At long last, the Official Injury Claim portal is here. Insurance Times’s Fraud Charter attendees reveal current concerns with its functionality amid low claims notifications
By Editor Katie Scott
The much-delayed Official Injury Claim (OIC) portal finally came to fruition last week (31 May 2021), despite the mixed emotions and functionality concerns of professionals within the personal injury claims arena.
Although the portal has been operational for under two weeks, industry experts used this month’s Insurance Times Fraud Charter roundtable event to share their experiences – and niggling worries – around using the new system so far.
The main consensus between law firms present at the online event was the concern about the lack of claims being notified through the portal – Keoghs partner Ruth Needham, for example, said most insurers are only seeing a single figure number of claims coming through, which certainly isn’t enough data to start doing trend analysis with.
Donna Scully, director of Carpenters Group and Fraud Charter chair, agreed – the current claims trajectory is making her feel “quite nervous”.
She explained: “There aren’t a lot of claims, so we’re thinking ‘is it working’? There’s not enough claims, so we’re hoping that there’s not going to be an avalanche of claims in a week or two weeks that are backed up. It’s more quiet than it should be and people are out [of lockdown] more now. We’re quite nervous.”
Laura Horrocks, fraud assessment and intelligence manager at Sedgwick, added that third-party administrator firms are having this same problem too.
“We aren’t notified of the claims, so we aren’t yet aware of the true number of claims that are being presented by our clients because we have to wait for them to reallocate them to us. It’s an ongoing challenge. Hopefully we won’t get an avalanche of claims in the coming weeks,” she said.
Despite these concerns, David Parkin, deputy director for civil justice and law at the Ministry of Justice (MoJ), informed attendees that the new portal is running smoothly and that the Motor Insurers’ Bureau (MIB) has contingency plans in place to deal with any potential claims surges.
He added that both the MoJ and the MIB are monitoring daily the “pick up of claims”.
Meanwhile, Simon Roylance, claims crime prevention team manager at LV=, confirmed that the insurer has not put any claims from the OIC portal through to the fraud team as of yet, however he is hearing anecdotal evidence that claimant law firms are struggling to put claims through the new system.
Emerging problems
Aside from tentatively waiting for the onset of whiplash claims, Scully added that the OIC portal’s search functionality is also “throwing up incorrect information and it is hard to find [the] correct insurer”.
She noted that this “emerging problem” is “slowing things down”.
Scully also believes the 30-day time limit for making decisions on claims that are using the OIC portal could be problematic if the clock starts as soon as a claim is notified, but before all the correct firms needed for the claim to progress are identified.
“At Carpenters, we have a big IT department and that department was very busy in the lead up and on day one and ongoing, we have a lot of IT people working on it – you have to do quite a lot to get it working and there are some workarounds,” she said.
“We’re making it work. It’s just when you put your claims on, where are they going and are they getting to the insurers? Once we get them on, we don’t know where they’re going because there’s 30 days for us to get a response. It’s like a black hole.”
Faye Fishlock, Carpenters Group’s head of defendant insurance services, also raised concerns around the use of “exceptional circumstances” – where payments specified in the compensation award tariff table can be increased by 20%.
She said: “Conversely to what the rules indicate, ‘exceptional circumstances’ are being claimed on the majority of the claims that are coming through.
“[Originally it was believed that], one in 100 claims would have exceptional circumstances – it seems to be 90, 95 out of 100 of the claims have got exceptional circumstances at the moment as well.”
Combatting this will require judicial guidance, Scully responded.
Meanwhile, access to individuals’ personal information is making some clients uncomfortable, noted Sarah Glenn, commercial director at RGI Solutions. One of her clients is worried about details “getting in the wrong hands”, so they have asked “that we don’t include personal addresses, we keep it with the corporate address when the statement’s being taken”.
Change in behaviour
Prior to the portal’s implementation, the Fraud Charter group discussed how fraud could blossom around hybrid and non-whiplash injuries in a bid to secure higher compensation amounts outside of the tariff table limits – Scully said that the roundtable was right to be worried and that their fears in this area have sadly been confirmed.
AXA’s Tom Wilson, senior counter fraud operations manager, concurred with this, adding that the insurer has seen a lot of leg injuries in recent claims. Scully noted she had witnessed an uptick in bruising.
In addition, Carpenters Group has seen many firms “reserving” their position until the medical report has been completed – the company believes this is a protective measure, allowing the full extent of injuries to “come out of the woodwork” before the involved parties make any moves.
The OIC portal launch has been as expected then – yes, a functioning portal has been provided for the sector to use, however there is still fine tuning to be done.
Earlier this month, for example, the MIB established a cross-sector working group after the MoJ announced the deferral of hybrid injuries from the new portal – this aims to create a framework and gain clarity from the Court of Appeal on dealing with mixed tariff or hybrid injury claims.
The thing is none of this is new. In the run up to the OIC portal’s introduction, the fraud concerns around claims with multiple injury types was raised numerous times by industry experts – including the Fraud Charter panel itself - yet these discussions weren’t factored into the portal’s development, or at least not strongly enough to prevent the expectation materialising.
Maybe this was simply to prevent further delays, however it seems premature to be sticking plasters on the portal so soon after its release.
Parkin was keen to collate feedback from Fraud Charter attendees on the portal’s operations – it will be interesting to see how the portal evolves in the next few weeks and months off the back of this.
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