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.
(a) Explain, with justification, how the false information provided by pedestrians A and B differs in law.
Refer to one relevant case in support of your explanation. (10)
(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. (12)
(c) Identify, with justification, the burden and standard of proof for each method of recovery you have
explained in (b) above.
Sample Solution