relevant circumstances and any such claim, compromise, settlement or judgement made or awarded"

I am not an employment law specialist but I personally would be questioning how legally enforceable/ compliant this would be given how ill defined it is and how broad spectrum.

For example, you have a narrow lane collision with a 50/50 settlement on liability with you having TPFT cover and had significant personal injury. Your heads of claim are 10k damage to your car, 50k loss of earnings (because of the sickness clause above) and 25k PSLA.

You receive a global offer of 80k and as its a 50/50 case you receive a cheque for 40k. Are your employers really legally going to be able to take all of it and demand that you repay them another 10k?