(a) Claimant walked rather badly holding onto his wife
(b) On examination he could hardly stand and could not walk unaided
(c) He had difficulty evacuating his bowels and he had to sit on a squatting toilet with his wife helping him
(d) He would not be able to go back to any form of useful employment whether sedentary type or standing for short periods.
(e) In other words he is permanently disabled
(f) He had no western toilet in the home he was staying (which was his friend’s residence) and he would have to sit on the eastern toilet on the floor with the legs stretched out to evacuate the bowels.
(g) He was living with a friend and often would have to change homes.
Extract From Medical Report of Doctor ‘B’
a) He is still not able to walk normally and need two crutches. Even at home he would have to hold onto something when walking around
b) He was not able to squat
c) On examination he had great difficulty walking around without the aid of crutches and he could take only a couple of shuffling steps without them
Opinion:He will never be able to go back to any form of useful employment and in fact needs someone to look after him.
Extract From Medical Report of Doctor ‘C’
a) The patient presented in a wheelchair and habitually progresses with the aid of a orthpaedic walking aids
b) He showed considerable difficulty in walking and had some difficulty in seating himself on the dental chair
Extract from Affidavit of Claimant
“I need crutches to walk about at home or otherwise I have to hold onto something when walking about. My wife assists me in my daily chores. I am also claiming $7,686.92 being medical expenses, $200/- for wheel chair, $50.00 for crutches”
The investigators established that the Claimant had misled the insurer (Defendant) by providing a wrong address and was not staying with friends as reported by his doctor. He was able to lead a normal life and was living by himself in a Housing and Development flat which he purchased for a sum of $245,000/- with a government grant of $30,000/-. He did not require the crutches or the wheelchair to move about. He spent most of his time lazing around and meeting his friends at the coffee shop at the vicinity of his house. He was also found to be a heavy smoker and betted heavily.
Shows the Claimant hobbling with a pair of crutches when visiting the hospital. He had to be further assisted onto the wheel chair, when visiting the toilet, buying food and even when boarding a taxi. Soon after leaving the hospital he discarded his crutches and was able to carry out his daily routine. He spent his time drinking alcohol and betted heavily.
Note: Claimant died of Cardio respiratory Failure Pending Further Investigations soon after the Surveillance and Investigation Report was handed over to his counsel.
