Psyche Influences Injury Claims, Study Says

Psyche Influences Injury Claims, Study Says

NU Online News Service, July 26, 2 :04 p.m. EDT?Insurers can keep costs down on personal injury claims that are aggravated by psychological distress by using early intervention programs, a new report from the United Kingdom recommends.[@@]

According to the study--published by the International Underwriting Association and the Association of British Insurers--up to three-in-10 people who suffer a personal injury do not recover, for psychological reasons, as quickly as might be expected.

The report--citing medical, legal and insurance experts--noted that between 20 percent and 30 percent of personal injury outcomes are aggravated in some way by psychological factors.

In approximately 5-to-10 percent of cases, psychological factors can turn minor physical injuries into serious problems, according to the report, entitled: "Psychology, Personal Injury & Rehabilitation."

The study's authors said the problem they described as Apparently Disproportionate Outcome (ADO) helps to explain why many injury claims take much longer to settle and at far greater cost than first seemed likely. ADO also makes a significant contribution to sickness-related absences at work, the report noted.

"Whenever a claimant comes forward with an injury that you would expect to clear up quickly?a back sprain or whiplash, for example ? it is important to bear in mind that it could become considerably worse for perfectly genuine psychological reasons," said Ashton West, chief executive of the Motor Insurers Bureau, who chaired the panel. "Recognizing these cases early and delivering appropriate interventions can prevent them from becoming unduly expensive."

The report suggested using behavior management guidelines, including:

? Providing a positive expectation that the individual will return to work.

? Scheduling regular reviews of progress.

? Keeping the individual active and at work.

? Acknowledging the difficulties of daily living.

? Maintaining positive cooperation.

? Communicating that more time off work reduces chances of successful return.

? Avoiding total cure expectations.

? Promoting self-management and responsibility.

? Avoiding confusion between reported symptoms and emotional distress.

? Discouraging working at home.

? Encouraging the claimant to recognize that pain can be controlled.

The report acknowledges that it would be impractical for insurers, legal solicitors or rehabilitation case managers to actively consider the psychological aspects of every personal injury case at the outset.

"As with other aspects of rehabilitation, psychological and social factors benefit from, but frequently do not receive, early intervention. Early psychological and social intervention can and does prevent deterioration," the report stated.

The publishers of the report said insurers should use its findings as a source of information and guidance. They should consider psychological factors and the suggested opportunities for change as well as seeking to develop tools for better case management within the current framework.

"Simply knowing that psychology has the potential to influence all types of injury cases is a good start," says Dr. Andrew Auty, who coordinated the research. "We favor a stepped approach, where the level of psychological intervention increases as and when it becomes necessary."

The report warned that the effectiveness of interventions decrease with time and patterns of distress and disability become entrenched and reinforced by symptoms, affected behavior and institutional responses.

According to the study, when the injured person encounters an uncertain diagnosis, lack of understanding of symptoms, and ambiguous and inconsistent information from those treating them, it is likely to exacerbate their distress and result in behavior that delays recovery.

The report was welcomed by both the International Underwriting Association and the Association of British Insurers. "The approach set out in the report will be good for injured people and good for their insurers," said Eamon Brown, chair of the IUA-ABI Rehabilitation Working Party.

Copies of the report are available free from the IUA by contacting Anthony Dickinson at anthony.dickinson@iua.co.uk

Every year over 300,000 people in the U.K. receive treatment for personal injuries resulting in claims under motor and liability insurance policies.

The International Underwriting Association of London represents international and wholesale insurance and reinsurance companies. The ABI is the trade association for Britain's insurance industry, and its more than 400 member companies provide over 97 percent of the insurance business in the U.K.