Secondary psychiatric injuries add ‘significant sums’ to PI claims costs – Kennedys

Insurers dealing in personal injury (PI) claims need to be aware of the domino effect of new psychiatric conditions that can develop as a result of being laid up with a physical injury, as these can add “significant sums” to the claim value, according to Robert Corrigan, associate at law firm Kennedys.

Speaking at a Managing General Agents’ Association (MGAA) webinar on Monday 9 November, titled ‘Emerging risks in injury claims’, Corrigan explained that victims of road traffic accidents who suffer physical injuries that keep them at home for extended periods of time could develop a consequential psychiatric condition, such as a gaming disorder – the analysis and treatment of this secondary condition would then need to be stacked on top of existing claims costs.

Although a relatively new condition, Corrigan said that gaming disorders were a particular concern here, especially during the coronavirus lockdown when many people are remaining at home.

A gaming disorder is identified when an individual prioritises gaming over other activities, such as going to work, eating or sleeping; the World Health Organisation adopted diagnosis criteria for the condition in May 2019 and the first NHS treatment clinic for gaming disorders opened in October 2019.

It is easy to see how a claimant recovering at home may turn to video or computer games to pass the time, however this can escalate. Corrigan cited, for example, an incident in China where an individual passed away due to exhaustion-related injuries caused by a gaming disorder.

“We can envision scenarios where a claimant suffers physical injuries, which will keep them homebound for say six months, however during that time they may develop a gaming disorder as an indirect consequence to the physical injury. This would add to their award for [pain and suffering and loss of amenity] and potentially also increase the claims for loss of earnings and treatment,” Corrigan explained.

Addiction expenses

Another condition that can influence personal injury payouts in a similar way is opioid addictions, which can often lead to other psychiatric disorders too, added Corrigan.

As opioids are commonly used to treat chronic pain or pain post-surgery, Corrigan said that it can be easier for claimants to establish causation and link an opioid addiction to their personal injury claim, for example if they were prescribed opioids following a RTA and then they became dependent on the drug as a result.

The treatment for opioid addictions and gaming disorders are similar – typically they would involve a detox, which can be expensive if conducted at an in-house facility, talking therapies and aftercare.

“It’s fairly easy to see how fairly simple claims can suddenly become more complicated, more than double in value and also increasing costs due to the extra work required and the additional expert evidence needed,” Corrigan said.

Claimants can even also be compensated for money that was wasted on their addiction, whether this be drugs, alcohol or video games.

Corrigan warned: “When reserving, it’s worth keeping in mind that one psychiatric condition can lead to another and even seemingly straightforward physical injuries can lead to psychiatric injuries, which can add significant sums to the value of the claim.”

When defending these claims, Corrigan advised insurers to be wary of red flags which signal that the claimant’s behaviour does not align with what they described in their claim, for example if they are regularly seen out of the house when claiming to have a gaming disorder.

He added that offering early intervention can also help to minimise costs, as often these are cheaper than resorting to in-house treatments later down the line.