Linking the Industry Together
January 2016 | Issue 17 | ISSN 2051-6495 News: Ed Fletcher outlines how to create a fairer future for clinical negligence claims. Law and Order: Amputation is not something new in Personal Injury or Clinical negligence cases, Abdo Haidar eliminates some prosthetics myths. Priorities in 2016: Rob Cummings considers the industry’s main priorities moving into 2016.
Modern Claims Magazine | January 2016 | Issue 17
“The 2015 Insurance Act is fantastic, as it will bring us in line with everyone else, and puts London right back in the centre of the insurance world”
Georgina Squire
Duncan Rutter “It is important that Government appreciates making significant changes to the system for compensating victims of accidents can have unintended consequences”
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03
Welcome to W
elcome to the New Year edition of Modern Claims! I hope you all had a very restful Christmas and Happy New Year. The start of the New Year provides a chance to refocus, asses what’s to come in 2016 and consider how you should position yourself and your business in the year ahead. In this issue of Modern Claims, I speak to our cover star and new President of the Forum of Insurance Lawyers (FOIL) about his hopes and plans for his tenure and how he plans to divide his time between this and his role as a Partner and Head of Catastrophic Injury at DAC Beachcroft. Full coverage can be found from page 13. In line with the ‘defendant’ focus in this issue, I also spoke to Georgina Squire, Head of Dispute Resolution and Partner at Rosling King LLP. Georgina told me about two landmark cases, which have changed the scope for professional negligence claims, and also explained why, in her view, the Insurance Act 2015 is the biggest change the insurance industry has seen in one hundred years (coverage from page 17). Also in this issue, Ed Fletcher, Chief Executive of Fletchers Solicitors, and honorary news writer for this issue, outlines how to create a fairer future for clinical negligence claims and explains what to expect this year (page 7-8). The Association of British Insurers (ABI’s) Rob Cummings
also considers priorities for the motor claims market this year, and discusses the possible implications if the hike in the small claims track limit from £1,000 to £5,000 is approved by the government, he addresses the insurer’s perspective on this issue on page 53. The Chancellor’s Autumn Statement has ignited much debate, not only around the small claims track limit, but also around the abolition of compensation in the case of minor, soft tissue whiplash injuries. The announcement has once again divided the claimant and insurance communities and many of our columnists in this issue have addressed the possible implications of an increase. To hear the views from the claimant community, some of our columnists, including Sue Brown, MASS (page 23) and Donna Scully, Carpenters, give us their opinions on page 23 and 51 respectively. I would like to thank everyone who has contributed to this issue of Modern Claims. If you have any feedback or ideas for a future edition, I’d love to hear from you. Please do get in touch with me via the details below. I would like to wish you all a happy and successful 2016.
Charlotte Parkinson, Group Editor, Modern Claims Magazine. 01765 600909 | charlotte.parkinson@charltongrant.co.uk @modernchar
Dates for your Diary: Doctors Chambers Modern Claims Awards | 28th April 2016 | New Dock Hall, Leeds Doctors Chambers Modern Claims Conference | 15th June 2016 | Old Trafford, Manchester United
Modern Claims Magazine
Issue 17 | January 2016 | ISSN 2051-6495
Project Director Kate McKittrick
Group Editor Charlotte Parkinson
Project Manager Rachael Pearson
Events Director Julia Todd
Production/Editorial Assistant Ebony Lawson
Events Sales Martin Smith Modern Claims Magazine is published by Charlton Grant Ltd ©2016.
All material is copyrighted both written and illustrated. Reproduction in part or whole is strictly forbidden without the written permission of the publisher. All images and information is collated from extensive research and along with advertisements is published in good faith. Although the author and publisher have made every effort to ensure that the information in this publication was correct at press time, the author and publisher do not assume and hereby disclaim any liability to any party for any loss, damage, or disruption caused by errors or omissions, whether such errors or omissions result from negligence, accident, or any other cause.
MC // January 2016
04
CONTENTS 03-08 INTRO & THE News 07 Ed Fletcher talks news
Ed Fletcher outlines how to create a fairer future for clinical negligence claims.
21-47 The Opinions 23 Sector Soapbox
11-20 THE INTERVIEWS 13 Interview with...Duncan Rutter
Charlotte Parkinson, Modern Claims, speaks to the new President of FOIL and Partner and Head of Catastrophic Injury at DAC Beachcroft, about the potential impact of increasing the small claims limit from £1,000 to £5,000 and what he expects during his tenure as President.
17 Interview with...Georgina Squire
Charlotte Parkinson, Modern Claims, spoke to the Head of Dispute Resolution and Partner at Rosling King LLP about two landmark cases which have changed the scope of professional negligence claims, and whether the Insurance Act 2015 creates a level playing field between policyholders and insurers.
07
Modern Claims’ resident Associations, including Susan Brown from MASS and BIBA’s Andrew Gibbbons explore the key issues in the claims industry at the moment.
25 Beyond the insurance space
David Williams, AXA Insurance
25 Protecting yourself and your felt
17
Andrew Fletcher, Ageas Insurance
27 A final nail in the coffin?
Lesley Graves, Citadel Law
27 The modern fleet
Andy Whatmough, S&G Response
29 Ahead of the Curve
Victoria Rawlings, TRS Claims
29 Lowering risks for your drivers
Gerry Lee, P R Hanna Solicitors
31 An open mind
Aaron Pearson, Three Graces Legal
25
31 Customer engagement: get it
right now
Tara Shelton, I-COG Claims Management
33 Clarity or confusion?
David Simon and Chris Foulkes, Triton Global
Editorial Columnists Aaron Pearson Director and Solicitor Three Graces Legal Abdo Haidar Consultant Prosthetist/Orthotist & Director The London Prosthetic Centre Andrew Fletcher Commercial Fleet Trading Manager Ageas Insurance Andrew Gibbons ACII Managing Director, Mason Owen Financial Services Ltd Chair on behalf of BIBA of the Industry Claims Working Group Andy Whatmough Managing Director S&G Response Chris Foulks Partner Triton Global Limited
MC // January 2016
Darren Gower Marketing Director Eclipse Legal Systems, part of Capita plc David Simon Chairman Triton Global Limited David J Williams Managing Director, Underwriting AXA Donna Scully Partner Carpenters Dr Hugh Koch Clinical Psychological and Director Hugh Koch Associates Ed Fletcher Chief Executive Fletchers Solicitors Emma Holcroft Director 2020 Investigations
Gerry Lee Senior Partner P R Hanna Solicitors, Belfast
Lisa Beale Head Checkaprofessional.com
Stephen Ward Managing Director Clerksroom & Clerksroom Direct
Helen Devery Partner BLM
Matthew Halton Forensic Engineer Laird Assessors
Hilary Meredith CEO Hilary Meredith Solicitors
Nicola Klimkowski Head of Business Control and Development LAMP Services Limited
Susan Brown Chair, Motor Accident Solicitors Society (MASS) Director, Prolegal
Janet Tilley Director of Volume Services Simpson Millar LLP Joe Pendle Director of Client Services Insurance Services Office (ISO) Keith Tracey Managing Director Aon Risk Solutions Lesley Graves Managing Director Citadel Law
Phil Swinburn Head of User Experience Slicedbread Rob Cummings Manager, General Insurance Association of British Insurers (ABI) Scott Whyte Managing Director Watermans Simon Pinner Director Box Legal Limited
Sucheet Amin Managing Partner Aequitas Legal Founder inCase™ mobile app Tara Shelton Founder & CEO I-COG Claims Management Victoria Rawlings Media and Marketing Manager TRS Claims Zoe Holland Managing Director ZebraLC
05
33 Risks on the horizon
Keith Tracey, Aon Risk Solutions
35 Technology to benefit both customer
and insurer
Dr Hugh Koch, Hugh Koch Associates
37 A single objective
Sucheet Amin, Aequitas Legal & inCase™ mobile app
37 A solution is required
51 Legal Opinion
Joe Pendle, Insurance Services Office (ISO)
35 Working together
49-58 The Features
Hilary Meredith, Hilary Meredith Solicitors
53 Priorities for the motor insurance
“Hot Tubbing?”
Matthew Halton, Laird Assessors
39 Leading the way
Lisa Beale, Checkaprofessional.com
41 Prevention is better than cure
Emma Holcroft, 2020 Investigations
Nicola Klimkowski, LAMP Services Limited
43 Taking centre stage in 2016
Stephen Ward, Clerksroom Direct
Rob Cummings considers the industry’s main priorities moving into 2016.
busted
Amputation is not something new in Personal Injury or Clinical negligence cases, but eliminating some myths on prosthetics and amputation can ensure your client receives a substantial win for them to continue living fulfilled lives, as Adbo Haidar reports.
Amputee Compensation Claims
Mark Ledger explains how continuing developments in prosthetics are enabling clients to return to a much more active life than was previously ever possible.
58 5 minutes with...Lindsey Davies
43 Don’t switch off
58 Ralli Solicitors Ltd chooses
45 So what happens now?
Zoe Holland, ZebraLC Simon Pinner, Box Legal Limited
45 Outside-in: Enterprise Mobile Apps Phil Swinburn, slicedbread
37
57 Key Issues to Consider for
41 Engage and raise awareness
market in 2016
55 Law and Order - Prosthetic myths
39 What are your thoughts on Experts
Modern Claims’ panel of resident legal experts including Donna Scully, Carpenters and Helen Devery, BLM outline key issues facing the claims industry.
Proclaim Practice Management software solution in six-figure deal Leading north-west law firm, Ralli Solicitors Ltd, is implementing the Law Society Endorsed Proclaim Practice Management Software solution from Eclipse Legal Systems.
53
47 The number one priority
Scott Whyte, Watermans
47 Facilitating customer choice
Miles Keeble, Veracity Claims Ltd
58 MC // January 2016
carpenters
Ed Fletcher talks news
07
Ed Fletcher Talks News... Ed Fletcher outlines how to create a fairer future for clinical negligence claims.
T
hose working in the claims sector have had more than their fair share of change in recent years and 2016 promises even more in the shape of fixed fees for clinical negligence. As the industry waits for the official consultation period to begin, many are already preparing the case for the defence highlighting how access to justice will be placed at risk in the race to cut the NHS’ legal bill. However, as those of us working in the area of clinical negligence are all too aware, the current system is far from perfect. It is possible that the introduction of a fixed fees system could be the opportunity many of us have been calling for, to ensure claims are fast and fair with both sides cooperating in the best interests of the injured party. A fairer and faster system could make a positive difference to thousands of people who have had to put their lives on hold while the true nature and cause of their injury gets bogged down in procedural game-playing. It may also be good for business. Greater speed and simplicity means a quicker turnover and shorter gap between hours accrued and fees paid, making it easier to manage cash flow. Of course, this requires some radical change and for the system of fair fixed fees to take a holistic approach that encompasses both professions. Many in the legal profession will be understandably sceptical. Motivations for change The primary motivation for change isn’t patient care, but to halt the NHS’ rising legal bill. In a climate of public spending cuts, the latest headline figure of £1.3 billion in fees and damages is politically and economically hard to take. Also, previous attempts to streamline the claims process and therefore reduce legal costs on both sides are yet to bear fruit. It’s hard to find anyone in the legal or health sector who believes that the much-heralded ‘Duty of Candour’ (where medical professionals admit to mistakes when injuries have been inflicted negligently) is yet to take root. It’s also possible to argue that radical change is not necessary as the impact of the LASPO changes on clinical negligence costs are yet to be assessed - the impact of which The Law Society is trying to quantify with its current costs survey. The latest figures I have seen suggest the 30% saving in legal costs that the government would like to see fixed costs deliver will actually happen now, irrespective of further change once the post LASPO cases wash through.
‘The introduction of a fixed fees system could be the opportunity many of us have been calling for, to ensure claims are fast and fair with both sides co-operating in the best interests of the injured party’
MC // January 2016
08
Ed Fletcher talks news
‘It’s time for a truce to be declared. For both sides to work together in a constructive manner to ensure the right outcome is reached in the quickest time with least cost’ So what should be on the agenda for discussion to create a system of fair fixed fees? 1. Appreciating the value of vetting Importantly, it requires the medical profession to appreciate the costs saved by the effective investigation of claims and the filtering of cases that occurs by claimant solicitors. A process that is currently invisible to the NHSLA. After a case has been through our vetting process, where often hundreds of pounds of disbursements have been incurred, we will only send a Letter of Claim to the NHS on well under 10% of cases of people who contact Fletchers wanting to make a medical negligence claim. This investigation service has to be provided by someone; claimant solicitors or the NHS. At present, it is claimant solicitors bearing the cost and a fair system of fixed fees should reflect this. 2. Duty of Candour must become reality The recent report from Dame Julie Mellor, the parliamentary and health service Ombudsmen, confirmed what professionals dealing with claims already know, that duty of candour remains a myth. In 73% of cases her office investigated, where there was a clear breach of a duty of care, the hospital had concluded no fault existed. If this attitude doesn’t change, fixed fees will become a shield for medical negligence to hide behind, as challenging such claims becomes unprofitable and unsustainable. Therefore, rules must enforce the right behaviours on both sides, encouraging the good behaviour and punishing the bad. Co-operation and reasonableness are crucial to minimising cost. 3. Focus on efficiency, not just lower costs Fair fixed fees will also require the focus to be on efficiency, not simply lower costs. The cheapest course of action is not always the right one, even when setting out to lower the legal bill. This will help ensure the system is impartial – anchored in good practice not political need – and accepted (who can argue with greater efficiency?). The most obvious illustration of this point are complex cases that are yet at a low enough claim value to fall under fixed fees.
‘The primary motivation for change isn’t patient care, but to halt the NHS’ rising legal bill’
MC // January 2016
Again, this requires co-operation on both sides and a willingness to accept that both parties have a duty of care to ensure a just and fair outcome. 4. Innovate with new approaches It will also be necessary to test innovative ways to handle cases. Both within law firms, where newer and more efficient systems will be necessary to ensure sustainable businesses, as well as for matters such as the use of expert witnesses. Experts are a large part of the ultimate bill – with each witness typically increasing costs by £6,000 to £12,000. Use of a single witness, initially on lower value, non-complex cases (say below £24,000) for condition and prognosis reports would make a substantial saving and reduce the knock-on costs of any resulting legal wrangling over differences of opinion. 5. Establish independent oversight As with any legal dispute, there is ultimately the need for a referee to blow the whistle and have the final say. At present, the courts play this role in clinical negligence, but the new regime will require new ways to resolve issues and enforce the spirit of fair play on both sides. Part of this can be achieved with good planning – e.g. setting out a framework of incentives and penalties to guide behaviour. But systems for alternative dispute resolution should also be explored, helping nip disagreements in the bud without incurring the expense of court time. The ultimate measure of success will be how fixed fees affect the current relationship between the medical and legal professions. Currently it feels like both sides sit in their trenches, with a mutual sense of mistrust, firing pot-shots at each other. While the injured party – someone to whom both sides owe a clear duty of care – is stuck between them in no man’s land waiting for help to arrive. It’s time for a truce to be declared. For both sides to work together in a constructive manner to ensure the right outcome is reached in the quickest time with least cost. Rather than being seen as a drain on NHS resources, clinical negligence can potentially become a valuable source of information about how to improve procedures and training to prevent future harm. At a time when the NHS’ role and reputation is in need of protection, this may be an important stepping stone in helping build a robust health service, confident enough to admit its mistakes and put the interests of patients first. Ed Fletcher is CEO of leading medical negligence and serious injury law firm, Fletchers Solicitors.
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The Interviews
11-20
The Interviews
11
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Interview with... Duncan Rutter
13
Interview with... Duncan Rutter Charlotte Parkinson, Modern Claims, speaks to the new President of FOIL and Partner and Head of Catastrophic Injury at DAC Beachcroft, about the potential impact of increasing the small claims limit from £1,000 to £5,000 and what he expects during his tenure as President.
Q A
What are your main aims during your tenure as President of FOIL? Are there any particular initiatives you will be focussing on?
I have three priorities for the year ahead. First, I will work with other stakeholders to improve the claims process. FOIL is committed to working towards maintaining access to justice whilst at the same time improving the claims process and removing excessive costs from the system. There is currently a wide range of initiatives being considered that relate to those aims. These include the review of civil justice by Briggs LJ, the CJC working group on Noise Induced Hearing Loss (NIHL) claims, and Carol Brady’s review of the regulation of claims management companies. Second, I will continue FOIL’s work tackling fraud. The Insurance Fraud Task Force is due to report soon. I am looking forward to seeing what FOIL can do to support initiatives which will lead to a reduction in fraudulent claims. Third, I will work towards improving professional standards. This year is the last year solicitors can collect CPD points to satisfy the SRA that we have kept up our continuing professional development obligations. Legal Executives have been reflecting on their development needs and recording the outcomes of their training since October last year. To replace CPD points, the SRA has published a rather basic statement of competency which all solicitors have to follow. FOIL is currently developing a statement of competency and statements of legal knowledge aimed specifically at insurance lawyers. These will supplement the SRA statements and will set out the competencies insurance lawyers need to act for insurers. We are working with stakeholders including the Chartered Institute of Insurers and The Law Society to gain support for this initiative and will be launching this in the first quarter of next year.
Q A
How will you be dividing your time as a Partner and Head of Catastrophic Injury at DAC Beachcroft and your FOIL Presidency?
Fortunately, I have an excellent team working with me in Winchester and in DAC Beachcroft’s Catastrophic Injury unit. This support will enable me to spend the time I need in leading FOIL through what I’m sure will be an interesting and challenging year.
‘FOIL is currently developing a statement of competency and statements of legal knowledge aimed specifically at insurance lawyers. These will supplement the SRA statements and will set out the competencies insurance lawyers need to act for insurers’
MC // January 2016
14
Interview with... Duncan Rutter
‘It is important that Government appreciates making significant changes to the system for compensating victims of accidents can have unintended consequences’
Q A
How does your background in both the insurance and legal industries aid the work you will be doing as President of FOIL?
FOIL is a broad-based organisation representing insurance lawyers across many different areas of practice. Over the course of 27 years as an insurance lawyer, I have dealt with many different types of insurance claim including property claims, policy coverage issues and the full range of injury claims from minor whiplash claims through disease claims to catastrophic injury claims.
Q A
Why is FOIL and the work the association does important within the insurance claims sector?
FOIL is important because it offers an independent voice and independent representation for insurance lawyers. Our work is often complementary to the work of the insurance industry but not always, we do fifer on some issues. It is particularly important in those cases that FOIL is able to put forward a strong and independent view. This is valued by insurers and by the claims sector as a whole.
Q A
What are the biggest issues in the claims sector which you are hoping to address?
I do not expect my year as President to run to plan. There are bound to be unexpected developments along the way. I was just 13 days into the job when the Chancellor delivered his Autumn Statement. Whilst we had been expecting a further attempt to increase the small claims limit for personal injury claims, the plan to remove the entitlement to general damages for low value whiplash claims took everyone by surprise. The Government will consult on these planned changes in the New Year. FOIL is committed to the removal of excessive costs from the litigation system, tackling abuse of damages for financial loss and tackling fraud but it is important that Government appreciates making significant changes to the system for compensating victims of accidents can have unintended consequences.
Making a fraudulent claim... is dishonest and no better than theft’
The Forum of Insurance Lawyers (FOIL) The Forum of Insurance Lawyers (FOIL) provides the defendant community — lawyers, solicitors and legal executives — a body that sits alongside other insurance legal representative organisations ensuring that views across the board are heard by Government and industry. FOIL has become an important interface between defendant insurance lawyers, insurers, self-insured organisations and lawmakers, operating at the forefront of discussion where changes in legislation or rules are discussed to achieve balanced outcomes which benefit the wider public interest. It celebrated its 20th anniversary in 2012. The organisation is led by practising lawyers, with a revolving one-year presidency. It has a permanent Chief Executive, drawn from a non-legal insurance industry background, leading a small expert management team responsible for driving forward long-term strategy, maintaining the timely flow of essential information to members. FOIL has a series of member-led sector focus teams (SFTs) closely aligned to the operational structure of the insurance industry which allow members’ specialist knowledge in areas such as Disease, Motor, Fraud and Costs to be harnessed fully to provide the strongest possible input to consultations and debate. There are 17 SFTs currently with others planned including for Product Liability and Captive Law.
MC // January 2016
Q A
What is FOIL’s view on the recent hike in the small claims limit from £1,000 to £5,000 - how will this impact the profession and claimants?
The Government will consult on the proposal to increase the small claims track limit in personal injury cases from £1,000 to £5,000 in the New Year. FOIL is concerned about this proposal but we have yet to see the detail. We welcome the indication that there will be a consultation and will play a full role in it. This is not the first time such a proposal has been put forward, the Government consulted on this in March 2013. FOIL did not support the increase then, as we believed it would lead to claims inflation, more expensive claims handling and would do nothing to address fraud. At that time the Transport Select Committee recommended the limit should not be increased accepting that access to justice would be impaired, that it would be difficult financially for solicitors to assist, it might fuel another boom for claims management companies, and that it could be counterproductive in discouraging fraud and exaggerated claims. The Government’s response to the consultation in October 2013 was that on balance it was persuaded not to increase the limit. It accepted it might have an adverse effect on genuine victims and wished to ensure safeguards were in place. It accepted that claims management companies might offer advice not in claimants’ best interests. It remains to be seen whether this new proposal will address those concerns.
Interview with... Duncan Rutter
15
‘FOIL is ... engaged in broadening its membership and is currently looking at how we can attract new members who service the London Market’
Q A
What impact could the findings of the CJC review into NIHL claims be?
There has been a massive increase in the number and cost of NIHL claims in recent years. This is imposing an increasing burden on the insurance market and the commercial sector which that market serves. FOIL is hoping the review will improve the process for dealing with these claims and remove some of the costs involved.
Q
Fraud is still a major issue in the insurance/claims industries; the Insurance Fraud Taskforce is due to report at the end of the year, realistically when and how to do expect the industry will start making headway against this growing issue?
A
Dealing with fraudulent claims is not straightforward. There is no magic bullet and progress will only be achieved with a range of measures aimed at discouraging fraudulent claims, identifying them and defeating them. One issue that must be tackled is the so-called ‘compensation culture’ which seems to regard making a fraudulent insurance claim as acceptable. It isn’t. It is dishonest and no better than theft. It is encouraging that lawyers acting for claimants have worked with the ABI and The Law Society to allow them access to fraud databases to help weed out fraudulent claims at the start. I am looking forward to the development of the definition of ‘fundamental dishonesty’ by the courts. Under the Criminal Justice and Courts Act 2015, a claim can be struck out if fundamentally dishonest. It is important that the definition of that term extends beyond the obvious cases to significant and deliberate exaggeration.
Q A
What does the future hold for FOIL – specifically in relation to its members and government lobbying?
FOIL will continue its lobbying role and will also continue to provide education for members, seeking to improve their professional standards. We will continue to engage with trade and industry partners who also work in the insurance sector. FOIL is also engaged in broadening its membership and is currently looking at how we can attract new members who service the London Market.
Duncan Rutter Duncan is a Solicitor Advocate with rights of audience in all higher courts. He has specialised in personal injury litigation since 1988 and has handled a wide range of RTA, EL and PL claims, including clinical negligence, disease and complex and high value claims. He also has wide experience of Health & Safety prosecution work. He now deals almost exclusively with catastrophic injury claims, particularly those relating to brain and spinal injury. He heads the firm’s Catastrophic Injury Group. Duncan is ranked by Chambers as a leader in personal injury litigation. His cases include Roebuck v Mungovin (House of Lords), Kane v New Forest District Council (Court of Appeal), Aer Lingus v Gildacroft et al (Court of Appeal) and Howell-Williams v Wood et al (Court of Appeal). He is the President of the Forum of Insurance Lawyers (FOIL) and a member of the Advisory Council of Trust Mediation. Duncan Rutter...is highly regarded for his expertise in claims involving devastating brain and spinal injuries. He is described as “very intelligent and switched-on.” Chambers and Partners UK 2014 Edition, Personal Injury, UK Wide DAC Beachcroft LLP is ‘a market-leading firm for defendant work’. Legal 500 UK 2012 Edition Personal Injury The South.
‘The Government will consult on the proposal to increase the small claims track limit in personal injury cases from £1,000 to £5,000 in the New Year. FOIL is concerned about this proposal but we have yet to see the detail’
MC // January 2016
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Interview with... Georgina Squire
17
Interview with... Georgina Squire Charlotte Parkinson, Modern Claims, spoke to the Head of Dispute Resolution and Partner at Rosling King LLP about two landmark cases which have changed the scope of professional negligence claims, and whether the Insurance Act 2015 creates a level playing field between policyholders and insurers.
Q A
Has the landscape for professional negligence claims changed in recent years, and if so why?
Yes it has changed, particularly in the last 3 years. There are a number of reasons for this: the financial downturn and recession have led to a lot more scrutiny of advice provided by professionals because as a result of the downturn, people have suffered greater losses. The landscape has also changed because lenders that have suffered losses on a variety of commercial and residential loans have started to look at the causes for some of the losses. There were two landmark court decisions, one on residential mortgages, Webb Resolutions Ltd v E.Surv Ltd[2012] EWHC 3653, which set the framework for claims by lenders against valuers. Mr Justice Coulson looked through a large number of authorities going back many years, and gave a view of the way a valuer’s position on a mortgage loan should be analysed. The second case was the decision in Titan Europe 2006 - 3 plc v Colliers International UK plc (in liquidation) [2014]. This was a landmark decision in that it was the first Court judgment on a claim against a valuer on a commercial mortgage-backed security (CMBS) loan. CMBS was prevalent at the height of the market in 2006-7 and is still active today. It usually involves a series of loans secured on real estate being combined into one CMBS structure with the notes (shares) classed in different layers and traded. This was the first case brought by one of those securitisation structures against a valuer. The Court of Appeal agreed with the first instance judge that the issuer is the correct party to stand as Claimant. The other main issue over the last 2 or 3 years (whatever the area of professional advice) has been the limitation period and how long liability lasts for. There are also debates around causation, which is the concept of how much of the loss can be put back on the professional if it can be proven that they were negligent, and whether this should be restricted in any way.
‘The financial downturn and recession have led to a lot more scrutiny of advice provided by professionals’
MC // January 2016
18
Interview with... Georgina Squire
‘Mediation continues to be popular as everyone can come to the mediation safe in the knowledge that if they don’t want to do the deal, they can walk out’ Rosling King LLP Rosling King is a UK-based law firm specialising in serving the needs of financial institutions and the real estate, private equity and construction sectors. From our headquarters in the City of London, our lawyers offer the highest quality of advice and service to clients across the world. Our firm has developed a respected breadth of practice over many years with distinctive skills and capability in the often complex, challenging and fast-moving worlds of commerce and finance. Our clients, many of them banks, financial institutions and insurance companies, require legal advisers who are expert in their specialist areas and can bring clarity to complexity. The ethos of Rosling King is to value and respect our clients and be wholly committed to help them find a better way.
‘The 2015 Insurance Act is fantastic, as it will bring us in line with everyone else, and puts London right back in the centre of the insurance world’
MC // January 2016
Q
Rosling King acts for a range of commercial clients, from banks to insurance companies – which sector presents the biggest challenge and why?
A
The area where there is most challenge is where people have purchased debt or loans and they are looking to make recoveries for losses, but they were not the commercial entity which entered into the contract or the retainer with the professional at the outset. We have seen quite a lot of this with banks selling off large swathes of loans over the last few years. It is not insurmountable, but needs some thought to ensure the claim is brought correctly. There are also issues around jurisdiction, where corporate entities who are based in the U.K. wish to bring claims here, but the problem has arisen on real estate security which is based overseas. As an example, on the Titan case, the underlying security was in Germany but we brought the claim here and there wasn’t a problem. In terms of professional sectors, the valuer sector has been hardhit by the numbers of claims brought against it, which have largely arisen out of lender valuations.
Q A
issue?
Has the role of mediation changed in relation to claims/ dispute resolution as a wider
Mediation has certainly become more widely used over the last 5 years to solve commercial disputes. The Court of Appeal case, Halsey v Milton Keynes General NHS Trust [2004] 1 WLR 3002, outlined the types of cases that would not be suitable for mediation and this encouraged people to mediate more. There have been subsequent authorities again trying to encourage people to mediate rather than litigate. We always try and push for early negotiation and settlement. Our aim is to try and avoid litigation and mediation can be a fantastic way of doing this. Mediation continues to
be popular as everyone can come to the mediation safe in the knowledge that if they don’t want to do the deal, they can walk out. It also gives people an opportunity to vent their feelings to one another, as well as the opportunity for the parties to listen to what the other has to say. Very often, those types of discussions can change someone’s view over the course of the day, which culminates in a private and confidential commercial resolution. We find that the commercial entities we act for generally want this. They don’t want the publicity, financial or time investments of the litigation process.
Q A
What is the most memorable case you have worked on and why?
It has to be the Titan v Colliers case, because it was a landmark decision and the whole of the CMBS market was awaiting the outcome. There are a lot of problems arising out of CMBS loans and there was an element of caution as to how these claims can be brought because of the complexities of the financial and corporate structure. It was an extremely challenging case but we have managed to break the boundaries and set new law, which has been confirmed by the Court of Appeal.
Q
What are the most fundamental changes to the insurance industry over the last 12 months and how have these changes impacted your work?
A
The Insurance Act 2015 is undoubtedly the biggest change in the industry in over one hundred years. We do a lot of work for commercial policyholders on coverage issues and we are already seeing the impact of this legislation. We had been falling behind the rest of the EU’s main insurance centres in terms of our coverage laws. We have been dealing with the challenges of out of date legal principles, often with draconian outcomes. The 2015 Insurance Act is fantastic, as it will put London right back in the centre of the insurance world.
Interview with... Georgina Squire
Q A
Does the Insurance Act 2015 put pressure on policyholders and was the Act the right step for the industry?
It was the right step for the industry and I don’t think it puts undue pressure on policyholders. It creates a more level playing field between policyholder and insurer. There is more transparency and the outcome for anyone failing to provide information inadvertently is much fairer under the new Act. The old outcomes were too stringent.
19
‘There will be disputes and litigation as a result [of the Insurance Act 2015] but I think there will be less coverage disputes’
Q A
Could the Insurance Act 2015 change the nature of claims/ dispute resolution? Undoubtedly, there will be a lot more claims around what constitutes a fair presentation of risk - which is where I anticipate the majority of issues will arise. There will be disputes and litigation as a result but I hope there will be less coverage disputes around this issue. One of the reasons I think avoidance disputes have carried on over the last few years is that it is an all-or-nothing result, where the insurer can walk away, leaving the policyholder without insurance (a disastrous result for them). Under the new Act, however, if there is some information missing, the consequences must be looked at and remedied accordingly; whether that is achieved by increasing the premium or the insurer not paying out for some or all of a particular claim is open for discussion, but there will be fairer and more proportionate options. Overall, the Act creates more of a balance and I am hoping there will be less litigation as a result.
Q A
What is next for you and Rosling King?
More of the same. We love our business and client base and are looking to build on our reputation as problem solvers and specialists within our specialist sectors of private equity, financial institutions, real estate and construction. We are not looking to do anything dramatically different, just continue with more of the same.
Georgina Squire Georgina is the Head of the Dispute Resolution Group at Rosling King and advises on a broad spectrum of commercial disputes. She acts in cases across most of the commercial divisions of the High Court, resolving disputes through arbitration and many forms of ADR, including mediation, expert determinations and mini-trials. Acting for lenders, investors, financial institutions, private equity funds and loan servicers on all forms of disputes arising from their businesses, Georgina is known for her expertise in professional negligence claims, having advised the claimant in most of the precedent case law in this field. She also advises on insurance and reinsurance claims, concentrating on coverage and professional indemnity disputes and has been involved in many high profile cases in the Court of Appeal and the Supreme Court. Georgina has considerable expertise in advising on construction and real estate related disputes. She has handled many claims arising from construction projects and also acts for lenders, developers, investors and other parties involved in the real estate and real estate finance sectors. Having qualified as a solicitor in 1983, Georgina is also a qualified mediator. She is the past Chair of the Law Society Litigation Committee, a founder committee member of TeCSA and has served on the TCC Users Committee. She currently sits on the committees of both the London Solicitors Litigation Association and the Chancery Users group.
MC // January 2016
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The Opinions
21-47
The OPINIONS
21
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Sector Soapbox
23
Sector Soapbox Denying access to justice
A
s everyone in the accident claims community will know by now, the Chancellor of the Exchequer dropped a double bombshell in his Spending Review and Autumn Statement. Announcing a new round of motor accident claims reforms, he signaled a substantial increase in the Small Claims Limit and the removal of the right to claim general damages for “low value” whiplash. Just one of these measures would have severely impeded the ability of accident victims to seek the full justice they deserve, but both together will have very serious implications. And it of course follows that the imposition of these measures would raise questions about the very future of independent legal advice in the sector. It simply cannot be right to deal with the purported compensation culture by removing the right to claim compensation from those who suffer injury as a result of negligent driving, in order that the insurers for the negligent driver can save money. There is a significant risk that the NHS and the benefits system will be left to pick up the bills that are currently met by the insurers for the at-fault driver. Denying accident victims access to independent legal advice at the cost of increasing the profitability of insurance firms, who have a very poor record of passing on any
savings, is scandalous and blatantly unfair. We are yet to fully understand precisely what is being proposed – does the increase in the Small Claims Limit apply across the board? What is the definition of minor whiplash? What is clear is that the Government has fallen foul of listening to only the self-interested views of the insurance sector who wish to maximize their profitability at the expense of all motorists. Accidents will of course still occur in the hundreds of thousands on UK roads – and injured victims will still require support. I fear that these reforms, inexplicably announced ahead of the conclusion of the Insurance Fraud Taskforce and the CMC review, could have significant unintended consequences, and are certainly not guaranteed to achieve the stated objective of reducing claim numbers. These measures will cost the Treasury hundreds of millions in lost revenue and it will all be so sadly predictable when, despite all this, insurers find some other excuse and premiums continue to rise. MASS will work tirelessly in the months ahead alongside others in the sector to combat these profoundly unfair and highly damaging proposals. No-one in the sector can do otherwise. Susan Brown is Chair of the Motor Accident Solicitors Society (MASS) and a Director of Prolegal.
Insurance Act 2015 – coming... ready or not!?
T
he Insurance Act 2015 is clearly the biggest single change to insurance legislation in over 100 years - certainly since the advent of the Marine Insurance Act 1906. The Act itself both during its conception and following it becoming law has been the subject of much discussion at the Industry Claims Initiative chaired by BIBA. The Act was designed to redress the balance between insurer and insured and bring insurance law more into line with the law applicable to normal commercial contracts. Many insurers have already declared that they will adopt the “spirit” of the Act, which I believe relates to the fact that they have already taken great strides to remove basis clauses from their insurance contracts, and in relation to claims, will not repudiate liability on the basis of unrelated warranties. However, in practical terms, an area which there seems to be growing concern is in the realm of “fair presentation” and “reasonable search”, which are new concepts introduced by the Act. These principles have been explained in the guide to the Act, published by BIBA and endorsed by the stakeholders in the Claims Working Group. In reality, the disclosure requirements of an insured are largely the same now as they will be in the future, in that a
material fact today is quite likely to be a material fact once the Act comes into effect. However, the absence of common law precedents, established through the courts, to underpin the new statutory definitions could initially lead to uncertainty. An unintended consequence of such uncertainty could be that insurers provide summary judgement in hindsight as to what a “fair presentation” should have been and may lead to the avoidance of claims in whole or in part. This is contrary to what the Act is aiming to do in providing more certainty to policyholders, but I believe that it is incumbent upon insurers, brokers and other stakeholders alike to work together to provide clarity in this area. Both brokers and insurers have already renewed cases that could be subject to the Act from 12th August 2016 as a result of any mid term adjustments that may occur, so it is important that the market works together to try to establish a framework for the mutual understanding on a case by case basis, as to what constitutes a fair presentation. This should ensure the clarity that it was hoped would be achieved through the new Act will actually be achieved in practice. Andrew Gibbons ACII, Managing Director Mason Owen Financial Services Ltd and Chair on behalf of BIBA of the Industry Claims Working Group. MC // January 2016
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The Opinions
25
Beyond the insurance space Protecting yourself and Could insurers/brokers be making better use of reward your fleet schemes for existing customers, with a view to improving retention rates and, if so, what schemes should they consider?
R
eward schemes seem to be all the rage at the current time, and with good reason. Almost regardless of the sector, firms running such programmes report improved customer satisfaction, retention and cross sale, and there is no reason to think this would be any different with Insurance Products.
There is an argument that we do already offer some ‘Rewards’, the Motor ‘No Claims Bonus’ being well established, and there are an increasing number of rebate clauses linked to renewal and loss ratio performance, being applied to other classes of business, particularly on midmarket and larger segments. These however lack what I see is the core appeal of most reward schemes we see outside of insurance, and that is the opportunity for real interaction. The value of some rewards is often not substantial at all, whilst ‘One Thousand Nectar Points’ sounds impressive, its only really a £5 discount, but the whole Nectar piece gives a customer the opportunity to interact and build a reward profile, and then benefit from gifts and/or savings in completely unconnected areas. So one option is to just sign up with one of the established reward programmes, and whilst that might help, my view is that you miss a great opportunity that you could achieve by doing something yourself. Only that way will you build real interaction and appreciation of your own brand and values, as well as using those interactions to gather further insights and even improve risk and your product offering, with a truly tailored solution. A good example of someone doing this well in the insurance sector currently is Vitality. They give discounts on days out, spa breaks, travel, cinema tickets, and cash back on shopping in selected pharmacies. The theory is that with some (but clearly not all!) benefits offered, the more likely you are to become healthier, which obviously improves the risk for Vitality, but it doesn’t feel to the customer that this is the only reason they are doing it. My conclusion therefore is that a great rewards programme is one that allows regular interaction, provides incentives beyond the insurance space, but also if possible helps to understand and improve the risk profile. Having Jessica Ennis-Hill and a cute little dog to front it probably helps as well! David Williams, Managing Director, Underwriting, AXA Insurance.
A recent study undertaken by Zurich revealed that work-related road collisions cost UK employers £2.7 billion each year. How can companies ensure the safety of their fleets on the roads?
R
oad journeys are a fundamental part of business life but when work-related collisions occur, they not only put employees’ safety in danger; they can also add to the bottom-line costs for employers and have wider reputational consequences. This can be particularly significant for SMEs who don’t tend to have the dedicated resource of a fleet manager. Our own research of SMEs1 found that 21% are travelling more than they were a year ago and 52% are planning to expand their fleet. However, 27% of all firms have needed to make an insurance claim in the past year for an accident that was someone else’s fault. It is impossible to stop work-related collisions taking place entirely, but by using a range of risk management techniques employers can reduce the expense and emotional consequences that employee injuries, lost productivity and vehicle repairs can have on their business. It is imperative that employers have the correct insurance cover in place to protect their employees and their fleet. Yet, worryingly our research showed that only 46% of SMEs with 11-25 vehicles have fleet insurance in place. Ageas Optima Small Fleet and Fleet Guard are tailored to the specific needs of small fleets and help to ensure that vehicles are back on the road quickly. For example, they offer guaranteed repairs through an Ageas approved repairer and industry leading Key to Key times. Our risk management specialists will also work with customers to help reduce claims frequency. As part of this, they may recommend telematics which can help improve profits, enhance driver safety and reduce business costs. By providing insights into how vehicles are driven, high risk behaviours can be addressed through staff communications and training. For example employers can ensure that drivers are taking regular rest breaks as well as identify issues such as excessive speeding. This can help the employer create greater engagement with their workforce and fleet, and improve driver safety. Employers can also give serious consideration to vehicle safety when choosing their fleet. In the Making Road Safety Pay report, commissioned by Ageas, the Road Safety Foundation recommends employees are provided with information about the Euro NCAP safety rating and encouraged to look for higher ratings when choosing cars themselves. If employers are providing vehicles, they should only purchase ones with high star ratings. Andrew Fletcher, Commercial Fleet Trading Manager, Ageas Insurance. 1. 1004 SMEs, survey conducted by Atomik 2015.
MC // January 2016
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The Opinions
27
A final nail in the coffin?
The modern fleet
What should those operating in the claims industry be most aware of in 2016 and why?
A recent study undertaken by Zurich revealed that work-related road collisions cost UK employers £2.7 billion each year. How can companies ensure the safety of their fleets on the roads?
T
he Chancellor of the Exchequer’s Autumn Statement attempt to undo hundreds of years of tortlaw has got to be what 2016 is all about. As one of my clients said recently “we cannot put the dead snail back in the bottle now” (a private PI lawyer joke with origins dating back to 1932).
Why any government would have the audacity to distinguish between a man injured operating faulty machinery at work, allowing them to recover financially where, when suffering the same injuries, a man hit in a rear end motor car accident would have no claim in the law of tort, is beyond us all. If this ‘reform’ occurs, it will be a national scandal - a final nail in the coffin for the vulnerable personal injury victim left standing alone against insurance giants. So when did the wrongdoer’s profits become more important than injured people? For many years law firms, operating in the defendant insurance legal sector has provided ‘more for less’ with insurers intent on driving down the cost involved in defending personal injury claims. When insurers demand a ‘Rolls-Royce claims handling service at paralegal prices’, defendant law firms have done their utmost to ensure that they continue to provide a service delivering ‘more for less’ year-on-year. In relation to claimant personal injury legal services, fixed costs have meant that a quality service cannot be provided for injured victims, especially in complex liability claims. Complex and worth less than £5,000? Sorry, not a chance if the small claims limit increases. The stark reality is that driving the cost of legal claims down will save the insurance sector ‘loadsamoney’ and the legal services market will be destabilised in terms of financial cuts and redundancies. We already know that claims are (under) settled daily through lack of access to quality justice. The injured will be far less protected than the Victorian ‘man on the Clapham Omnibus’ and the most vulnerable in society will receive, yet again, rough justice. So, in 2016 I believe that those operating in the claims industry must be aware of access to justice for vulnerable claimants against wrongdoers and those who insure them. Why? If we don’t then what are we here for? Anyone fancy a ginger beer? Lesley Graves, Managing Director, Citadel Law.
W
hatever the fleet size it is critical to have public safety at the forefront of everyone’s mind with both employers and employees having responsibility for on road activities. Any sizeable fleet operator should be utilising the latest technologies that provide high levels of safety and compliance thanks to a combination of telematics, tracking systems, driver training and fleet compliance. Most modern solutions offer alert systems along with a real-time notification system that sends the fleet or depot manager an email or SMS to alert them of safety breaches or driver noncompliance. In the modern world, dynamic reporting offers a change in the reporting mechanism from passive systems (where breaches waited to be uncovered) to a pro-active risk management solution. It is also the change that puts at risk the traditional insurance FNOL model of claims handling, which is reliant upon a driver reporting an incident. In our business, we see alerts coming in on a daily basis regarding driver behaviour as well as incidents. These are not just notification of a new incident, but the ongoing collation of driving trends from monitoring speed, harsh braking, in cabin duress, panic button alerts, excessive idle time and excessive driving hours (fatigue management), right through to leaving or entering a pre-defined area. In addition to real time alerts, real time reporting allows us to investigate past events for a particular driver, vehicle or company division. This information is incredibly useful when reviewing employee or divisional safety or when updating training programs and safety procedures. The information that is driven from telematics and the ever popular video technology gives real time understanding of driver behaviour and actual driver trends. The application of this extends beyond accident and repair management to a more comprehensive risk management solution focused on reducing claims frequency. Like many, this is something we are working closely with our strategic partners on. It is interesting to note that the cost of electronic software such as telematics in recent times is the single largest change within the commercial sector. Today as much as 35% of the total vehicle build cost is electronic and software related compared to 15% a decade ago in the fight to increase the safety of the modern fleet on the road today. Andy Whatmough, Managing Director, S&G Response.
MC // January 2016
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The Opinions
Ahead of the Curve How can companies in the claims sector work to improve transparency, communication and clarity for the benefit of consumers and the rest of the industry?
I
t’s simple. The systems and ability to do so are there for the taking, I’m unsure why there should be any difficulty with this. At TRS, we offer our customers, whether it is insurers, loss adjustors or brokers, the opportunity to use our systems, allowing us to share and see the same information as required. This is transferable and already in place for our guys in ‘the field’, creating a smoother and quicker claims experience for the insured. Whilst on site, we can scope a room, identifying both buildings and contents liability, as well as works that are required. With this same information shared to head office, we can organise the claim, appointments from start to finish, tailoring visits to fit the insured and allowing them to see and (if desired) arrange the diary. We offer the insured the ability to make their own decisions on settlement based on fact for all to see, discussing these options with assistance and guidance builds trust. This way the customer has all the knowledge they need, as do our trades. This transparency and clarity of the whole process makes TRS the quietest call centre in the country, few parties chases us, no one is unaware of what to do or who will do it, and the insured is reassured that TRS have a hands-on approach. This is reflected in our 0.025% complaints ration. Sit back and relax, whilst we turn your house back into a home. Recently, I attended the I Love Claims conference, which saw over 300 claims professionals with hot topics including customer service and working together in partnerships. If I am completely honest, it is slightly frustrating to hear the same issues and questions being posed year upon year. TRS and the parties involved with us do work in partnership, using the same platform to ensure communication and clarity isn’t a problem. If the industry as a whole also adopted this, the same information can be shared to reduce further issues such as Fraud. As our partners have noticed, fraudulent claims have reduced. Victoria Rawlings, Media and Marketing Manager, TRS Claims.
29
Lowering risks for your drivers
O
rganisations with employees who drive for work have a duty of care to ensure all their drivers are safe; this includes employees driving their own vehicle on company business. After appropriate road risk assessment, there are three main ways that employers can improve fleet safety: managing drivers, managing vehicles, and managing journeys. Accurate recording and monitoring of incidents and near-misses is essential in effectively improving fleet safety. Employers should record all incidents involving staff driving for work, including near misses, to help identify common issues. Making use of new technologies such as telematics can be an invaluable tool in helping organisations monitor driver behaviour. It should also be an essential ingredient in collating and maintaining appropriate records and updating these at regular fixed intervals with invasive techniques that ensure compliance on a continual basis. It is essential that employers develop a comprehensive training and education programme for their drivers and this should be provided continually throughout employment for all drivers. Inadequate vehicle maintenance can cost lives. Employers must ensure vehicles driven for work – whether company or employee-owned – are well maintained, particularly safety-critical components such as brakes and tyres, to protect their drivers and members of the public and avoid costly insurance claims and repair bills. Companies with vehicle fleets should buy or retrofit vehicles with the latest safety features that are shown to help prevent or reduce the consequences of crashes, and organisations with large vehicles, such as trucks and buses, should also ensure their vehicles are fitted with the latest blind spot-minimising technology. The simplest way to reduce the risk vehicles pose to people is to reduce the number of vehicles on roads. Some business travel can be avoided altogether through the use of communications technologies such as teleconferencing and webcasts. Where business travel cannot be avoided, it is important that journeys are planned to avoid residential areas and instead stick to motorways and other major roads wherever possible. This is not only safer for drivers as these roads have a lower crash risk, but also lessens the risk to vulnerable road users. Finally, employers need to remember to positively fulfil their legal obligations. Adhering to the good practice’s detailed above will greatly improve their chances of doing so and help mitigate their legal liabilities under extensive legislation, especially the very onerous sanctions contained within the Corporate Manslaughter Act. Gerry Lee, Senior Partner, P R Hanna Solicitors.
MC // January 2016
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The Opinions
An open mind What are the key risks that SME’s should be aware of in 2016?
A
s ever, the principle risks may relate to legal, financial and staffing issues. However, the most prominent – we are led to believe – throughout 2016 are those risks posed by cyber security, regulatory breaches, competition and the European Referendum.
As a new start-up law firm with Three Graces Legal, an additional risk we face, is a failure to obtain and then retain clients. The legal sector has undergone some of its biggest changes in recent years. How then, do we avoid being swept away and cast-adrift of the competition? So, when sitting-down to discuss a new service area or a different opportunity, I believe fostering an intimate understanding of that business encourages openness, develops confidence, and builds trust with clients and partners alike. This is fundamental to development and growth. As a new start-up, we have to be aware of everything and close our mind to nothing. We are told time and again that the legal sector is perceived as apathetic where change is concerned. That as a profession, our reluctance to consider something new often means we lag behind other service providers. Our aim, from the beginning, has always been about facing this challenge head-on and embracing new opportunities, developing concepts and identifying innovation. We have identified a real need to listen to what our clients want from us. All clients are different. Sure, we could spend our time telling our clients about everything we do. But how can we ensure this matches their requirements? By investing time into learning about our clients, and listening to their needs, we can develop a bespoke service which suits. It is then about identifying what else we can do for our client that shows a commitment from us to them and their business. Diversity within the services a business offers is becoming more and more crucial. Going forward, this has to work in-tandem with what Professor Richard Susskind calls a ‘more for less challenge’. That is, other than the work you ordinarily charge for, what else can you do for a client that maintains the relationship over the long-term? This is key to ensuring the survival of both yours and your client’s business. Failure to address these simple but effective concepts suggests a failure to handle risk. Aaron Pearson, Director and Solicitor, Three Graces Legal.
31
Customer engagement: get it right now How can companies in the claims sector work to improve transparency, communication and clarity for the benefit of consumers and the rest of the industry?
T
he claims industry shares many different personas and sales are generated from various avenues. Regardless, we must all focus on one simple factor – customer service. Much can be learned from those who practice customer care as a priority. Complaint rates are lower and brand equity is stronger. We should be promoting this to our workforce ‘as a state of mind’ as promoting these characteristics sets us apart and lifts the market as a whole to a place of higher integrity. But only if we get it right. Sharing information alone does not empower the consumer. It can overwhelm and confuse people from making successful decisions if they do not understand. So before we become more transparent, we have to become more engaging. The key is to place the science of what we all collectively do behind the commitment to customer care. As a specialist, I-COG validates volume claims for international insurers and has the lowest complaint rate in the industry. Why? Because we are advocates of transparency and because we explain with clarity why we do what we do. The upshot is the customer walks away with a positive image of their insurer, regardless of what happens with their claim. Most complaints surround not being informed of the decision made, not the decision itself. In my experience customers respect you for communicating openly and even though they may not agree with it all the time, they understand ‘the why’. I quite often smell something akin to anxiety when I suggest a client should be more transparent and engage more with customers. Change is often feared, but once you demonstrate the tangible results, it builds such confidence. Synonymously, the customer feels more cherished and valued. In short, we all need to practice a more human approach. Tap into human connection techniques – personal calls to customers instead of sending a generic letter in the post, sending a bunch of flowers if they complete a questionnaire about your communication efforts throughout the process. The customer ‘feels’ this response and this is what sells – emotional connection. They will also respect your brand and what you stand for. Soon claims will be validated over face-time video and, guess what? Transparency and communication will be key. So lets get this right now rather than never understanding this influence. So ask yourself, ‘what have I got to lose?’ Tara Shelton, Founder & CEO, I-COG Claims Management.
MC // January 2016
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The Opinions
33
Clarity or confusion?
Risks on the horizon
Companies and individuals who are convicted of Health and Safety offences will face greater fines when new sentencing guidelines come into force in February 2016. How could this affect companies operating in the claims industry?
What are the key risks that SME’s should be aware of in 2016?
W
here Health and Safety offences have been committed, sentencing had already seen huge changes in the last 2 years. The recently published sentencing guidelines mark a further shift along this road. The guidelines apply to any offender sentenced after 1 February 2016 for an offence committed after 6 April 2010.
The guidelines adopt a formulaic step by step approach and are designed to give more consistency and certainty in an area where very little guidance existed previously. However there is concern that there is some vagueness in terminology. By way of example, when considering culpability (step 1) there are 4 categories, very high, high, medium and low and whilst all are defined, “medium” is simply “between high and low”! Given the very significant increases within the different bands of fines which can be in the £millions depending on the size and culpability of the company, this can potentially make a huge difference to the fine imposed. The same applies to individuals where there are 4 categories of harm: deliberate, reckless, negligent and low. These depend on the individual’s state of mind - how will this be proved? In a case involving a death but a low category of harm (i.e. little fault) the starting point is an eye watering 26 week’s custody so the category will therefore be crucially important. We foresee: 1. A substantial increase in the level of sentencing for both corporates and individuals; 2. sentencing hearings becoming much more complex and lengthy; 3. greater use of experts from medical, industry and financial fields; 4. more “Newton hearings” where interlocutory issues are decided; and 5. fewer guilty pleas and more contested trials. These developments will obviously impact on those charged with managing claims, whether at the insurer or the policyholder. Claims managers will no doubt wish to get ahead by preparing for these changes, most importantly by setting up their own network of specialist advice and support to deploy as soon as an incident happens. If that doesn’t avoid a prosecution altogether then it should help to mitigate the outcome. This will be vital given the significant financial, custodial and reputational ramifications for the policyholder. On any view of the matter, none of this is going to make cases with a Health and Safety aspect any less expensive to handle. David Simon, Chairman, Triton Global and Chris Foulkes, Partner, Triton Global.
T
he risk landscape for SME’s in 2016 is likely to resemble current assessments. There are always the current risks that become uppermost in “risk” thinking, depending on current events and news stories. In that category exposure to terrorism and cyberattacks spring to mind.
Any organisation either explicitly or implicitly should have a risk appetite, for example, we have zero tolerance for risks such as regulatory, legal non-compliance or employee harassment. More discreetly, depending on appetite, this might extend to say not allowing BYOD. That brings us to the topic of so called emerging risks, of which we are likely to hear more in 2016. In terms of “popular” emerging risks, three deserve close attention in 2016: 1. Cyber breaches with the important secondary loss from reputation damage. It appears that governments, regulators, the media and the public will become less tolerant of breaches of confidential information. The EU Data Protection Regulation looms. 2. Business interruption is currently appearing at the top of many surveys of risk concerns for SME’s. Reviewing the basis of insurance cover, and its appropriateness for the continuity issues faced, is a vital exercise. 3. Under-insurance or poor insurance will come into focus as the new Insurance Act will be in force in August 2016. Each of these is worthy of a separate discussion. In terms of other risks that are occupying risk managers’ minds; terrorism, reputation, supply chain disruptions, political violence and loss of key people are all worthy of mention. As to what risks any organisation should be aware of, there may of course be important geographic or sector considerations. The best answer is therefore produced through a risk register, which is a living document that is regularly reviewed and used in the operational and strategic management of the organisation. This encourages a broad view of exposures and facilitates risk identification that is current and relevant to the vulnerabilities of the individual business and its sector. That permits the prioritisation of key risks. For many of the risks identified a package of commonly purchased insurances will serve to mitigate their effects through transfer. Added to this, business continuity plans, which consider loss scenarios and responses, should provide protection against many key risks. Horizon scanning and accessing risk surveys are good ways to stay current on risks that may become important to the business. Keith Tracey, Managing Director, Aon Risk Solutions.
MC // January 2016
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The Opinions
Technology to benefit both the customer and insurer
G
eorge Osborne’s intention to raise the small claims limit for personal injury claims from £1,000 to £5,000 and abolish general damages claims for minor whiplash incidents will have knock-on effects for both personal injury solicitors and insurers. Indeed, it’s heightened the impact of the Jackson Reforms, which already added stress on insurers and personal injury lawyers to protect their bottom line. Digitisation of the personal injury claims process is an excellent example of using technology to promote greater collaboration between insurers, solicitors, and claimants to reach fair, data-driven settlements in the shortest time frame. Insurers don’t need a complete IT overhaul to access and use big data. There are numerous data-rich industry portals, such as the Ministry of Justice (MoJ) portal and credit history and fraud databases, that are accessible using web-based application-to-application (A2A) tools. This is a simple way of linking insurer and solicitor IT applications to the rich data that already exists, allowing them to make better-informed decisions that produce better outcomes. Making the best use of existing data is one way new technology is bringing benefits. Another is using technology to streamline the process. There is often talk of the ‘customer journey’ in other industries and how this experience should be made as smooth and swift as possible. In instances of personal injury, standardising the claims process by providing accurate guidelines for injury payouts based on historical offers and injury severity not only reduces the overhead associated with overpayments but also dramatically improves the customer journey. By removing the need for claims handlers to juggle swift claims resolution with a measured payment, the overall experience of personal injury claims can be improved for claimant and handler alike. ISO finds that the majority of personal injury claims are settled immediately or upon the first counteroffer with an automated process. Technology is being used to improve the customer experience and avoid protracted claims settlements by analysing injuries and calculating a mutually beneficial settlement. In turn, this automation optimises workflow by driving reductions in cycle time with a faster settlement—in short, a resolution that suits both customer and insurer. Joe Pendle, Director of Client Services, Insurance Services Office (ISO).
35
Working together How can the different players in the claims sector improve ‘customer responsiveness’? What is the best culture for managing claims more effectively?
W
hat impression do we give our clients? We know that we have multiple ‘customers’. Medicolegal companies, lawyers, insurers, the judiciary and experts all interact with each other at some stage in most claims. Historically providing a ‘quality service’ has rested on us being professional and well trained – in recent years techniques and values of ‘Continuing Quality Improvement (CQI)’ have seeped into the culture of providing appropriate compensation and recourse to justice for legitimate claims and claimants. Before I address the required culture to bring about continuous improvement, I want to draw our attention to the ‘first impression’ we all give – do you know what yours is? An interesting study of Australian Law firms found potentially very expensive service failings. It showed that 78% of initial enquiry contact with law firms did not deliver a very positive result for prospective clients with 45% of these resulting in calls to competitors. This research titled ‘No Second Chance’ implies what it says – that with all of us, a telephone call, an email, a document, a conversation or request, maybe a one-off opportunity to ‘get it right’. We exist in a constantly competitive time and market place, where all our respective services rely on the personal/professional element of relationships. We need to be constantly vigilant as to whether our customer’s experience with us has been excellent or not! But what does this actually mean? It needs to encompass six fundamental CQI values, which are: • Putting customers first • Anticipating and knowing their expectations • Meeting, and trying to exceed(!), these • Getting our service ‘right first time’ • Reducing the costs of poor quality service • Looking after our colleagues and staff. This ethical, compassionate approach has been equated with the North American concept of Therapeutic Jurisprudence, which I have discussed in previous editorials. Each ‘player’ in the claims sector needs to ask the question ‘how do we manage our quality, and continuously improve it?’. We need to address how each player views the other players – lawyers have views about agencies, judges have view about experts, claimants and the MOJ have views about all of us, not always favourable. The challenge for 2016 is to work together to deliver this and communicate our success. Dr Hugh Koch, Clinical Psychological and Director of Hugh Koch Associates.
MC // January 2016
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The Opinions
37
A single objective
A solution is required
Will apps help bring down the cost of claims management or are they too much of a ‘one-size-fits-all’ solution?
Are there systemic failings in the policies and practices of the Ministry of Defence and the armed forces when it comes to training, exercises and selection events?
S
ince I built my first mobile app for my own legal business back in 2012, I have seen a noticeable impact on the cost of claims management in personal injury.
The challenge my firm faced back then was a simple one. We had too many clients asking general questions about the next steps and updates on their case. Perfectly valid questions but time-consuming and unrecoverable as a cost. At the time, Jackson was looking at curtailing fees in personal injury even further and it was apparent to me that I needed a solution to deliver information and updates to my clients fast and efficiently. Email and text messages had their place but were limited. Emails were no longer getting the instant response we once took for granted and texts were limited in characters, response rates and ultimately a cost. But with an app I could use our case management system to automate information at no ongoing cost. Sure the initial investment would be an initial expense but in time, the app would be self-funding as we save time but also overheads, in particular, print, paper and postage. Fast forward 18 months and the app, inCase, had been redeveloped and now offered the facility to send documents for clients to read and if necessary sign. All of a sudden, we had opened up the ability for clients to sign retainers lowering the cost of acquisition and saving on agents. With apps, you can effectively deliver cost management savings but there needs to be clear focus on the solution the app is providing. In the example of inCase, it is a communication tool. It is designed to make communications with clients effective and easy. User experience and graphics are incredibly important and can genuinely result in an enhanced client experience. Making an app do too much will ultimately bring about its failure. For example, I am often asked why doesn’t inCase cater for multiple legal sectors? The simple answer is that it will be too confusing for the end user. Having content about multiple sectors which has no relevance to the user will lower their experience and lead to dis-engagement. Look at SKY. They have several apps for several objectives. In my view a “one size fits all” app will fail. But an app that has a single objective and meets that effectively will reduce the costs of claims management.
T
his question is currently being considered by a parliamentary inquiry, which I appeared before in December. Historically the MoD has enjoyed no accountability or ownership for accidents resulting in injury or death on manoeuvres or whilst practising for war. A lack of intervention in the armed forces, (for example from the Health and Safety Executive) and Crown censorship has resulted in a blasé culture towards accidents and attrition rates. There remains a lack of a proactive, blame free approach to the reporting of not only post incident details but near misses that allows for rapid feedback of safety-related information to all concerned parties. Selection events needs to remain realistic to maintain an effective military force but not at the risk of three deaths in one event as in Brecon. Mistakes made in the Brecon Beacons selection event were so extreme they verged on a reckless disregard to life. In September 2002 Parliament, concerned about the amount of fatalities in military diving exercises, commissioned a 6 months report into the safety standards of all military diving. [House of CommonsDefence-Written Evidence 30/09/2005.] This report made recommendations to take immediate effect to reduce fatalities and states “funding is not acceptable as a reason for failure to meet the current safety standards.” That report was not actioned for 2 years resulting in 2 more military deaths with no accountability or reprimand. The failings in military diving standards recognised the lack of reporting, (in addition to post accident reporting) of “near misses, no matter how trivial” and recommended that a blame free, simple risk based reporting system of incidents and near misses could save lives. To date these recommendations, some 10 years later, have not been implemented, no one is auditing or policing the MOD on these matters. A robust, simple and effective reporting system post incident and also, importantly, capturing near misses no matter how trivial, is urgently required. Hilary Meredith, CEO, Hilary Meredith Solicitors.
Sucheet Amin, Managing Partner of Aequitas Legal, Founder of inCase™ mobile app.
MC // January 2016
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The Opinions
What are your thoughts on Expert’s “Hot Tubbing”?
E
xpert Witnesses who attend Court can sometimes be anxious. Even those with great experience may be unnerved by the cross examination, especially from a hostile barrister. It is therefore of great importance that an expert not only listens but is able to communicate his opinion clearly and accurately. It is not unusual for the Judge to intervene to clarify or simplify a question if the expert is struggling to make sense of what is being said. It is this interjection and dialog between Judge and expert that produces, in my experience, the best responses from the expert. I was asked to give evidence in a London Court recently. The suggestion by both parties’ barristers to have all experts cross-examined simultaneously by the Judge was submitted as a solution to eliminating areas of disagreements between the engineers. This format, called Concurrent Evidence is popularly referred to as “Hottubbing”. The experts are sworn in together in front the Judge and asked the same questions in turn. In this case, the Judge seemed to welcome the submission by the barristers and certainly did not dismiss the idea, however as preparation had not been put in place, he did agree to allow both barristers to get together with the Experts, (in this instance there was more than two experts involved) so that the areas of disagreements could be eliminated, thereby reducing the time the experts would be cross-examined. It transpired that the barristers working together without prejudicing their respective client’s positions was a very effective way of asking the experts exactly the same questions. The process was effective and did highlight the expert’s transparency and overriding duty to assist the Court rather than what some interpret as a tendentious position in the courtroom. If this format is to be adopted effectively in Court (and I see no reason why it could not be), it is very important that the judicial system puts in place a set of rules to encourage Concurrent Evidence to be allowed, or at the very least piloted. I believe that this format of giving Expert evidence would be of greater assistance to the Court and could also reduce ambiguous answers as a result of direct dialog with the Judge. Matthew Halton, Forensic Engineer, Laird Assessors.
39
Leading the way How can companies in the claims sector work to improve transparency, communication and clarity for the benefit of consumers and the rest of the industry?
W
e appear to have followed our American friends and have become a nation open to claiming. However, it now seems in some cases, consumers have shared experiences and heard what is going on behind the scenes, such as how some companies are mistreating prospective clients, by bombarding them with unsuspecting texts and phone calls. In business, you have to be forward thinking, go out and ask for the business, but receiving texts about an accident which has not happened, is a bit like placing divorce lawyer services, at a wedding outfitters, poised ready for what could happen. For prospective clients it is uncomfortable and an invasion of privacy. Making claims and the use of misleading marketing by some CMC’s has spoilt and tarnished what is for some consumers a much needed lifeline to making a claim, without any initial expenses. Those pro-active, forward thinking CMC’s are aware that business can still be done and will look at what prospective clients have been made aware of and address the way they do business. Cost is obviously an issue, but if a client needs access to making a claim, needs advice and has no money, it is still an avenue they will travel down, providing they can access information about the CMC they are speaking with and they are transparent about the business on offer. Trust is also an issue, as consumers are becoming increasingly aware of how dressing a shop window can be inviting to lure in prospective clients, but the questions most will be asking is what their experience will be with the firm and how they treat their customers. Over the coming years, it will become common practice for prospective clients to be looking for third party, completely independent reviews. As it is so easy for anyone to build a website and place on the site anything they wish, it will not be enough to reassure a prospective client. Forward thinking companies who provide their prospective clients with the tools they need to make a choice, provide transparency and are open for their previous clients to share their customer service experience, will benefit hugely from placing their heads above the parapet. Why not let it be you who leads the way! Let your clients compare quality, transparent services – not prices! Lisa Beale, Head of Checkaprofessional.com www.Checkaprofessional.com or call us on 0800 093 8414
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The Opinions
Prevention is better than cure A recent study undertaken by Zurich revealed that workrelated road collisions cost UK employers £2.7 billion each year. How can companies ensure the safety of their fleets on the roads?
H
aving a fleet of vehicles on the road and employing staff to drive those vehicles is a worry for any business. As a business you are responsible for the maintenance of your fleet, the safety of your drivers and the safety of other road users who are being put at risk by sharing the road with your drivers.
When everything is running smoothly with your fleet and your drivers it is easy to take them for granted. But particularly with a small business, if one of your vehicles needs an unplanned repair or one of your drivers is off sick it can have a big impact on the running of your business and can cost a significant amount of money, whether that be in covering drivers who are off sick, getting behind in work which upsets customers, hiring a replacement vehicle or the time involved in dealing with an insurance claim. The best cure is prevention. There are obviously aspects that are uncontrollable such as the other drivers on the road but you can minimise the risk of collisions being contributed to by your own drivers in a number of ways: • If your fleet is in constant operation ensure you do your research and make sure you have reliable cars that your drivers feel comfortable in with the best possible crash safety scores. • Ensure that your vehicles are in tip top condition and are serviced frequently. Ensure that any recommended repairs are carried out when the vehicles are serviced. • Ensure that your drivers know how to carry out the basic vehicle checks before they go on long journeys, such as tyre pressures, water and oil levels. Send your drivers on regular advanced driving courses. This helps drivers identify bad driving habits and trains them to be thinking and looking ahead to be able to identify and avoid potential hazards evolving ahead of them. These courses also provide drivers with a refresher on driving theory which can easily be forgotten in the years since their driving tests. Instructors feedback to managers with the outcome of the course and identify any drivers which managers should be concerned about so that further appropriate action can be taken such as providing further training or removing them from the road if they propose an immediate threat to their own safety or the safety of other road users. Emma Holcroft, Director, 2020 Investigations.
41
Engage and raise awareness
W
ith the advancement in technology available at our fingertips anytime and anywhere, the natural consequence of the internet is cyber-crime as a fast-growing area of crime. Criminals are able to exploit the mega speed of the internet to commit a diverse range of criminal activities. This is scary because there are no barriers and the ability to commit cyber-crime is limitless. This is organised crime and whether you are an individual, small business or a large corporate, we are all at risk of having our data stolen. The most recent cyber attack to make the headlines is the TalkTalk data breach, whereby a significant number of TalkTalk customers had their personal details hacked. Fraudsters used the stolen data to call the customers and pretended to be from TalkTalk. There are also other examples of companies that have been the subject of a cyber attack, but what can we do to protect our data? We have a statutory duty to make sure data such as names, addresses, bank accounts, Facebook profiles, Twitter profiles, client records to name but a few, are protected. If you think that you can do this by increasing security and controls in relation to your IT infrastructure - by focusing on antivirus software, firewalls and anti-malware software – this is certainly a start but it’s not enough, as you need full engagement which starts at board/ executive level and cascades down to the team. It is critical for staff to be trained to raise awareness. Cyber criminals are very intelligent and will know your market and business. A common scam is Spoofing, whereby a fraudster would pose as a director of a firm and email an employee, requesting that they transfer some money. On the face of it, the email address appears identical, but the request itself is unusual. Another example is receiving an unusual email with an attachment - again proceed with caution and delete it or investigate its origin. Many businesses use cloud storage data solutions to store commercially sensitive and personal information. It will be a challenge to keep this data confidential. You need to think about who can access the data and where it is being downloaded to, as an employee can increase the risk of data getting into the wrong hands, and risky behaviour can assist these criminals. To stay one step head of the game we have to be better protected. We can learn from the mistakes (preferably from others!) and by keeping our software updated, but in my opinion the most important task is to engage with staff to raise awareness. Nicola Klimkowski, Head of Business Control and Development, LAMP Services Limited.
MC // January 2016
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The Opinions
Taking centre stage in 2016 What should those operating in the claims industry be most aware of in 2016 and why?
P
reviously we’ve already discussed the benefits of B2B collaboration in the claims industry and our recent contract successes are a testament to the fact that successful collaborative partnerships will be key to successful claims handling in 2016. However, the elephant in the room – direct access – is increasingly a reality in the claims market.
In an age where clients’ compensation funds often pay for litigation, the rise of the savvy legal consumer who is prepared to shop around and demand value for money is here. For many, the idea of legal representation is key – whether the professional is qualified as a solicitor, paralegal, CiLEX or even (*LIGHTSBLUETOUCHPAPER*) a barrister. Like it or not, claims professionals at the Bar are being marketed directly to the consumer and clients are happy and willing to pay for their legal support. Albeit I’m talking about a smaller percentage of the overall claims consumer base at present but with slick marketing campaigns and numerous marketing partners, the fight to deliver professional and value-for-money legal advice to consumers (in the way they want it) is well and truly on. Yet this isn’t simply a game of ‘us v them’. Clerksroom Direct, (comprised over 1000 public access barristers from 150 chambers across England and Wales) for example, works closely with and to the benefit of many UK law firms. We have referred hugely valuable claims to departments as we identify cases that demand an experienced solicitor. This is our regulatory obligation – one we take seriously as it’s in the best interest of the consumer. It’s also a benefit to the many high profile practices we work with. For consumers, it offers more control, greater clarity of fees and wider alternative options to seek resolution to their claim. Another ‘one to watch’ is the role of mediation in the claims process. Clerksroom Mediation is increasingly called upon to manage ADR for claims as the market becomes more restrictive, less profitable and as consumer choice takes the lead in defining the claims process.
43
Don’t switch off How should the PI sector react to the Chancellor’s statement regarding the lift in small claims limits for PI to £5,000?
T
he fivefold increase to £5,000 is a bombshell and even more challenging is the removal of compensation for minor soft tissue injuries. It will impact on the sector significantly if not potentially catastrophically and it will be disastrous for Claimants too. How will the Courts also cope when the system is already under significant pressures? Factoring in the impact on profitability, including the current cost of case acquisition, the proposed changes are at risk of becoming a market exit ‘no brainer’ for PI firms. The vast majority of RTA Portal claims each year fall into the £1,000 to £5,000 bracket. For volume firms, the £5,000 limit could affect as much as 75 to 85% of the business across RTA, EL & PL. This will impact on ATE and BTE providers, as well as potentially impacting on case acquisition schemes. Now is not the time to be isolationist in the sector. Sharing of data and knowledge is critical. The re-start of the Access to Justice Action Group (“AJAG”) is a fundamental foundation to unify strategy and approach to the reforms. (AJAG@ralli.co.uk) The key is to focus NOW rather than sit back and wait. Firms need to look at re-modeling and understand the impact. Access to sophisticated processes and key case data trends is more critical then ever. The voice of the Claimant must also be heard but a large part of this is educating the public of what the changes mean for them. This is not an easy task coming from lawyers. The PI sector’s reaction needs to be structured, LOUD and relentless. There is an urgency required to any response and sadly this Christmas it is not a time to switch off and wait until to see what the New Year brings. Zoe Holland, Managing Director, Zebra LC.
We are a long way off either of these solutions catching up with traditional claims litigation but as both consumers and the legal sector face increasing constraints over fees, the impact of collaboration, alternative legal representation and ADR will increasingly drift towards centre stage over the next 12 months. Stephen Ward, Managing Director, Clerksroom Direct.
MC // January 2016
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The Opinions
So What Happens Now?
T
he government has in the past two weeks made a surprise attack on personal injury claims as part of George Osborne’s spending review. The Small Claims Limit for personal injury claims is to be increased from £1,000 to £5,000, and compensation for whiplash claims will be curtailed.
The increase in the small claims limit flies in the face of the government’s relatively recent decision not to do so. In 2013, there was wide scale consultation on various personal injury issues, the upshot of which was that the transport select committee and the Ministry of Justice recommended that the small claims limit should remain unchanged at £1,000. Since then, there has been no real warning that this issue was to be revisited and that there might be an imminent announcement on the subject. If the Small Claims Limit was to be increased then an increase to £5,000 was previously regarded as being at the extreme end of the scale. This change would of course see claimants unable to recover their solicitors’ costs in an area where it is extremely unlikely that litigants in person would be able to pursue their own claims, with the result that after deduction of their solicitor’s costs, claimants will end up receiving a much lower percentage of their damages. Still worse, the government has said that it intends to introduce measures to end the right to general damages for minor whiplash injuries, and will consult on the detail in the New Year. It is believed to favour reimbursement of expenses and the cost of rehabilitation but to limit claims for general damages possibly by barring claimants who have not obtained medical treatment within say 14 days of the accident. It appears that the government has taken advantage of a distant general election and an extremely weak opposition to push through most of the items on every motor insurer’s wish list. Christmas has come early for them, but sadly not for people who are injured through no fault of their own. Simon Pinner, Director, Box Legal Limited.
45
Outside-in: Enterprise Mobile Apps
T
here is no doubt that the mobile revolution has forever changed so many of our daily experiences. With the use of mobile technology, we can do things like pay for coffee or accurately find places we need to be, even when we have no idea where they are. Our gadgets can even anticipate what information we need and present it to us when it is most useful. Not even the industrial revolution created such a swift and radical explosion in technological innovation and economic growth worldwide. Back to the future The origins of mobile apps can be traced back to the summer of 1983, where a young man wearing a small bow tie and waving his arms excitedly, gave a conference speech in Aspen, Colorado. This was Steve Jobs, the visionary co-founder of Apple Inc. six months away from launching the first Mac. Some twenty-fours years before the first iPhone, and 27 years before the first iPad. That day in Aspen, Jobs predicted the evolution of a new digital distribution system, where software would be downloaded over phone lines. That day in Aspen, Jobs saw the future of apps and app stores coming. A new value chain In 2007, the launch of the iPhone and the creation of the first true app ecosystem brought about a gradual restricting of the mobile value chain. Since this time, real value has transferred away from the traditional pillars of the mobile economy, namely telecommunication services and handsets, into app ecosystems. This global app economy was worth $53Bn in 2012, and is expected to rise to $143Bn in 2016. Today, mobile is moving out of the pocket and becoming wearable; making people’s surroundings flexible and adaptive. With the growth of wearable tech, the need for intelligent aggregation of content will further fuel app innovation. Transformation The transformative effect of mobile technologies is fast becoming a growth engine for many enterprises, as Enterprise Mobile Applications (EMAs) enable innovation and a re-think of business processes for the future. Processes where external customers connect seamlessly to the enterprise in order to access, capture and process the right information directly at the point of activity. Furthermore, Enterprise Mobile Applications (EMAs) are enabling organisations to increase employee productivity regardless of time or location, and, more importantly, they are transforming business processes and putting companies ahead of those who haven’t started to consider their mobile strategy. Phil Swinburn, Head of User Experience, slicedbread.
MC // January 2016
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The Opinions
The number one priority What should those operating in the claims industry be most aware of in 2016 and why?
T
he simple and only answer to this question is and should always be – accident victims.
The claims industry has been something of a war-zone in recent times. Within all this melee, to some extent at least, many have forgotten that there still remains a person who requires advice and guidance to get them through what is a pretty traumatic event in their life. That was and remained the case before the Jackson review (and the Gill and Taylor Reviews in Scotland), that was and remained the case before LASPO and that remains and will remain the case after the Chancellor’s recent Autumn Statement and whatever may follow from it. From legislature to judiciary, to the mere mortals like you and I working within the industry, we need an industry that offers accident victims protection, access to justice and a means to move on from this event in their life. It doesn’t matter if it is “only” a neck strain, a back strain, a cracked bumper or a dent. The accident victim didn’t ask for it to happen or want it to happen. In the majority of cases they have never been through this process before (nor have they wanted to) so they need our help. They need a claimant solicitor who can process their claim efficiently and keep them informed of the process. They need a repairer that will fix their car properly. They need a car while theirs is off the road. They need to deal with suitably qualified medical experts to get them back on their feet and to assess their injuries. They need an insurer who will deal with their case fairly and with integrity. These are basic needs, not luxuries or ransoms. They are the needs of the hundreds of thousands of people in the UK that are involved in a road accident each year and for everyone operating within this industry and those making the rules that govern it, these should always be the things that remain the top priority. Scott Whyte, Managing Director, Watermans.
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Facilitating customer choice Will apps help bring down the cost of claims management or are they too much of a ‘one-size-fits-all’ solution?
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t probably isn’t unfair to group the apps that are currently available in the market into the one size fits all basket, however that said, they can still help bring down the cost of claims management through streamlining the notification process.
Market research suggests that more and more customers are willing to use apps to report motor claims and effectively self serve as a viable alternative to the traditional notification methods. This may come as a surprise, but its not just single vehicle accidents or theft claims that are being notified in this way and as such its likely that customers will soon expect their insurer to offer this method of reporting. Good news for the insurer of course who can use the app to communicate more regularly with the customer and use it to outline the claims process, encouraging immediate notification and collection of all the relevant information at the scene. IT integration into back office claims systems should be a pre-requisite to launching an app. Collect all the detail relevant to the claim regardless of liability to avoid follow up phone calls and use the phone technology to its full potential allowing the upload of relevant photographs and using the sensors to accurately report the accident location. Insurers shouldn’t forget the customer. There needs to be more in it for them, consider allowing them to select their nearest recommended repairer and use that selection to drive the booking in process. Incentivise them to use the app (discount the excess) and benefit from the saving to be made by avoiding that 20-minute notification call. Claims notification apps don’t have to be one size and neither should they be, they should automate and drive processes where possible through integration with back office systems as well as those of the supply chain and these will be bespoke to each insurer. Differing customer demographics should also drive the application build and insurers can enhance the relevance of the app and what it displays depending on your customer base. Ultimately, although the customer’s willingness to use apps to report motor claims is increasing, self service isn’t for everyone and it shouldn’t be overlooked that this is a distress purchase, so its essential to give the customer the ability to phone within the app. Miles Keeble, Non-executive Director, Veracity Claims Ltd.
MC // January 2016
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Legal Opinion
Legal Opinion A knee-jerk reaction?
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n 25th November 2015, George Osborne pledged to raise the small claims limit for personal injury claims to £5,000 and scrap general damages for ‘minor’ soft tissue injuries. It was a surprise to hear these reforms coming from the Treasury and not the Ministry of Justice. It was even more surprising that they were revealed prior to publication of the Fraud Task Force Report, which is due out shortly. Osborne says the reforms will remove over £1bn from the cost of providing motor insurance and he expects the industry to pass on this saving, so motorists see an average saving of £40-50 per year off their insurance bills. The proposed rise in the small claims limit has been on the agenda for years and the ABI have lobbied hard for it. The government opted not to increase it in 2013 after being warned against the move by a Report of the Transport Select Committee. The Government said then they would not increase the limit until safeguards were in place to protect genuine claimants but I cannot see that any safeguards are in place now. Further, the TSC recommended that the Government tackle fraud better instead of raising the limit and simply disenfranchising innocent accident victims. The Government then extended the MoJ Portal to cases up to £25,000 and included nonRTA cases, introduced AskCuePI and MedCo and set up the Fraud Task Force. All this work was carried out by the MoJ in an effort to tackle fraud better. However, instead of assessing the success of these reforms and waiting to see the FTF Report, the Treasury (not MoJ who were tasked with addressing fraud) has stepped in and proposed further major reforms out of the blue. The proposal to scrap general damages for minor soft tissue injuries has us most perplexed. It is a bizarre proposal. It is a plan to abolish the right to damages for injuries caused by somebody’s negligence. For the first time in UK legal history there will be a non-actionable injury. APIL warn that a rise in the small claims limit will see an epidemic of cold calling from claims farmers as they rush to take advantage of vulnerable people on a contingency basis, who otherwise won’t be able to afford legal representation. I am very concerned these reforms are not well-thought out and are ‘knee-jerk’ and I sincerely hope they are not implemented in the rushed and shambolic way LASPO was. Donna Scully, Partner, Caprtners.
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The latest news and views from Modern Claims’ resident legal experts.
New Guidelines for Health and Safety Offences – the stakes just got higher
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ew Sentencing Guidelines relating to the “Health and Safety Offences, Corporate Manslaughter and Food Safety and Food Hygiene Offences” come into force on 1 February 2016 and will significantly increase the level of fines and potential custodial sentences imposed by the courts. Culpability relates to the extent to which the offender failed to meet the standards required of them. For individuals, this will depend on a person’s attitude i.e. whether they knowingly and intentionally ignored relevant standards or were wilfully blind or negligent to them. For organisations, their attitude to safety, such as existing health and safety procedures and whether failings were systemic throughout the company, will be assessed. Harm is determined by considering the risk and level of injury created by the offence. The category is calculated by assessing the likelihood of harm occurring – high, medium and remote – and the seriousness of the injury – which is split into three levels A – C: A: Death, injuries reducing life expectancy and those resulting in lifelong dependency on others B: Injuries affecting a person’s ability to carry out day to day activities C: All other injuries. Fines are based on the turnover of the company with micro companies being those with a turnover sub £2million; small companies £2 - £10 million; medium £10-£50million and large over £50million. Assessment for culpability and harm carries sentences ranging from £250,000 - £450,000 for a micro company to between £4 - £10million for a large company. Corporate manslaughter fines are likely to soar with recommendations in large companies of figures of around £20million for the most serious of breaches. Individuals face an increased risk of custodial sentences under the new guidelines with up to two years imprisonment for offences with high culpability and harm but also a range of penalties below this including 26 weeks custody for some offences with a medium or low culpability. The personal risk of a loss of liberty have therefore increased for individuals charged. The guidelines which will challenge both businesses and people alike are a stark reminder of the importance of good safety management at all levels. What does this mean for businesses? 1. Some argue that we may see an increase in cases being taken to trial where previously they may have been a guilty plea given the increase in financial or personal risks at stake. 2. The impact of such high penalties could erase all profits for some businesses and in some cases see the business go under. 3. Larger fines may mean that we see courts imposing longer time periods for payment to avoid companies liquidating or losing employees. Helen Devery, Partner, BLM.
MC // January 2016
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Priorities for the motor insurance market in 2016 Rob Cummings considers the industry’s main priorities moving into 2016.
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And it will be vital to use data in ways that are acceptable to consumers, policymakers and regulators.
he UK motor market has faced regulatory, political and media scrutiny like never before in recent years. However, the Chancellor’s Autumn Statement demonstrated that this is a Government the industry can work with to achieve our long-term strategic goal, to improve the regulatory landscape to deliver better outcomes for our customers. So what are the industry’s main priorities as we go into 2016? Continuing the civil justice reform programme Our first priority will be to make sure that the two very welcome policies announced in the Autumn Statement – restricting general damages for whiplash claims and increasing the Small Claims Track Limit – are implemented in a way that reduces unnecessary frictional cost and gets rid of frivolous and fraudulent claims, while ensuring that honest claimants continue to be protected. Following the LASPO reforms, the industry lived up to its commitment that savings from the civil justice reforms would be passed on to consumers. Insurers delivered over £1bn of savings to motorists through lower car insurance premiums. That shows what can be achieved and the size of the prize. We also want to see progress on broader reform of the civil justice system – including making sure MedCo delivers effective accreditation and auditing of MROs and introducing a robust regulatory framework for CMCs through Carol Brady’s independent review. We would also like to see serious consideration given to whether the current three year limitation period to make a low-value personal injury claim remains appropriate. Young driver reform Insurers remain disappointed that the last Government’s long-promised Green Paper on young driver safety was never published. The need for young driver testing and training reform is still just as pressing. 40% of young drivers will have an accident within six months of passing their driving test.
‘We would also like to see serious consideration given to whether the current three year limitation period to make a low-value personal injury claim remains appropriate’ The Government is currently consulting on some modest proposals for driver testing reform, but we will continue to support a more ambitious approach focussed on the key risk factors of driving at night and with passengers in the vehicle, as we know that, where they have been introduced, graduated driver licensing schemes addressing these have a dramatic impact. Alongside that, we will continue to work with Government to make sure the potential benefits of telematics technology for young driver safety are realised. Data and digital The digitisation of society will impact everything that motor insurers do and the race is on to exploit this. Data is helping the industry prevent fraud, make the case for important public policy outcomes and deliver new industry initiatives. However, with opportunities come risks. Issues the industry will need to grapple with include developing the analytical capabilities to deal with huge volumes of varied and unstructured data and the commercial challenges of incorporating ‘big data’ into pricing, claims, and marketing.
Autonomous vehicles The development of connected and highly-autonomous vehicles creates challenges that the motor insurance market will need to come to terms with. With human error accounting for around 90% of road accidents, the potential safety implications of autonomous technology are enormous. But, just as with data, there will be insurance and regulatory questions to address, notably on liability disputes, but also on the future of the licensing system and the motor insurance product. In 2016, the ABI will be working closely with Ministers and officials to address these challenges. The reputation of the industry Probably the general insurance product that faces the most Parliamentary and media scrutiny, motor insurance will, I’m sure, continue to be in the spotlight. At the ABI, we’ve worked hard over many years to improve practices in what is a highly competitive market. At our Biennial conference, our Chairman announced two initiatives – an ABI/ BIBA code of practice on renewal, and the publication of the overall claim acceptance rate for Motor, Property and Travel policies. This shows our continued commitment to improving the reputation of our industry, and we will continue to drive this work forward in 2016. Conclusion Much has been achieved in recent years to improve the market – an industry that continues to evolve in an ever-changing landscape. More change will come. I hope that in the course of this Parliament that, as an industry, we will have made meaningful progress to address these five key issues – civil justice and young driver reform, data issues, autonomous vehicles and the industry’s reputation. Rob Cummings is Manager, General Insurance at the Association of British Insurers (ABI).
MC // January 2016
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Law and Order – Prosthetic myths busted Amputation is not something new in Personal Injury or Clinical negligence cases, but eliminating some myths on prosthetics and amputation can ensure your client receives a substantial win for them to continue living fulfilled lives, as Adbo Haidar reports. Myth 1: One size fits all With an average prosthetic use of 10 hours per day, the most frequent problems occurring in the residual limbs are discomfort, skin breakdown and pain. Comfort has been stated as the most important factor among prosthetic limb users. When a limb has been amputated, the stump or residual limb is different from one person to the next. The most fundamental element in the creation of a prosthetic is the sockets; the crucial interface that connects these sophisticated prosthetics to peoples’ residual limbs. The prosthetic limb may be fitted with the most technological advancements but the socket remains the real point of contact. Different measuring techniques are used in the industry at present to capture the size and shape of residual limbs. These techniques remain limited and are unable to identify the infrastructure of residual limbs and pressure tolerance of individual amputees. It can be a time-consuming process, involving the production of multiple check sockets before a well-fitted socket can be achieved, during which each check socket is modified according to the feedback of the patient. As a result, the design of a prosthetic socket is still basically an art, which is highly dependent on the experiences and skills of the prosthetist.
‘An important part of an amputee’s care is rehabilitation, this can range from psychological counselling if needed, occupational therapy to physiotherapy’ Myth 2: One limb for life The residual limb changes constantly in an amputee’s life, some of these factors include growth, ageing eg. from teenager to adulthood to elderly, and lifestyle changes, for example amputees who become more active in sports. An able bodied person wouldn’t think twice about a simple task such as taking a shower but as a lower limb amputee, showering with a crutch is not ideal or safe. Even the most expensive prosthetic limbs are built to withstand only three to five years of wear and tear, meaning
they will need to be replaced over the course of a lifetime, and they’re not a one-time cost. The technology behind these prosthetics are completely different to a prosthetic used for walking down the road or climbing stairs. Each amputee’s activity levels rely on the type of prosthetic limb they are able to obtain. The prosthetist works in close partnership with the patient to establish the right prosthetic for them and their lifestyle. Myth 3: Amputees only see their prosthetist at the fitting An amputee will need to visit their prosthetist for the rest of their lives. From the first consultation, they will be required to visit the prosthetist once a month to ensure comfort of the new socket and learn to adjust to the limb properly. Thereafter, it may be once every 6 months to ensure the prosthesis is in good working order and most importantly, as their lifestyle changes so does the residual limb and the socket. An important part of an amputee’s care is rehabilitation, this can range from psychological counselling if needed, occupational therapy to physiotherapy. Rehabilitation is vital for the amputee to learn to cope with the changes in their life, be it from a psychological aspect to learning how to walk with their new limb and to prevent additional muscular damage for over compensation. There is no definitive time scale on rehabilitation, this depends entirely on the level of amputation and how soon they can learn to become mobile. With the right support and care, the client will be equipped with the tools they need to continue living life to the full. We hope this article has helped to clear up some of the myths surrounding prosthetics and given you some fresh new insight. If you would like to join us for a workshop about the life cycle of prosthetics, or arrange an informal meeting, please contact us to discuss further. Abdo Haidar is a Consultant Prosthetist/Orthotist & Director at The London Prosthetic Centre. www.thelondonprosthetics.com enquiries@thelondonprosthetics.com LPC are leading experts in cutting edge upper and lower limb prosthetics, including custom silicone cosmesis products. Our ultimate purpose is to create the turning points that enhance the lives of our patients – helping them to take back control of their world and achieve new and amazing things with their new custom-made prosthetics. The team is led by Director/ Consultant Prosthetist, Abdo Haidar who specialises in upper and lower limb prosthetics, has over 20 years of NHS and private experience, and is a member of The Expert Witness Institute.
MC // January 2016
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Key Issues to Consider for Amputee Compensation Claims ???????? ?????? ??????
Mark Ledger explains how continuing developments in prosthetics are enabling clients to return to a much more active life than was previously ever possible.
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he goal for any amputation compensation claim is for the client to be awarded enough compensation to return to a life as close to that of pre-amputation as possible. Continuing developments in prosthetics are enabling clients to return to a much more active life than was previously ever possible. However, the latest technology may not always be the most suitable for your client’s needs. I work closely with law firms to ensure the reports I produce are tailored to provide the specific information required for their clients. Amputation clients often require orthotic and physiotherapy input, in addition to their prosthetic treatment, as the additional strain on the rest of the body can cause muscular and joint problems. A multidisciplinary approach usually delivers the best results for the client and this should not be overlooked when making an amputation compensation claim. I regularly work with Orthotists and Physiotherapists to enable clients to make the best possible recovery and reach their mobility goals. If these are taken into consideration from the outset, all relevant experts can be instructed, allowing time to be saved and the most appropriate recommendations to be made. Prosthetic technology has advanced dramatically in recent years, leading to a correlating increase in the cost, so I request instructing solicitors ask for substantive evidence to accompany the recommendations I make. I find the Courts are more likely to award compensation for recommendations for high-cost components when clients have already completed a successful product trial. In my experience, video evidence of such a trial is highly compelling to the Courts and can usually be completed very quickly and at a relatively low cost. Developments in prosthetics are happening more quickly than ever before: what is considered the best option for your clients today may well no longer be so in six months from now and amputation compensation claims can take a substantial amount of time to reach a conclusion. This has led to an increasing need for the completion of addendum reports throughout the course of the legal proceedings, to ensure that clients receive the best rehabilitation outcome possible. To find out more about the Blatchford Clinic, please visit blatchford-clinic.com. Mark Ledger, Principal Prosthetist, Blatchfords.
MC // January 2016
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5 minutes with...
5 minutes with... Lindsey Davies
Q: Has the industry changed drastically since you started working in it? A: The regulatory environment has grown tremendously in the last 20 years. The rise of the regulator has seen almost a complete reversal in attitude towards compliance and the purchasing of insurance. In the 90’s we were taught: “the insured knows everything and the insurer knows nothing” it was felt insurers were at a disadvantage. This has completely changed now and for consumer products, this was the right thing. Firms have started to realise that if you embrace compliance and conduct within your culture and employ the right kind of person, it can make huge business sense. Q: What has been the key positive or negative impact of change in your area of the market? A: It is hard for insurers to work out exactly how to execute the regulatory changes without losing business. We need to use data and technology more. There is a lot of data gathering but not much sharing, which creates duplication and inefficiencies. Regulation has been a key driver in the wake up call for the market to modernise and collaborate more. Q: Who inspires you and why? A: People inspire me in general, especially the people that live through such adversity and still have a positive outlook,
and achieve and help others. I remind myself this on occasions when I am down or stressed. Mine are first world problems and I am extremely lucky and grateful for my lot in life! It could be much worse and we forget that too much in this country. Q: Have you had/got a mentor? If so, what was the most valuable piece of advice they gave you? A: I have a number of mentors, pearls of wisdom include: “Be authentic” – Don’t try and speak differently or act differently - it doesn’t work. You will be at your best and happier if you are yourself. “Don’t get in the way of yourself” – Women tend to put barriers in their own way. Men try anyway, ask for pay rises anyway and that’s why (most of the time) they are paid more and end up in the jobs they want. Try and fail is better to not try at all! On public speaking: “When you speak often enough about the things you care about something will just click”. Q: If you were not in your current position, what would you be doing? A: Running a busy restaurant – I love food and wine, and being busy! Lindsey Davies is Deputy Head of Delegated Authorities, Performance Management Directorate, at Lloyds. The views expressed in this article do not necessarily represent those of Lloyds.
Ralli Solicitors Ltd chooses Proclaim Practice Management software solution in six-figure deal Leading north-west law firm, Ralli Solicitors Ltd, is implementing the Law Society Endorsed Proclaim Practice Management Software solution from Eclipse Legal Systems.
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mploying over 60 staff, Ralli provides a full range of legal services to private individuals, businesses, charities, and the security forces. The practice has a particular strength in managing personal injury claims for clients nationwide, and it is in this part of the business that Ralli will be implementing Proclaim. Darren Gower The 6-figure deal incorporates the Proclaim Practice Management solution, tailored for use by the entire claims function. The integrated Proclaim ‘lead management’ system will empower Ralli to analyse and track sources of business, while offering a more streamlined and efficient client inception process. As part of the drive towards paperless working and rapid client engagement, Ralli is implementing Eclipse’s SecureDocs solution to provide online document signing in a secure browser-based environment. In addition, Eclipse is carrying out a migration of data from both the accounting and case management systems currently in use at Ralli. Martin Coyne, Managing Partner at Ralli Solicitors Ltd,
MC // January 2016
comments: “Choosing the right software solution for such a vital part of our business is a big undertaking. We were impressed by the sheer scope of what Proclaim can offer - from enhancing the way our staff work, through to improving the end client experience. The Law Society Endorsement cements our confidence in Eclipse and Proclaim; we look forward to a long and happy relationship!” Tracey Smith, IT Development Manager at Ralli Solicitors Ltd, adds: “In an increasingly complex and competitive environment, a fully integrated solution which improves efficiency, adds value to the claims process and strengthens client engagement is critical. Proclaim will allow us to respond to the challenges we are faced with and meet changing customer demands with agility and confidence. We have every hope that this market leading software will satisfy our immediate and long term business needs; enabling us to achieve a stronger competitive position.” For further information, please contact Darren Gower, Marketing Director at Eclipse Legal Systems, part of Capita plc, via darren.gower@eclipselegal.co.uk or call 01274 704100. Alternatively, visit www.eclipselegal.co.uk
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