A litigious path to healthy recovery: An injured engineer found that some policies are less permanent than they look. Caroline Merrell reports

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A SOLICITOR acting on behalf of an injured electronics engineer is suing the engineer's former employer for more than pounds 200,000 over his dismissal following a protracted disagreement over a health insurance policy with Unum.

Eddy Shackleton from Clwyd had a car accident nearly 10 years ago on his way to a job. His car was hit by two other cars and he sustained what initially appeared to be a simple whiplash injury.

Mr Shackleton said: 'I went off to hospital eventually and was immediately put into a neck brace. That was the last day that I did any work.

'For the first 26 weeks I was paid a full income. After that the company's disability policy came in.'

After further medical tests were carried out, Mr Shackleton was found to have far more serious injuries than was at first thought - injuries that caused him to have pins and needles in his fingers and gave him periodic severe pains in his neck.

The company, then called Case Communications, now part of Cray Electronics, had a group permanent health insurance (PHI) contract with Nel Britannia, now Unum.

Mr Shackleton then earned about pounds 8,300. When the policy was activated his income was cut to two-thirds of his salary.

All went well for a few years, then, unknown to Mr Shackleton, the insurer stopped paying his benefit to the employer.

The employer continued to pay out the equivalent of the benefit for another couple of years in the form of ex gratia payments, but the company finally dismissed him for non-attendance at work at the end of 1989.

Mr Shackleton's condition was never assessed by a doctor on behalf of the insurer.

Mr Shackleton has subsequently received compensation of pounds 170,000 for injuries sustained in the crash.

The size of the award was made on the basis that Mr Shackleton was entitled to receive the money from the PHI contract.

Mr Shackleton's solicitor, Norman Jones based in the Wirral, tried to go through the insurance ombudsman to try and sort the matter out. He said: 'Unfortunately the scheme does not cover group permanent health insurance contracts.

'I am astonished that insurers should refuse to meet their obligations under the policy without having Mr Shackleton examined by their own doctor.'

Mr Jones decided to sue Mr Shackleton's former employer for breach of contract.

Unum refused to comment on why it had decided to stop paying out on the policy. It said that in general it stopped paying out on policies if it felt that people were fit enough to go back to work.

A spokesperson said that the insurer could either get medical evidence to support this view or other evidence.

The company will also stop paying if the employee covered on the scheme stops being employed by the company.

Cray Electronics refused to comment on the case directly. A spokesman said it was considering taking a third-party action against Unum.

Unum has been involved in a number of disputes about non- payment of its policies.

At the end of last year Michael Lever, an ME sufferer from Christchurch in Dorset, managed to be reinstated on to his company's PHI scheme. The company agreed to accept an ME specialist's view that Mr Lever was genuinely incapacitated.

(Photograph omitted)

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