You are a claims handler for an insurer. You have received a claim from one of the insurer’s policyholders, ABC Ltd, a bus company. One of ABC Ltd’s buses was involved in an incident which resulted in serious injuries to two pedestrians. The whole incident was caught on closed-circuit television (CCTV) cameras and the policyholder has accepted full liability. Pedestrian A claimed for loss of earnings, for a six-month period, due to reduced mobility as a result of the incident. Pedestrian B claimed for loss of earnings . Payments have been made to both pedestrians in full settlement of these claims. Subsequently, you have established that: Pedestrian A had been playing golf with no apparent mobility issues, during the period for which they claimed. Pedestrian B presented fake payslips in support of their claim. Pedestrian B has since moved overseas to another country. You are now seeking to obtain recoveries from pedestrian A and pedetrian B. Explain, with justification, two methods of recovery available to the insurer for the claims payment paid to pedestrians A and B. Refer to one statute in support of your explanation.

The methods available for recovery stem from the stipulations of the Proceeds of Crime Act 2002, which allows for the recovery of assets obtained through fraudulent means. The insurer could use two methods to recover money lost due to the false claims made by pedestrians A and B. First, under the Proceeds of Crime Act 2002, outlined above, the insurer could recover money that has already been paid out to insured parties when a conviction is confirmed.

Stated differently, when a court of law finds that the claimant received compensation for the loss based on false claims, it may order that the insured pays back the money. Alternatively, the law also allows insurers to recover similar proceeds when the compensated party has left the country. Such is the case involving pedestrian B because he had already left the country after receiving compensation.

Secondly, under first-party claims, the insurer has grounds to terminate the contract or only compensate the pedestrians on aspects of the claims that were genuine while recovering the money paid through fraudulent claims. Under the first-party claims principle, the insurer is allowed to terminate a contract after detecting fraud or when the fraud happens. They also have a right to recover damages made because of any fraudulent claims. Furthermore, if it chooses to terminate the contract because of false claims, it is not required to pay back the premiums paid so far.

Therefore, it could withhold any premiums made by the insured party after completing the falsified payments. This type of remedy is often employed when there are serious cases of contract violations. According to section 7(3) of the Insurance Act 2015, the relevance of the set of circumstances impacting claims settlement is important in determining the methods available for recovery. Subject to this statement, the non-disclosure of important facts relating to the mobility and trustworthiness of the victims is central in settling their claims.

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Academic.Tips. (2022) 'You are a claims handler for an insurer. You have received a claim from one of the insurer's policyholders, ABC Ltd, a bus company. One of ABC Ltd's buses was involved in an incident which resulted in serious injuries to two pedestrians. The whole incident was caught on closed-circuit television (CCTV) cameras and the policyholder has accepted full liability. Pedestrian A claimed for loss of earnings, for a six-month period, due to reduced mobility as a result of the incident. Pedestrian B claimed for loss of earnings . Payments have been made to both pedestrians in full settlement of these claims. Subsequently, you have established that: Pedestrian A had been playing golf with no apparent mobility issues, during the period for which they claimed. Pedestrian B presented fake payslips in support of their claim. Pedestrian B has since moved overseas to another country. You are now seeking to obtain recoveries from pedestrian A and pedetrian B. Explain, with justification, two methods of recovery available to the insurer for the claims payment paid to pedestrians A and B. Refer to one statute in support of your explanation'. 9 October.

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Academic.Tips. (2022, October 9). You are a claims handler for an insurer. You have received a claim from one of the insurer's policyholders, ABC Ltd, a bus company. One of ABC Ltd's buses was involved in an incident which resulted in serious injuries to two pedestrians. The whole incident was caught on closed-circuit television (CCTV) cameras and the policyholder has accepted full liability. Pedestrian A claimed for loss of earnings, for a six-month period, due to reduced mobility as a result of the incident. Pedestrian B claimed for loss of earnings . Payments have been made to both pedestrians in full settlement of these claims. Subsequently, you have established that: Pedestrian A had been playing golf with no apparent mobility issues, during the period for which they claimed. Pedestrian B presented fake payslips in support of their claim. Pedestrian B has since moved overseas to another country. You are now seeking to obtain recoveries from pedestrian A and pedetrian B. Explain, with justification, two methods of recovery available to the insurer for the claims payment paid to pedestrians A and B. Refer to one statute in support of your explanation. https://academic.tips/question/you-are-a-claims-handler-for-an-insurer-you-have-received-a-claim-from-one-of-the-insurers-policyholders-abc-ltd-a-bus-company-one-of-abc-ltds-buses-was-involved-in-an-incident-which-resulted-2/

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Academic.Tips. 2022. "You are a claims handler for an insurer. You have received a claim from one of the insurer's policyholders, ABC Ltd, a bus company. One of ABC Ltd's buses was involved in an incident which resulted in serious injuries to two pedestrians. The whole incident was caught on closed-circuit television (CCTV) cameras and the policyholder has accepted full liability. Pedestrian A claimed for loss of earnings, for a six-month period, due to reduced mobility as a result of the incident. Pedestrian B claimed for loss of earnings . Payments have been made to both pedestrians in full settlement of these claims. Subsequently, you have established that: Pedestrian A had been playing golf with no apparent mobility issues, during the period for which they claimed. Pedestrian B presented fake payslips in support of their claim. Pedestrian B has since moved overseas to another country. You are now seeking to obtain recoveries from pedestrian A and pedetrian B. Explain, with justification, two methods of recovery available to the insurer for the claims payment paid to pedestrians A and B. Refer to one statute in support of your explanation." October 9, 2022. https://academic.tips/question/you-are-a-claims-handler-for-an-insurer-you-have-received-a-claim-from-one-of-the-insurers-policyholders-abc-ltd-a-bus-company-one-of-abc-ltds-buses-was-involved-in-an-incident-which-resulted-2/.

1. Academic.Tips. "You are a claims handler for an insurer. You have received a claim from one of the insurer's policyholders, ABC Ltd, a bus company. One of ABC Ltd's buses was involved in an incident which resulted in serious injuries to two pedestrians. The whole incident was caught on closed-circuit television (CCTV) cameras and the policyholder has accepted full liability. Pedestrian A claimed for loss of earnings, for a six-month period, due to reduced mobility as a result of the incident. Pedestrian B claimed for loss of earnings . Payments have been made to both pedestrians in full settlement of these claims. Subsequently, you have established that: Pedestrian A had been playing golf with no apparent mobility issues, during the period for which they claimed. Pedestrian B presented fake payslips in support of their claim. Pedestrian B has since moved overseas to another country. You are now seeking to obtain recoveries from pedestrian A and pedetrian B. Explain, with justification, two methods of recovery available to the insurer for the claims payment paid to pedestrians A and B. Refer to one statute in support of your explanation." October 9, 2022. https://academic.tips/question/you-are-a-claims-handler-for-an-insurer-you-have-received-a-claim-from-one-of-the-insurers-policyholders-abc-ltd-a-bus-company-one-of-abc-ltds-buses-was-involved-in-an-incident-which-resulted-2/.


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Academic.Tips. "You are a claims handler for an insurer. You have received a claim from one of the insurer's policyholders, ABC Ltd, a bus company. One of ABC Ltd's buses was involved in an incident which resulted in serious injuries to two pedestrians. The whole incident was caught on closed-circuit television (CCTV) cameras and the policyholder has accepted full liability. Pedestrian A claimed for loss of earnings, for a six-month period, due to reduced mobility as a result of the incident. Pedestrian B claimed for loss of earnings . Payments have been made to both pedestrians in full settlement of these claims. Subsequently, you have established that: Pedestrian A had been playing golf with no apparent mobility issues, during the period for which they claimed. Pedestrian B presented fake payslips in support of their claim. Pedestrian B has since moved overseas to another country. You are now seeking to obtain recoveries from pedestrian A and pedetrian B. Explain, with justification, two methods of recovery available to the insurer for the claims payment paid to pedestrians A and B. Refer to one statute in support of your explanation." October 9, 2022. https://academic.tips/question/you-are-a-claims-handler-for-an-insurer-you-have-received-a-claim-from-one-of-the-insurers-policyholders-abc-ltd-a-bus-company-one-of-abc-ltds-buses-was-involved-in-an-incident-which-resulted-2/.

Work Cited

"You are a claims handler for an insurer. You have received a claim from one of the insurer's policyholders, ABC Ltd, a bus company. One of ABC Ltd's buses was involved in an incident which resulted in serious injuries to two pedestrians. The whole incident was caught on closed-circuit television (CCTV) cameras and the policyholder has accepted full liability. Pedestrian A claimed for loss of earnings, for a six-month period, due to reduced mobility as a result of the incident. Pedestrian B claimed for loss of earnings . Payments have been made to both pedestrians in full settlement of these claims. Subsequently, you have established that: Pedestrian A had been playing golf with no apparent mobility issues, during the period for which they claimed. Pedestrian B presented fake payslips in support of their claim. Pedestrian B has since moved overseas to another country. You are now seeking to obtain recoveries from pedestrian A and pedetrian B. Explain, with justification, two methods of recovery available to the insurer for the claims payment paid to pedestrians A and B. Refer to one statute in support of your explanation." Academic.Tips, 9 Oct. 2022, academic.tips/question/you-are-a-claims-handler-for-an-insurer-you-have-received-a-claim-from-one-of-the-insurers-policyholders-abc-ltd-a-bus-company-one-of-abc-ltds-buses-was-involved-in-an-incident-which-resulted-2/.

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