I have recently started working for an organisation that has actual insurance (I previous worked in the Civil Service where such vulgarities as compensation were paid out from money found in the back of the treasury sofa). I have been told that the practice is for the details of ALL accidents that MIGHT give rise to a claim need to be forwarded to the insurers just in case along with ALL relevant documentation.  This is described as being proactive.

I always thought (perhaps naively) that insurers only came into play if a formal letter of claim had been sent by the claimant’s solicitors, to the employer,  setting out the claim (what is actually for and what amount). Otherwise we end up second guessing a possible claim for we know not what with our investigation process being slewed towards defending a theoretical claim rather than establishing the root causes of an incident to enable lessons to be learned.

What are other people’s experiences?  

Hi.

We conduct our investigations and store all documents until requested from our insurers. No second guessing what may be a claim and what won't be.

Like Andrew, we also have a positive relationship with our insurers, but on the basis that we have been able to submit requested information without any issues.

https://www.out-law.com/topics/regulatory/health--safety/personal-injury-and-employer-liability-portal/

One of the main reasons for early and possible over reporting is the cost implications of the claims portal. 

Statute of limitation is 3 years from date of accident or diagnosis of disease. 

Insurers have 1 day to acknowledge a formal letter of claim. This could arrive 2 yrs and 364 days after the event. 

They then have 30 days to investigate (EL claims) and 40 days for PL claims. 

If insurers comply with those timescales then the claimants costs are fixed to around £1500 for claims that fall in the wide net of the portal. Stops the old situation where claimant got say £2k and their solicitors pocketed £6-10k. 

If the timescales are not met, the claim will then fall out of the portal procedure and the revert to the old cost charging regime. 

Your insurers are unlikely to be happy if you did not report an incident, a claims arrives 2 years later and you no longer trade from the loss location and key witnesses have left the company. Makes investigation a real problem with large cost implications. 

As an insurer I do come across clients that over report and we can recognise that pattern of reporting. When asked for guidance I suggest they report:-

- All RIDDOR incidients in the disease / injury category. 

- All incidents were hospital visit required. 

- All incidents where the IP has intimated they will be making a claim, either verbally or in writing (but not formal letter of claim). This picks up the small non RIDDOR incidents where the IP is looking to pursue matters further. 

Originally Posted by: A Kurdziel

Thanks Andrew

How do you know if an inicident give rise to a potential claim?

The person in our insurance office seems able to identify those without use of a crystal ball: not just who might be making a claim but also what for. My own experience is that claims often come from unexpected directions, while the poor sod who you think has a good claim, grits their teeth and gets on with it.

As a rule of thumb, all RIDDORS go to insurers and also incidents involving colleagues who have previously claimed. I wish I had a crystal ball for the rest- as you rightly say claims can come straight out of left field. As we have staff working in other company's sites if there are slips and trips we will always inform about them.

I have been caught out in the past where a claim came in and the insurers weren't notified that it was a 'possible' claim at the time of the incident. As it was a small cut to the forehead and NOT a RIDDOR we didn't inform- yet a claim came in. The insurers do understand that we are not psychic...

Its all good fun!!

Andy

I am not saying that we will not be recording and investigating the incident but what has happened here is that the finance person who deals with insurers has gotten hold of an incident report  and decided (without any sort of consultation or real evidence) that this a  possible claim and is now demanding all sorts of reports.

Meanwhile H&S are steadily putting together the story of what happened and what can be done to prevent reoccurrence.

The incident is a simple slip and currently I cannot see how anyone can make a claim from it (but I have been surprised before). It is not a RIDDOR.

From what I understand of the civil actions protocol the defendant has 21 days to simply acknowledge the claim.  The defendant then has 3 months to investigate the claim and make a response to the claim.  So why people are jumping up and down before a claim even exists baffles me.   

PS Tea Ladies (persons) are now extinct in the Civil Service and were even before my time (18 years ago). All we had was a nasty vending machine.  

RIP the tea trolley (..and I'm obviously showing my age too !)

From what you're saying it seems more like internal politics than the demands of your insurers (in so much as your finance person seems to be over-riding the H&S Dept).  You're right in thinking that it's way too early to get bent out of shape about a claim that may never even materialise, but your finance person obviously prefers the belt and braces approach of informing the insurers of all incidents.

I can only suggest that you meet up with the person concerned and perhaps set the ground rules (or at least agree common ground on what needs to be reported to the insurers and what doesn't) ?  None of us know for sure which accidents/incidents will result in a claim (and we've ALL been wrong before !), but I think you do develop a "sixth sense" from the findings of your investigations and witness statements usually, and I'd make the argument that the H&S Dept are possibly better placed to decide upon what is likely to interest the insurers than perhaps the (albeit well-meaning) finance person ?

You say you're new to the organisation, so maybe it's simply a case of building up trust and a good working relationship between the finance and H&S Depts ?  Maybe they've been let down in the past ?  Just a thought....