Liability Insurance - Access to Justice - Problems and Solutions A Claimant Solicitor’s Perspective A Claimant Solicitor’s Perspective Fraser Whitehead Partner Head of Parliamentary and Legal Affairs Department

Access to Justice means… All deserving cases must receive proper compensationAll deserving cases must receive proper compensation Without avoidable delayWithout avoidable delay With encouraged access to legal advice to ensure “proper”With encouraged access to legal advice to ensure “proper” Accept present system not deliveringAccept present system not delivering Joint responsibility for thisJoint responsibility for this

So what ” problems” keep us apart? Rooted history of opposition…Rooted history of opposition… Adversarial nature of trial process encourages “getting one over”….Adversarial nature of trial process encourages “getting one over”…. Perceived demands of each others commercial environments…..ah!Perceived demands of each others commercial environments…..ah!

Regulation Solicitors Regulatory AuthoritySolicitors Regulatory Authority Legal Complaints ServiceLegal Complaints Service Duty of clients “best interests”..firstDuty of clients “best interests”..first Inadequate professional service riskInadequate professional service risk

Competition Maximising damages and the beauty paradeMaximising damages and the beauty parade Trials speak louder than settlementsTrials speak louder than settlements Staying in front reputationStaying in front reputation

Reputation Professional negligence - covering all corners Professional negligence - covering all corners Standards of performance not “proportionated” to value of caseStandards of performance not “proportionated” to value of case The industry talks…… renewal…The industry talks…… renewal…

Obligations to Insured/ Client ….and the profit motive Duty to do best and maximise damagesDuty to do best and maximise damages Contrasts with desire to minimise premium costsContrasts with desire to minimise premium costs Costs/ profit rise with damages/timeCosts/ profit rise with damages/time Contrasts with insurers own profit objectiveContrasts with insurers own profit objective Has industry has dumbed down- eg Collossus Has industry has dumbed down- eg Collossus

Solutions Change Change Keep adversarial weapons in their placeKeep adversarial weapons in their place Non proliferation treaty?Non proliferation treaty? Collaboration where its properCollaboration where its proper Where interests of client/ insured meetWhere interests of client/ insured meet Look for where they meet Look for where they meet

“PI CASE TRACK” AXA - RJW and the DCA -- (MoJ) paper on PI process Taking the initiative And it works……. The experience to date…….

Principles Principles 1.Genuine claimants should receive: 1.Access to Justice 2.Proportional medical assessment 3.Treatment where appropriate 4.A fair transparent settlement 2.Stages - Necessary, Sufficient, “Best Practice” 3.Stakeholders agreement to Consensual Approach 4.Fair to all, can be used by all

The claim process © 2007 Capita Commercial Services Limited Admiral Group

Approval Proposed claim ‘published’ to insurer with recommended pathway (from IMA)Proposed claim ‘published’ to insurer with recommended pathway (from IMA) The insurer agrees whether or not the claim is suitable for ClaimsenseThe insurer agrees whether or not the claim is suitable for Claimsense Has three options:Has three options: Accept liability (full or shared)Accept liability (full or shared) Agree to carry on processing (and carry cost)Agree to carry on processing (and carry cost) RejectReject Any further rehabilitation treatment that is recommended after initial treatment will be referred back for approvalAny further rehabilitation treatment that is recommended after initial treatment will be referred back for approval

PathwayRehabilitation Medical Reporting A Self Help IMA B Physical Only + RTW Mix Physio +RTW Physio + CBT + RTW NHS Monitor + Top Up IMA P Treatment Discharge Report (plus sign off report) C1 Physical Only + RTW Mix Physio +RTW Physio + CBT + RTW NHS Monitor + Top Up IMA P Treatment Discharge Report GM Report D1 Physical Only + RTW Mix Physio +RTW Physio + CBT + RTW NHS Monitor + Top Up IMA P Treatment Discharge Report CM Report C2 Better but claiming IMA NHS Treatment Discharge Report GM Report D2 Better but claiming IMA NHS Treatment Discharge Report CM Report Rehabilitation and Medical Reporting

Speed Pathway A - Instruction to settlement 11 weeks (average) Current Average: 52+ weeks Average across all Pathways - Instruction to settlement approx 17 weeks (depending on rehab)

Benefits are Realised….. IMA average time instruction to report 7 daysIMA average time instruction to report 7 days IMA disputed 0% cases settlement report 60 % cases Rehabilitation facility recommended 30% casesIMA disputed 0% cases settlement report 60 % cases Rehabilitation facility recommended 30% cases Rehabilitation then undertaken 100% casesRehabilitation then undertaken 100% cases Rehab report as settlement report 30% casesRehab report as settlement report 30% cases GP report as settlement report 10% casesGP report as settlement report 10% cases Consultant report utilised 0% casesConsultant report utilised 0% cases

Cost Average Costs - £2350Average Costs - £2350 (PCR + Medical + ATE) (PCR + Medical + ATE) PICT - £825PICT - £825 SAVING-£1525SAVING-£1525

Benefits to Insurers Legal FinalityLegal Finality Reduce settlement timeReduce settlement time Lower transaction costsLower transaction costs Better return to work (loss of income)Better return to work (loss of income) Enhanced customer experienceEnhanced customer experience Expected better renewal ratesExpected better renewal rates Anticipated streamlining of internal claims handling costsAnticipated streamlining of internal claims handling costs Meeting expectations on access to justiceMeeting expectations on access to justice

Claimant Benefits Faster settlement timesFaster settlement times Early Assessment of the injury and RehabilitationEarly Assessment of the injury and Rehabilitation Access to information and improved CommunicationAccess to information and improved Communication Appropriate Legal AdviceAppropriate Legal Advice No hidden charges or unnecessary costsNo hidden charges or unnecessary costs Process subject to independent review by consumer representativesProcess subject to independent review by consumer representatives

Benefits are realised…... Length of IMA report- 3 pagesLength of IMA report- 3 pages Length of Rehab report - 3 pagesLength of Rehab report - 3 pages Length of Letter of Claim - 1 pageLength of Letter of Claim - 1 page Reduction in ClaimsReduction in Claims 20% Drop out at Initial Medical Assessment20% Drop out at Initial Medical Assessment Possibly spurious/ fraudulent/ exaggerated casesPossibly spurious/ fraudulent/ exaggerated cases An additional but welcome benefitAn additional but welcome benefit Average settlement £ 2500Average settlement £ 2500

Claimant Comments "I thought a personal injury claim would be complicated but I felt this process was easy to understand and a great service – every insurance company should be like this” "I knew where I stood at all times and the whole process took just over 3 months" “I thought it was excellent from start to finish”.

Independent file auditIndependent file audit External Feedback Neil McLaughlin, Morgan Cole Summary from independent file audit commissioned by defendant insurer

Questions Thank you from BOTH of us…..