Saturday, October 27, 2012

Accident Claims Don’t End After You Leave the Hospital

Wednesday, December 9, 2009, 17:35
This news item was posted in medical insurance category and has 0 Comments so far.

If you’ve ever been involved in a road accident, then you will know that the suffering doesn’t end once you’ve left hospital, been patched up and reached the safety of home.

Because it’s then that you have to start dealing with the aftermath. The paperwork, the phone calls and of course the dreaded people from insurance and their lawyers.

There are lots of important decisions to make, and correspondence to deal with just when you barely feel like you can manage to understand daytime TV. But letting it slide can damage your chances of compensation, delay a final settlement and even lead to you being blamed for an accident that may not have been your fault.

Known faults in the system

It isn’t as if the faults of the system are unknown. A claim from a road accident takes an average two years to settle, according to the Association of British Insurers. If your compensation case is related to an accident at work, it takes nearer three years.

“For many thousands of people who have experienced accident or injuries through no fault of their own…the system is failing,” said the Citizens Advice Bureau, for a recent cross-industry report on the personal injury system.

One of the problems with personal injury claims is that your lawyers don’t normally notify the other side until they have investigated the circumstances of the claim. This is unnecessary because in 80% of claims liability is uncontested. Early notification would dramatically cut the length of time required to make a settlement, and make it easier to track down witnesses and get accurate statements made while memories are fresh.

No wonder then, that for every £1 of compensation paid in motoring cases another 43p is spent on lawyers, which rises to 88p when compensation is £5,000 or less. “For lower value claims it often takes too long and involves costs which can be disproportionate to the amount at stake,” the Law Society admitted.



Lucky escape

I have some personal experience of just how creaky this system is.

My wife was involved in a serious car accident in January. She and two colleagues were pulled from the wreckage of near head-on crash. My wife’s life was probably saved by the air bag that stopped her head hitting the steering wheel, though she suffered concussion and bruising.

The emergency services were fantastic. A passing St John’s ambulance full of trainees (on day one of their course!) were there within a minute. Paramedics arrived five minutes later, while an air ambulance hovered overhead. There could not have been a speedier or more professional service had the car contained the Prime Minister.

Exemplary services

She was seen within half an hour at A&E at the nearest hospital and a policeman was there waiting to take her statement while the events were still fresh in her mind. I was there to get her home and had already notified the insurers.

Next morning, the hassles began.

Having an accident turns your life upside down. You need a replacement car, you need your possessions back from the wreckage and where has it been towed anyway? If you’re not well enough to go to work, you have to notify your employer. Then you have to decide when and what to tell friends and relatives. You need to see your GP. And you also need to check on the health of those who were in the vehicle with you.

Industry outsourcing has made this a labyrinth



Changes in the insurance industry have made everything more complicated. Our car was insured through Marks & Spencer. However, this is really just a brand badge on a service provided by others, many others. Look underneath this trusted label, and there was a confusing ants’ nest of responsibilities and activities.

The vehicle underwriting was handled by one insurance company, the firm looking after my wife’s personal injury claims was a separate law firm. The appointment to see an independent doctor was handled by a third company, and the doctor works for a fourth, private medical company.

A cast of thousands

Then there was a fifth company which arranges for a replacement hire car, itself sourced from a sixth firm. The seventh organisation is the garage which held the wreckage of the vehicle. The eighth firm, whose policies are very important but perhaps the one you will rarely deal with directly, is the insurer for the other side, against whom you will claim.

Many of these eight companies have call centres, and except for the lawyers (and the garage) you rarely get to speak to the same person twice. This is enough to send your head spinning, even without concussion. It is not a system designed to make the accident victim feel on top of events. It is designed for cheap claim processing, though it often fails that objective. Just one example of waste was that my wife received written reminders from three separate organisations about just one medical appointment.

Who is the client anyway?

The other trend that you notice is that although you may be the victim of the accident, and your premiums are funding this entire circus, you are expected to fit in to the convenience of the insurers, and the independent medical experts they employ, rather than them to you.

On day two after the accident, my wife was told by a representative at Fortis (the vehicle underwriter) that she had to go and fetch anything she wanted from the vehicle immediately, “because the garage was charging them £12 a day to hold the wreckage”.

No account was taken of the fact we didn’t yet have a hire car, that my wife was in no state to drive or that the garage (this being the wilds of Lincolnshire) was an hour’s drive away. She was, quite understandably, upset. After I had a (not very) quiet word with Fortis, we were given a manager’s direct line, and the service improved dramatically.

Don’t inconvenience the doctor

Likewise, all three accident victims were expected to drive for up to an hour for an assessment by the insurer’s doctor. He wouldn’t come to them, even though they live within a few miles of each other. When my wife and one of her colleagues did make the trip to Lincoln, the doctor tried to get them to share an appointment!

Wasting the GP’s knowledge and skills

Oddly enough, the one person who is well-placed to provide a medical opinion is often left out. Your local GP will know you and your medical history better than any private doctor who is parachuted in, and will almost certainly have given you an examination soon after an accident.

By contrast, a private medical appointment will be with someone who is writing dozens of reports, may well not include any physical examination, and will take place months after the accident when bruises may have faded and cuts healed.

However, the GP isn’t “independent” enough for the insurance industry. Indeed, he wasn’t good enough for my wife’s employer either, whose outsourced human resources department called in another healthcare organisation to provide its own doctor to assess her suitability to return to work. For that, they inevitably insisted, she would have to do the travelling rather than the doctor.

The CBI had it right when it said: “The current system is inefficient and complex with high transaction costs at the expense of the injured person and society in general.”

Minor improvements

There are some hopes. The government is planning to set strict rules for how long insurers have to contest liability, and lawyers will have to notify the other side’s insurers within five days of being involved in a case. There are proposals to remove the duplication of work undergone by claimants’ lawyers, and a simplified proposal for negotiating compensation.

Putting all this right is going to take years. If you have an accident, you need to organise your own priorities in the meantime. Here are a few common sense pointers.



At the time of the accident, if at all possible get witness names and addresses. Take photographs of the vehicle positions on the road or get someone else to do so.

At hospital, ask the name of the A&E doctor in case you need later access to the notes. Ask him/her to write down as much detail as possible.

Start keeping a diary of your injuries, even if they only initially feel slight. Keep a record of all expenditure, from headache tablets through to car hire, incurred because of the accident.

Assert your rights. Don’t be bullied into taking the route that is easiest for the insurers, if it is not the best for you. Likewise for private medical appointments.

Get your own GP to make as detailed notes as possible, and demand that they be contributed to the case record.

Get a friend or relative to deal with difficult phone calls or correspondence, or use your local CAB.

In the end, a few actions that you take early on are likely to be crucial in making sure your claim is ultimately successful. For the rest, you just need huge reserves of patience.

Christian is an author of several articles pertaining to No Win No Fee, Compensation Claims, Accident Claims, Personal Injury Claims and other legal articles.

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