Guidance

Official Injury Claim Advisory Group Meeting 18 July 2022 14:00 – 16:00

Updated 18 March 2024

Applies to England and Wales

Attendees:

Ministry of Justice (Chair and secretariat) (MoJ)

Motor Insurers’ Bureau (OIC service operators) (MIB)

Civil Procedure Rule Committee (CPRC)

Association of Personal Injury Lawyers (APIL)

Motor Accident Solicitors Society (MASS)

Forum of Insurance Lawyers (FOIL)

Association of British Insurers (ABI)

Law for Life

HM Courts and Tribunal Service (HMCTS)

MedCo

Apologies:

Support Through Court (STC)

Introduction

The Chair welcomed attendees and outlined the agenda for the meeting.

MoJ noted that STC would be stepping down from the group and thanked them for their valuable contribution to previous meetings.

The Chair confirmed that, in addition to considering a replacement for STC, overall membership of the Advisory Group would be reviewed again over the summer to ensure that, one year after the implementation of the reforms, representation on the Group provided MoJ with the necessary advice on the operation of the system.

ACTION POINT 1: MoJ to review membership of the Advisory Group.

Actions from previous meeting

The Chair confirmed that the data fields requested at the previous meeting had been included in the meeting pack.

In response to an action from the previous meeting, the ABI provided verbal feedback from their members on the detailed reasons given by compensators for removing claims from the Official Injury Claim (OIC) service.

The key findings included:

• The exit descriptor ‘Complex issues of fact or law’ is used widely and includes claims that exit due to:
  • the nature/extent of injuries;
  • incorrect/missing information on the Small Claims Notification Form (SCNF);
  • the claim being started in the wrong jurisdiction (e.g., Scotland);
  • the inclusion of a stolen vehicle; and
  • it being deemed there is a risk of prejudice (e.g., where the same insurer covered both parties).
• There is also some overlap in relation to the reasons for exit chosen by insurers; ‘other’ also appears to be used for many of the same reasons as above.

The ABI noted that some rationalisation of the various exit categories provided in the OIC service, and/or guidance on their usage, would be welcomed. MoJ agreed and confirmed it will consider the feedback with the MIB.

Members suggested that more comprehensive reasons should be recorded by an insurer at a time when they decide that a claim should be removed, to ensure that there is scrutiny of and accountability for the action.

MIB noted that the latest data release indicated that the number of claims exiting portal has decreased. Members questioned whether this was a behavioural change or simply because users are now more comfortable with the process and no longer starting claims in the wrong portal etc. It was also queried whether this was likely to continue, and MIB confirmed that the data should continue to be monitored.

ACTION POINT 2: MoJ to consider the proposals and any action from the ABI report on reasons for exit from the OIC.

OIC performance

MIB provided an overview of the operational data published on the OIC website on 11 July.

Claims Portal Ltd (CPL) data was also presented, which showed that claims exiting CPL due to being commenced in the ‘wrong portal’ is averaging at around 200 per month.

Members provided their thoughts on claimant outcomes following one year of operation of the OIC service. APIL provided a brief overview of analysis they have completed which was based on several data sources. MoJ agreed to consider the analysis provided and would liaise with members on this over the summer period.

A helpful discussion was held in relation to:

• Cases where a court pack may be downloaded but the claim does not progress to court. It was noted that there is a similar trend within CPL and that there may be several reasons for this, including packs being rejected by the court for errors, the need to get further instructions from clients, and problems arising from adjusting existing business practices to the new system. Members were encouraged to get in touch with HMCTS where they hear of issues relating to the way court staff were dealing with court packs.
• Members acknowledged that MIB have engaged regularly with claimant representatives. MIB are also in particularly regular contact with the larger users and noted there is a balance to be struck in relation to delivering updates quickly for large users and more slowly for smaller volume users.
• MIB reminded members that they run defect surgeries every month to help users through specific issues, for which they have had no take up in several months. It was acknowledged that MASS and APIL are sometimes receiving feedback from claimant firms which is different to what MIB receive from them. It was agreed that a discussion between all parties would be helpful.
• It was also agreed that members should get in touch with HMCTS if they experience any issues with litigating claims.

ACTION POINT 3: MoJ to facilitate additional dialogue between MIB and claimant members on service issues and bug fixes.

ACTION POINT 4: MoJ to consider the additional data analysis that had been provided by OICAG members and report back to the Group at the next meeting.

Key stages of a claim

Following the commitment made at the April Advisory Group meeting, MoJ had carried out work with MIB to define the ‘key stages of a claim’. This data covers how long claims take between key points in the claims process, for both represented and unrepresented claimants. The aim of this work was to better understand the claimant journey and identify trends or issues in the OIC process.

MoJ explained that this first view reflected the ‘happy path’ - a straightforward journey to settlement with no dispute. This view can be altered to reflect more complex pathways once the happy path view is agreed and relevant data becomes available.

Currently, the data shows that generally unrepresented claimants move more quickly between stages than represented claimants, particularly in relation to the medical reporting stage.

Comments from members included:

• Elements of the claim process differ between represented and unrepresented claims which may be one of the factors driving an apparent disparity in the time taken between represented and unrepresented claimants at certain stages.
• It is important to understand if there are delays, and if so where they are. If any are identified, further work would be needed on whether this is as a result of consumer choice (i.e., waiting out prognosis before disclosing the report) or if there are technical or user business system issues creating delays.
• It would be useful to also have a snapshot depiction (a ‘helicopter view’) of how many claims are at each stage at a particular point, in order to understand whether there is an issue at a certain stage in the process.
• It was observed that the increasing number of settlements suggests no apparent backlog in relation to the medical reporting stage for unrepresented claimants. This could suggest that reports for represented claimants are being held back.
• How long a claim takes is not the only thing that matters to the injured person or the only measure of success; therefore, we must be cautious when drawing conclusions.

Now the key stages of a ‘happy path’ claim have been agreed, MoJ and MIB will consider which other pathways merit regular monitoring.

ACTION POINT 5: MIB to look at preparing for the OICAG a ‘helicopter view’ of claims on the system, so we can better understand where claims are at a particular time, to help identify flows and any bottlenecks.

Medical Reporting Deep Dive

MoJ presented a paper on medical reporting which looked more deeply into the data available from both MedCo and OIC on the represented and unrepresented claimant journey. The aim of the paper was to analyse the data (from what period) and identify areas where the group could provide input and ideas for improvement.

In summary the data identified three areas for further consideration, these were:

• Liability decisions and when the medical report is sourced – the data indicates that in a significant proportion of represented claims, a report is commissioned prior to the receipt of a liability decision from the compensator. This has potential implications for the accuracy of the instructions given to the report provider, including sight of the defendant’s version of events, which in turn can lead to delays in agreeing the report/settling the claim.
• The time taken to attend an examination following selection of a medical report provider – the data shows that, on average, unrepresented claimants attend an examination almost twice as quickly as represented claimants, with a significant proportion being examined around 3 weeks post-accident. This is understandable to a degree, as they are likely to want to settle their claim as quickly as possible, but there is a question as to whether this is too soon after the accident for their injury to have settled down and to enable an accurate prognosis.
• Differences in the time taken to upload medical reports – due to the differences in the way medical reports for represented and unrepresented claimants are sourced, we have data on the unrepresented journey but not for represented claimants as they do not use OIC to source medical reports. It is, though, apparent that this is where many such claims are being delayed for technical, strategic or business-related reasons.

Several points were made in discussion including:

• The different medical evidence processes for represented and unrepresented claimants may help to explain some of the differences.
• MedCo confirmed that they are reminding medical experts of their responsibilities and what they should be doing at each stage of the process, including with regard to inclusion of the defendant version of events and causation/mechanism of injury. They also encouraged members to reach out to them where they hear of any issues in relation to medical reporting.
• It was reported that insurers have experienced problems relating to the extent to which experts clearly set out all injuries and their causation. This is worse if the expert is instructed before the liability decision. Insurers are also frustrated where the defendant’s version hasn’t gone to the expert as required by the Pre-action Protocol, as it can make an assessment of causation more difficult.
• It was acknowledged that there could be some friction between the desire for efficiency and speedy progression of a claim (hence early examination) and the need to provide full and accurate evidence to the court if it is required.
• It was noted that there are some benefits to early examination, e.g., access to rehabilitation, though it was agreed that this does not negate the need to provide the medical expert with all required information.
• Some members flagged difficulties with uploading medical reports experienced by professional users.

ACTION POINT 6: All members to seek views on trends identified within the medical reporting paper and to report back in writing ahead of the next OICAG meeting.

ACTION POINT 7: MoJ will continue monitoring the data in relation to medical reporting and will provide an update if the data changes.

User feedback

MIB gave an overview of the work undertaken to gain a better understanding of the unrepresented claimant user experience. This includes:

• A one-off Ipsos MORI piece of research into the unrepresented claimant journey;
• Exit surveys sent to all users who leave the OIC process – including those who have settled/not settled; and
• Interviews with high volume professional users.

MIB presented the key areas that emerged across all three workstreams which included:

• Data input errors/exit reasons: some exits are driven by users making initial errors in the claim leading to the submission of a new one
• OIC Portal Support Centre (PSC): some users were confused about the level of support offered by the PSC
• User Experience and User Interface: problems were identified with the service when using a mobile phone, and some users also wanted more information on how they were progressing/timescales;
• Medical Process flow: there was some uncertainty relating to the selection of medical experts or whether a claimant could use their own GP. Also, some professional users had issues with uploading medical reports (e.g., using mobile);
• Tariff rates and compensation: unrepresented claimants were sometimes unaware of tariff bands from the outset; and
• Timescales: some frustrated by how long their claim took.

It was acknowledged that customer satisfaction was to a large extent outcome-driven; those who had settled were more likely to report a positive experience with the service.

Law for Life have only been able to speak to a small number of unrepresented claimants, but some have also mentioned a lack of confidence with knowing how to choose a medical expert.

Summary and next steps

MoJ summarised the actions arising and next steps, and confirmed that:

• the minutes will be circulated to members for approval before publication on Gov.uk; and
• the next meeting is scheduled for 11 October 2022.