Advice Please - Insurance Co Settled Claim without our knowledge

[Prudence]

Hi all, would be so grateful for any advice.

 

Back in July last year, my husband was slowly reversing in a carpark when it was claimed he reversed into another vehicle. He does not believe that this was the case, both vehicles were back to back. When my husband got out the man of the couple was near the vehicle and the woman was coming from a nearby building. They exchanged names, address, tel nos. My husband could see no damage to either vehicle. He tried to take a photograph on his phone but the couple jumped in the car and sped off.

 

My husband tried to ring the woman concerned a little while later but the man answered and said she was 'at the hospital'. We were called by the police and asked to produce insurance documents etc which we did. We were amazed to receive a letter and papers etc from a well known 'no win no fee' solicitor a few days later. The woman was claiming injury, loss of earnings and all sorts. My husband phoned his insurance company and explained. They asked us to forward them the letter and not to worry about it at all. We did so and heard no more about it until yesterday. We have received Court Claim papers!!

 

We phoned our Insurers this morning and they say that they wrote to us at the end of October to say the other side had a witness etc & to ask us if we had any further details. We never received that letter. So apparently they just went ahead & settled the claim! The lady I spoke to assumed that this claim received today was for the balance of a discrepancy in the amount. We are furious as we did not receive the letter and when I pointed this out, she said they just go ahead, they don't chase up or anything! They didn't even call us! Nor did they write afterwards to tell us what had happaned! The Insurers said to just forward these Court papers on to them and they will deal with them. But they are addressed to my husband personally!

 

They just went ahead without any word, agreement, signature, diagrams or anything from my husband! Now we have a claim against us on our record We have recently spoken to the broker who is looking into this for us but I would be interested to know where we stand legally. Any advice,thoughts? Many thanks.

[Desperate Daniella]

This appears to be a [problem]. It is well known that these things happen.

 

I think your insurance company is at fault, obviously, for not trying harder to contact you in October, but it's what to do now that's important.

 

Firstly, I think you should ask for copies of the original claim which the insurance company settled on - I'm assuming you didn't keep a copy? - and see if any proof has been given with regard to injury, loss of earnings and so on. Did any of this come with the Particulars of Claim that you received today?

 

The insurance company should have checked their names on a register to see if they have made any claims like this before, but may not have done so.

 

It's highly suspicious that they bolted when your husband tried to take photos of the damage. What witness? How did they have time to speak to a witness if they bolted?

 

If they are taking you to court for the balance of something your insurer has already paid, you can defend the action and hold them to strict proof of their losses. Send an acknowledgment to the court saying you are going to defend. This has to go within 14 days, and you'll then get another 14 days to put file your Defence at the Court, which should give you enough time to get the documents together/investigate further.

 

DD

Edited February 17, 2010 by Desperate Daniella
sp

[Prudence]

Thankyou so much for your reply Daniella. Yes, we have the original papers, I did keep a copy. I will get them out and have a look at them. I believe I saw mention of a hospital report. The papers that came today seemed very confusing. There was a schedule of 'predictive costs' attached. I will have a look at the papers and come back later. Thanks again.

[Mossycat]

I'm confused

 

If you received Court papers yesterday, what have your insurers actually paid out for?

 

Mossy

[Desperate Daniella]

Predictive costs is a threat. How much are they quoting for these?

 

It's very easy for anyone to go to hospital and moan and groan a lot.

 

Do you know how much your insurance company paid out for this?

 

Also, your husband is pretty clear that there was little, if any, damage to their car. What kind of injury is she claiming? We are talking about reversing in a car park. Even if your husband had done what they say, it's hardly likely to have injured anyone badly at the speed he is describing. If he'd been reversing at great speed and banged into them it would be understandable if she had some kind of injury, but clearly he wasn't.

[Prudence]

Hi, thank you Daniella and Mossycat for your replies. The original papers state the claim consists of the following: Peronal Injury, Possible loss of earnings,Special Damages. The current papers attach a schedule of Predictive Bill of Costs. Value of the settlement for Personal Injury (General Damages) and Special Damages was around £2500 Then underneath that it says Predictive Profit Costs, success fee, disbursements, all amounting to another around £2500!!!

There is no correspondence attached from our Insurer, only their solicitors letter (dated November) which appears to accept an offer from our Insurers of around £2500. So I am deducing they are seeking another £2500 'predictive costs' whatever they are!

This is unbelievable, what can we do?

[Mossycat]

Hi, thank you Daniella and Mossycat for your replies. The original papers state the claim consists of the following: Peronal Injury, Possible loss of earnings,Special Damages. The current papers attach a schedule of Predictive Bill of Costs. Value of the settlement for Personal Injury (General Damages) and Special Damages was around £2500 Then underneath that it says Predictive Profit Costs, success fee, disbursements, all amounting to another around £2500!!!

There is no correspondence attached from our Insurer, only their solicitors letter (dated November) which appears to accept an offer from our Insurers of around £2500. So I am deducing they are seeking another £2500 'predictive costs' whatever they are!

This is unbelievable, what can we do?

 

The first and most important thing that you need to do is to get that paperwork to your own motor insurers.

 

Then follow it up with a telephone call to your insurers and ask them to confirm any payments they have made, any offers of settlement they have made and ask for the reasons why. Reaffirm to them the accident circumstances and ask why they are making offers/payments in this instance.

 

Post back when you have done this, that will enable us to give you more definitive answers than simply speculating.

 

Mossy

[Prudence]

We very much think he was set up. He did not feel any bump he just saw someone (presumably the witness) knocking on his window and shouting at him that he'd hit the car behind. He got out and the rest is as above. We do have a witness (if we can find him). The claim forms actually arrived in an open window envelope, the position of the address bears no relation to the position of the window! There is a Claim Form and an Acknowledgment of Service (part 8 costs only claim)

[Prudence]

Thankyou Mossycat,we will do that. The paperwork will go first class recorded delivery tomorrow. We shall phone the Insurers and ask the questions you outlined. In the details of claim it says 'predictive costs were served on the defendant's insurers on XX Nov however the defendant's insurers have failed to remit payment for the balance of the ATE policy.' Thanks again.

[Desperate Daniella]

Hi Prudence,

 

Agree with Mossycat. We need more information.

 

They sound like total con-merchants. You poor things.

 

DD

[Desperate Daniella]

Also, whatever your insurers did, they should not have left you open to this further claim, which I think is a try-on. Even if the accident had been your fault (if it occurred at all) you should only be liable for the excess on the policy. What they paid should have been a full and final settlement of this claim. It it wasn't, why not?

[Mossycat]

What they paid should have been a full and final settlement of this claim. It it wasn't, why not?

 

That's what I was wondering too.

 

Even if it was made as an interim payment it wouldn't or shouldn't warrant this kind of action from the third party solicitors.

 

Mossy

[Prudence]

Thank you DD and Mossycat. Much appreciate your support here. Just having a quick look in before I go to bed. Have just had a good look at the envelope the claim forms came in and it is franked by the court but dated 15 Feb, although the actual claim forms are stamped 8 Feb!!!! Very strange. It's a miracle they got to us as well as the only possible way they could have was by the post office opening the envelope!

[Endymion]

To be honest, from what you have posted it seems that there is little you can do in regards to the claim.

 

It would appear that your insurers have made an offer to settle and this has been accepted. As such, this forms a binding contract between your insurers and the Claimant and failure to pay it can result in proceedings being issued to enforce payment against YOU.

 

However, I suspect what has happened is that these may be Part 8 proceedings in respect of costs due to the damages having been paid, although as it was an RTA it should have been predictive costs and as such, the amounts fixed - unless your insurers pleaded that it was an LVI and it was therefore put into the multi-track and the predictive costs.

 

In order for us to give you better advice can you advise the following:-

 

1. In the bottom left hand side of the claim form does it say N1 claim form or N208 claim form?

2. In the particulars of claim does it confirm if any payments have been made, offers in respect of liability made or part 36 offers made?

[Desperate Daniella]

Hi Endymion,

 

I am confused here. Even if the insurers pleaded that it was a LVI, surely Prudence (and the rest of us) are covered by our insurance companies for any type of accident, whether LVI or head on collision? Why wouldn't Prudence be covered for an LVI accident in full?

 

DD

[Endymion]

OK - pleading that the claim was an LVI means that in effect, the insurers are pleading that the Claimant is making a fraudulent claim. As such, and due to the serious nature of the allegations, the claim is usually moved from the predictive fast track costs scheme and into the multi-track where costs are just assessed on the standard basis. This does not mean that your insurance will not cover you, it just means that there will be more negotiation as to the level of costs paid to the Claimants if they are succesful in their claim and it is more likely that Part 8 proceedings are issued for a detailed assessment of costs.

 

However, saying that, I doubt LVI was raised in this matter as it would be unlikely any insurance company would settle until they had their own medical evidence, and/or witness evidence from their insured and/or any independant witnesses and/or engineers specialising in LVI claims.

 

Does this make sense?

Edited February 18, 2010 by Endymion

[Desperate Daniella]

Yes, what you have explained does - but this whole thing doesn't!

 

Let's see which forms Prudence got.

 

DD

[Prudence]

Hi & thank you Endymion. It says N208 in the bottom left hand corner.

Details of claim do not mention payments have been made, just

asking for Predictive Costs.

 

We have now heard from our broker who has rang the insurers for us. Apparently a sum of almost £6000 was paid out to include car damage,personal injury, special costs, solicitor's costs. They had two witness statements & the insurers said they went ahead because of timescales, they had a summons, etc, and because they had the two witness statements. Also they put all the fault on us! The broker said they didn't even do a 50/50 as they usually do in such circumstances! Unbelievable! I've never heard of insurers paying out so easily! We had phoned them and told them the circumstance at the time, yet they still went ahead after no reply to 1 letter which we didn't receive; no follow up letter, no phone call, no email to us or the broker! We don't care if the Insurers want to be defrauded and pay them out thousands, that's up to them, but not for us to suffer the consequences!!!

[Endymion]

Oh dear. Yes, the claim has been issued for costs only as the damages have been agreed.

 

There is, i am afraid, nothing you can do regarding the settlement then.

 

Remarkable that your insurers have settled such a claim without making you an essential and large part of the defence.

 

Personally I would contact your insurers and say that you dispute the settlement in this matter and that as a result you wish for your no claims bonus to remain unnafected (in the end it's their money and if they want to dish out thousands of pounds for a potentially fraudulent claim then thats their problem - if it doesn't affect your NCB and future insurance costs).

 

State that the claim was emminently defendable on both liability and causation and they have failed to act in you best interests. If they dispute this I would refer it to the Insurance Ombudsman.

 

I would also ask to speak to the claims handlers manager who dealt with the claim to inform them said claims handler is an idiot.

Edited February 18, 2010 by Endymion

[Desperate Daniella]

This is unbelievable.

 

The insurers have been totally incompetent, and I suggest you tell them that unless they totally indemnify you against ALL costs you will report them to the Insurance Ombudsman immediately. Call them and tell them what Endymion has said above.

 

They made no proper attempts to contact you, and have left you facing this costs claim.

 

Outrageous.

[Prudence]

Thankyou so much, very much appreciate your advice. Have sent the claim papers to insurers and am putting together a letter of complaint. We have been talking about this constantly for two days with family members. So many things beggar belief. They wouldn't hang around long enough for my husband to call the police or take photos, yet went to the police afterwards as the police called my husband and he had to go to the police station to show his insurance documents! Not surprising they sped off, they had work to do! They were down the hospital pronto, then the police and the next day the 'no win no fee' solicitors (as the letter from them to us was dated the very next day after the incident). How come they went to a solicitors? It's not normal practice.

We have so many questions. Are we entitled to know the full facts and see all the evidence?

[Mossycat]

I've just caught up with this thread and I'm shaking my head in total disbelief at what your insurers have done.

 

This has all the hallmarks of a [problem], do as Endymion has suggested, that's quality advice.

 

Just to answer your last question, it is normal to go to a solicitor if personal injury is involved but the speed at which they have acted suggests you are not the first 'accident' they have had, it certainly sounds like they knew exactly how to play the system.

 

Mossy

[Prudence]

Thanks Mossycat. I'll let you all know what sort of response we get from the insurers. Just one last thing, we sent the claim papers on to insurers as instructed by them. The papers named my husband as defendant but as they requested these, I'm assuming the insurers can deal with this court claim on our behalf? We don't need to get in touch with the court, do we?

[Mossycat]

Your husband had to be named as the defendant, your insurers can act on his behalf in Court (in reality they will instruct a solicitor to do that)

 

You don't need to advise the Court, but you may be required to attend (I say may be required but that depends on if they want to defend it, which doesn't seem likely given what they have already done)

 

Mossy

[Desperate Daniella]

Hi Prudence,

 

This is so shocking. If your insurers intend to settle and pay it all then they may not provide you with the evidence, although I would ask to see it in any case.

 

They have the responsibility for all of this and, as we've already said, under the circumstances your no claims bonus should not be affected because they mishandled it.

 

DD