Claims Management Policy. Business Services Organisation

Transcription

1 Claims Management Policy Business Services Organisation September 2011

2 1. Introduction From time to time, claims for damages are pursued against the Business Services Organisation (BSO). Arising from its obligations related to controls assurance, and linked to DHSSPS Guidance on Risk Management and Claims Handling, the BSO is required to have a policy on the management of these claims. There are risks involved in the activities of all complex organisations and this Policy is part of the BSO s overall Risk Management strategy for processing claims and providing information to managers to help reduce those risks. 2. Policy Statement The BSO will take steps to manage personal injury claims arising out of activities carried out by the organisation. Personal Injury claims are defined as Any claim in respect of injury to any person including bodily injury, psychiatric injury or death for which an HSC body is legally liable and which does not fall within the definition of clinical and social care negligence 3. Policy Aims The key aims of the policy are to: Ensure that any claims arising are managed effectively; Protect staff and the BSO from vexatious allegations; Provide value for money for the taxpayer; Contribute to learning around the management of risk. 4. Key responsibilities 4.1 The Chief Executive has overall responsibility for the management of personal injury claims and will keep the Board informed of major developments. 4.2 Operational responsibility for ensuring that claims are properly managed is delegated to the Chief Legal Adviser (the Claims Manager). 4.3 Personal injury claims received by any member of staff should be sent immediately to the Claims Manager and the appropriate Director should be made aware that a claim has been received. 2

3 5. Policy Implementation Role of Claims Manager 5.1 All correspondence concerning legal claims should be routed through the Claims Manager who will manage, handle and co-ordinate all claims arising from BSO activities. Such claims usually relate to employers/occupiers liability. A quarterly report will be sent to the BSO Senior Executive Team and the Governance Audit Committee setting out anonymised details of all claims received during that period. The Claims Manager on the advice of the qualified legal adviser handling the claim will set a reserve for damages and costs against each claim and these figures will be included in the report. The Claims Manager will ensure compliance with the pre action protocol for personal injury claims. Where there is a conflict of interest, it may be necessary to instruct external solicitors to act on behalf of B.S.O. 5.2 Claims Handling A record of claims will be maintained on the DLS Legis database. All claims must be investigated in a timely manner to establish an objective account of the incident and to identify and secure all records relating to the incident. The decision to seek to negotiate a settlement or to continue to defend a claim will be taken by the relevant Assistant Director or Director following receipt of legal advice. Any settlement must be approved by the Chief Executive. Payments will be processed in accordance with the BSO Scheme of Delegation. Training and Awareness 5.3 The BSO will ensure that appropriate staff will receive training on the Claims Management Policy. The BSO will take steps to promote awareness of the policy at induction. Policy Monitoring and Reporting 5.4 A report will be sent to the BSO Senior Executive Team and the Governance Audit Committee in relation to requirements set out in paragraph 5.1 on a quarterly basis. In addition, the BSO will use these statistics as evidence towards compliance with the Risk Management controls assurance standard issued by the DHSSPS. 3

4 Grading of Claims (FRS12) 5.5 Once a claim has been established it will be graded using Minimum, Average and Maximum values for; (i) estimated estimated settlement figure plus cost of case, and (ii) probability of payment These values will be entered into the DLS case database Legis and updated as the matter progresses by the Claims Manager or delegated solicitor. The Director of Finance will also be advised of these values. 6 Corporate Assessment 6.1 The policy will seek to minimise the possibility of adverse events affecting the BSO s staff or its services. 6.2 This policy has been screened for equality implications as required by Section 75 and Schedule 9 and of the Northern Ireland Act Equality Commission guidance states that the purpose of screening is to identify those policies which are likely to have a significant impact on equality of opportunity so that greatest resources can be devoted to these. Using the Equality Commission s screening criteria, no significant equality implications have been identified. The policy will therefore not be subject to equality impact assessment. 6.3 The BSO has considered its obligations under the Human Rights Act 1998 and is satisfied this Policy does not breach these obligations. 6.4 This Policy conforms with the HSSPS Policy on Handling of Personal Injury Claims. 7 Policy Review 7.1 The policy will be subject to formal review every two years from the date of implementation. Approved By: Date Approved: 4

5 This Policy should be read in conjunction with the following BSO Policies/Strategies: (i) Adverse Incident Reporting Policy (ii) Health & Safety Policy (iii) Risk Management Strategy (iv) Complaints Policy (v) Waste Management Policy Sources: NHS Litigation Authority RPST Phase 2 Assessment Tool, March 2002 DHSSPS, Core Risk Management Standard, 2002 DHSSPS, Circular: HSS (f) 20/2002 DHSSPS Circular HSC (SQSD) 5/10 Handling Clinical and Social Care Negligence and Personal Injury Claims This Strategy can also be made available in larger print and can be translated into a range of minority languages to meet the needs of those people who are not fluent in English. Please contact us on (028) if you would like a copy in an alternative format. 5