Insurers dismiss MP’s fear that medical panels could become their ‘captives’

The insurance industry has rejected suggestions by a Labour MP that medical expert panels used to validate whiplash claims could become “insurers’ captives”.

Andy Slaughter, MP for Hammersmith, said in a House of Commons debate last week: “I am not sure [medical panels] are the simplest or right solution. When the panels have been used in other countries – Australia is the obvious example – they have become the captives of the insurance industry. I hope that will not happen here and they will be genuinely independent.”

However, Tony Emms, pictured, UK chief claims officer for Zurich, defended the panels, due to be introduced in 2014, arguing they would fulfil the objective of providing impartial advice to the court. “We believe the use of independent medical panels should be implemented for all road traffic accidents,” he said.

In a consultation earlier this year, the Ministry of Justice proposed two options for the composition of the panels: a government-led medical accreditation scheme; or a national call-off contract, which would be developed by a range of stakeholders.#

Zurich favours the call-off contract, on which only accredited medical experts could bid to be listed. Emms explained: “Critically, this would be decided by a board, which would include representatives from the courts’ service, insurance companies and claimants. Zurich would also like to see the introduction of both standard report formats and standard instruction formats available equally to claimants, insurers and, for contested claims, the courts.”

Nigel Teasdale, a member of the Forum of Insurance Lawyers’ motor sector focus team and partner at DWF, said Slaughter had overlooked the fact that independent medical panels are already present in the current system.

He said:“Experts must [already] confirm that their duty is to the court, not to the claimant or defendant, and through the General Medical Council, which regulates medical practitioners.”

“However, such a simplistic view does not take into account the commercial drivers at play. Suppliers of claims monitor solicitors to ensure conversion rates are high. They do not want to use medical experts or agencies that impact those conversion rates. Commission may also be paid and the current process means everyone involved has an interest in a positive medical report being supplied.”

While Kennedys partner Niall Edwards agreed with Slaughter that the reform of medical panels is not a solution in itself to fraudulent whiplash claims and the claims culture, he added that the proposed changes would improve the current system, which often sees the submission of dubious medical evidence in claims resolutions.

“Medical panels are a progressive step in the right direction to ensure medical examinations are more consistently rigorous, and the reports that people then see in the road traffic accident portal are of more consistent quality,” he said. “At the very least, this is going to stop these fairly dubious cut-and-paste reports, which are suspiciously formulaic and similar in diagnosis and prognosis.”

DAC Beachcroft partner Andrew Parker, meanwhile, stressed that the critical issue the government must address relates to the relationship between claimant lawyers and claims management companies. “There are too many links between claimant solicitors and medical agencies and CMCs,” he said.

“One of the drivers around this is the cost you can recover for the report. These reports are typically paid for by the defendant insurer but commissioned by the claimant, so we have this problem where the cost is disconnected from the person paying for it. Not only do we need independent medical reporting, we also need a cap on the cost of routine reports.”

Deborah Evans, chief executive of the Association of Personal Injury Lawyers, added that it is too early to tell whether the government proposals would work, but reiterated Apil’s faith in the plans.

She told Post: “A skilled, experienced medic who specialises in soft-tissue injuries should be able to identify a fraudster, or an exaggerated claim. However, unless the issue of pre-medical offers is tackled, cases will still settle without the claimant seeing a doctor, thus creating an environment where fraud can still prosper.

“When the government implements a better quality system of medical reporting, it must insist it be used in every case.”

This article was published in the 14 November 2013 edition of Post magazine