Accident & Investigation Pack for Employers & Public Liability Injury Claims Guide to this Accident and Investigation Pack The 2013 Ministry of Justice (MOJ) reforms comprise a package of interlocking changes designed to speed up the process of handling liability claims whilst eliminating disproportionately high legal costs. They radically alter the way Employers Liability (EL) and Public Liability (PL) injury claims are managed by introducing new tighter timescales and fixed costs, with cost penalties for non compliance. This pack has been designed to provide: l A brief overview of the changes and how they will impact upon Insurers and Policyholders. l Advice on what to do in the event of an incident which could give rise to an EL/PL injury claim. l An accident investigation guide and forms which will enable the capture of relevant information and evidence on Day 1. The need to act immediately when an accident happens Under the new regime EL and PL claims (up to 25k) will be handled within a web based Portal process, which will be managed by Insurers. Claimants still have three years in which to make a claim but will notify their claims directly to Insurers via the Portal. Defendants may no longer receive the traditional Claimants Solicitors letter and Insurers may learn that claims have been made against policyholders before the defendant policyholders themselves. Once a claim is received, the defendants (or more usually Insurers on their behalf) must confirm whether liability is accepted within 30 days for EL and 40 days for PL. Previously there was a 90 day period to respond. If defendants do not respond within the deadline the claim will drop out of the Portal and increased legal costs are payable. Immediate accident investigation, evidence gathering and reporting are essential to ensure that the right decision is made within the deadline. Once the liability decision has been communicated further deadlines apply to settlement negotiation and failure to comply again comes with cost sanctions. The changes should benefit Insurers, Policyholders and self insured Defendants by driving down claim spend and legal costs. However, failure to comply will result in legal cost penalties that apply regardless of whether the claim eventually succeeds and winning defendants can no longer recover their costs from the 'other side'. If claims are not correctly managed the changes may lead to increased claims spend which could adversely affect insurance premiums. The information in this document is proprietary to GAB Robins UK Ltd and is supplied on the understanding that it shall not be copied, stored in a retrieval system, or transmitted in any form by any means, electronic, mechanical, photocopying, recording or otherwise, or supplied to a third party without the prior written consent of GAB Robins UK Ltd. GAB Robins UK Ltd acknowledges all company names and trademarks mentioned in this document.
Insurers Objective Insurers objective is to ensure that as many claims as possible are handled within the Portal to keep legal costs to a minimum. This can only be achieved by ensuring that every incident is fully investigated promptly to: l Determine if a claim is valid and a compensation payment due or l Secure the evidence available to defend the claim Defendants Objective To help your Insurers drive down the cost of claims by providing them with the information they need, within the timescales prescribed, to enable them to make the right decision on legal liability. The Arista Broker s Role l Education ensuring that your clients understand the changes l Investigation working with clients to implement fast and effective procedures for gathering evidence l Notification reporting incidents promptly How to use this pack To ensure prompt fact gathering following accidents (regardless of whether a claim has been made) you can use our Accident & Investigation Pack to: l Capture the facts at the time of the incident l Collate evidence and documentation claims are rarely successfully defended without supporting documentary evidence. l Record your findings Arista Casualty Team gabr_arista@gabrobins.co.uk Telephone: 0844 770 5150 How can GAB Robins help? GAB Robins are on hand to offer support and professional advice to you as soon as an incident happens and throughout the life of a claim. Whether you are an insured, a broker or an insurer looking for an MOJ compliant solution, we can help. Casualty Field Services Casualty@gabrobins.co.uk Telephone: 03333 200233 www.gabrobins.co.uk Please contact the Arista Casualty Team if you have any general queries
Step by Step Guidelines for Accident Investigation Step 1 Inspect accident scene including any work equipment and take photographs. Obtain, secure and remove or isolate from use, as far as possible, any defective equipment/premises allegedly causative of the accident. If CCTV footage is available, retain permanent copy for day/time of incident. Step 2 Complete Form 1 - Accident & Investigation Report, unless you have another form provided by your Insurers. Describe what happened, give as much factual detail as you can. Identify any discrepancies, doubts or uncertainties but avoid speculation or opinion. Step 3 Use Form 2 Witness Statement to record all witness evidence. Interview injured person and record their account, signed and dated if possible. Identify any other witnesses and record their accounts, ensuring that they are signed and dated (you may need to print further copies of Form 2 Witness Statements, as needed). Step 4 Complete Health & Safety Executive (HSE) forms if the incident is notifiable to the HSE, and retain copy for Insurers. Step 5 Complete Form 3 Pre-Action Document Disclosure Mandate. It is important to collate and attach all relevant documentation as the claimant s solicitors will request documentation when a claim is presented and you must make such documents available. These may include: l Accident Report Forms, HSE Forms, written findings of internal investigations, training records, evidence of supply and use of Personal Protective Equipment, maintenance logs for premises/equipment, risk assessments etc. The MOJ Civil Procedure Rules contain a Pre-Action Personal Injury Standard Disclosure List which you can access at: l http://www.justice.gov.uk/courts/procedurerules/civil/protocol/prot_pic#ida23kcc Step 6 Complete Form 4 Earnings Schedule if the accident involves an employee. Identify period of absence and attach copies of Statement of Fitness to Return to Work Notes, to Form 4. Step 7 Once investigation is complete, notify Insurers / brokers and retain copies of all completed reports, statements and documentation in a secure place.
Form 1 - Accident & Investigation Report Insured Address Name of Person completing Form Contact Tel No Role/Position 1. Details of the Injured Party Full Name Address Date of Birth NI Number Who was the Injured Party? (Please tick) Employee Contractor Visitor Other (please specify) Wage at time of incident 2. Details of the Incident Date of accident Date reported Time of accident Person report to Location of accident Reported by Description of accident Was the accident recorded in the Accident Record Book? (Please tick) No Yes (attach copy) Form 1 Accident & Investigation Report
Was the accident reported to the HSE? (Please tick) No Yes (attach copy Riddor) Were there any witnesses? No Yes (if yes, please provide details below) Name Position 3. Details of Injury Brief description of injury Was First Aid administered? Did the injured person attend hospital or GP? Was the injured person sent home? Did the injured person have any time off work? Is any absence continuing? 4. Visual Evidence of Accident Were any photographs taken? No Yes (if yes, please provide detail below) Number Date taken Taken by Detail Is there any CCTV Footage? No Yes (if yes, please provide detail below) Has a permanent copy been made? Where is it retained? Who is responsible for its safekeeping? Form 1 Accident & Investigation Report
Form 2 - Witness Statement Name Address Occupation Details of the accident to which this statement refers Date of accident Time of accident Location Injured party Statement I believe the facts stated in this statement are true Print Name. Witness to statement Print Name. Occupation. Form 2 Witness Statement
Form 3 - Pre Action Document Disclosure Mandate Insured / defendant Claimant Claim Number We are required to disclose the following information to the Claimants representatives. Please complete the list below. Document Attached? Can be located at / does not exist (state which) Accident report / First Aid report Witness statements Locus photographs Riddor Communication from HSE Pre and Post accident risk assessments Minutes of Health and Safety meetings Details of similar incidents Repair / inspection / maintenance records If the Claimant is an employee, we require the following information Training records / job description / contract of employment Loss of earnings form Any other documentation I state that I have carried out a reasonable and proportionate search to locate all the documents which I am required to disclose. I certify that the list of documents set out in or attached to this form is a complete list of all documents which are or have been in my control and which I am obliged to disclose. Form 3 Pre-Action Document Disclosure Mandate
Form 4 - Earnings Schedule Injured party Occupation Insured Date of Accident Pre-Accident Earnings Week No. Date Gross Earnings 1 2 3 4 5 6 7 8 9 10 11 12 Tax/NI Deductions Overtime Expenses SSP Net Earnings Post-Accident Earnings Week No. Date Gross Earnings 1 2 3 4 5 6 7 8 9 10 11 12 Tax/NI Deductions Overtime Expenses SSP Net Earnings Print Name. Form 4 Earnings Schedule