Collateral investigation of H.A.R.M files key

There are a small percentage of bodily injury claims that represent a high exposure for an insurance company based solely on the credibility of the plaintiff, Marc Gorbet, lawyer, Gerald A. Swayne & Associates, told delegates at the Annual Toronto Fraud Forum on Oct.2.
Dubbed H.A.R.M files, High Award Risk Matters they contain an underlying structure, which necessitates early collateral investigation or adjusting in order to effectively prepare the matter for trial, Gorbet noted.
The files are identified based on certain common elements including employment (often in either well-paying jobs or working at an unpleasant or difficult position), student (close to completion of a professional or technical trade program with high employment probability upon completion), injury profile (subjective complaints disproportionate with accident or injury, chronic pain, inconsistency, unresponsive to treatment), among other considerations (immediate retention of counsel, familiarity with LTD, AB/BI claims), Gorbet told attendees.
The collateral approach focuses on the periphery of the substantive issues to identify alternative sources of credibility, he said. This means speaking to those that interact with the plaintiff, but are not directly involved in the case, such as friends and coworkers, who might be able to offer impartial evidence on things such as the plaintiff’s activities and employment.
It also includes focused and consistent surveillance, covert inquiries, financial and background checks, pretext approaches and undercover scenarios and staged approaches, he added.
By moving outside the plaintiff’s immediate area of control, alternate sources of credibility can be determined, Gorbet said, and potentially show holes in the plaintiff’s credibility.