The Claims Process
Please carefully read the following notes about making a claim for uninsured losses. The below information applies to claims involving both vehicle and personal injury losses and is merely an initial guide. We will of course throughout your claim provide relevant advice to you.
What Are Uninsured Losses?
These are your typical losses that are not covered under your own insurance policy. They can comprise of both financial losses and personal injury. For example damages for personal injuries are not usually covered by your own insurance policy and therefore if you wish to claim for injury compensation, this has to be presented against another person’s insurance. Even if you are insured on a “fully comprehensive” basis, there is often an excess to pay that would an uninsured loss. Another example is if you are insured third party or third party fire and theft, repairs to your own vehicle are not covered at all and therefore have to be claimed back from the other party’s insurance.
Hence the term “uninsured loss recovery” covers the process for claiming damages and financial losses which are not already insured under your own policy of motor insurance.
How Do We Begin To Make Your Claim Against The Other Party?
If you instruct us to act for you in a claim for personal injury arising out of a road traffic accident after the 29th April 2010, or a claim for personal injury arising out of an accident at work or against an occupier (for example a trip on a highway) after the 31st July 2013 we are obliged to submit your claim to the insurers of the party who caused the accident, on-line using a Claim Notification Form (CNF) or (Form 1). The amount of detail which needs to be provided is extensive.
This only applies to claims where the value of the injury or injury related claims such as earnings loss or private medical treatment is likely to be less than £25,000.00.
The following are specific exclusions of RTA claims:
- Untraced Drivers Agreement
- A party is deceased
- A party is bankrupt
- A party is protected
On the same day as we submit the CNF form to the insurers, we must send a hard copy to the other driver in printed form.
Certain questions on the CNF are mandatory and the CNF must be signed with a statement of truth. NB. This document will be used as the letter of claim and must therefore be 100% accurate and signed by the you, the Claimant.
If you don’t have all of the information to hand, we may not be in a position to submit your claim and advance your case until you do. However the person taking the information on our behalf will be able to advise you further about this.
A Quick and Easy Process If There Is No Dispute
The good news, however, is that once the claim has been submitted to the Defendants insurers they have only 15, 30 or 40 Business Days (three, six or eight weeks), depending on the type of claim, to concede liability and accept that their insured was to blame. If they miss this deadline, the claim will leave this streamlined process and be dealt with as any other injury claim. Please note in MIB Uninsured cases this deadline is 30 Business days.
If Liability is denied then the Claim will fall out of this process. If the Claim falls out of the process at this stage then the Defendants insurers have a period of 90 days from the date of the letter of claim to investigate and thereafter either admit/deny liability.
The above procedure must be adopted by all Claimants and their Solicitors in an effort to save time and litigation costs. We will write to you with the case progress and to advise how we intend to proceed following the stages referred to above.
For all other Claims, the claim will commence by way of a detailed letter to claim to the responsible party’s insurers.
How Long Will Your Claim Take To Settle?
It is for the person making the claim to both show that the other party was to blame for the accident and also to prove and document the extent of the losses suffered. As you will appreciate claims do take some time to resolve. In our experience, on average a high proportion of non-injury claims take 4-6 months to settle from the time of reporting the accident. Of course, depending upon the circumstances of the accident and the nature of the claim it can take considerably longer to resolve, particularly when fault is disputed. Legal action can unfortunately be a lengthy process.
If your claim involves personal injury, then the time period to settle your claim will be much dependent upon the nature of the medical report that we obtain on your behalf. This will describe the injuries that you have suffered as a result of the accident. If the medical report suggests an entirely straightforward injury, then the claim can often be settled within a 6 month period. If however the injuries are more serious and require further investigation or simply a waiting period to monitor the progress of the injury, then the claim can take significantly longer. Each of these type of cases must be dealt with on their own merits.
If blame or “liability” for the accident is not disputed by the other party’s insurer but for reasons such as those above it is not sensible to settle the personal injury claim, then it may be possible to obtain payment of the other financial losses suffered whilst leaving the injury claim to one side. Such a payment is known as an “interim” payment.
Will Court Proceedings Be Necessary?
Once all of the relevant evidence is available in relation to (a) who was at fault and (b) the losses you have sustained, we will attempt to negotiate a settlement of your claim with the other party’s insurers as quickly as possible. If however we are unable to agree an appropriate level of damages, we will then, with your authority, arrange to issue Court Proceedings against the other party.
Even if liability for the accident is admitted, it may still be the case that the other party’s insurers will not make a reasonable offer for the damages element of your claim. It is quite common therefore that litigation is commenced solely for the personal injury element of cases.
If your case is heading towards a Court Hearing, we will of course provide you with relevant advice and will always arrange suitable representation at any Hearings that may take place.
Please note that there are certain time limitation periods that are governed by statute. It will be necessary to issue Proceedings within 3 years from the date of the accident if you were injured. If your claim merely consists of property damage and resultant financial losses then it will be necessary to issue Proceedings within 6 years from the date of the accident. This period is different for children on those Claimants who are unable to act for themselves.
What Do We Expect of You?
You have a legal obligation to keep your losses to a minimum. You cannot profit from a claim and should treat your losses as though there was no guarantee that you would get the money back. We would ask that you provide us with clear instructions by means of promptly replying to all of our correspondence and enquiries, supplying us with all of the information we request, so that we can speedily progress your claim. Quite often we will require your instructions in writing even if you have already spoken to us about your decision.
Do not be afraid to ask for help. We are here to help you and give you professional advice.
The Effect of You Being To Blame In Part Or In Full For The Accident
To successfully recover damages you must first prove that liability for these losses rests with the other party. In certain circumstances you may be held partly to blame for your accident, if for example you were speeding or not wearing a seatbelt. In such a case your damages will be reduced by an amount proportional to the blame that you have. If you are found half to blame you get half the damages payable, for example. This is very important when you come to losses such as hire charges, recovery & storage charges or physiotherapy costs when a contractual duty arises for you to pay for these services. Those providing the service do not have to accept any less than their full entitlement and this must be remembered.
Social Security Benefits – How Do They Affect Your Compensation?
If you are or have been in receipt of relevant Social Security benefits since the date of your injury or disease, any compensation payment you receive, should your case be successful, may be reduced by an amount equal to the Social Security benefits paid to you. This applies to compensation payments made because of injuries or disease arising on or after 1st January 1989.
Under the scheme, compensators (the body responsible for paying the damages) have to repay to the Department of Social Security the full amount of certain Social Security benefits that have been paid to you because of your accident, injury or industrial disease. The compensator may reduce your compensation to cover the amount of benefit they have to repay to the Department of Social Security.
They may only do this when your compensation includes money for:-
- loss of earnings
- cost of care or loss of mobility and that corresponding benefits have been paid.
The following is a list of heads of compensation together with relevant benefits:-
Compensation for Loss of Earnings during the relevant period:
- Industrial Injuries Disablement Benefit
- Employment Support Allowance (an umbrella term for incapacity benefit and sickness benefit)
- Income Support
- Invalidity Pension
- Invalidity Allowance
- Jobseeker’s Allowance (an umbrella term for unemployment benefit and unemployability supplement)
- Reduced Earnings Allowance
- Severe Disablement Allowance
Compensation for Cost of Care during the relevant period:
- Attendance Allowance
- Care Component of Disability Living Allowance
- Disablement Pension increase for Constant Attendance Allowance
- Exceptionally Severe Disablement Allowance
Compensation for Loss of Mobility during the relevant period:
- Mobility Allowance
- Mobility Component of Disability Living Allowance
Retirement Pension will not affect your compensation award. However, if after retirement age (60 for women, 65 for men) you carry on getting any of the benefits shown above, they may be subject to recovery.
The period during which the benefits may reduce the amount of compensation begins on the day following the accident or injury, or in the case of a disease, from the date on which the first claim to benefit is received in consequence of the disease in question. It ends on the date the final compensation payment is made or 5 years from the beginning of the period whichever is earlier. Therefore, if your claim takes longer than 5 years to settle, only the benefits you received in the first 5 years will be taken into account.
The deduction is paid direct to the Department of Social Security (DSS) by whoever pays the compensation (the compensator). Often this will be an insurance company. When you make a claim for compensation, the compensator must tell the DSS about your claim.
If, however, you receive a compensation payment from a compensator who is not resident, or does not have a place of business in any part of the United Kingdom, you are responsible for notifying the Compensation Recovery Unit about your claim. We shall do this on your behalf and the Unit will then tell us which benefits you received and the amount you must pay to the DSS. We would then pay this to the DSS out of your compensation payment, rather than the compensator doing so.
The DSS will in due course provide us with a detailed certificate confirming the amount which is to be deducted from your compensation. We will forward a copy of the certificate to you and if you do not agree with the information given in the certificate you have the right to ask for the certificate to be reviewed and you also have a right of appeal. Details of how to ask for a review and how to appeal will be sent with the certificate.
The above rules only apply to injuries or diseases which arise on or after 1st January 1989. If your injury or disease happened before that date, any compensation that you are awarded for loss of earnings or profit may be reduced, but the money will be kept by the compensator and will not be paid over to the DSS.
If you are getting Income Support, Tax Credit, Jobseeker’s Allowance, Housing Benefit or Council Tax Benefit, you must tell the office that pays your benefit as soon as you get your compensation.
Certain benefits, such as Income Support are affected by capital payments and you may find that any compensation payment you receive reduces your benefits or makes you ineligible for them. If you require any further advice about this, please contact your local Benefits Agency.
To summarise, under the scheme, your own damages will only be affected if recoverable benefits have been paid in accordance with those listed under 3.1 and 3.2 above. The full amount of those benefits will then be deducted from your overall award.
If you have any queries about the recovery scheme, please do not hesitate to telephone us and we will be glad to explain the matter further. Alternatively, you may contact the Compensation Recovery Unit direct at Durham House, Washington, Tyne & Wear, NE38 7SF. Further information can also be found at the Compensation Recovery Unit’s website www.dwp.gov.uk/cru.
What Can You Claim For?
As a result of this accident, you should be financially compensated to place you into the position that you were at before the accident. In other words any financial losses that you incur as a result of the accident should be able to be claimed from the other party. With regard to what these items actually can be, we have listed below brief details of various types of uninsured losses for you to consider and some helpful hints. This list is not exhaustive but merely an aid. The duty is only on you to tell us about any potential claim you wish to bring.
Please bear in mind that all claims require evidence for example bills, receipts, invoices, estimates and tickets. Keep them safe and provide them to us upon request.
If your damage a vehicle in a claim, then unless you have comprehensive insurance cover and your insurers are dealing with your claim, we will arrange for your vehicle to be inspected by a qualified independent motor engineer. In the case of a possible write-off once the vehicle has been inspected you will need to arrange to move the vehicle to a place of free storage. The damage to your vehicle is the proof of your claim. Do not have the vehicle completely repaired until after the inspection. Once the other insurers’ agree the damages, the vehicle will remain your property.
Most comprehensive policies are subject to an excess that you’ll pay to the garage when you collect your vehicle. In the case of a write-off, your insurer will deduct the excess from the settlement figure. A garage receipt or copy of the settlement letter will suffice as proof of this item of claim. The excess is payable irrespective of whose fault the accident is.
Towing or Recovery and Storage Charges
Again, a comprehensive policy covers these charges. Otherwise, you can claim for the towing/recovery fee if your vehicle was not drivable after the accident. If it is subsequently immobile, try to find free storage or certainly, the cheapest. If the vehicle is being stored anywhere other than your home address, please tell us immediately.
Most comprehensive policies include the provision of a courtesy car removing the need to hire. If this does not exist or you are only insured on a Third Part Fire and Theft or Third Party Only basis, you can hire a similar vehicle to the one you own for a reasonable period. Remember to keep hire costs to a minimum and watch out for the extra charges that may not be recoverable, e.g. collision damage waivers and extra insurance benefits. Hire is expensive – if you have any concerns please call us.
On occasion we can arrange for you to be supplied with a hire vehicle on credit. Should you need an alternative vehicle and your insurers do not supply one, please contact us to discuss the matter further.
Loss of Use
If you are without the use of your vehicle and have not had a replacement whilst your own is off the road, we will be able to claim for what is known as “loss of use”. You will need to keep a record of how long you have been without the use of a vehicle for. This is compensation for the inconvenience you have been put to in not having a vehicle at your disposal. There is not set amount payable for this head of claim but we will usually try to recover somewhere in the region of £5 – £10 per day.
Travel Expenses (Bus, Train, Taxi Fares)
Whilst deprived of the use of your vehicle, you may incur additional travel expenses over and above the normal cost of running your vehicle. If you do, keep all the tickets and receipts and make a note of the journeys and costs.
Additional Mileage of vehicles
You may on occasion have to undertake journeys as a specific result of this accident that you would not normally undertake, perhaps to go to regular physiotherapy sessions or even visit our offices. Keep a record of such journeys as the mileage can add up to quite an amount. Please pass any parking receipts to us too.
In such cases, if the sum cannot reasonably be included in your claim for miscellaneous expenses (see below), we will claim the cost of the mileage for the type and size of engine within your vehicle in accordance with the published vehicle running costs by the RAC.
You will probably incur costs in relation to sending letters, making telephone calls and also possibly travel expenses to a medical examination. We will normally make a claim for these in each and every case for a nominal amount. If you feel you have incurred a particularly high level of such expenses, please keep a record of them and we try to claim a greater amount of compensation for them.
If your clothes have been damaged in an accident, we will claim for the costs of them. You will need to supply a list of the damaged items detailing how old they were at the time of the accident and the replacement cost. Please note there will probably be a deduction made by the insurers to reflect wear and tear of the items if they are older than 6 months at the time of the accident. This will be a percentage of the replacement cost.
You will need to obtain a written replacement quote for the items damaged unless you have receipts.
Please note in the event the items of clothing are of particular expense, we would advise you to keep the damaged articles as the insurers may require to inspect them. This is especially the case with motorcycle leathers.
If your motorcycle helmet was damaged in the accident, we will attempt to claim for the cost of a replacement helmet without any deduction for wear and tear given that it is not recommended to us a helmet again if it has been damaged. You should ensure you keep the helmet for inspection at a later date. You will need to obtain a written replacement quote from a local motorcycle dealer. If you require assistance regarding this, please contact us.
If any items of personal effects are damaged as a result of the accident, please detail the same to us with replacement values/quotes. Again if the items are of expense, e.g. above £100, please ensure you keep the items for possible inspection by the insurer.
Loss of Earnings
If you have been absent from work as a result of the accident, we will write to your employers to ascertain if you have lost any earnings. We will attempt to claim for your loss of earnings that you would normally “take home”, i.e. after deductions for income tax and national insurance. Even if you have been paid in full whilst you were absent, it may be that there will be a clause within your contract of employment that will require you to repay that sick pay if you make a successful claim for compensation. If such a situation exists, we will claim for the amount you were paid as detailed by your employers and when payment is made, repay this directly to your employer. One of the benefits of this process is that your employer may re-instate the sick leave you have taken as a result of the accident. However this will ultimately be an issue between you and your employer.
If you feel that your absence has affected from work your promotion prospects or any other financially rewarding aspect of your job, you will need to explain this to us.
In the case of a self-employed person, an accountant may be required to supply the written evidence. Please note you can only claim your net wages after normal deductions.
Before we finalise any claim for loss of earnings, we will send you our calculation of your loss for you to agree.
If you are injured and wish to pursue a claim for compensation, we will instruct a suitably qualified medical expert of appropriate seniority dependent upon the extent of your injuries. You will need to attend a medical examination following which a medical report will be compiled, a copy of which will be provided to you for agreement
We will be in a position to advise you as to the potential value of your claim once we are in receipt of the medical evidence.
Subject to your agreement, the medical evidence will be disclosed to the third party’s insurer and we will then attempt to negotiate settlement of your claim without the need to resort to litigation.
If you require treatment and pay for the same privately, please ensure you keep copies of all receipts and submit these to ourselves. On occasion once your medical report is to hand and there is a recommendation that you would benefit from physiotherapy, subject to such treatment not being available on the NHS, we may be able to arrange for private physiotherapy for you on a credit basis. Should this situation occur, we will discuss matters with you in greater detail at that time.
Other financial losses
Should you incur any other financial losses as a direct result of the accident, please ensure you keep records and suitable documentation in order that you may tell us details of the same. If in doubt, please speak with us and we will advise you as need be.
Please Note if you are VAT registered you may be required to pay or unable to recover the VAT on your losses. You will however, be able to reclaim these within your VAT return, if applicable.