Manchester Claims Association. MedCo. Ian Scanlan 15 th October 2015

Transcription

1 Manchester Claims Association MedCo Ian Scanlan 15 th October 2015

2 Introduction Ian Scanlan Group Head of Business Development at Winn Group. The group comprises of Winn Solicitors, On Medical and On Hire. On Medical post April 6 th became a Medical Agency in its own right, with ten Tier 2 companies and one Tier 1 application being processed. 15/10/2015

3 Four Minute Summary of MedCo April 6 th MedCo goes live. Tier 1 has more applicants then initially envisaged. Tier 2 has significantly less applicants than envisaged. April/May Tier 2 firms initially receive more work than Tier 1. Speed Medical applied for ten Tier 2 shell companies. Premex, Doctors Chambers and On Medical follow suit. MOJ and MedCo get angry about multiple MRO Gaming. 15/10/2015

4 Four Minute Summary of MedCo Lots of statements made, very little action. Call for evidence requested by MedCo in July Awaiting response - end of 2015 or beginning of 2016? Accreditation of experts unveiled October All experts to be accredited by 1 st January Bond Solon or Doc Slot available for expert training at a cost of circa /10/2015

5 MedCo Registration Solutions MRO Audits commenced July 2015: All 14 companies registered as high volume national (Tier 1) MROs have been audited. Audited companied which fall to demonstrate that they have met the qualifying registration criteria will be removed from the system. Audits will also identify companies whose practices are in breach of the MedCo User Agreement and enforcement action will be taken against them. Direct Medical Expert Accreditation Scheme: Training to be rolled out from 1 st October All medical experts will be expected to have undergone accreditation training by 1 st January Two providers currently selected to provide the accreditation training. Registrations Figures of the order of: 175 MROs 457 Medical Experts 1,673 Authorised users Search Figures of the order of: 199,000+ searches on the MedCo system resulting in the selection of an MRO. Over 19,000+ searches resulting in the selection of a medical expert. Subgroups/Feedbacks Mechanism: Established sub-groups to analyse management information, monitor user activity and investigate areas of concern to include: Audit Operations Accreditation IT User feedback system to allow users to suggest system improvements and report concerns. Peer Review to focus on the quality of medical reports. 15/10/2015

6 Medical Experts Accreditation Five Core Areas of Knowledge Professional Obligations Medical History Clinical Examination Model Medico-Legal Examination and Report Legal Content 15/10/2015

7 Medical Experts Accreditation Minimum Requirements Registered with MedCo. Valid registration form the appropriate professional body (GMC/HCPC). Must hold a valid licence to practice or have a agreeable endorsement. Must have signed the MedCo User Agreement. Must have declared any financial links. 15/10/2015

8 The Problems Two pending judicial reviews Randomisation Lack of infrastructure and resource at MedCo Audits Haphazard change Back office collectives Shared marketing collectives 15/10/2015

9 The Big Problem Has anyone truly thought about the claimant? 15/10/2015

10 Manchester Claims Association Any Questions? On_Medical All views expressed are those of the chap I bumped into outside just prior to this seminar and are not those of On Medical, Winn Solicitors and On Hire.

11 MedCo Manchester Claims Association

12 Today's session What's been happening to date Impact Feedback The future

13 What's happening Tier 1 isn't tier 1! Tier 2's aren't tier 2! High Volume National MROs Low Volume not necessarily National MROs The convoy effect, 10, 10

14 No, not that one but the 10 Speed, 10 Premex

15 What's happening DME instructions through MROs DME use and agreements Payment terms

16 Impacts Are we going to see number of companies go out of business? Audits Understanding the agreements

17 Hands up! Is the data from the medical report uploaded to Medco by the insurer?

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21 Data contributors agreement 5.1 (e) the transfer to MedCo of any Expert Data and or Case Data shall comply with all applicable law and that it has all necessary consents, approvals and licences (including but not limited to the consent of relevant data subjects for the purposes of the Data Protection Act 1998) to enable the lawful transfer and subsequent use by MedCo and any user of the Database (including without limitation the Authorised Users) of such information in accordance with and for the purposes envisaged by this Agreement (including without limitation the Authorised User Purpose);

22 MROs are not receiving the work they expected DMEs don't understand when the rules apply Self policing Accreditation Audits Impacts on clients Feedback

23 The future Accreditation and what that will look like Audits of MROs Consideration of the data cube

24 Presentation to Manchester Claims Association Don Clarke 15 th October 2015

25 Reviewing the Objectives of the Reforms A brief Chronology Jackson Report January 2010 December 2012 Government s Consultation on the number and costs of whiplash claims LASPO Act 2012 April 2013 Introduction of Reforms Extending the Portal April 2015 Fixed Costs for Medical Experts via MedCo January 2016 the requirement of all Medical Experts on the portal to be accredited

26 Reviewing the Objectives the number of claims

27 RTA Portal data: Lies, damned lies and statistics May June July Aug Sept Oct Nov Dec Jan Feb March April 2010 / / / / / 2016

28 The Cost of Claims April 2013 fixed fees more than halved to 500 to Stage 2 Reduced fixed fees outside the portal But the claimant market has adjusted and we have seen: De facto referral fees being paid in a variety of guises General damages inflation from September 2012 to April 2015 of 30.1% An increase in frequency of 8.6% from 2012 to 2015 ( the death of access to justice?) Increased frequency and cost in terms of rehabilitation with some large firms having a rehabilitation frequency which comfortably exceeds 50% compared with a market average in the low 20% range

29 Success or failure Jackson/LASPO? Clear failure in respect of frequency and the cost bonus for insurers is eroding fast 5.2% increase in motor premiums in the three months to the end of June 2015

30 MedCo Implemented too quickly and without due consideration to the commercial realities of the claims world resulting in unintended consequences: Changed a consolidating MRO market into an expanding market Multiple MRO Gaming The impact of an expanding market on quality the price-quality-volume triangle The provision of data in a set format. Why not introduce a competitive tender to select independent national and regional MROs to provide expert medical evidence stipulating: Compulsory auditing of the medical experts on their panel The provision of copies of the audits to MedCo True financial independence from those instructing them

31 Possible further reforms and necessary steps An effective referral fee ban criminal penalties Ensuring that rehabilitation takes place where appropriate and at the right time and in compliance with the N.I.C.E. guidelines Curtailing the excesses still prevalent particularly in the CMC market we await outputs from the Insurance Fraud Taskforce and the Treasury/MOJ review on CMCs Reducing MROs on MedCo via competitive tender process Get the accreditation process right

32 The political piece Conservative Government They are pursuing cost of living policies motor insurance feeds into this Impact of previous Government intervention now more than questionable - Small Claims Track increase? Care not cash? Future reform more likely under this Conservative Government. Watch this space!

33 What is still to come? Output from the Insurance Fraud Task Force end 2015 Output from the Treasury / MoJ review of CMCs end 2015/ Q Output from MedCo Framework review end 2015 MedCo accreditation MoJ LASPO review 2016/17? Further RTA PI intervention? Driverless cars pilots summer 2015