Seeking advice following car insurance medical assessment recommendation

boots_babe

Hi,

Having never had a serious car accident before, I am hoping for a bit of guidance from those of you more experienced. Last August I was involved in a car accident in the motorway. 4 cars involved including me, but as I stopped without hitting the car in front, then got multiple shunts in the back, it's a no fault claim. One of the other parties involved has accepted fault.

DLG Legal Services have been appalling throughout, they never seem to actually DO anything! Finally 13 months after the accident they sent me for a medical assessment (laughable given how much time has now passed), and I have just received the medical report and insurer recommendations. This is where I am hoping for some help - my claim handler is now off for 2 weeks and have been told no one else can help so I thought I may seek your advice in the meantime.

My medical assessment deals with 2 main issues - 1 is whiplash, 1 other (by far the more serious). The assessment explains that a 'tariff' that applies for the whiplash part, which is all clear and makes sense to me.

However for the 'other' medical issue, it states the below:

"We note that you have also suffered injuries other than to your neck, back or shoulder. You are

also entitled to receive compensation for these injuries but these are valued differently. In order to

value these injuries we research comparable cases, look at the current industry standards and use these, together with experience to reach a valuation. Based upon you making a full recovery as expected within the medical report we would value these injuries at between £X and £Y.

As the concept of valuing whiplash injuries by way of a tariff is completely new, the Courts are still to determine how claims which include a mix of whiplash and non-whiplash injuries are valued together This means that there is considerable uncertainty across whole personal injury claims industry as to how this will work. This does mean that there is an increased risk that the other driver’s insurers may not be willing to meet our valuation, we will advise you if this impacts your claim and keep you updated with regards to timescales where necessary."

I guess I understand that as far as it goes - they are saying that for whatever reason, non-whiplash injuries have not previously been given a value for compensation purposes, that this can be done now, but it's a new process and so there is greater uncertainty as to how the other insurer would receive the claim. 

However, they then go on to state my 'total' compensation claim figure. This is less than the 1 whiplash plus 1 other figure combined. I'm not clear whether this is an error (highly possible given my experience with them so far), or if I'm meant to infer from the quoted text above that they have therefore reduced the overall claim figure, to make it more likely to be accepted.

In effect, the reduced total quoted means I would be paid far less for the 'other' claim than for the 'whiplash', which is completely illogical to me, as it was the 'other' claim that has caused me by far the most pain and general disruption to life. It doesn't seem right that this would be 'downvalued'.

Clearly those of you reading this thread can't know what DLG were thinking when they wrote the letter! But I hoped some of you may have been in a similar situation, and could maybe advise as to whether the 2 components of your claim were then amalgamated into a 'reduced' total, or if they were simply added together as you would expect?

Many thanks.

D924

Whiplash has been a cash cow for predatory practices for many years, the tarriff system is meant to limit some of the insane, ridiculous, highly profitable claims by placing fixed rate values on injuries.

Your "other" claim doesn't come under a tariff system, so its value needs to be proven on its own, by way of receipts for medical bills, time off work, and so on. Unfortunately if you've been treated by NHS, you won't have any medical bills and will get a very minimal payout.

https://www.legislation.gov.uk/ukdsi/2021/9780348220612

boots_babe

Hi, thanks for replying.  If anything the whiplash figure seems high, I agree that it's become known as a way for people to make a quick profit! When I went for my somewhat pointless medical assessment,  the other people in the waiting room were discussing what they would do with the money. It all felt very uncomfortable and grubby.

Anyhow, re the 'other' item, I did have medical appointments and was referred to a spinal consultant for a small procedure.  The costs incurred specifically for this were not huge, and I've submitted my receipts for that,  which have been accounted for by the insurers separately from the compensation claim.

I had a period of many weeks where I was pretty much incapacitated,  I can't attach a specific cost incurred as there was none. But I had huge pain and my lack of ability to move was hugely debilitating and massively restricted my life for that period. I thought that's what compensation was intended to help make up for, rather than simply costs incurred?

It's a genuine question in my last sentence, if the information I've been given by DLG is all correct then that's fine. I'm not wanting to push for more than I'm entitled to, it's just that DLG have made so many glaring errors in my dealings with them that I don't trust them one bit. And I've never dealt with anything like this before.  So am grateful for any advice.

Bigphil1474

Whiplash can be a longer term issue though, whereas any 'damage' that can be repaired isn't. Appreciate that some whiplash claims are nonsense, but my lad had whiplash that affected him for about 10 years, and the money heh received paid for physio for that time.

What they've said seems to make sense to me - the 2 separate conditions have separate values, but a combined value will be less than the 2 separate values added together - any loss you will have won't be doubled e.g. a days lost work due to whiplash and the other condition is the same amount of money lost whether you have one or both. 

I could be wrong but my understanding was that compensation was paid to cover any actual or potential financial losses or costs incurred as a result of the injuries, not for any loss of enjoyment or pain and suffering.

Bluebell1000

My understanding is that there are two elements to the compensation. One is for the costs incurred, and the other is for the injury itself, and how that has impacted your life - including whether you are expected to make a full recovery, or whether it may cause long term issues. 

DullGreyGuy

General damages, that cover pain suffering and loss of amenities, historically were almost always heard in the Fast Track or above and ultimately individually negotiated. You therefore didn't get £1,500 for your neck pain and £7,500 for your busted foot but a single figure of £9,000 because ultimately you couldn't do your weekly ball room dancing because of both issues so you dont effectively get paid twice for that.

As your letter explains, we are in a new world now. Whiplash and minor soft tissue issues have been taken out of Fast Track, given a set tariff and put into Small Track. Legislation is great and all but as is normal, and acceptable in a common law situation, there are gaps. It doesn't state how someone with both a tariff injury and non-tariff injury should be dealt with in detail such as adjusting down the non-tariff injury to adjust for the fact the tariff has already considered some of your loss of amenities which the second injury didn't change. 

Special damages are totally separate and cover the losses which you can pin a real value to like the damage to the car, loss of earnings, medical bills, hire cars etc etc.

boots_babe

Thanks so much for everyone's replies. It's a world I know nothing about and so feel quite lost. I would have hoped to rely on the people dealing with my claim, but as they've been so useless I know I cannot trust them to give me correct information. So I really value people taking the time to reply here.

My tangible costs have all been dealt with separately, I have submitted receipts etc, and I have a separate document that the claims company has sent me detailing these, and they have said these will be claimed in addition to the compensation figures.

What you've said DullGreyGuy makes sense, thank you. What I've been told (with made up numbers) is:

whiplash claim (£3k) + other injury claim (£3k) = £4k total. 

Which to me read as though my 'other' claim was being valued at the reduced figure of £1k, which would be totally illogical as this is the thing that has caused me the most pain and disruption to general life. 

But it sounds as though this is all quite normal given the way legislation is, so I'm now reassured that DLG have not made (another!) error here, and I should accept the figure they have given.

Thanks all.

DullGreyGuy

It would be useful to know, at least in ballpark, what the actual numbers are. 

Pre the introduction of the tariff then for minor injuries (pretty much anything under £5k) we had a simple matrix which had duration of the injury on one axis and the number of body-parts injured (1, 2 or 3+). You basically looked across the two axis and there was your initial offer. We subsequently made it a little more technical considering both the claimants solicitor firm and our insured's location (courts in the north are more generous than those in the south east).

In your example you've said the two items have an equal value individually which in theory means they were approximately the same severity (pain x time) and so combined I wouldnt have placed more than a 1.5 multiplier. 

You do have to look at the detail though, for example losing two eyes will payout more than double the settlement of the loss of one eye given the compound impact is that you are now blind

boots_babe

The real figures are in the same order of magnitude as the example that I gave. Although in reality, the pain and life disruption was many times worse for the 'other' claim than for the whiplash one. 

I think from the feedback on here it is sounding as though it is likely correct that they have given a reduced combined figure.

DullGreyGuy

boots_babe said:

The real figures are in the same order of magnitude as the example that I gave. Although in reality, the pain and life disruption was many times worse for the 'other' claim than for the whiplash one. 

I think from the feedback on here it is sounding as though it is likely correct that they have given a reduced combined figure.

It's roughly in line with the pre-whiplash reform world... your claims handler will be better placed to say in the new post-whiplash reform world. I've not directly done claims handling for many years.