Government must overhaul whiplash medical reporting standards and use evidence-based medicine

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If the Government must overhaul whiplash medical reporting standards if it chooses to press forward with reform of soft tissue injury claims, according to Beacon Independent Medical Examiners.

In its response to the Ministry of Justice’s consultation paper Reforming the soft tissue injury (whiplash) claims process  – which closes today – the company has said that the Government should give serious consideration to demanding the use of evidence-based medicine in whiplash medical reporting.

Beacon has said that there is “no good reason” for people to continue to simply rely upon medical expert opinion based on a claimant’s story or an individual doctor’s own experience.

“The evidence-based medicine (EBM) model is a proven effective tool for settling claims more accurately and giving stakeholders the key facts needed to weed-out exaggeration and fraud,” said the firm’s CEO Phillip Kizun.

“Evidence-based medicine is used to settle insurance claims in other advanced jurisdictions such as Australia, Canada, and the United States. Why not here in the UK?”

According to Beacon, EBM involves the use of current evidence-based and peer-reviewed medical literature to inform a doctor’s opinion when assessing the expected recovery time from an injury. EBM is supposed to improve decision-making by emphasising the use of evidence from well-designed and conducted research. Beacons maintains that fair and objective conclusions can be drawn about the claims made using this methodology.

“Disappointingly we do not believe that evidence-based medicine is used to qualify insurance claims and it is not being considered seriously,” said Kizun. “This is in spite of the huge savings on offer.”

“The fundamental issue is that the current UK claims system reinforces exaggeration and fraud. In the vast majority of low-value claim medical reports a doctor’s opinions is based on the claimant’s history, which is taken as reliable, in spite of financial incentives to provide false information. Doctors take the claimant’s word when they attribute severe symptoms to a minor collision such as whiplash occurring following a decision.

“The doctor is paid to produce a report, confirming the subjective claims made by the individual. This practice of accepting the doctor’s experience and personal opinion as sufficient to support a medical claim, ignores objective assessment of the claims made using the latest medical science.”

Kizun added that dealing with the medical elements of a personal injury claim had been marginalised and undervalued for far too long.

“Gone are the days when a range of medical opinions are relied upon when documenting an injury. By using opinion based on science to both document an injury and then to qualify a claim using the same science, everyone with a legitimate claim wins. Those looking to take advantage of current weaknesses in the system lose.”

In its response to the consultation Beacon has stressed its belief that EBM would have a radical and positive impact on insurance claims. It says that the public would see premiums reduced considerably in the future.

“There are many shades of fraud and realistically it would be difficult to eradicate completely, however, evidence-based medicine would make the most significant measurable difference in the shortest space of time,” said Kizun.

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Marek Handzel

Marek Handzel is the editor of Claims Magazine. Marek welcomes articles, letters, or feedback from readers and can be reached by emailing marek.handzel@barkerbrooks.co.uk