Question 9 – Across more than one Learning Outcome (30 marks)
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 seriousinjuries to two pedestrians. The whole incident was caught on closed-circuit television (CCTV) cameras andthe 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 theincident.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 theyclaimed.
• 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 paymentpaid 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 haveexplained in (b) above.(8)