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Can the NHS claim back costs against companies and Employers Liability Ins?
Rank: New forum user
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Can the NHS claim back costs against companies and Employers Liability Ins?
Do you think it would be possible for the NHS to claim back monies spent on repairing someone who has been in an accident, from the company responsible?
Would this help to focus more attention on OHS in businesses?
Would this help the NHS improve it's cost structure?
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Rank: Super forum user
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things are already happening re this area
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Rank: Forum user
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at this time the National health service do not charge for
patients health
if it was brought in when would the charging stop
do you charge a smoker for a lung transplant
or a motorcyclist for speeding and hitting a wall
there is not even a charge for a patient who goes for a private operation were things go wrong and the NHS has to use its resourses for ITU and to put the person back together again
however who knows what the future holds it would save a fortune but insurance premiums would sky rocket
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Rank: Super forum user
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Williams
Except for RTA’s where they claim against the liable drivers insurance. There has been talk of extending this to work related injuries for a number of years.
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Rank: New forum user
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Rank: Super forum user
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Remeber that it will be the EL insurer that pays. Thus the employer is insulated from the direct costs - they are not "passed on" to the employer.
Thus, it is, in my opinion, highly unlikely that the claiming back of such costs would act as any sort of motivator for employers to increase their efforts in H&S/risk management.
Phil
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Rank: Super forum user
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One problem is the way that EL works in this country. (I work for the government and we don't have EL, so bear with me). In theory the insurance premium that an employer pays should be directly related to their H&S record and how many claims have been made against the company- this is what I was told in my NEBOSH diploma ( which was run by a well know insurance company which might be biased!)
In practice talking to H&S professionals issuers seem to calculate premiums in the basis of type of business, so you can have a really good employer in the same area of work as a really poor one and both end up paying the same premium.
Perhaps this is what needs to be looked at.
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Rank: Super forum user
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This practice of cost recovery is extensive and has been for years with regards Public Liabilities - so the principles are set out.
Underwriting risk is a pretty well though out business and insurers are in the business of making money like all other companies - so measures are already in place to penalize companies with poor safety records and high numbers of claims. This comes in the form of any excess amounts - if an employer has a high record of claims to keep his premium down he take an hit on the excess - so in essence you are self insuring for most claims and the underwriter is covering you for the big one!
If you opt for ground up cover and the insures underwrites the whole risk but you pay a whacking premium for this. You have to declare your claims experience in any renewal process clarity in this is essential or its fraud.
Employers aren't immune or insulated for any cost as its either the excess or the premium - you pay in the end and its a legal requirement to have it.
So if you not good at safety you do pay one way or the other…………………………….
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Rank: Super forum user
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There are 2 elements here
1: Claim back via the insurance route
2: Claim back directly from the employer without going through the insurer
I am lead to believe that route two is currently being piloted and yep the NHS do not claim back [at this moment in time but watch this space as 'certain people' want the NHS to go into private hands!] from private people for private things but when a person has an injury at work different parameters apply as the employer is responsible unless the employer proves otherwise
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Rank: Super forum user
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Morning Bob - Is there any further info available on the pilot?
I presume any cost recovery scheme could only work once liability as been established as with PL………..
The two elements you discuss will, I presume again, will depend on the type of policy the employer has e.g. ground up or excess.
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Rank: Forum user
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DP,
See the links at post number 5 from Tim.
Happy reading.
Clive
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Rank: Super forum user
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To pick up on a couple of points about how EL insurance works. Have to be brief - there is so much to write down.
Excesses: This are extremely rare - non-existent - in EL insurance. OK they exist in Motor, household and even Public Liability insurance - but hardly ever in EL. They are generally regarded as being against the principles/aims of the EL (Comp Insurance) Act.
Pricing: There are two methods. Firstly the employers accident/claim history is examined and then projected forward to generate an estimated premium. Costs and expenses (& profit) are added to this. But this approach can only be used for an employer who has claims and in sufficient numbers to makes the calculations sensible. Thus it is reserved for larger firms... And there aren't many of those!. Most SMEs have few claims, perhaps one every year or so at most.
For these insurers adopt the pooling principle - the contributions of the many pay for the losses of the few. Thus there are books of rates for say printers or sheet metal workers. Insurers know, say, how many claims will come from 100 printers and can charge each of them the appropriate amount. Thus premiums for SMEs are based on what insurers call "book rates" that are adjusted by what we can find out about an insured's practices and approach to H&S/risk management.
I would also add that after a claim an employer's premium will undoubtedly rise. But for an insured paying, say, £15k for their EL it will not rise by the £100k that may have been paid out for a claim.
EL insurance is essentially a smoothing mechanism and does not really "concentrate the minds" of employers nor encourage them to improve on risk management. That was never its intention!
Hope that makes sense
Phil
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Rank: Super forum user
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Thanks for that Phil
As I thought this pooling approach seems to work against the idea of the poor employer paying the highest premium. I know that in Europe in particular Germany, insurance companies are very heavily involved in managing H&S and in effect the use of premiums is seen as key to modifying the behaviour of poor performing employers. Perhaps this is something that the government will have a look at
(Yeah, I know they won’t cos they just want to hand it all back to the employers and let them get on with it- Fix our broken society etc)
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Rank: Super forum user
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The principle of compulsory ELI is a 'no blame' social utility system supported by legislation to ensure those that have been injured at work can claim redress for loss of earnings, amenities, etc from the employer's insurer. ELI was never designed to penal or even encourage employers to manage the risks they create - mores the pity.
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Rank: Super forum user
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A Kurdziel wrote:Thanks for that Phil
As I thought this pooling approach seems to work against the idea of the poor employer paying the highest premium. I know that in Europe in particular Germany, insurance companies are very heavily involved in managing H&S and in effect the use of premiums is seen as key to modifying the behaviour of poor performing employers. Perhaps this is something that the government will have a look at
(Yeah, I know they won’t cos they just want to hand it all back to the employers and let them get on with it- Fix our broken society etc)
Some insurers do help clients to manage their risks and I've been employed in this field for over 20 years.
It can work well with heavier trades such as quarrying, mining, construction and heavy manufacturing. Insurers also use risk surveys to manage security, business interuption and fire risks (from a property perspective) as well.
It is not however cost effective to do this for the lower end of the SME spectrum. A risk survey will cost in the region of £500 to £750 plus expenses. At the low end, the annual premium may only be £300-500 for the liability portion of the premium.
Insurance is currently in what we call a soft market - premiums are low because firms are competing for business. As firms start to lose money in a big way, so the premiums will rise. A typical hard market / soft market cycle takes around 10 years.
Brokers, acting for the policyholders, will play various insurers off against each other in a bid to secure a lower premium. There is willingness to move on premium for cases that have surveyed well. For those that have not, we will either charge increased rates or cancel the policy mid term as per cancellation procedures within the contract.
So those that manage the risks well can get the better premiums.
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Rank: Super forum user
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Phil - I understand completely as I work for a very large company - I generally focus on this - in larger company's excesses are not as rare as you may think and we must remember they can be used also as and advantage to large company's……………..
If you have a good safety record and as a company you know you keep you staff safe and if needs be you have in place arrangements to defend claims - you can use the excess as a mechanism to self insure - take the risk yourself and keep down the premium - it would be in the hands of your Broker to do this on your behalf.
You are righ we could spend all day on this!
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Rank: Super forum user
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EL excesses are rare because they cause a lot of problems and insurers do not like them.
It would work if we only dealt with accident claims since you are dealing with matters at the time of the accident or within a 2-3 year time frame to allow for late reporting. You would then be able to collect the excess or pass to the policyholder to deal if the matter is within the excess.
The problem arises with long tail disease claims. When you are notified 20-30 years down the line, it may then be impossible to collect the excess or even trace the firm that you insured so long ago.
To manage it, you would need to keep tabs on every firm you ever insured that had an excess system in place, and check their financial status.
EL excesses are the reserve of government departments and large firms that have set up internal mechanisms to ring fence the money that may be needed to pay claims 20-30 years hence. Very few firms have those safeguards in place.
As Phil says, they are common within Public Liability, Product Liability, motor and property covers though and they work well in sharing the risk between policyholder and insurer.
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Rank: New forum user
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Hi All,
Great responses thank you, I think you answered my questions.
As it happens I do know a company with a large excess which helps them keeps premiums down and does help to bring focus to accident prevention, although there are many other factors which also help in this area.
I suppose the key issue for the NHS would be to keep track of all the injured persons to enable them to claim money back when fault is attributed. That would be a big task.
BR
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Rank: Super forum user
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Friends; can I note to you that when I replied I was not talking about the NHS claiming back costs from employers via the EL insurance route so please take note of this fact
There are other ways of claiming back costs incured by one party on behalf of another party which use other ways of enforcing their claims apart from identifying blame i.e. the simple invoice route is an example e.g. invoicing for a cost of a bandage is one of them!
Please note that I have personal experience of sharp people using such unexpected involce routes before, for other things thus by-passing the insurers; and they always got their money even against large companies with lots of legal people working for them who are trying to stop such means of payment [You have to be very sharp to stay ahead these days] and I am lead to believe that the invioice route and not the ELI route is one of the things that the NHS is looking at
I am lead to believe that its in parts of North Wales and Northern Ireland that such routes are being looked at. However I am not fully up to date so if anybody has better info please inform this site
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Can the NHS claim back costs against companies and Employers Liability Ins?
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