At McClarrons, we know that care providers operate in a uniquely high-risk and high-pressure environment. When a serious liability claim is made, the emotional and financial stakes can be enormous. This recent case study highlights how a collaborative, forensic approach from broker, insurer and legal teams helped bring about an excellent resolution for a client facing one of the most serious and complex claims we’ve supported in recent years.
The incident
In late 2022, a member of staff at a care provider suffered a severe back injury while attempting to manually assist a service user. The claimant was diagnosed with a rare and serious condition affecting the spinal cord that can result in temporary or permanent paralysis, alongside other life-changing issues.
At the time of the incident, internal risk assessments and protocols required two carers to be present when lifting this particular service user. However, it emerged that on the day of the incident, one carer had left the premises, leaving the claimant to undertake the lift alone.
This breach of procedure had significant consequences: the injury flared a previously existing condition and the claimant, then in their early twenties, became temporarily wheelchair-bound, required hospitalisation and surgery, and reported being unable to work.
The claim and the challenge
A claim was submitted by the injured party, with an initial reserve placed by the insurer at £2.6 million. The scale of this reserve reflected the potential long-term loss of earnings, ongoing care costs, and significant medical intervention anticipated due to the claimant’s age and prognosis. Understandably, this caused great concern for the client, who had never encountered a claim of this scale before.
Adding to the complexity was a request from the claimant’s solicitor for a £100,000 interim payment, which was rejected for several reasons, not least because liability was denied, and the client and their insurer did not believe the claimant would ultimately succeed in their claim.
Investigating liability
Working closely with the client, the insurer’s major loss team and appointed panel solicitors, launched a robust investigation. The key question was whether the client’s internal procedures and processes had been sufficiently communicated and were practiced, and whether the incident could have been prevented.
Surveillance and digital evidence played a vital role. During our investigation, it became clear that while the claimant was alleging immobility and loss of work, their public social media presence told a different story. Images and posts showed the individual on nights out, enjoying New Year celebrations, and even announcing a new role with a new employer.
This intelligence was passed to the legal team and insurer, who used it to challenge the veracity of the claim. Crucially, it helped to undermine the suggestion that the client’s actions had caused long-term, career-ending harm.
The outcome
After sustained efforts over several years, and just months before the limitation period was due to expire, the claimant’s solicitors confirmed they would no longer be pursuing the client. Instead, they indicated their intention to pursue the NHS for alleged medical negligence relating to the claimant’s treatment.
As a result, the client was completely exonerated from liability. What began as a potential multi-million-pound claim was resolved with only minimal defence costs, which were covered by the client’s policy, saving the client an enormous financial and reputational burden.
The impact
The client expressed their sincere relief and gratitude at the outcome. Having faced the potential of serious financial exposure and increased resultant premiums at renewal, they now face a significantly improved risk profile with the insurer, with no major liability claim affecting their insurance position.
For care providers, this case serves as a powerful reminder of the importance of diligent procedures, clear record-keeping and early, proactive engagement when a claim is made. It also highlights the vital role of using an insurance broker who is not just there for the placement of insurance, but in defending the interests of their clients when it matters most.
How McClarrons can help
Claims management represents just one aspect of the comprehensive service we provide as a trusted, independent insurance broker. By arranging your cover through McClarrons, you benefit from a broad range of services and support that extend well beyond the claims process. To learn more about how working with a broker can enhance your insurance experience, we invite you to read our blog, The Benefits of Using an Insurance Broker.
You can also find many of our other success stories and case studies on our News webpage here.
