Some insurance firms settling claims without medical reports to prove injuries

Some insurance companies are settling personal injury claims without medical reports to prove injuries actually occurred, the Minister of State with responsibility for the area has said.

Michael D'Arcy, the Minister of State in the Department of Finance with special responsibility for insurance, told The Irish Times he found the differing approaches to payouts from separate insurance companies "frustrating", with some giving awards to claimants too easily and others fighting claims too strongly.

“What I find frustrating – and I have met all of the major players in insurance here individually – is I find the business models very diverse,” he said. “I find the settlement channels incredibly diverse.

"I give an example of Company A. I won't name them – this is their model in terms of settlement – they will settle without a medical report. And then Company Z on the other side of the spectrum, even where someone has very obviously been impacted, they will fight you every step of the way.

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“Now, I think Company A is wrong in that, and I think Company Z is wrong in that, and everybody operates in between. It is about trying, when we get sight of the transparency and the information, to see exactly what has happened.”

Compulsory

Now medical certificates confirming personal injury claimants have actually been injured may become compulsory in insurance cases as part of efforts to reduce costs across the sector.

Mr D’Arcy said the long-awaited national database tracking insurance claims will be up and running by the end of this year.

The database is designed to develop an understanding of how the cost of claims is affecting motor insurance premiums and is part of an overall strategy aimed at tackling spiralling costs.

The Central Bank (National Claims Information Database) Bill 2018 passed all stages in the Oireachtas before Christmas, and is awaiting President Michael D Higgins's signature.

Mr D’Arcy said the database will be up and running by the second half of this year by which time the Central Bank will have completed an examination of claims over the previous decade, as well as for the first six months of 2019.

Medical certificate

The information to hand when the database is launched will allow the Government to make policy changes it believes are necessary to bring down the cost of insurance. The prospect of ensuring that everyone who receives an insurance payout in personal injury claims must have a medical certificate is one such idea, Mr D’Arcy said.

“If I see some companies settling without medical reports, well then there is a policy decision potentially to be made for government. It might be that there has to be a medical report on every settlement.

“It could be – I am just using that as an example. If I see too much money being paid out too easily, too quickly, that is something we have to look at. To date, we have no sight of the settlement channels. I don’t know what is going on, which is remarkable. We will have that by quarter three [of 2019].”

The data being collated will not be broken down by individual companies, but will instead aggregate details from across the sector.

“It will be aggregate data, so I will have a percentage of the data,” Mr D’Arcy said. “So if 40 per cent of medical claims are settled without a medical report, then there will be an issue.”

Fraudulent claims

A separate database of all privately insured drivers, which seeks to target fraudulent insurance claims, has gone live in some areas of the country.

It has been formulated using information provided by insurance firms and is part of a new Garda scheme targeting uninsured drivers using hand-held devices to scan number plates. It is understood this is in operation in areas of the country where gardaí have the required technology.