Insurer Refuses To Pay Out To Work Injury Victim
Insurance companies, along with banks and other financial institutions
, are not exactly top of the tree when it comes to popularity with the public.A story that the UK press reported this morning is unlikely, for the time being, to change that perception.
45 year old Joe Greensmith suffered a 'horrific' work injury in 2007 when a pipe with which he was working exploded in his face, leaving him needing thirty thousand pounds' worth of dental treatment and surgery to repair the extensive damage to his upper jaw. In addition to these physical problems, he has also since struggled with memory loss due to minor brain damage caused by the accident.
Proud to say he does not claim benefits, Mr Greensmith is instead locked in an intense battle with the insurance company Aviva, from whom he bought personal injury insurance to protect him against exactly this sort of eventuality.
Yet, the insurer, and the broker through which Mr Greensmith bought his policy, have decided to thus far reject any claim on his behalf, relying on the technicality that Mr Greensmith did not submit his timesheet for the week in April 2007 that the accident occurred. The reason for this? He was lying, heavily sedated, in hospital.
The payroll company through which Mr Greensmith usually paid his policy contribution, having not received the sheet, did not make that week's insurance payment. Aviva, and the broker Naylor Wright, argue that this invalidates the policy.
"Aviva has been totally heartless," says Mr Greensmith. "My life has been at a standstill since the accident and I have spent the past three years fighting them, rather than getting on with (things)."
He says he took the insurance policy out in good faith, since he did not wish his wife to become financially unstable if something should happen to him. Ironically, he is now relying on her. He has had to make over thirty visits to the dentist and recently needed a bone transplanted from his hip to his damaged jaw.
Refusing to just lie down and accept his lot, Mr Greensmith made a request under the Freedom of Information Act, which was granted, to see the correspondence between Naylor Wright and Aviva. The results clearly demonstrated that both parties initially agreed that to not grant the claim would be 'extremely unfair.'
However, as time progressed, they seemingly had a change of heart, with Naylor Wright in particular getting cold feet, fearing that awarding Mr Greensmith his work injury claim would 'undermine their position.'
The case has now been referred to the Financial Ombudsman Service, who have apparently recommended that Aviva pay up the GBP130,000 that Mr Greensmith requires, as well as 8% interest on top of that. However, they are still stalling and are awaiting the Ombudsman's final verdict before making any decision.
Aviva were in the news a couple of weeks ago when it was revealed they hired private detectives to track the movements of a taxi driver who they suspected had made a fraudulent work injury claim from them. He had been awarded GBP52,000.
Mr Greensmith's claim is for over twice that amount. It seems Aviva, although being very keen to separate clients from their money, are rather more reluctant to hand it back again.
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