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Chronic Fatigue Syndrome Sufferer Defeats Insurer’s ‘Faker’ Claim

It is often said that insurance companies do not like paying out and, in one case that lent support to that truism, an insurer put private detectives on the tail of a chronic fatigue syndrome (CFS) sufferer but utterly failed to prove that he had lied and faked his condition.

The case concerned a successful financier who had been diagnosed with CFS after suffering an apparently minor chest infection. He had to give up work and made a claim on his income protection policy. The insurer paid out for four years before ceasing payments on the basis that there was nothing wrong with him. He responded by launching proceedings to enforce the policy.

The insurer relied upon covert video evidence shot during five separate periods. The footage showed the man, amongst other things, out shopping, in the pub with friends and attending his daughter’s nativity play. He was accused of being a downright liar and having attempted to pull the wool over everyone’s eyes.

In rejecting those allegations, however, the High Court found that the video evidence fell very far short of undermining the man’s case. Noting that he would have had to be a very good actor in order to deceive so many, including his friends and family, for so long, the Court found that there was nothing inherently implausible about his account that he had good and bad days.

The Court’s decision meant that the insurer was obliged to pay him about £300,000 to cover the period since his payments ceased. If he continued to be incapable of working until he reached pension age, the policy would yield a total of about £2.4 million.

Miley v Friends Life Limited. Case Number: HQ15X03146