We quickly ascertained that the claimant had sustained massive brain injuries and for the last ten years had resided in a rehabilitation centre. Due to the passing of time, the original police investigation report was no longer available. Moreover, the driver had left our insured’s employment many years earlier and there were no available records relating to her whereabouts. We therefore had a real challenge in terms of getting the evidence needed to fully understand legal liability and, if necessary, defend the claim.
Louise utilised the services of her colleagues in our Global Investigation Services team, who were able to establish that the driver was living at the opposite end of the country.
This enabled Louise to obtain a witness statement, confirming that the claimant had stepped into the road and into the path of her vehicle without warning, giving her no opportunity to avoid a collision. From further investigation Louise was also able to identify and track down one of the police officers who had attended the incident and who had since retired. This witness also provided a statement, confirming that the insured’s vehicle did not mount the pavement. Both statements were disclosed to the claimant’s solicitors with a denial of liability. Matters were formally discontinued and a case reserve of £1.14M removed.
Every day in Casualty Claims across EMEA we deal with a variety of cases, many of which
are complicated and time-consuming. The circumstances are often unclear and the damages
and losses sustained significant. Through a dedicated and highly skilled team of Casualty
Claims adjusters we make sense of the confusion, identify the critical issues and get to work –
bringing those claims to optimal and fair outcomes for our insureds and for the claimants –
with minimum fuss and maximum expertise.
Here we recall some of those claims our adjusters have dealt with...
“A very sensitive matter
involving a dreadfully injured
young man, and a claim
made many years after the
event. Louise’s thorough and
effective investigation of a trail
gone cold ensured that a fair
and correct decision on legal
liability was made.”
In 2003, our insured’s driver was proceeding on a main road when she collided with a pedestrian – Mr M. The police attended and investigated the incident and as a result no charges were brought against our insured’s driver.
Nearly a decade later AIG were approached by lawyers acting for Mr M, with an allegation that the insured’s vehicle had actually mounted the kerb and collided with the claimant.
“Whilst one cannot lose sight of the
fact that this is a dreadful and tragic
event, Louise’s work has protected the
customer’s position and ensured that
the right call was made.”
Louise Walton
Major Loss Auto Claims Adjuster
Elixabete
Albela Martinez
Major Loss Casualty
Claims Adjuster
Page 2 of 5
In 2006 a fire broke out in one
of our insured’s storage and
distribution plants in Spain.
As a result, two neighboring
properties were severely
damaged and claims against
our German multinational
insured followed in the
Spanish courts.
Oliver in Germany and Elixabete in Spain worked on the claim together, Oliver liaising closely with the insured and Elixabete providing expertise in relation to local law and damages. They firmly denied legal liability on behalf of the insured, on the grounds that there had been no negligence. Oliver and Elixabete sought to argue that fault lay with the manufacturers of some defective equipment which, they contended, had caused the fire. In 2014 a Spanish Judge held that AIG’s assessment of legal liability was correct and that there was no culpability on the insured’s part.
“A cross border partnership
between our major loss adjusters
in Spain and Germany ensured
that the insured, quite properly,
prevailed at trial.”
Oliver Werner
Major Loss Casualty
Claims Adjuster
Miss L, a senior employee of a
large multinational company,
suffered catastrophic spinal
injuries following a biking
accident whilst competing in
a company sponsored team
event.
Recognising the dreadful personal tragedy to our insured’s employee, Martin worked fast to ensure that our £1.95M contribution towards a larger settlement pot was paid within months of the claim being made.
Our multinational policyholder had taken a great interest in the case, and was keen to make sure that Miss L, a highly regarded member of the organisation, was well cared for, and were ultimately delighted with the outcome.
“Thank you very much for all of your assistance in working with
us to get this done in such a timely manner. We, too, felt it was a
good result and we’re very happy not to be in litigation with our
employee, who suffered such an extreme loss. We appreciate the
partnership with AIG. Thank you again.”
Martin Dawson
Major Loss Casualty
Claims Adjuster
A 48 year old technician employed by one of the subcontractors suffered serious injuries following a fall of fourteen feet, whilst trying to install cables at ceiling level.
The claimant had exited the cradle of the site lift and removed his harness to climb on top of a metal cabinet, which had been recently installed. The cabinet subsequently collapsed and the claimant suffered career ending trauma, including a badly fractured foot and severe back injuries. He never returned to work. Our insured, as the main contractor, were named as one of the defendants, alongside the claimant’s employers and the engineering company who were responsible for the claimant’s supervision on a day to day basis. Jim took the view that there was no culpability on the part of our insured, arguing that liability rested with the engineering company and the subcontractor, with substantial contributory negligence on the part of the claimant. The engineering company believed however that as the main contractor our insured had a liability of 50% and therefore the case was heard at the High Court.
Our insured were the main
contractors on an office
and residential apartment
block development project
in Ireland.
“Jim’s tenacious and justified
denial of legal liability, on
behalf of the insured, ultimately
ensured no damages exposure
to them, and protection of their
claims experience.”
Nick Denham
Major Loss Casualty
Claims Adjuster
Jim Lynch
Major Loss Casualty
Claims Adjuster
“It actually goes some way to
restoring our faith in the legal
justice system, and the use of
common sense. We would also
like to thank AIG in having faith
in ourselves, Thanks again.”
Insured’s Company Director
The claimant and his legal team sought €895,000 damages plus the same again in legal costs. The case had run for 3 days when Jim’s robust position paid off – the Judge accepted his argument that the main contractors were too removed from supervisory responsibilities. The injured claimant thus received fair and proper compensation from the two other defendants. Our insured, quite correctly, had nothing to pay.
A claim was received on
behalf of Mr A, an employee
of our insured, alleging that
he had received a blow to
his head when a piece of
debris fell from a defective
crane. Three days after
the alleged accident Mr A
collapsed at home and was
rushed to hospital, where he
underwent emergency brain
surgery. Significant damages
were sought.
Our major loss adjuster, Nick, immediately contacted the insured who were rather astonished that a compensation claim was being pursued. For whilst the employers were aware that Mr A had recently undergone major surgery, the alleged accident came as news to them.
Nick therefore organised some background checks on the claimant which revealed that he was known to the police. Detailed statements were taken from the four colleagues whom Mr A claimed had witnessed the accident and would support his version of events. All four individuals confirmed that the accident had never occurred.
Nick was also able to prove, through a detailed analysis of documentation, that there was nothing wrong with the crane at the time of the alleged incident. Nick denied legal liability on the grounds that no accident had occurred as alleged, and much to the delight of our insured, the matter was withdrawn.
An issue arose when the distributor’s
specialized staff discovered that tubes supplied by our insured had a faulty printing design. The lettering was not only blurred, but also easily removable. The claimant quickly filed for damages, seeking compensation for manufacturing costs, inspection and sorting expenses, loss of profits and loss of their license for the end product.
Matthias scrutinized the statement of loss forensically and such was his attention to detail that we were able to successfully challenge numerous items. Following several rounds of negotiation on behalf of the insured, AIG were able to agree a settlement with the third party at approximately one third of the amount originally claimed.
Our insured’s legal department expressly thanked Matthias for his efforts in settling this case.
The insured manufactured and
delivered tubular packaging
to the claimant, a leader in
the production of beauty,
and cosmetic products.
The claimants would fill the
packaging tubes, supplied by
our insured, with various types
of hair and shower gel, and
then sell the end product on
to distributors.
“On behalf of our insured Matthias scrutinized the
statement of loss forensically and such was his attention
to detail that we were able to successfully challenge
numerous items.”
Matthias Karaus
Major Loss Casualty
Claims Adjuster
Page 4 of 5
Sarah Scott
Major Loss Casualty
Claims Adjuster
Recent feedback from a broker
to Sarah Scott following the
settlement of a highly complex
personal injury claim
“Hello Sarah, Such wonderful
news, for all parties. The insured
were (and are) so very relieved
when I called a few minutes ago
and very grateful of course! Thank
you so much for your considerate
handling – it was an added
burden placed on you all and you
have served us admirably.
On top of that, to keep having to
ask you how the case sat regularly
as the insured asked, you showed
so much patience and supplied
us with an incredible amount
of information each time. I’m
not sure I could have been so
patient! Thank you for such a
good result all round and such
empathy showed to us along the
way. (You are very approachable
as you show such empathy!) We
will keep our fingers crossed the
courts approve this in due course.
Have a great weekend – it is well
deserved!”
“Martin’s ability to cast doubt
over, if not fully repudiate, many
aspects of the claim led to Mr S
accepting a nominal amount in
full and final settlement.”
being underpinned by the specific suggestion that the ladder was old and defective. With all the hallmarks of a potentially expensive “pain” case – our major loss adjuster, Martin, identified numerous issues that didn’t ring true; co-workers described as “witnesses” knew nothing of the incident; alleged prior complaints about the condition of the ladder had no corresponding defect sheet record as per company requirements; there were conflicting stories from the claimant with regards to the precise mechanics of the incident, and his physical reaction to what were effectively soft tissue injuries seemed disproportionate. Martin focused on obtaining forensic medical and surveillance evidence and eventually this work bore fruit. Whilst Martin could not quite prove that the incident did not occur, his ability to cast doubt over, if not fully repudiate, many aspects of the claim led to Mr S accepting a nominal amount in full and final settlement. The resultant £520K reduction in case reserve has gone a long way to protect the insured’s claims experience.
A claim was made by a Mr S,
who allegedly suffered an
injury whilst employed as a
delivery and maintenance
driver. Court proceedings
were served, with a demand
for over £975K plus costs.
Mr S, the claimant, drove a light goods vehicle which had an integrated ladder that he was required to use in his role. The claimant alleged that he had slipped and fallen whilst descending the ladder, causing a wrenching injury to his lower leg. Mr S never went back to work and pursued his seven figure claim on the basis of breaches of the Work at Height Regulations and the Provision & Use of Work Equipment Regulations, his case
