Hospitals failing to claim back huge sums from insurance firms

NHS hospitals are wasting the chance to claim back hundreds of millions of pounds from insurance companies for the cost of treating accident victims, legal experts have warned.

Overworked managers are routinely failing to chase costs for the care of patients injured on roads or in the workplace, and rely on insurers themselves to volunteer that payment is owed.

New figures reveal that the amount successfully recouped by trusts in England has decreased by 12 per cent over the last two years to just under £163 million in 2015-16.

“I genuinely don’t think the NHS realises how much they are losing through all of this.Jill Greenfield, head of personal injury at Fieldfisher

Last night, an executive for the Association of Personal Injury Lawyers (APIL) said the sum was likely to represent less than half of the cash potentially available to the financially ailing sector.

Department of Health rules also mean the total recoverable cost for each patient is capped at £48,849, meaning that hospitals – in deficit by £2.45 billion last year – are missing out on recovering the full cost of seriously injured patients, if claims are pursued.

Jill Greenfield, APIL committee member and head of personal injury at City solicitors Fieldfisher, said: “I genuinely don’t think the NHS realises how much they are losing through all of this.

“When hospitals treat accident victims, they’re often unwittingly cushioning the costs of the insurance industry.”

Research by APIL estimates that the cap on patient compensation deprives NHS trusts of £20 million a year, roughly equivalent to the cost of 750 nurses’ salaries.

The Government, however, argues that the Compensation Recovery Scheme rule ultimately saves money because it makes the system of clawing back funds from insurers simpler.

Under current law, motor, workplace and other insurers are obliged to notify the Department for Work and Pensions’ Compensation Recovery Unit when a payout is being claimed by an injured party.

The unit then contacts hospitals, asking for details of the treatment given.

But Ms Greenfield said many victims of personal injury never reached the stage of litigation, and far more money could be recouped if trusts proactively went after insurers.

“It’s not unduly difficult, but very often trusts are not claiming the money at all,” she said.

A spokesman for the Department of Health said: “We expect hospital trusts to claim costs for accidents involving personal injury compensation so they can reinvest this money in vital frontline services.

“The introduction of a cap on the costs ensures more efficient and effective collection of funds by trusts, and avoids costly litigation battles where costs might be higher than the actual NHS charges being recovered

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