Post author: Martin Saunders, Head of Service
I hope that everyone has had opportunity to review and reflect upon the routine data release we shared last week as well as the previous blog article on Claim Lifecycles, the feedback from the industry so far has been very positive. As we promised, we are looking further into Dormancy and are now able to share some additional insight.
What is Dormancy?
Within the OIC system we track claims progress through various stages. We know claims are presented and go through the process of liability being resolved, getting and sharing a medical, making and receiving offers and settling. Dormancy happens when claims start to stick in the process – with a lack of input/update to the system leaving the claim in the same status. Of course, some claims will need to stay in a particular stage whilst details are worked through by advisors, but our insight suggests Dormancy is playing an increasing role in being a barrier to claims progressing. Something that I explored with more detail in my previous blog on Claim Lifecycles.
I previously discussed the ‘Pend Medical’ stage that many claims are currently sat within in the system. However, in this piece I wanted to share further examples of claim stages to give greater insight and context:
Pending Withdrawal Claim – we looked at claims where the claimant/representative had requested that the compensator/TPA (third party administrator) withdraw the claim from the system. The volumes are shown below and by applying a figure of 30 days to define dormancy – a not unreasonable amount of time for this action to be concluded – we see that there are potentially 16,270 Dormant claims, waiting for the compensator to action.
Pending Removal Claim – this example shows a similar scenario to Pending Withdrawal, however the claimant/representative has been informed that their claim has been withdrawn by the compensator/TPA (third party administrator). A similar pattern emerges, with an amount of 27,906 claims listed as dormant – waiting for the claimant/representative to action.
What’s going on?
We have had the benefit of speaking to a number of compensators and claimant representatives. Broadly, the sense is of a mixture of claims that have fallen away for any number of very good reasons, and equally housekeeping with the quality of data held in the system being eroded by it not being updated. It doesn’t mean the data isn’t accurate however – it is from the system perspective, but if elements have not been updated, it could indicate progress is not correctly understood. We had two examples recently that put some colour on that issue. A bulk transfer of handling between TPAs that has now resulted in a system clean up by the new TPA, that saw over 1,200 claims fall into a settlement category within a few days. These claims had been settled many months back but by bringing the system up to date, the claims have moved and has had a resultant knock-on to such things as closed lifecycle. The second example was a claimant organisation we have spoken about concerning cases seemingly dormant in a ‘Pending Fees’ state. Again, hundreds of claims involved and another simple case of not updating the portal when all the work had been undertaken.
So, as we turn the year end and look forward to 2024 – when the system turns 3 and we will have the Supreme Court outcome on mixed injury, why not take opportunity to take a look at the system to ensure that the claims you are processing are up to date?
Is this useful?
This level of data has not been previously shared, if you find it of interest and would like to see more, please let us know.