“There is a striking contrast between the appearance of the subject of these observations and the man I saw on 25 August. I can confirm that they are one and the same person even though the degree of animation is starkly different. The man captured by surveillance can walk, speak and engage in interaction with those around him in a normal manner, which was clearly not the case when Dr Fleminger and I examined him. Under the circumstances the diagnosis of a conversion disorder is no longer tenable. Mr Patel’s disability is feigned. Moreover, this must be evident to his son, whose description to us of his father’s condition can only be described as frankly deceitful. He lied to us. Mr Patel did not do so, as he did not speak, but his pretence of disablement represents an equally regrettable attempt to deceive, presumably for the purpose of financial gain. It is now possible to go beyond what I stated in my recent report. Not only is there no neurological explanation for Mr Patel’s disability but there is no medical condition, whether physical or psychological, to account for it”
“Subject to paragraph (2), the general rule is that evidence at hearings other than the trial is to be by witness statement unless the court, a practice direction or any other enactment requires otherwise.”
“Where, at a hearing other than the trial, evidence is given in writing, any party may apply to the court for permission to cross-examine the person giving the evidence.”
“[62] In my judgment, a claimant should be found to be fundamentally dishonest within the meaning of s.57(1)(b) if the defendant proves on a balance of probabilities that the claimant has acted dishonestly in relation to the primary claim and/or a related claim (as defined in s.57(8)), and that he has thus substantially affected the presentation of his case, either in respects of liability or quantum, in a way which potentially adversely affected the defendant in a significant way, judged in the context of the particular facts and circumstances of the litigation. Dishonesty is to be judged according to the test set out by the Supreme Court in Ivey v Genting Casinos Limited (t/a Crockfords Club), supra. [63] By using the formulation “substantially affects”
“That case concerned an accident at work in which the claimant was found to have fraudulently exaggerated the extent of his claim. It was common ground that deliberately to make a false claim and to adduce false evidence is an abuse of process. The Supreme Court held that the court does have the power to strike out a statement of case under r3.4(2) and under its inherent jurisdiction for abuse of process even after the trial of an action in circumstances where the court has been able to make a proper assessment of both liability and quantum. However, it was held that, as a matter of principle, it should only do so in very exceptional circumstances. The Supreme Court considered whether the possibility in such circumstances was so theoretical that it should be rejected as beyond the powers of the court, but concluded that it would be unwise to limit in advance the kinds of circumstances in which sufficient abuse might be found. It was stated that in deciding whether or not to exercise the power the court must examine the circumstances of the case scrupulously in order to ensure that to strike out the claim is a proportionate means of achieving the aim of controlling the process of the court and deciding cases justly. The draconian step of striking a claim out is always a last resort, a fortiori where to do so would deprive the claimant of a substantive right to which the court had held that he was entitled after a fair trial. The Supreme Court stated that it is very difficult indeed to think of circumstances in which such a conclusion would be proportionate. Such circumstances might, however, include a case where there had been a massive attempt to deceive the court but the award of damages would be very small.”
“[54] From13 April 2015 , s57 has provided defendants with the means of having a personal injury claim dismissed or struck out on the basis of “fundamental dishonesty”
“[95] The need for such a rule, severe as it is, has in no sense diminished over the years. On the contrary, Parliament has only recently legislated to apply a version of it to the allied social problem of fraudulent third party personal injuries claims.Section 57 of the Criminal Justice and Courts Act 2015 provides that in a case where such a claim has been exaggerated by a “fundamentally dishonest” claimant, the court is to dismiss the claim altogether, including any unexaggerated part, unless satisfied that substantial injustice would thereby be done to him. Parliament has thus gone further than this court was able to do in Summers v Fairclough Homes.”” “[95] The need for such a rule, severe as it is, has in no sense diminished over the years. On the contrary, Parliament has only recently legislated to apply a version of it to the allied social problem of fraudulent third party personal injuries claims.Section 57 of the Criminal Justice and Courts Act 2015 provides that in a case where such a claim has been exaggerated by a “fundamentally dishonest” claimant, the court is to dismiss the claim altogether, including any unexaggerated part, unless satisfied that substantial injustice would thereby be done to him. Parliament has thus gone further than this court was able to do in Summers v Fairclough Homes.””
“At no stage during the interview did Mr Patel acknowledged [sic] my presence, with the exception of one occasion when he briefly made eye contact (see below). I found him lying in bed with his eyes closed. His lips would sometimes move. At times his eyelids flickered. When I tried to interact with him by introducing myself and asked him to look my way this caused no immediate reaction. However after a minute or two of talking to him his eyes opened a little. To start with he started blankly in to space without any eye contact. However with a little bit of further stimulation from both me and his son, he did open his eyes and look around, and at one point made eye contact with me lasting a second or two. Blinking rate was generally reduced, but he did blink on occasion. His facial expression was entirely blank. By and large there was very little movement of his face and no movement of arms or legs. At no time did he speak. When I approached him and put my fingers in his left hand, which was lying limply by his side, and asked him to grip my hand, there was no movement. There was no movement when asked to raise his hand, or asked to open his eyes. The muscle tone in his arms was not increased. I did not undertake a physical examination.”
“Mr Patel’s presentation is very unusual and is not explained by organic disease, and the description of his condition rests heavily on the report of family members; it is reasonable to ask if his presentation is in some way false or feigned. I think this is very unlikely because the deterioration in his condition, and therefore the development of what I think is a conversion disorder, started early in the course of his recovery and in the context of evidence of emotional distress associated with anxiety, and was witnessed by the clinical team looking after for him… Mr Patel’s conversion disorder is not unlike that in other patients I have seen, in whom there was no obvious secondary gain (e.g. they might gain financially by being disabled) and in whom intensive observations by clinical staff (for example while they are in in-patient care) indicates that the disability is constantly present”
“His presentation when I saw him was extraordinary. He was mute, unresponsive and virtually unable to move any body part. To the untutored eye his appearance was that of profound disablement. However, there were clinical markers of a non-organic disorder. He did not move any limb on request, yet when I raised either arm he held it up briefly before letting it flop back onto the bed. There was no muscle wasting, which would have been a virtually inevitable consequence of a bed-bound state. From his son’s account, he is able to control his sitting posture in a chair without armrests, which would be surprising in someone so disabled… The clinical picture indicates that his presentation is either feigned or the result of a conversion disorder. Dr Fleminger has opted for the latter, but the distinction cannot be made confidently based on the clinical picture alone. Dr Fleminger pointed out that he has seen similar cases in whom "intensive observations by clinical staff indicates that the disability is constantly present". Based on my examination alone I cannot make a distinction between feigned disability and a subconscious conversion disorder. I agree with Dr Fleminger that the hallmark of the latter is consistency, i.e., unchanging disability regardless of circumstances and whether or not the patient is aware that he is being observed. In Mr Patel’s current state it is equally impossible to say whether there may be a small core of organic cognitive impairment. Bearing in mind the rapid recovery of a normal GCS and the resolution of the radiological abnormalities, I would not have expected any permanent brain damage and I would therefore say that no such damage has occurred in Mr Patel’s case. I conclude that there is no neurological basis for Mr Patel’s apparent disability or any need for care, assistance, therapy or case management. His ability to engage in the standard activities of daily living and his potential to return to employment depend on non-neurological factors.”
“The reason why I probably mentioned my father always needs two carers is because my father was on many occasions hoisted out by the carers initially and I was specifically told by the hoist supplier that even if one person can manage, there must be at least two people for the use of equipment for health and safety reasons. So when my father cannot manage and needs assistance I said he needs two carers.”
“Many times his behaviour has been challenging as he is often unresponsive. It is not always easy to get him to cooperate or participate in activities. Whenever he is cooperative my sons try to take him out.”
“There is a significant difference in his condition on a day-to-day-basis.”
“He no longer has that same enthusiasm and determination for life. He spends a lot of time in his room and he is often reliant on his family… Sometimes he does not acknowledge me or talk to me, but occasionally he does talk”
“In these cases brain damage, if any, will have been minimal. The level of the award will be affected by the following considerations: a) the severity of the initial injury b) the period taken to recover from any symptoms c) the extent of continuing symptoms d) the presence or absence of headaches The bottom of the bracket will reflect full recovery within a few weeks.”