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Beneficiary faces ACC fraud charges Mike "Milky" Gibson

#1 User is offline   Tomcat 

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Posted 12 January 2009 - 08:48 AM

Beneficiary faces ACC fraud charges

By LANE NICHOLS - The Dominion Post | Monday, 12 January 2009

A long-term beneficiary, caught on video lifting boulders and trimming hedges while claiming about $100,000 for a back injury he said stopped him from working, is facing fraud charges.

In July it was revealed ACC had spent tens of thousands of dollars investigating Kaikoura bed and breakfast operator Mike "Milky" Gibson after receiving repeated complaints.

ACC investigators obtained extensive film footage of Gibson lifting boulders, launching a boat, shovelling shingle and building fences while repeatedly signing ACC statements claiming his back was too sore for him to work.

But despite the footage, complaints and information from private investigators hired by ACC, officials had not prosecuted him.

However, ACC spokeswoman Sarah McGregor confirmed that legal action was now under way against Gibson, who is due to appear in Kaikoura District Court to face several benefit fraud charges on January 30.

"Legal action is pending. It's a legal matter before the court at the moment," she said.

McGregor refused to give further details about Gibson's case.

Gibson has been on and off ACC for the past 20 years, receiving weekly compensation for the last five for a back injury that he and his doctors said prevented him from heavy lifting, twisting, bending or standing.

A year ago Gibson's doctors were shown video footage and it is understood they refused to continue signing his ACC forms for the back injury.

Mr Gibson declined to comment.

http://www.stuff.co.nz/4815489a11.html
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#2 User is offline   Alan Thomas 

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Posted 12 January 2009 - 10:29 AM

This fellow has a strong work ethic who was injured while working. He is about to have surgery again which may or may not end his incapacity to work but the fact remains that he is incapacitated to work.

The principal question is whether or not isolated activity that has been prescribed against within the instructions in the medical certificates gives the ACC grounds to cancel a claim in order to allege fraud.

What is the legislated procedure?

If there is an apparent anomaly between medical certificates and what is seen in photographs, video and numerous witnesses what is the ACC required to do with that so-called information.

Is the information sufficient to cancel the claim or should the information go to a superior medical assessor who looks at all of the medical evidence and even conducts an additional clinical examination?

In this case the doctor has been persuaded not to provide any more medical certificates. This is quite common as the ACC would usually have a quiet word with the doctor. My own doctor was persuaded not to sign to the medical certificates on the basis that there was going to be a criminal prosecution and that they would threaten him with criminal prosecution as well if they continue to provide medical certificates. My doctor was so outraged that after the conviction he continued providing medical certificates that incapacity had not ended despite ACC alleging that it had. Doctors are easily nobbled as they only have one insurance company that will pay the legal expenses if they get into any difficulty. The legal advice is almost invariably to drop the patient. A doctor in the South island was fined $7,000 for not signing medical certificates in the not too distant past but this is a rarity.

I will go so far as to say that the ACC have already received directions from various appellate court judges and even the Supreme Court on this matter and are choosing to disregard the law in preference of its own policies. What I am reading and seeing is a blatant attempt of the ACC to manipulate public opinion. In the Lyntott case the ACC also encourage neighbours to take video which ultimately became part of a review as training course to identify a fraud and lack of entitlement. The courts found in Mr Lyntott's favour indicating that reviewers are not independent but I trained by a doctrine of belief rather than the legislation.

Videos photos or even witnesses are not the measuring instrument to determine end of incapacity. Legislation requires an end of incapacity to be measured by a medical professional following a clinical examination. I am outraged at the arrogance.

For a criminal prosecution to get underway there needs to be an "informant". Generally this will be the private investigator or somebody from the ACC fraud unit. If the individual that has signed the "informations" to initiate a prosecution has no clear understanding of the ACC act then they will be making a statement without knowing it to be true which of course is perjury. Generally in these cases the ACC rely upon public opinion and appearances together with the momentum of a multibillion dollar organisation under the umbrella of government to achieve a decision in their favour to reduce their liabilities. Acquiring such a document for the purposes of reducing liability is is of course fraud. The fraudulent document of course will be the court judgement itself. Despite large numbers of these types of convictions being successfully appealed to my knowledge no one within the ACC has ever been criminally prosecuted for misleading the court. ACC invariably arraigned someone to sign the informations to the court registrar who is not qualified to do so in much the same way as is done with acquiring search warrants.
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#3 User is offline   doppelganger 

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Posted 12 January 2009 - 10:48 AM

View PostTomcat, on Jan 12 2009, 09:48 AM, said:

Beneficiary faces ACC fraud charges

By LANE NICHOLS - The Dominion Post | Monday, 12 January 2009

Gibson has been on and off ACC for the past 20 years, receiving weekly compensation for the last five for a back injury that he and his doctors said prevented him from heavy lifting, twisting, bending or standing.

.

http://www.stuff.co.nz/4815489a11.html


I bet anything you like that his medical certificates do not say such a thing.

I bet that the certificates say that he can not return to his origal employment as it required heavy lifting, prolong periods of twisting, bending or standing.

can see the Corporation point of view but the ACC can not claim fraud with out trail and being guilty. His medical certificates and reports meant that ACC would be supplying rehabilitation in all of these areas. This would be a very interesting case.
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#4 User is offline   Alan Thomas 

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Posted 12 January 2009 - 10:57 AM

Doppelganger it will be the ACC that had accused this man of fraud by going to the court registrar to initiate the prosecution.

This case is not unusual but what is it ordinary is the incredible lack of legal knowledge regarding ACC matters to construct a defence for such fraud allegations. Senior ACC lawyers will invariably state that this type of case needs both criminal and ACC lawyers defending a fellow such as this.

The most interesting point will be the wording on the ACC cancellation of claim letter the ACC cannot allege fraud while the claimant and right of entitlements remained valid. Obviously the ACC appeal to be cancellation decision letter needs to be addressed before this matter go to the criminal court as the criminal court will not be interested in determining whether or not the ACC had carried out the assessment processes properly before making a determination prior to reaching a decision, as in the Burnet case.
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#5 User is offline   gaffa09 

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Posted 12 January 2009 - 11:10 AM

A year ago Gibson's doctors were shown video footage and it is understood they refused to continue signing his ACC forms for the back injury.

==============================================================================
How dear they ,
Did they show the doctor the best of 20 year recordings all in 5 minutes .

++++++++++++++++++++++++++++++++++++++++++++++++++

Videos photos or even witnesses are not the measuring instrument to determine end of incapacity. Legislation requires an end of incapacity to be measured by a medical professional following a clinical examination. I am outraged at the arrogance.
================================================================================
=
You have got that right Allen
ACC are an underhanded pack who will go to any length .
ACC tried this on me back in the 1990s and gave the private investigator all my private Info
I also am outraged
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#6 User is offline   MG 

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Posted 12 January 2009 - 11:19 AM

Like the Mounties, ACC always gets their man. I'd love to know what ACC told his doctors. Oh well, once he gets put away (and we pay for his accommodation costs) I'm sure his rich neighbours will be able to snaffle up his property so they can fly their helicopters to their hearts' content.
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#7 User is offline   Huggy 

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Posted 12 January 2009 - 11:48 AM

There is a lot more to it than what you have read in the paper.

This is another classic example of one hand not knowing what the other hand is doing.

All will be revealed in good time.
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#8 User is offline   Reality 

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Posted 12 January 2009 - 12:57 PM

View PostHuggy, on Jan 12 2009, 12:48 PM, said:

There is a lot more to it than what you have read in the paper.

This is another classic example of one hand not knowing what the other hand is doing.

All will be revealed in good time.


January 30 is when it will all be revealed Huggy. Eat your words then pal.

So Mr Gibson can ignore his doctors medical instructions not to lift, twist, bend or stand whenever it suits him??? To ACC the medical certificate determines a claimant's status in order for compensation to be paid. If the Dr says not to do various activities then the patient should not. If Mr Gibson chooses to ignore medical instruction and then claim compensation then that is fraud. I have read of similar cases in the past that have resulted in jail terms, and rightly so.

Doubtless the good members of ACCForum will be saying there is a conspiracy between ACC, doctors and rich neighbours to force Mr Gibson off his land. Yeh, right
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#9 User is offline   gabby 

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Posted 12 January 2009 - 01:30 PM

View PostReality, on Jan 12 2009, 01:57 PM, said:

January 30 is when it will all be revealed Huggy. Eat your words then pal.

So Mr Gibson can ignore his doctors medical instructions not to lift, twist, bend or stand whenever it suits him??? To ACC the medical certificate determines a claimant's status in order for compensation to be paid. If the Dr says not to do various activities then the patient should not. If Mr Gibson chooses to ignore medical instruction and then claim compensation then that is fraud. I have read of similar cases in the past that have resulted in jail terms, and rightly so.

Doubtless the good members of ACCForum will be saying there is a conspiracy between ACC, doctors and rich neighbours to force Mr Gibson off his land. Yeh, right

hey reality, no sarcasim intended but are you an ex acc employee or case manager you sound a bit like a cm i had once.
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#10 User is offline   neddy 

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Posted 12 January 2009 - 01:40 PM

View PostReality, on Jan 12 2009, 01:57 PM, said:

January 30 is when it will all be revealed Huggy. Eat your words then pal.

So Mr Gibson can ignore his doctors medical instructions not to lift, twist, bend or stand whenever it suits him??? To ACC the medical certificate determines a claimant's status in order for compensation to be paid. If the Dr says not to do various activities then the patient should not. If Mr Gibson chooses to ignore medical instruction and then claim compensation then that is fraud. I have read of similar cases in the past that have resulted in jail terms, and rightly so.

Doubtless the good members of ACCForum will be saying there is a conspiracy between ACC, doctors and rich neighbours to force Mr Gibson off his land. Yeh, right

View PostReality, on Jan 12 2009, 01:57 PM, said:

January 30 is when it will all be revealed Huggy. Eat your words then pal.

So Mr Gibson can ignore his doctors medical instructions not to lift, twist, bend or stand whenever it suits him??? To ACC the medical certificate determines a claimant's status in order for compensation to be paid. If the Dr says not to do various activities then the patient should not. If Mr Gibson chooses to ignore medical instruction and then claim compensation then that is fraud. I have read of similar cases in the past that have resulted in jail terms, and rightly so.

Doubtless the good members of ACCForum will be saying there is a conspiracy between ACC, doctors and rich neighbours to force Mr Gibson off his land. Yeh, right

I think you do the majority of us a disservice.

To quote Samuel Johnson "“When speculation has done its worst, two and two still make four”

Everything so far has been pure speculation.
No evidence has been presented
No evidence has been challenged or rebutted

We need to wait and see what is presented and by whom before we make a judgement call and until then, despite what people may think, the case is sub judice and Milky Gibson must be be considered innocent until proven guilty
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#11 User is offline   fairgo 

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Posted 12 January 2009 - 01:41 PM

Hear hear Neddy,

Unless you know the facts Reality then I suggest you just wait like the rest of us until all the info is placed before a judge and or jury. Remember in this country people are still innocent until proven guilty.

ACC simply initiating prosecution does not mean they have it right,nor that the guy is guilty as charged- that's what a trial is for.
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#12 User is offline   Reality 

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Posted 12 January 2009 - 01:43 PM

View Postgabby, on Jan 12 2009, 02:30 PM, said:

hey reality, no sarcasim intended but are you an ex acc employee or case manager you sound a bit like a cm i had once.


Never worked for ACC. In fact I would never work for any government department, I could not cope with the stifling layers of bureaucracy.

There is plenty to be critical of about ACC but I don't criticise them over this case. It's my levies that have been helping to pay Mr Gibson.

His case seems simple to me. If the Dr says you can't bend lift etc then you don't. If you think you can bend lift etc then discuss with your Dr and get your certificate changed if the doc agrees. Don't work (presumably for his B & B venture and profit) AND then claim compo as well.

That $100,000 he has stolen, plus the $xxxx for the investigation and court case would be better spent on providing entitlements for others that do the 'right thing'. Just like some of the deserving cases I read about on ACC Forum.

Do I still hear a chorus of support for Mr Gibson?
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#13 User is offline   Reality 

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Posted 12 January 2009 - 01:51 PM

View Postfairgo, on Jan 12 2009, 02:41 PM, said:

Hear hear Neddy,

Unless you know the facts Reality then I suggest you just wait like the rest of us until all the info is placed before a judge and or jury. Remember in this country people are still innocent until proven guilty.

ACC simply initiating prosecution does not mean they have it right,nor that the guy is guilty as charged- that's what a trial is for.


If that is the case then why are you not telling Gaffa the same, he is jumping to Mr Gibson s defence.

I disagree with your sentiment, if we all stayed silent and never put up an opinion then this site would have no reason to exist. There are plenty of accusations and abuse flying around on this site and from what I see it is all mostly personal opinion.
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#14 User is offline   neddy 

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Posted 12 January 2009 - 02:02 PM

View PostReality, on Jan 12 2009, 02:51 PM, said:

if we all stayed silent and never put up an opinion then this site would have no reason to exist.

I agree with your sentiment, but not with the way you apply it.
Opinions unless based on fact are pure speculation, period

I suggest we leave this case to play out in court and then decide who got it right and who did wrong
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#15 User is offline   Alan Thomas 

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Posted 12 January 2009 - 02:12 PM

Reality I agree that we need to look at sides of the argument. You and I appear to be fundamentally opposed. At least it appears that we are expressing our reasons for our beliefs based on some form of substance which is the lifeblood of this site.

I think you are fundamentally wrong in law when you say "...If Mr Gibson chooses to ignore medical instruction and then claim compensation then that is fraud. I have read of similar cases in the past that have resulted in jail terms, and rightly so."

Reality I would strongly suspect that you like many New Zealanders have become subject to ACC propaganda which is in effect social engineering to persuade the population at large to a certain type of belief system, to the financial advantage of the ACC, that is not supported in law. The ACC is a multibillion-dollar Corporation sufficiently financed to achieve social engineering.

My thoughts are that Mr Gibson is clearly a person who pushes his physical capacity to its limits at every opportunity both before and after his injury. Personality does not change because of an injury. We do not know that the activities videotaped were or were not within the specifications of the medical certificate. He may very well have been able to do a limited amount of activity from time to time but not work full-time. I recall another man was convicted on the basis that that he mowed his lawns every day despite his injury. It is obvious that other fellow was mowing his lawns every day he is only doing a little bit of lawn at a time. Only a moron would think otherwise yet it does appear that the jury was full of easily manipulated morons.
Reality I doing the right thing I suppose you mean that people are injured should stay in bed and watch television rather than exploring the limits of their incapacity.
If the person disobeys the medical instructions that does not make one iota of difference to the ACC liability. Should the worst happen and the person is incapacity should increase because of the forbidden activities in the ACC would have a degree of right not to pay out on the additional incapacity but certainly could not cancel the existing claim as some kind of punishment.

The doctrine of belief that the activity (such as working) takes precedence over the medical certification is a complete nonsense and at odds with legislation. At best any activities can only be presented to the medical professionals that reassess the extent of incapacity. Such information may ultimately caused a modification of the ACCs liability at the information in itself is not information as referred to under the act. For example when Mr Burnett was working or earning and paying tax no did not mean that the ACC could cancel his claim on the basis that he was no longer incapacitated. He was nearly working while incapacitated. In this case the work he was carrying out was driving while brain-damaged. ACC would need to determine whether or not a driving occupation is suitable for the extent of his brain injury.

So far the doctor providing the medical certificate has been persuaded not to present any more. Obviously he is going to be a witness for the ACC but he will be caught between the devil and the deep blue sea. Either the doctor was breaking the law by not signing medical certificates for a person who still remains incapacitated or he has done a patient a disservice by providing medical certificates that he cannot work when he actually can by way of incompetent diagnosis. As the fellow concerns is going to be operated on in the coming weeks because the surgeon considers he cannot engage in any work I would tend to think that some form of on lawful pressure has been placed upon the good doctor. In which case it looks like the doctor will be subject to disciplinary measures from the medical Council with holding a signature from medical certificates.

ACC on the other hand I going to need far more than videos of a man looking rocks to satisfy the legislated processes which require medical information in order to make a determination. Videotapes do not have medical certification stamped on them and certainly do not mean that the fellow's back is no longer injured it merely that he was doing what he was told not to do or that he was doing moderate activity even within the medical certificate carrying out limited work task activities in a very limited and controlled way. This type of information is private information that is not available to his neighbours and neighbours have obviously breached the stands privacy videotaping with the result that he will no doubt soon as neighbours for the damage to the ACC relationship and his fledgeling bed and breakfast business that has now failed because of a publicity. ACC expected this fellow to fund the bed and breakfast company placing the full risk of rehabilitation upon himself. ACC did not even offer even the most basic small business management course or any other form of rehabilitation assistance. There was no assessment as to whether or not the work task activities of the bed and breakfast company was within this fellow is physical capabilities. In other words ACC were conning him to use his own money so they could benefit. If the bed-and-breakfast business failed the fellow would have no business and ACC would claim he now had a work capacity even though the failure of the business proved that he did not.

In my own case where the ACC succeeds in a criminal conviction because they thought I was working they did not have regard for the factor that my medical certificate allowed me to carry out two hours light duties work per day. Even with the worst-case scenario there is nothing to suggest any activity that exceeded the medical certificate. The ACC relied upon imagined extrapolations of information. This is all about technique of presentation of assumption rather than the information required by legislation. The practice is illegal and must be stopped by way criminal prosecutions of the individual staff members had engaged in such practices.


Neddy I disagree that we should stand back and wait to see what happens. I think that would be both immoral and cowardly when the Court of Appeal had clarified the understanding of law and duties of the ACC and addressing matters such as this. Decisions of New Zealand should be completely outraged that the ACC had not been proactive in this fellows rehabilitation and left him to his own devices.

I consider it is the duty of all claimants they comprehend these points of law to rally to the defence of Mr Gibson. If we cannot offer practical legal assistance we could perhaps provide moral assistance including attendinghis court hearings. We should certainly be outraged at the way in which the ACC had deliberately sidestepped the protection built under the legislation for financial gain. The public in general such as Mr reality should be ashamed that they are trying to get a discount from their levy payments by false allegation and false imprisonment. Producing false documentation to lead court to believe this man is no longer incapacitated is certainly a criminal offence.

As far back as the Lyntott case criminal prosecution records found in his favour when he was a founder preinjury and "working" on his daughter's farm pottering about doing basically the same type of activities that you did preinjury. Most recently the Burnett has confirmed that the ACC must carry out the legislated procedures prior to making a determination. There is no fraud case to answer if the ACC had not carried out a proper determination prior to making a decision that there was an overpayment and therefore fraud. The threshold for this case is that he is no longer incapacitated and is fit to return to his preinjury occupation. Neighbours and private investigators or the general public such as Mr Reality do not get to have a say all form an opinion even as the law does not allow them to override medical reporting.
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#16 User is offline   fairgo 

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Posted 12 January 2009 - 02:23 PM

The problem is unless you are Mr Gibson himself no-one really knows what this case is really about. As stated previously the man has the right to a fair trial which hopefully he will get.
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#17 User is offline   Alan Thomas 

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Posted 12 January 2009 - 02:31 PM

Fairgo some of us have spoken to this fellow personally but certainly most will have seen him on television to the extent they would have a basic understanding as to the nature of the allegation. The case is really quite basic.

ACC consider members of the public with the video cameras can override medical certification in total disregard of legislated criteria to determine an end of incapacity.

Whatever task activity he was engaged in this for the doctor to determine whether or not the information is relevant. As the doctor is paid a nickel but expected to sing a dollar song the doctor has my sympathy because he would have been receiving pressure from the ACC and private investigators on one side with his insurer on the other side saying dump this claimant because the insurance company would not want to pay any of the doctor's legal expenses. It is the ACC plan to continually undermine the confidence of doctors which is worsened by the ACC refusing to pay for specialist assessments it more complicated cases.

In this case the overriding fact is that this man does have an injury that prevents him from doing any work safely and without risk of additional harm. Whether or not the activities were harmful is of course completely irrelevant.

Fairgo as this fellow is in your territory, or close to it, I hope that you would rise to the occasion in much the same manner as you did for huggy because it is the right thing to do. Remember huggy was also carrying out unreported work task activities that caused the ACC to believe his incapacity had ended. The purpose of right minded people on this site is to join together and exert pressure for ACC to do what is lawful.
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#18 User is offline   Reality 

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Posted 12 January 2009 - 02:39 PM

You complicate things Alan
    Mr Gibson said he could not work because of a back injury

    The Doctor certified that he was unable to do heavy lifting, twisting, bending or standing because of his back - presumably that is what Mr Gibson told the doc. and signed the certificate.

    Mr Gibson lifted boulders, trimmed hedges, shovelled shingle, built fences and launched a boat. These activities are more than the normal light daily activities that we all do in order to exist.

    To any reasonable person this would indicate that Mr Gibson has a capacity to work. If Mr Gibson did not tell his doctor that he was able to lift boulders etc then that is fraudulent behaviour.

    Doctors certify fitness to work depending on the patient's job. Obviously an accountant could work with a much greater level of disaiblity than a labourer. Thus a labourer doing household activities would not be physically fit for work but an accountant would be.

    Rehabilitation is not the same as working. It should be done under supervision is a safe and structured manner and there should be the capacity to vary the workload depnding on reaction - which of course is not generally possible in the workplace. Presumably Mr Gibson failed all attempts at rehab, thus proving to all and sundry that he was incapable of working in a manual occupation.

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#19 User is offline   Huggy 

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Posted 12 January 2009 - 02:51 PM

Reality you do not know this person, questions i would like clarification on would be how old is the video footage is????, was the video filmed before or after his injury???????, has the video footage been interfered with??????? is the person who filmed the video prepared to stand by the video footage in a court???????, and i could go on, i bet you dont know anything of the case, as a matter of fact you probably know fuck all so what gives you the right to make comment when you do not know the circumstances.

Its people like you who screw it up for innocent people with your sarcasm.

You werent involved in exposing ACC's dodgy contract with the KPI's that the PI's operated under........
You werent involved in the Fraud Unit Enquiry...........
You werent involved in sweet FA so you have no idea how ACC's fraud unit or its contracted PI's operate.
Perhaps a reality check is what you need so as you understand what goes on behind the scenes.

My case wasnt a clear cut case and if you seen the information i bet you would have jumped to conclusions that i was guilty, until you know the other side of the story perhaps you should keep your sarcastic views to yourself.

And dont call me Pal i wouldnt be seen dead with a person who has an attitude like you.

ACC's Investigations unit got rid of people who had attitudes like you for obvious reasons that there is always 2 sides to a story and that other side needs to be considered before decisions are made.

You arent one of those incompetant investigators they dumped by any chance are you, like Mr Jamie Clark ????????
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#20 User is offline   Reality 

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Posted 12 January 2009 - 03:15 PM

View PostHuggy, on Jan 12 2009, 03:51 PM, said:

....as a matter of fact you probably know fuck all so what gives you the right to make comment when you do not know the circumstances.

Its people like you who screw it up for innocent people with your sarcasm....


Dearest Huggy

So Mr Gibson is innocent now? And I take it from your comment that you know a lot more than I do about this particular case?

I merely point out the obvious and ask the question: How can a man who apparently is about to have back surgery (according to Alan Thomas) and who has told his doctors he cannot work be fit enough to shovel, lift boulders etc etc? Are you saying that Mr Gibson is not the man in the video after all and that all the good folk of Kaikoura are mistaken?
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