MedCo suspends 20 users for trying to game system

Evans: generally pleased

Evans: generally pleased

MedCo has so far suspended 20 users for trying to bypass the random allocation of medical experts and medical reporting organisations (MROs), which it described as a “serious breach” of its rules.

In an update issued yesterday, MedCo said it has “identified, monitored and investigated users who appear to have been intentionally manipulating the search function on the MedCo service including repeat searches to achieve the desired outcome”.

The authorised user agreement bans “searches of general or speculative nature”, and requires a user planning to conduct a second search for the same claimant on the same accident date to first submit an explanation as to why this is necessary.

To date, 20 authorised users have been notified of their suspension. In line with MedCo’s escalation procedures, suspended users have been asked to make appropriate representations to explain their conduct,” the update said.

“Further users have also been identified manipulating the search function in a similar manner and MedCo is in the process of making contact to enforce user agreement compliance procedures via warnings, suspension, and if necessary termination of the use of the system.”

It urged user to “ensure your organisation’s compliance and that your staff using MedCo are fully conversant with the rules and acceptable use of the service”.

In his speech last week to the Association of Personal Injury Lawyers’ annual conference, civil justice minister Lord Faulks said the government was pleased with the work of MedCo one year in, including how it was identifying those trying to circumvent the system.

In March, the Ministry of Justice (MoJ) published the results of its review of MedCo and the measures it intends to introduce to stop users gaming the system.

The MROs approached by Litigation Futures to date have declined to comment on the proposals for various reasons, but others have been more forthcoming.

Deborah Evans, chief executive of APIL, said the association was “generally pleased” with the outcome, including the greater choice of expert and changes that will help ensure national MROs genuinely have that level of coverage.

“We were looking for the quality of provision to be raised through the setting of clear criteria and robust service standards that were checked not just a pre-registration, but on an ongoing basis through audit and accreditation. This review delivers this,” she continued.

“As the deadline for accreditation has been extended until 1 June, it is still too early to say that quality has been raised, but the training package is fully in place and should guarantee the required level of knowledge and understanding of process.

“We wondered whether regulation of MROs might be appropriate – yes, individual practitioners are regulated but there may be sense in regulating the organisations, particularly with a view to monitoring compliance with the ban on referral fees as payment would take place at organisational, not individual level. This point has not been taken up but we will keep a watching brief on that to see if it is needed. We want this to work.”

Nigel Teasdale, vice-resident of the Forum of Insurance Lawyers (FOIL) and FOIL’s representative on MedCo, said the changes addressed several of the issues it had raised.

“The changes to the qualifying criteria and the declaration of financial links should make the rules clearer and reduce the potential for abuse. As MedCo becomes established, it is important that the regime continues to evolve and FOIL welcomes the MoJ’s continuing commitment to keep the framework under review, particularly on the issue of formal regulation for MROs, which FOIL would support.”

Niall Edwards, head of the motor group at leading insurance law firm Kennedys, said the MoJ was right to take action, but queried the increased choice of 12 MROs. He explained: “One cannot help but ask whether it is really in the interests of justice to stretch experts thinly over numerous MROs such that they keep ‘popping up’. Is there a tipping point between quality and quantity?”

He predicted that MROs would object to changes to the qualifying criteria aimed at defining what an MRO is, on the grounds the MoJ should not be interfering with business structures, while they were likely to say that extending the declaration of financial links from one to three years would be impractical.

Mr Edwards added: “There are other areas that have not been addressed by the MoJ. There is still no financial declaration required on family links, and no new ‘MRO to MRO’ declaration. Further guidance is also awaited for ‘employee’ links and payment of referral fees/commission.”

He concluded: “One cannot help but ask that, if MROs have been successful in ‘gaming’ the MedCo system so far, won’t they simply continue to adapt and devise new tactics, especially if there are areas left under review?”

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