2 jun 2020

Should MedCo video examinations stay?

On 23 March MedCo temporarily lifted the ban on the use of remote examinations on claimants for the purpose of obtaining MedCo reports.

In a recent communication from MedCo, they commented that several users have contacted MedCo to express their concerns about the potential for compensators to challenge medical reports just because examinations were not undertaken face to face.

MedCo responded by highlighting a recent joint statement of intent between the ABI (Association of British Insurers) and ACSO (Association of Consumer Support Organisations) for progressing claims during the COVID-19 crisis. Within this statement of intent is reference to remote examinations. 

It is worth noting that whilst this is a statement of intent, this is not a guarantee that remote video examinations will not be challenged, especially by non ABI members, such as self insureds, or where genuine issues or questions arise. 

Any challenge on the probity or £180+VAT fixed cost of the MedCo report will not be the basis of the method of examination itself being by remote video, as long as the latest MedCo guidance has been followed. For the avoidance of doubt, the MedCo guidance does not require compensator approval for a remote examination and this Statement of Intent reinforces that position. Examinations should not be delayed for any such purpose.

The statement of intent suggests that there will not be a challenge to the video MedCo report solely based on it being a video examination as long as the latest MedCo guidance has been followed, however within the guidelines issued by MedCo it does state for legal representatives to advise claimants of the risk of a compensator challenging the report.

Legal representatives should ensure that claimants are made aware of all potential risks including, but not limited to, the fact that there may be a higher risk of a compensator challenging the report, and possible need for a further report etc.

The existing MedCo guidance up to this point has not been in favour of embracing remote video assessments, instead favouring a face to face physical examination by the expert. 

One could argue there are pros and cons to both remote video assessments and face to face examinations, fraud risks can exist in both scenarios.

We have recently explored some interesting issues around proving a whiplash injury, a largely subjective injury, in a recent blog by Michael Bickerstaffe.

MedCo are already tackling a high level of abuse within the MedCo platform as illustrated in the latest MedCo factsheet published for March 2020. The enforcement action is against medical experts, MRO’s and solicitors.

Looking back over the previous twelve months, comparing March 2020 to April 2019 figures we can identify the enforcement action taken against medical experts, MROs and solicitors for that period: 

  • 385 warning letters sent
  • 125 users suspended from MedCo register
  • 488 users have been terminated from the MedCo service

Is the current medical reporting process providing a robust enough process for assessment of claimant injuries?

An average of more than one warning letter sent a day in last 12 months to MedCo users in relation to enforcement action.

Total numbers since MedCo went live in April 2015, as of March 2020:

  • 1,500 warning letters sent 
  • 530 users suspended from MedCo register
  • 2,782 users have been terminated from the MedCo service

Even though the introduction of the MedCo platform is relatively new, the process of obtaining a medical report has remained largely unchanged:

  1. Claimant attends medical examination
  2. Assessment undertaken
  3. Report compiled by medical expert
  4. Sent to claimant representative
  5. Sent to claimant for approval
  6. Sent back for amendment if inaccurate
  7. Report approved
  8. Report submitted to insurer.

For low value whiplash claims where the claimant has already recovered at the time of the examination the medical report is little more than an expert documenting the claimants version of events and agreeing with the claimants alleged recovery period. What would be lost if this was to take place over video call?

From our experience with dealing with travel sickness claims, medical assessments are routinely undertaken via video examination, this is accepted practice in this area given the majority of assessments are undertaken on claimants that have fully recovered. It is accepted that there are no additional benefits from a physical examination, given the nature of the injury i.e. short term sickness. Medical evidence obtained in this manner hasn’t undermined our ability to detect and defeat fraudulent travel sickness claims.

One could suggest that video recordings of any ‘examination’ have far more evidential value than just a written report. The recorded examination would provide a first hand account from the claimant. The medical expert could provide their opinion and prognosis either as part of the video recording or within an accompanying written report. Streamlining the process, with less ambiguity around the assessment of injuries. This would be especially useful in cases where surveillance evidence calls into question the severity of injuries or where there is a dispute between the claimant and the expert as to what was reported.

Video recordings don’t change the evidence, just the method of obtaining it.

Outside of MedCo there are current examples of more severe injuries having video examinations and rehabilitation treatment being provided over video call. Insurers and lawyers are likely to raise issue with those reports particularly where discrepancies arise in the evidence, this could also offer the claimant a ‘get out’ for a difficult line of questioning as they can point to the video examination. 

A combined 33,482 Direct Medical Experts and Medical Reporting Agencies were selected on MedCo in March 2020. Are these the unintended pilot test cases for a MedCo video assessment revolution? 

Does this lay the groundwork for an even simpler compensation journey for litigants in person? Especially when you consider the impending introduction of the new litigant in person claims portal

On balance MedCo video assessments should be here to stay, but there needs to be an appreciation towards increased fraud risks, and where video examinations are undertaken a defendant should be able to obtain their own evidence or request a physical examination without justification.

Read others items in Motor Brief - June 2020

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