A trial undertaken by motor insurer Highway has shown that case management led rehabilitation can lead to earlier settlement negotiations and increased accuracy on reserving by helping claimants return to pre-accident employment or to consider practical alternatives.
The three-year trial provided comprehensive data on the effects of rehabilitation on claims expenses, settlement times and reserves.
Unfortunately, information on these issues within the Insurance Market is often unavailable or inconclusive.
Nearly a third of Highway's serious personal injury claims were considered suitable for rehabilitation. These included claimants who had experienced a moderate to severe musculo-skeletal injury, and care treatment and other services including assistance to return to employment.
All files were subject to an Immediate Needs Assessment (INA) – often carried out shortly after an incident. In approximately 30% of the cases, the rehabilitation process stopped at the INA stage, mainly because it was felt, by both parties that the claimant would not benefit from continued input. Over 50% of cases did receive continued case management, treatment provision and other services.
Highway's rehabilitation trial showed:
Medical updates from case managers lead to more accurate reserving. Receiving regular medical updates from the case managers on over 50% of cases referred for rehabilitation assisted Highway in the Measurement of reserves, leading to increased accuracy.
Claimants receiving case management led rehabilitation seem to have a better chance of returning to work. Almost half of the claimants involved returned to work within 18 months of injury or had a reasonable prospect of a return to some form of employment or positive training.
The review also identified challenges that need to be overcome for the future. Not all claimants benefited from the Immediate Needs Assessment. There was clearly a need for early, detailed discussions, between the solicitors and insurer to establish the best way to address their client's particular needs. It was necessary that both parties establish whether a proposed case manager had the necessary experience to deal with the often-complex issues involved and rehabilitation providers should be expected to carefully monitor the performance of their case managers.
Peter Gallagher, Highway's claims director, said: “Our trial has highlighted the fact that rehabilitation does work, however more research is still needed if the industry is to fully embrace it.”
