NEW COMPULSORY SYSTEM FOR OBTAINING MEDICAL REPORT IN WHIPLASH CLAIMS IS ON THE STARTING BLOCKS. ARE YOU READY FOR IT?

 By Kate McKinlay

‘MedCo Registration Solutions’ is the new compulsory system for sourcing medical reports in soft tissue injury claims brought under the PAP for low value PI claims in RTAs.

It is a non-profit making organisation with an independent chair and cross industry representative bodies acting as Directors  on its board, namely:-Association of British Insurers, Association of Medical Reporting Organisations, Association of Personal Injury Lawyers, British Medical Association, Chartered Society of Physiotherapy, Forum of Insurance Lawyers, The Law Society, Motor Accident Solicitors Society, and the Motor Insurers Bureau.

• ‘To achieve the Government’s overall policy objective of tackling fraudulent whiplash claims through the MedCo model’
• ‘an objective system of accreditation supported by random allocation in the commissioning process is the appropriate means by which to safeguard the independence of medical experts’ (Gov Consultation paper Dec 2014^[1])
• ‘to tackle fraudulent whiplash claims and in particular the issue of direct financial links between those who commission reports and those who produce them’

It will no longer be possible therefore for a user to instruct an expert from a company to which the solicitors firms has direct financial links or indeed any other relationship.

 All low level whiplash first reports, and therefore by association all providers of such reports. This is split into two categories;- Medical Reporting Organisations (MROs) and individual medical experts who wish to be instructed directly rather than through a referral organisation aka an MRO.

 HOW DOES IT WORK?

Users will be able to search for either MROs or individual experts.  Users are insurers, solicitors, claims management companies or ‘other compensators’ e.g. litigants in person, . There is not at the moment any suggestion of any advanced search ability e.g. geographical, turnaround time etc.  The automated search engine will then produce a shortlist of either MROs or individual experts.

The search engine will then produce a shortlist of seven.  An MRO based search will produce 1 high volume national MRO (‘1st tier’) and 6 smaller MROs (‘2nd tier’).  A individual expert search will produce a shortlist of seven medical experts. Again it is not clear yet whether or not an advanced search facility will be available to allow for geographical variations, foreign language speakers, availability etc.

REGISTRATION

From 6th April 2015, all MROs and individual experts wishing to supply first stage low value medical reports must be registered with MedCo in order to do so.  MROs must also be accredited by 6th April 2015.  Individual experts must be accredited by January 2016.Details of what this will involve are yet to be announced.

To register, individual experts must be registered with either the GMC (General Medical Council) or HCPC (Health and Care Professionals Council), pay registration fee of £150, and complete the registration form.

Any MROs wishing to register must also be accredited.

ACCREDITATION

ALL MRO are required to comply with a robust accreditation procedure which requires:-

• A declaration all those individuals and organisations to which they are linked
• A commitment to paying experts on set credit terms irrespective of the outcome of the case
• Payment of a bond of at least £20,000 (to ensure that medical experts are protected in the event of a failure of the MRO
• Evidence of £1m PII and £3m Public Liability Insurance
• Compliance with all reg requirements re information security
• Demonstration that they have necessary systems to comply with anti-bribery legislation
• Having and following an appropriate business ethics policy
• A documented complaints handling process
• A MedCo compliance officer
• No shareholders, directors, officers declared bankrupt or convicted of fraud in last 5 years
• Direct management of its panel of experts so ensuring that experts comply with regulatory requirements
• payment of requisite registration fee (£15,000 for 2nd Tier or £75,000 for 1st Tier  – see below for further details on 1st Tier MRO)
• Collection, and provision on request of management information.

IN ADDITION 1st TIER  AKA HIGH VOLUME MROs MUST SHOW:

• Minimum of two years trading history
• Operational capability i.e
  • capacity to process min 40,000 independent reports p.a. and
  • contractual arrangements with at least 250 medical experts
  • Contracted medical experts in listed postcodes
  • a minimum of five distinct unassociated clients at time of registration, none of which represent more than 40% of the total instruction volume
• A bond of £100k
• A documented Disaster Recovery Plan
• A chief Medical officer registered with GMC of Health Care Professionals Council
• Appointment of a Caldicott Guardian ( i.e. a senior person responsible for patient confidentiality and appropriate information sharing)
• Payment of fee for registration and on-site inspection
• Demonstrate ability to offer A2A functionality.

SOON!

For all CNFs sent on or after the 6^th April 2015, the first report in a soft tissue injury claim (aka whiplash) MUST be a fixed cost medical report commissioned from a medical expert or MRO sourced via MedCo.

PRACTICE NOTES

It is not known how many MROS and/or individual experts have already registered. However given that the significant registration fee levels were only announced last week, common sense suggests that this new system may limp off the starting blocks rather than race. This is likely to generate delays in processing claims after 6th April. ‘Compensators’ would therefore be well advised to get as many CNF issued as they can before 6th April in order minimise the anticipated disruption and teething problems that MedCo will bring.

The amendments to the CPR are contained in The Civil Procedure (Amendment No. 8) Rules 2014 and affect, amongst others, rules 21.2, 30.3, Part 36 and 37.3.

 CONCLUDING THOUGHTS

The combination of MedCo, and fixed fees of £150 for initial whiplash medical reports is  likely to have a significant impact on an already vulnerable PI market.   Solicitors’ firms who have their own agencies face particular risk as the viability of their reporting arms is tested to the max. With the deliberately prohibitive accreditation requirements for MROs, it is also likely that the report-writing market will shrink which will, in turn, affect choice and diversity. Whether or not these changes will meet their target i.e. to improve quality and reduce fraud, remains, at the time of writing, a question for the crystal ball.

Kate McKinlay

Zenith Chambers

17.3.2015

^[1] http://www.justice.gov.uk/downloads/civil-justice-reforms/whiplash-consultation-response.pdf

Tags: claim, claims, medical report, Whiplash