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Resolving Injury Claims Risk managing the bitter pill with early care PowerPoint Presentation
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Resolving Injury Claims Risk managing the bitter pill with early care

Resolving Injury Claims Risk managing the bitter pill with early care

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Resolving Injury Claims Risk managing the bitter pill with early care

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Presentation Transcript

  1. Resolving Injury Claims • Risk managing the bitter pill • with early care • without unnecessary proceedings

  2. The Current System Does Not Work! • For claimants • For the public sector • For lawyers • Many have tried to fix it – none have succeeded • InterResolve has started afresh with a blank sheet

  3. The InterResolve Scheme A completely new system for resolving injury claims A ‘Care Network’ - involving • Medical and rehab providers • Responsible insurers, employers, local authorities, NGOs and others who want to • Help care for people from point of injury • Identify and resolve legitimate claims • Increase use of early rehab • Attack fraud/exaggerated claims – pre lawyer/pre-CMC

  4. network Claimants Major employers Local Authorities NGOs & others Other public bodies InterResolve Central IT system; objective rehab assessments; neutral facilitator and administrator Rehab. providers Medico-legal providers Local PCT & GPs Local CAB/ Law Centres LawAlliance Contracted lawyers Principals Service providers Other stakeholders Start in the local community • Payers; Lawyers; Service providers • InterResolve is neutral, non-conflicted hub

  5. The InterResolve Network Use network to develop • Public awareness and message • Injury claims not just about money • Start to change public attitude • Message will take time • Concerted effort needed • Anti fraud measures • Early offer of rehab can act as fraud filter • Data sharing locally to identify serial claimants

  6. The InterResolve Network Use network to develop • Early rehabilitation treatment • Early care/rehab can control/reduce future loss • Start with objective assessment • Get message out to those you want to help • But take care not to encourage claims

  7. Problems with current system For claimants • Delays and frustrations • Traded and commoditised by CMCs • Not told what really happens when respond to TV ads • Care/rehabilitation – too little/too late

  8. Problems with current system For payers • Hugely disproportionate claims costs • Particularly for smaller claims • PAP, ATE & MLR as though for litigation • Delays in being able to offer rehabilitation • Fraudulent/frivolous/exaggerated claims

  9. Problems with current system For lawyers • Case referral fees and advertising costs • CFA formalities • Cost of funding disbursements (inc mediation) • Costs wars & satellite litigation • Cashflow delays and tight profit margins

  10. The InterResolve Claims A New Claims System • Straightforward claims • Providing earlier settlement • With independent legal advice, but • Without formal legal representation – at 50-80% less cost • More complex claims • Contractually agreed terms with lawyers for • Agreed/fixed costs • Conduct without Pre-action Protocol • Medical evidence • Advanced ADR options – all without need for legislation

  11. claims Claimants Simple Claims Legal & Medical Opinions w/o representation More Complex Claims Referred to lawyers under contract InterResolve LawAlliance LawAlliance • A new group • Specialist personal injury lawyers • Contracted into InterResolve Claims scheme

  12. claims LawAlliance Advisors first, litigators last Route 1 Simple Claims Anonymised ILOs (LA membership details public ) Route 2 More Complex Claims Retained under contract • No PAP • No ATE • No CFAs • No success fees • No referral fees No formal representation • Early rehab report/ medical prognosis • Independent Legal Opinion • LA member can decline • Neutrally facilitated settlement Contracted representation • Agreed conduct of claim • Agreed fixed legal costs • NCB Rules apply • No costs disputes • Early mediation/ADR • Opt out for CPR • Special ATE • Costs crystallised ) )Total costs (medical, ) legal & IR) sub £1k )= Savings 50-80% )

  13. The Benefits 9

  14. The Benefits 9

  15. The Benefits 9

  16. The Benefits 9

  17. The Winners • Legitimate claimants • Early care/rehabilitation • Fewer delays/less frustration • Earlier claims settlements • Greater involvement in process and outcome

  18. The Winners • Payers (insurers, employers, local authorities, NGOs and others) • Hugely reduced claims costs • Reduced claims administration costs • Reduced future general and special damages • For EL – employees back to work • Increased fraud control

  19. The Winners • Lawyers • New source of business • Better business model • ‘Free’ new cases without referral fees/ advertising costs • Cashflow and profitability benefits (this is reason why so many now joining LawAlliance)

  20. The Winners • UK Plc – the wider scene • Public • Positive cultural change • Public wellbeing • Business • Reduced direct and indirect cost • Workplace/reduced business interruption benefits • State • Changes effected without legislation • Relieved pressure on NHS • Availability of data from scheme • Independent monitoring by Nottingham Trent University

  21. Where we are now • LawAlliance • Detailed contract - terms negotiated with SSC • Announcement of launch this week • Growing interest (inc from defendant firms) • Insurers, employers, LAs, NGOs • Extensive discussions during 2005 • Initial pilots (C.5,000 cases) targeted 2006 • Announcements due Spring 2006 • Keen for Local Authorities to join local schemes

  22. network Claimants Major employers Local Authorities NGOs & others Other public bodies InterResolve Central IT system; objective rehab assessments; neutral facilitator and administrator Rehab. providers Medico-legal providers Local PCT & GPs Local CAB/ Law Centres LawAlliance Contracted lawyers Principals Service providers Other stakeholders Start in the local community • Payers; Lawyers; Service providers • InterResolve is neutral, non-conflicted hub

  23. Peter Ashdown-BarrManaging Director and CEOpeterab@inter-resolve.com 020 7877 0370 InterResolve Holdings Ltd Tower 42, 25 Old Broad Street London EC2N 1HN www.irbics.com