Report from the Claims Club Meeting
Report from the Claims Club Meeting
14th February 2008, Treating customers fairly and insurer relationships with medical reporting organisations were discussed at the first claims Club meeting of 2008, as Jonathan Swift writes The insurers with the worst record for paying medical reporting organisations were named at last week’s claims club meeting, with many larger players coming out worse than their niche counterparts.
Dr Harry Brünjes, the chairman of Premier Medical Group, spoke about the background of the tariff system introduced in the wake of the 2006 Court of Appeal judgment in the case of Wollard v Fowler, which he described as a “bunfight”. Master Hurst clarified that the fees charged for supplying medical reports and records are reasonable and proportionate, and that they can be recovered in full as a disbursement from the defendant liability insurer under CPR45.10 (2).
Dr Brünjes asked the audience whether they thought everyone was now paying the fees within the 90 days as insurers are supposed to, whether the systems were working effectively, or whether some were better than others, before admitting he had compiled his own top ten based on his firm’s experiences.
At the top of the list was Provident with 100% followed by Fortis, where, he joked, “his friend, head of technical claims Nick Gunter, played the hard man” but paid on time in 95% of all cases. Moving on Equity was third, Allianz fourth and HSBC fifth.
Dr Brünjes continued by adding: “The bigger the insurer the worse their pay schedule appears to be”.
LARGE PAY-OUTS LEFT MEDICAL INSURERS IN POOR HEALTH
Insurers are paying for the large fees paid to medical professionals in the past, and the more esoteric the claim the larger the cost to companies, it has been warned.
Dr Harry Brünjes, the chairman of Premier Medical Group, said: “If you need a neurologist in Penzance, they will charge you an arm and a leg because they are likely to be the only one. It is the same if you need a neurophysicist in Cromer.
“These people have got leverage because of a generation of insurers who blindly paid out claims.” However, he added that in the future the insurance industry may be in a better position when negotiating fees because of a proliferation of medical schools churning out more doctors than needed. “There are simply too many out there,” he concluded.