01/02/2022

Official Injury Claim: emerging data and trends

Seven months since the launch of the Official Injury Claim (OIC) portal in the UK, more data is emerging every day as claims progress. Whilst early analysis of data can sometimes be misleading, there is now sufficient data to start forming conclusions.

Artificial Intelligence (AI)

As medical reports are received, we deploy Kennedys' AI tools and text analytics to analyse both structured data from the portal and unstructured data in the form of medical reports.

We have invested a lot of energy to ensure the efficacy of the approach whilst exploring and experimenting with the noise in respect of human decision-making in comparison.

Karim Derrick, Product and Innovation Director

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Delayed disclosure of medical reports?

Our findings are showing that four in five medical reports are still pending for accidents that occurred five or six months ago, which is surprising.

If MoJ timelines were replicated in the OIC portal, we would expect more claims to have achieved settlement by now, and certainly more medical reports to have been disclosed. Perhaps reports indicating a six month prognosis, for example, are being held until the expiry of the prognosis period? However, we are now seven months since the OIC’s implementation and more medical reports were expected to have been disclosed by this point.

Although this may not pose a problem in the short term, it will start to become an issue if people stop using the portal because it takes three months for the claimant to obtain a medical report in the zero-three month bracket. A prognosis of three-six months is more likely, and onwards to the six-nine month bracket. It is also worth bearing in mind that the savings projected by having the OIC portal in the first place, will be eaten into with every delay and extra step needed. 

Equally interesting is that the data shows significantly higher proportions of claims submitted by litigants in person have medical reports supporting them. It therefore appears that a litigant in person is able to progress claims reasonably proficiently.

Exceptional severity claims

Our data also shows there is enormous variation in respect of claimant representative firms where the claimant is claiming exceptional severity.

Mike Gilpin, Commercial Director

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Some claimant representative firms are actually running at 100%, whilst others are coming in at high 40s. In contrast, some aren't putting any in. What will be interesting in respect of those who are silent on the point, is what sort of instructions are given to the medic and what they are asked to comment on by way of exceptional severity. 

Notable from our data is that more litigants in person are claiming exceptional severity. Are medical examiners supporting the claimant contention that the case merits an exceptionally severe award? In the majority of cases no exceptional severity has been claimed and the medical examiner has not offered a different view. 

For those claims where the SCNF indicated exceptional severity and the medical report had been submitted, the medics agreed that a diagnosis of exceptional severity was merited in around 60% of the cases. In 3% of claims, no exceptional severity was claimed in the first instance, but was found by the examiner. 

What does exceptionally severe amount to? Comparing the MoJ position and the OIC position is instructive. Currently claimant representatives are talking about aggravating symptoms and features, so it may well be as low a bar as that.

Ian Davies, Partner

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Whiplash claims – lower than expected?

Currently only 11% of what can be described as purely whiplash claims are present.

Psychological injuries on the increase?

Psychological elements were indicated in 72% of MoJ claims pre-OIC. Current statistics are showing that this is growing to 82% in OIC claims. We are also seeing how composite claims are appearing i.e. those that contain an element of psychological injury but also non-tariff injuries.

Prior to the OIC launch, roughly a third of MoJ claims had that composite nature. Early insight into the data in the first six months indicate this has increased by 40%. Around 45% of all claims now are a mixture of whiplash, psychological and non-tariff injuries.

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