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Resolving Injury Claims Risk managing the bitter pill with early care without unnecessary proceedings. The Current System Does Not Work!. For claimants. For the public sector. For lawyers. Many have tried to fix it – none have succeeded.
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Resolving Injury Claims • Risk managing the bitter pill • with early care • without unnecessary proceedings
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
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
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
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
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
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
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
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
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
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
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% )
The Winners • Legitimate claimants • Early care/rehabilitation • Fewer delays/less frustration • Earlier claims settlements • Greater involvement in process and outcome
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
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)
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
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
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
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