Loss of insurance benefits

Loss of insurance benefits

I was involved in a pretty nasty crash a little over a year ago. I needed a full year off work and have returned to work part-time. The insurers for the other driver have been perfectly decent.

Liability was admitted swiftly, I have had rehabilitation, some adaptations to my rented house (and a promise to remove them and make the property good once I move out), specialist spinal physiotherapy and my lost wages have all been paid along with all of my kit being replaced. They even provided me with a taxi account so I can get about.

Then the person dealing with the claim at the insurance company changed and I was told that despite the fact I am on part-time wages, there would be no more interim payments and the spinal physiotherapy, essential for managing my pain, would be stopped unless I disclose my medical records.

My solicitors seem completely unsettled by this. I do not want my medical notes to go to the insurers as there are very personal things on there including counselling that pre-dates the accident. My injuries are now stable.

I am able to cope with part-time work, but my medical team has told me that my injuries are unlikely to recover much further and I am unlikely to ever work full-time again, as I need rest periods between days working. My employer’s occupational health people seem to think the same and my job has been reduced from five full-time days a week to Mondays, Wednesdays and Fridays, 10am to 4pm. What should I do?

Answer

You really have three choices. Option one is to go along with what the insurer says, which is a truly bad option. It never plays well to encourage insurers to be belligerent or difficult.

Of your two remaining options, you can give disclosure of relevant medical Information. You are not bringing any form of psychological claim so there is no relevance to the counselling you had all those years ago.

If the case goes to court and the insurers or their solicitors demand sight of your full medical records, a method which has worked very well for me is to say to the insurers; “Here are all the medical records apart from two completely irrelevant matters. If you are going to insist on seeing matters I say are irrelevant, we will put them in front of a judge in a sealed envelope. The judge can open it and decide whether those documents are irrelevant or not.” I have had very similar cases and in every one, the judges have said these documents are irrelevant – and that’s the end of the matter.

Your third option – which I would be most tempted to go for because your position has now stabilised and you know your likely ability to work – would be to issue proceedings in court quickly. Despite having been perfectly decent for the first year, the insurers have now decided to play hardball. It sounds like the person who has taken over the claim for the insurers is newly promoted, so has decided to start laying the law down to injured people. That never goes down well with me, or most judges.

My strong feeling is that you should be getting a spinal surgeon’s report ready as quickly as possible and asking your solicitors to issue proceedings, thereafter applying to the court for an interim payment, which is bound to succeed. The tests are well known and you meet them. You have a substantial claim, liability is not in any issue and the third party is insured. You’ll win and the insurers’ belligerent claims manager will have to explain why all the good work done by his predecessor has just been undone and legal costs are going up.

Andrew Dalton

RiDE Magazine January 2018

Posted by Andrew Dalton. Last modified: March 26, 2018 at 11:26 am

Andrew Dalton is a highly experienced trial lawyer who delights in taking on difficult and demanding motorcycle cases. He has a tough and relentless litigation style and is utterly focused on getting the best possible outcomes for his clients.

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