Friday 21 February 2014

Are Insurers Having Difficulty Keeping Claimants in the MIG?

I previously reported that based on HCAI data that it appears the minor injury definition was holding up.  However, that doesn't mean claimants are remaining in the Minor Injury Guideline (MIG).  I would like to continue to examine data related to minor injuries.

Again the information is based on first set of standard HCAI reports which were published by the IBC in December 2013.  The standard reports are published on an “accident half year” basis. In accident half year statistics, the experience of all claims with accident dates in the same accident half year is grouped together. The accident half years are defined as calendar half years, with January to June being the first half and July to December being the second half for each of the stated years.

The chart below provides some insight into what might be happening to MIG claims over time.  Although as many as 75% of claims are classified as strains and sprain and should fall under the minor injury definition, only a fraction of those claims receive MIG treatment only.  A majority of those claims actually receive treatment within the MIG and additional treatment outside the MIG.  One might conclude that the situation has been improving over time since each accident half year, fewer claims are receiving both MIG and non-MIG treatment.  However, the newer claims are likely still open and many of those in the MIG only category could move over time into the MIG and non-MIG category.

This doesn't necessarily mean that insurers are having a serious problem keeping claimants categorized as having minor injuries.  The MIG provides up to $2,200 in treatment but the SABS caps medical and rehabilitation expenses for minor injuries at $3,500.  So many of the claimants receiving both MIG and non-MIG treatment may topping up to the $3,500 cap.  In fact, the average amount paid per claimant in each accident half year never exceeds $3,500 for those receiving both MIG and non-MIG treatment.  You will have to make your own conclusion whether claimants are escaping the minor injury cap.  I would suggest that it might not be a problem.

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