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England and Wales High Court (Queen's Bench Division) Decisions |
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You are here: BAILII >> Databases >> England and Wales High Court (Queen's Bench Division) Decisions >> Joseph Fielding Properties (Blackpool) Ltd v Aviva Insurance Ltd. [2010] EWHC 2192 (QB) (23 August 2010) URL: http://www.bailii.org/ew/cases/EWHC/QB/2010/2192.html Cite as: [2011] Lloyd's Rep IR 238, [2010] EWHC 2192 (QB) |
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QUEEN'S BENCH DIVISION
MERCANTILE COURT
B e f o r e :
(sitting as a Judge of the High Court)
____________________
JOSEPH FIELDING PROPERTIES (BLACKPOOL) LIMITED |
Claimant |
|
-and - |
||
AVIVA INSURANCE LIMITED |
Defendant |
____________________
Graham Eklund QC (instructed by Greenwoods Solicitors) for the Defendant
Hearing dates: 7 – 11 and 14 – 18 June and 1 July 2010
____________________
Crown Copyright ©
INTRODUCTION
(1) During the currency of this policy JFP made a fraudulent claim for which Aviva paid it £9,870, in respect of damage to a drain at Hoo Hill in September 2008 ("the Drainage Claim"); and/or
(2) JFP failed to disclose to Aviva at inception that Mr and Mrs Leonard had made a fraudulent claim against a prior insurer, National Insurance & Guarantee Corporation ("NIG") in respect of water damage to a lodge owned by them at Whitecross Bay Leisure Park and Marina, Windermere ("Whitecross Bay") in February 2007 ("the Langdale 9 Claim"); and/or
(3) The failure by JFP to disclose to Aviva at inception the fact that on numerous occasions previously Mr Leonard had made misrepresentations and/or nondisclosures when presenting to other insurers in the past.
" The balance of probability standard means that a court is satisfied an event occurred if the court considers that, on the evidence, the occurrence of the event was more likely than not. When assessing the probabilities the court will have in mind as a factor, to whatever extent is appropriate in the particular case, that the more serious the allegation the less likely it is that the event occurred and, hence, the stronger should be the evidence before the court concludes that the allegation is established on the balance of probability. Fraud is usually less likely than negligence…Built into the preponderance of probability standard is a generous degree of flexibility in respect of the seriousness of the allegation. Although the result is much the same, this does not mean that where a serious allegation is in issue the standard of proof required is higher. It means only that the inherent probability or improbability of an event is itself a matter to be taken into account when weighing the probabilities and deciding whether, on balance, the event occurred. The more improbable the event, the stronger must be the evidence that it did occur before, on the balance of probability, its occurrence will be established…"
(1) for JFP, Mr and Mrs Leonard, Peter Lund, a site manager employed by Mr Leonard or one of his companies, Sean Cummings, a self-employed general builder who has worked for Mr Leonard, Martin Salthouse, who is self-employed and runs a contracting and plant hire business, Nicola Duignan, JFP's company secretary and book-keeper who has also worked for Mr Leonard in his other businesses, and John Holdsworth who used to work at Whitecross Bay;
(2) for Aviva, Robin Wintrip who was previously an insurance claims investigator employed by the loss adjusters Crawford & Co. ("Crawfords"), Alastair Watson, previously the General Manager at Whitecross Bay, Alex Hodgson formerly the Maintenance Manager at Whitecross Bay, Alisha Bamford a special investigator in the technical department of Halifax General Insurance Limited ("Halifax"), and Geoffrey Woods, the underwriter at Aviva who wrote this particular policy.
THE DRAINAGE CLAIM
Introduction
"FraudWe will at our option avoid the policy from the inception of this insurance or from the date of the claim or alleged claim or avoid the claim(a) if a claim made by you or anyone acting on your behalf to obtain a policy benefit is fraudulent or intentionally exaggerated, whether ultimately material or not or(b) a false declaration or statement is made or fraudulent device put forward in support of a claim."
("Condition 7")
(1) The claim was entirely false because the problem with the drain was in fact not its collapse but a lack of maintenance which was not an insured peril;
(2) The Main Invoice was bogus alternatively parts of it were fraudulent and/or the amount claimed was exaggerated as a result of which Aviva was entitled to, and did, avoid the whole policy from inception once it became aware of this matter. The effect is said to be that not only must the £9,870 be repaid but so should a payment made in respect of the earlier fire in June 2008. Moreover, Aviva is absolved from any liability to pay the subject claim in respect of the fire in November 2009.
The Main Invoice -description
"M. SALTHOUSE CONTRACTORS
Invoice no : 2645
Date : 15th September 2008
VAT reg no 784422122
Martin Salthouse
Catterall hall farm
Esprick Preston
PR4 3HJ
TO:
JFP Limited
Site Office
Hoo Hill Ind Estate
Bispham Road
Blackpool
Lancashire
FY3 7HJ
WORKS CARRIED OUT
- Inspection of drains
- Jet drains
- CCt drains
- Flush drains
- Excavation of drains
- Replace / back-fill"
"M. SALTHOUSE CONTRACTORS
Invoice no 2645 CONT....
Date 15th September 2008
VAT reg no 784422122
Martin Salthouse
Catterall hall farm
Esprick
Preston
PR4 3HJ
- Finish Road surface
- As above – Top water drains
All work inclusive of:
Hire of plant
Transport of Plant
Fuel.
Labour materials as discussed.
Sub-Total now Due: £8400 + VAT
Total amount now due: £9870.00"
PAID IN FULL
WITH THANKS"
Procedural history
"Break down of payments for drain claim
Payments made ref drain fox bro machine hire on acc 162.66 Payments made ref drain fox bro concrete on acc 398.25 Payments made ref for res bar steel petty cash 90 Payment for drainage paid on card b & q 380 Payment for safety fence on acc AAA 329 Payment for woods waste stone chq 001458 12/9/08 193.99 Additional labour Sean Cummings cash 19/9/08 1000 Payments made to M Salthouse cash 12/9/08 2000 Payments made to M Salthouse chq 001462 15/9/08 1000 Payments made to M Salthouse cash 19/9/08 2000 Payments made to M Salthouse chq 23/9/08 500 Total 10053.90
See bank statement for cash withdrawals"
The Main Invoice -Analysis
The number 2645
(1) If this was intended simply as a reference number it could have gone anywhere on the document; see for example the manuscript writing on other invoices from Mr Salthouse at 18/129, 130 and 132; Ms Duignan said that she did not intend the number to look like an invoice number and just put it next to the word "invoice" because there was a gap. But there were plenty of other gaps in the document.
(2) Not one other document has been produced bearing a similar reference number. This is notwithstanding the fact that Ms Duignan said that the number would have been produced by the old system when logging on an invoice which had been received but not yet paid. At that stage it was a journal entry. The invoice would be tied to that reference number until it was paid when its status would change from being "outstanding" to "paid" when a different number would go on, for example a cheque number. It is remarkable that it has not been possible to find even one document bearing this out even granted the absence of the old software and computer. There are other invoices from Mr Salthouse without any invoice numbers eg those at pp129, 130 and 132 and yet when first received there was not thought to be a need to put a reference number on them;
(3) Mr Leonard said that Mr Salthouse was not very good with his paperwork and if he missed things out on his invoices they would add them for their records. But that does not support the claim that they were adding a mere reference number of their own. Mr Leonard also said that the addition of these numbers was so that JFP could track its payments to Mr Salthouse on that invoice. But I did not understand how. What appears usually to be done is that details of payments are written on the invoice itself (again see 18/129, 130 and 132) and also entered in the company ledgers. But no payment details are shown on the Main Invoice. Ms Duignan said that she only became aware that the Main Invoice had been paid just before it was sent off to Ms Schofield. She said that no payment details were entered for this invoice because there were too many entries relating to it. I do not accept that. I also do not understand why, when the invoice was eventually entered as paid, as Ms Duignan said it was, there is no reference to the invoice itself anywhere in the ledger; she said that the journal entry was overridden when details of two cheque payments in relation to that invoice were entered. But the invoice does not appear anywhere with cheque numbers as its payment reference. Or even the number 2645 as a substitute for an invoice number. Contrast the payment of what turned out to be two Fox Bros invoices shown in the purchase ledger extract at 18/5 where their numbers are referred to albeit elided into one.
"Paid in full with thanks"
The date on the invoice
Was this an insured peril?
Length of the works
The arrangement with Mr Salthouse
(1) £2,000 cash on Friday 12 September;
(2) A cheque for £1,000 on Monday 15 September;
(3) £2,000 cash on Friday 19 September;
(4) A cheque for £500 on Monday 15 September
making a total of £5,500.
Mr Leonard's Diary entries
"Martin owes
Drain BXQ £380
Fleton Steel £90
Sean wages £1000 Fox Bros ?
Fence ?"
Fox Bros Invoices
"This is a receipt for the amount of £2335.84 received on 15.12.08 cheque number 001569
Allocated as follows invoice 1951 £1162.66
invoice 153 £1398.25
This leave an outstanding balance of £225.07"
Res bar steel petty cash -£90
B & Q payment -£380
Access all areas -£329 -fencing
(1) First the invoice is numbered 226 and is addressed to another of Mr Leonard's companies LPS. But it seems out of sequence with other invoices, addressed to JFP. See invoices 222-225 from May to August 2009. Those other invoices formed part of the expenses claimed in relation to the November fire. See 19/471504;
(2) Second the payment relied upon amounts to £380 plus VAT not £329 inclusive of VAT. Mr Leonard says that the £329 was an agreed amount exclusive of VAT and there is writing to this effect on the invoice at 18/28. Mr Leonard says that he received a credit to bring the cost down to £329 but there is no evidence of this. There is a credit note in the sum of £100 plus VAT but this is undated and in the wrong amount;
(3) Third the invoice is dated 12 September 2008 but charges VAT at the post-November 2008 rate of 15%. That would be impossible unless the invoice was produced at some point after its date. Mr Leonard had no real explanation for this. There was no evidence, for example, that a payment might have been made without an invoice in 2008 and then an invoice produced to evidence it in 2009 when VAT had changed.
Woods Waste stone -£193.99
Payment to Sean Cummings of £1,000
Payments to Mr Salthouse
Conclusions on the drainage claim
Fraud
(1) JFP falsely and fraudulently stated by submitting the Main Invoice in its ultimate form to Aviva that
(a) Mr Salthouse was owed £9,870 by JFP for the work done and
(b) JFP had paid that sum to him;
(2) The claim for £9,870 was fraudulently exaggerated anyway because on any view JFP had not paid more than about £6,700 to anyone; here even if an allowance for some fencing were included it would not make much difference;
(3) The claim made was thus both fraudulent and intentionally exaggerated within the meaning of Condition 7;
(4) The Main Invoice, as sent, was also a fraudulent declaration or statement or device within the meaning of Condition 7 firstly because of the matters referred to in sub-paragraphs (1) -(3) above and secondly because the number 2345 AND "2645 CONT" and "PAID IN FULL WITH THANKS" were written on it as if they had come from the author of the invoice Mr Salthouse. In fact they did not, as Ms Duignan and Mr Leonard knew;
(5) Although there is no further requirement under Condition 7 or the common-law rule as to fraud to show that the insured was dishonest, it must follow on the facts found by me here that Mr Leonard (and thus JFP) was, in relation to the matters set out in sub-paragraphs (1) to (4) above.
A lesser genuine claim?
Assuming (without deciding) that a policy of insurance is avoided only by a claim which is "substantially fraudulent" or "fraudulent to a substantial degree", I reject the submission that this is to be tested by reference to the proportion of the entire claim which is represented by the fraudulent claim. That would lead to the absurd conclusion that the greater the genuine loss, the larger the fraudulent claim which may be made at the same time without penalty. In my judgment, the size of the genuine claim is irrelevant. The policy is avoided by breach of the duty of good faith which rests upon the insured in all his dealings with the insurer. The result of a breach of this duty leaves the insured without cover. In the present case the insured took advantage of the happening of an insured event to make a dishonest claim for the loss of goods worth £2,000 which to his knowledge had not occurred. In my view, the right approach in such a case is to consider the fraudulent claim as if it were the only claim and then to consider whether, taken in isolation, the making of that claim by the insured is sufficiently serious to justify stigmatising it as a breach of his duty of good faith so as to avoid the policy.
The making of dishonest insurance claims has become all too common. There seems to be a widespread belief that insurance companies are fair game, and that defrauding them is not morally reprehensible. The rule which we are asked to enforce today may appear to some to be harsh, but it is in my opinion a necessary and salutary rule which deserves to be better known by the public. I for my part would be most unwilling to dilute it in any way."
Proportionality?
Reliance
Consequences
"...there is no basis or reason for giving the common law rule relating to fraudulent claims a retrospective effect on prior, separate claims which have already been settled under the same policy before any fraud occurs. It is unnecessary to reach any conclusion in this case on the common law position relating to separate claims which are still unpaid at the time of the fraud, though there seems to be some force in the argument that the common law relating to fraudulent claims should be confined to the particular claim to which the fraud relates while the potential scope and operation of more general contractual principles might in some circumstances also require consideration.."
and submits that in truth the November fire claim is an unpaid claim which arose prior to the fraudulent drainage claim.
LANGDALE 9
Introduction
The Rival Contentions
The Evidence
Conclusion
NON-DISCLOSURE
Introduction
(1) It failed to disclose that it had made a fraudulent claim upon NIG in relation to Langdale 9;
(2) It failed to disclose that Mr Leonard or one of his businesses had made false statements to other insurers in the past either when seeking insurance from them or when making a claim under a policy with them; there are said to be 10 such instances;
(3) It failed to disclose to Aviva when adding Langdale 9 to another policy held by Mr and Mrs Leonard in December 2007 that it had suffered the water damage in February 2007.
Item No. | Date | Nature of allegation | Insurer | Paragraph in Re-Amended Defence and Counterclaim |
1 | Pre-23 March 2001 | False statement that Mr Leonard had no previous convictions in proposal for 14 Bispham Road | Halifax | 15 (3) |
2 | 18 July 2001 | False statement in claim WS that Mr Leonard had no previous convictions | Zurich | 15H |
3 | 21 September 2001 | False statement that Mr Leonard had no previous convictions in proposal for 11 Preston Old Road | IGI | 15 (1) |
4 | Pre-23 March 2001 | False statement re prior losses in proposal for 14 Bispham Road | Halifax | 15A |
5 | 11 February 2002 | False statement re size of prior claim against Zurich | Halifax | 15C |
6 | Pre-25 November 2002 | False statement re prior losses in proposal for 10 Clayton Gate | Halifax | 15D |
7 | December 2003 | False statement re prior losses in proposal for 34 Eastbank Avenue | Halifax | 15E |
8 | 21 April 2004 | False statement re prior insurance and losses in proposal for Cocker Avenue | Axa | 12 |
9 | 29 April 2004 | False statement re other businesses in proposal for garage business insurance | NIG | 15G |
10 | 26 February 2007 | False statement re prior losses in proposal for Langdale 9 | NIG | 10 |
11 | 30 May 2007 | False statement in WS re prior losses and insurers when making claim for Langdale 9 | NIG | 15F |
12 | 17 December 2007 | Failing to disclose prior water damage to Langdale 9 when adding it to NU policy 24176964CHC | NU | 18 |
Presentation for the subject policy
The Law
Generally
Mr Wood's Evidence generally
number of prior claims that were disclosed in the presentation. They are set out at 4/429 in paragraph 8 of his WS. He said that they were not so significant or unusual that they caused him to impose particular terms on this policy. Although challenged on the point I accept that he did review briefly each of those claims to see if they would affect the policy. Next, as the documents show, JFP was presented as an insured connected with Mr Leonard who already held policies with Aviva in his name or in the name of his other businesses. See for example the internal document at 4/465. I am sure that Aviva was keen to get his business on this occasion and secure future business if possible. But I do not think that this caused Mr Woods to be unconcerned about the risk. Equally, the fact that Mr Woods had a good relationship with Andersons, the broker to JFP, does not in my view detract from his evidence that overall he would not have written this policy had he been aware of the prior false statements and non-disclosure. It simply does not follow that Mr Woods would not have had the qualms which he said he would have had.
Item 1: False statement that Mr Leonard had no previous convictions in proposal for 14 Bispham Road
"Have you or any member of your family normally residing at this property ever had any criminal convictions or cautions or is any prosecution pending?
NO."
Item 2: False statement in witness statement to Zurich that he had no convictions 18 July 2001
Item 3: False statement made to IGI Insurance that Mr Leonard had no previous convictions in proposal for 11 Preston Old Road
"Have you ..even been convicted of, or is any prosecution pending for arson or any criminal offence other than road traffic offences?"
Mr Leonard ticked the "No" box. He also signed at declaration at the end of the form stating that all the information provided was true to the best of his knowledge and belief.
Items 1 – 3: materiality and inducement
Item 4: False statement re prior losses in proposal for 14 Bispham Road
"Have you or any member of your family normally residing at this property ever had any losses during the last 5 years whether insured or not, for any property or event now to be insured?
NO."
Item 5: False statement to Halifax re size of claim against Zurich
Item 6: False statement to Halifax in November 2002 in proposal for 10 Clayton Gate
"Have you or any member of your family normally residing at this property ever had any losses during the last 5 years whether insured or not, for any property or event now to be insured?
NO."
Item 7: False statement to Halifax in December 2003 in proposal for 34 Eastbank Avenue
"Have you or any member of your family normally residing at this property ever had any losses during the last 5 years whether insured or not, for any property or event now to be insured?
[claims advised]
Contents Theft £9,000."
Item 8: False statement re prior losses in proposal to AXA for Cocker Avenue
"Have you ..
(a) previously held insurance for any of the covers to which this proposal relates at these premises or elsewhere? If YES please advise name of insurers and policy number....
(e) had within the last five years any losses whether insured or not...."
Item 9: False statement about other businesses in proposal to NIG for garage business insurance
"Do you or any of the directors or partners engage in any other business or occupation?"
Item 10: False statement re prior losses in proposal to NIG for Langdale 9
"Have you or your spouse/domestic partner…in respect of the risks now to be insured:
(a) made any claim, suffered any loss or damage during the last five years whether the subject of an insurance claim or not?"
"Have you ever insured the buildings and/or contents of this or any of your previous homes?"
Item 11: False statements in WS made to NIG in relation to claim for Langdale 9
"I have made two previous claims. One was for storm damage on 18th January 2007. In February 2007 I was involved in a ski-ing accident…"
"For several years my property portfolio, my garage and my sunbed shops have all been insured with National Insurance and Guarantee Corporation Ltd with no claims."
Item 12: Failing to disclose prior water damage to Langdale 9 when adding it to NU policy 24176964CHC
Conclusions on materiality and inducement
The right to refer to Mr Leonard's previous conviction and the Rehabilitation of Offenders Act 1974
"4.— Effect of rehabilitation....
(2) Subject to the provisions of any order made under subsection (4) below, where a question seeking information with respect to a person's previous convictions, offences, conduct or circumstances is put to him or to any other person otherwise than in proceedings before a judicial authority—
(a) the question shall be treated as not relating to spent convictions or to any circumstances ancillary to spent convictions, and the answer thereto may be framed accordingly; and
(b) the person questioned shall not be subjected to any liability or otherwise prejudiced in law by reason of any failure to acknowledge or disclose a spent conviction or any circumstances ancillary to a spent conviction in his answer to the question.
(3) Subject to the provisions of any order made under subsection (4) below,—
(a) any obligation imposed on any person by any rule of law or by the provisions of any agreement or arrangement to disclose any matters to any other person shall not extend to requiring him to disclose a spent conviction or any circumstances ancillary to a spent conviction (whether the conviction is his own or another's); and
(b) a conviction which has become spent or any circumstances ancillary thereto, or any failure to disclose a spent conviction or any such circumstances, shall not be a proper ground for dismissing or excluding a person from any office, profession, occupation or employment, or for prejudicing him in any way in any occupation or employment.....
(5) For the purposes of this section and section 7 below any of the following are circumstances ancillary to a conviction, that is to say—
(a) the offence or offences which were the subject of that conviction;
(b) the conduct constituting that offence or those offences; and
(c) any process or proceedings preliminary to that conviction, any sentence imposed in respect of that conviction, any proceedings (whether by way of appeal or otherwise) for reviewing that conviction or any such sentence, and anything done in pursuance of or undergone in compliance with any such sentence......"
OVERALL CONCLUSION