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Medical Assessments in Personal Injury Claims: Purpose, Process, and Costs

By Ian Morris | Updated July 31st, 2024

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Quick Answer: Medical assessments are crucial in personal injury claims as they provide objective evidence of your injuries and their impact. These assessments are typically arranged and paid for by your solicitor as part of the claims process, with costs recovered from the defendant if your claim is successful.

When pursuing a personal injury claim, claimants often have questions about medical assessments. Why are they necessary? Who arranges them? And importantly, who pays for them? Here we will address these questions and explain the vital role medical assessments play in securing fair compensation for your injuries.

The Importance of Medical Evidence in Personal Injury Claims

In order to prove how much compensation should be due, claimants need to provide medical evidence to support their claim.

Proving Your Case

To succeed in a personal injury claim, you need to prove two key elements:

Liability: That someone else was responsible for your injury
Quantum: The extent of your injuries and their impact on your life

Medical evidence is crucial for establishing quantum. It provides an objective, professional assessment of:

The nature and severity of your injuries
Your prognosis and expected recovery time
Any long-term or permanent effects
Required treatments and rehabilitation

Valuing Your Claim

Medical evidence forms the foundation for calculating your compensation. It helps determine:

General damages: Compensation for pain, suffering, and loss of amenity
Special damages: Financial losses and expenses related to your injury

Without robust medical evidence, it’s challenging to accurately value your claim and negotiate a fair settlement. With this in mind, your solicitor will want to view your medical records relevant to the treatment you have had for your injury.

The Medical Assessment Process

Accessing Medical Records

Your solicitor will typically request access to your relevant medical records. This includes:

GP records
Hospital records
Treatment notes from physiotherapists or other specialists

These records provide a history of your injury and treatment, which informs the medical expert’s assessment.

Arranging the Medical Examination

Your solicitor will arrange for you to be examined by an independent medical expert. This expert is usually:

A consultant in the relevant medical field
Experienced in providing medico-legal reports
Independent from both your treating doctors and the defendant

The Examination

During the examination, the medical expert will:

Review your medical records
Discuss your injuries and their impact
Perform a physical examination if necessary
Ask about your recovery and any ongoing symptoms

The Medical Report

Following the examination, the expert will produce a detailed report covering:

The nature and extent of your injuries
Your prognosis and expected recovery time
Any recommended treatments or rehabilitation
The impact of your injuries on your work and daily life
Any long-term or permanent effects

This report is shared with both your solicitor and the defendant’s representatives.

Who Pays for the Medical Assessment?

Initial Costs

In most cases, your solicitor will arrange and pay for the medical assessment upfront. This cost is considered a ‘disbursement’ – an expense incurred on your behalf as part of pursuing your claim.

Cost Recovery

If your claim is successful, the cost of the medical assessment is typically recovered from the defendant as part of your legal costs. This means you don’t have to pay for it out of your compensation.

Unsuccessful Claims

If your claim is unsuccessful and you have a No Win No Fee agreement, you generally won’t be liable for the cost of the medical assessment. Your solicitor will cover this expense as part of the risk they take on in representing you.

Multiple Assessments

In some cases, particularly for complex injuries, multiple medical assessments may be necessary. These might include:

Assessments by different specialists for multiple injuries
Follow-up assessments to monitor your recovery
Assessments by other experts (e.g., occupational therapists) to evaluate the impact on your life

The same principle applies – your solicitor will typically arrange and initially pay for these, recovering the costs if your claim is successful.

Medical assessments are a vital part of the personal injury claims process. They provide the objective evidence needed to prove the extent of your injuries and secure fair compensation. While the process may seem daunting, remember that these assessments are arranged and typically paid for by your solicitor, ensuring you have the best possible evidence to support your claim.

Frequently Asked Questions

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Comments & Questions

Read on for questions and advice about claiming...

I have a current personal injury claim with solicitors on a no win no fee basis. The claim has been accepted by third party. It was recommended I reject premedical offer and obtain medical exam from an appointed medical expert. The medical expert opinion is that I have a minor soft tissue Injury of a week prognosis recovery time. I am told this would achieve a maximum of £840 compensation. I have also been told that if I request premedical offer and not disclose medical report i would be liable to have not only the 20% fee but also the cost of medical be deducted off compensation too….is this correct?
I have legal expenses cover which includes personal injury claims. Solicitors advised I could not use them to pursue a claim unless it was a case that went to court. Is this advise accurate?

It is impossible to say with certainty whether the advice you have been given is correct or misleading, but there are question marks over some of the advice. If you had legal expenses insurance in place, you would have been entitled to use that to select a Solicitor of your choice – or one of the Solicitors that work on the panel for that provider.

You should perhaps consider a formal complaint to your Solicitors outlining the advice you’ve been given and questioning the same. If the outcome of your complaint is not satisfactory, you could then involve the regulator and legal ombudsman for an independent review.

In April 2022 I worked at a care home. I left my hand on the side and was painfully burned as someone had over-filled the kettle too much so it splattered boiled water onto my hand.

I was not offered any first aid and no one seemed interested. I managed to bear the pain because I finished my shift 15 minutes later. Once finished, my partner took me straight to hospital as he had never seen me in such pain. The hospital gave me first aid straight away, but I still had to wait to see a Doctor. When I was seen by the Doctor, he dressed my wound and booked me in to the Doctors for follow up care. I then attended follow up appointments regularly where they dressed the injury again. I had to wear rubber gloves so I could shower. The Doctors wrote me a sick note so my hand could heal, only to find out that I had been sacked for no reason when I returned to work. I am just interested if this was legal?

In terms of your employer letting you go or ‘dismissing’ you as a result of your absence, it is somewhat of a grey area. If you were within a probationary period at the start of your employment, they could have used the excuse of missing work as a reason not to keep you on. Likewise, if you had worked for the employer for less than 2 years, it is very easy for an employer to terminate employment.

Hi the only way I could prove my case is by having an upright MRI Scan. Would this be something you covered if I decide to hire you to take up a case for me? I hav been in a wheelchair for 25 years but I am still experiencing the same putting at risk and medical negligence because I have a rare condition. Whether it’s in the privat eor public health sector. I am I believe currently at a high risk of paralysis without the relveant tratment yet are hitting brick walls to get it.

Whether or not such a scan could be provided or agreed during the process of a claim would depend on a medical experts opinion, rather than a Solicitors request. A Solicitor would instruct a medical expert to conduct an assessment with you and review the situation, but only if the medical expert were to request such a scan – and only if the defendants then agreed to it, would such a scan be provided.

Another concern in your enquiry is the timescale – you mention a period of 25 years? It would help if you explained what the nature of your claim would be for, but as you are probably already aware, claimants must take action and pursue a claim within 3 years of the date of an accident or negligence to be able to hold a defendant liable.

Can I ask if I have to pay my expenses to travel out of county to see specialists for examinations related to an injury I incurred that was not my fault?

My Solicitor is saying that I can’t and that this is my expense? I am very unhappy about this as it is not only likely to cost me the travel but hotel costs too.

This examination could be done locally but as ‘they’ dont have specialists in my area, I am expected to travel out of county, on public transport when I don’t drive and have extreme anxiety. The examination is a simple standard one, as it was a bang to my head. It just seems really out of order and I’m not sure i’m happy to progress with them. Surely this an expense that could be claimed back?

Sadly, the costs of traveling to and from a medical assessment are not a recoverable cost – certainly not a cost that you are automatically entitled to recover. In normal circumstances, the costs of attending a medical assessment will be minimal as it is extremely unusual for any claimant to be forced to travel beyond a local area to see an expert and the need to seek overnight accommodation is unlikely to be accepted by a defendant in any event.

Have you asked your Solicitor if it is possible to have the assessment carried out remotely via a video call?

Hi there,
My daughter has been made a offer of £12.000. Up to now solicitor had taken 25%. She needs her shoulder pinning due to car accident.
Her solicitor and doctors scan report recommended she has this surgery done.
Would she have to pay for this too out of her compensation which would obviously be more than £12.000?

Is the surgery you mention not available on the NHS? If it isn’t and the surgery would have to be undertaken via a private provider for a fee, then the costs should be met by the defendants in settlement (so long as there is no disagreement on the medical experts report) – which would be on top of the £12k settlement fee you mention. We can’t speak for your Solicitors of course, but our Solicitors do not deduct any fee from any element of a settlement that is for future medical costs or surgeries.

I have had a personal injury claim for over two years. I have had to pay out for an MRI and for an inspection report, also for a medical assessment. Is this normal? I have been told no win, no fee is illegal in Northern Ireland.

Solicitors in Northern Ireland are governed by the Law Society of NI and it is not permitted for Solicitors to practice a No Win No Fee method of running personal injury claims.

We can assist with linking people with a specialist Solicitor able to operate within the Northern Ireland legislative framework and would recommend that you seek help from a specialist in Northern Ireland’s personal injury sector for detailed advice regarding the process.

Hi in reference to a personal injury claim following a road traffic accident if during my claim I need treatment of any kind will the costs of any treatment be deducted from my claim if settled?

The costs of your medical treatment should be included in the total claim settlement value. If the costs have not been paid directly to the treatment provider and given to you in settlement, you would then have to pay the provider directly. However, it is usually the case that costs will already have been paid to the provide and the balance of settlement provided to you.

I have had a medical report from an independent medical advisor regarding my broken and subsequently repaired humerus. The NHS have closed my medical file. The independent medical advisor suggested i have a private mri scan to prove what i don’t know and that i pay for it. I thought no win no fee solicitors should not demand i pay for the scan. Your opinion would be useful and i may well be asking you to handle my case.

If your Solicitor instructed a medical expert to provide the report, you should not be paying the costs for any scan as the Solicitor should do this and recover the costs in due course.

My medical expert requested an MRI before giving a final prognosis on the outcome and effects of my injury in the future. My solicitors recommended a MRI clinic and their fee was £1000. Should they deduct this from my expenses or should they claim that separately and not deduct it from my compensation?. Also, my psychological report was delayed through no fault of my own as the legal advisor hung onto it for two weeks. in meantime the insurance company came through with a second offer which was reasonable and I wanted to accept it but the lawyer said that I would have to pay for the psychological report as it came through after the offer was made by the insurance company even though the insurance company knew that one was going to be delivered and had a report from my private psychologist stating that I had suffered from post traumatic stress due to being hit by a reversing car. Is this correct? should I be charged for that too when it was a dereliction of duty not to have sent the report immediately after it was received by the lawyer and I had checked it?

In most cases, it is only possible to recover the cost of one medical expert report when settling a claim for compensation. This can vary in complex cases where multiple injuries were sustained or where two separate types of injury – such as with you, physical and psychological – require experts of different medical specialities to provide reports.

In your case, has your Solicitor spoken with the defendant and asked if they will consider covering the cost of the 2nd report given the relevance to your claim?

My mum as just received a settlement claim, unfortunately she passed away in October, so won’t see it, but they have taken off treatment fees, and obviously the insurance and their 25% over £5000 of her settlement, I don’t understand why they have taken treatment fees.

You need to ask the Solicitors for a written breakdown of the total claim settlement and what has been allowed for various things – including treatment costs. It could well be that the Solicitor had to fund the cost of rehab treatments and that they must then deduct those from the total settlement amount.

After 5 years my daughter has accepted a nett settlement figure, her solicitor has written to say that the other side will not accept his costs and he is trying to resolve this. She has signed the acceptance of the settlement figure nett so will she have to pay costs out of this if solicitor cannot get third party to accept his costs?

It is unlikely that the defendant will not accept any of the Solicitors costs. The Solicitor may have to explain certain costs, but it should be resolved in your daughters favour. However, claimants do face the prospect of contributing to their Solicitors costs in some circumstances. However, in a No Win No Fee case, any such contribution towards the claimants Solicitors costs should be capped at 25% of any agreed settlement.

How much does a medical report typically cost?

Of course, it varies depending on the nature of the instruction or the kind of medical expert report that is being asked for. However, as guide you can expect a medical experts report to cost in the region of £800 – £1200.

Can costs of a medical expert be recovered if we as claimant are not represented by a solicitor?
Can the cost be part of special damages?

Medical expert report costs are usually a recoverable cost. However, before instructing a specialist, it is wise to ensure that the defendant agrees to the instruction and costs of the report.

Hi my mum has been asked for 600 pounds to get a scan in a personal injury claim is this common practice?
Thanks

Far from being normal or common, for a claimant to be asked to pay any costs during the process of claiming compensation is extremely unusual and should be queried! The only reason that a claimant could be asked to pay a fee for a scan or medical report is if the claimant is demanding a 2nd opinion (if a first medical report did not give the claimant the news that they had hoped for). A claimant can only recover the cost of a medical report or medical costs if they succeed and it is unlikely that a defendant would be expected to pay for a 2nd opinion.

If your Mother has not demanded a 2nd opinion, if her claim is being managed on a No Win No Fee basis, she should query this cost demand fully.

If one of my medical reports is deficient or negligent do I need to approach another expert?
Who pays for this additional report and can the other side see the previous deficient report?

If there is a demonstrable inaccuracy in a medical report, it should be pointed out and notified to both sides as in that case, a further report can be instructed and the claimant would not bear the cost.

However, if you simply have a view that your report is deficient in some way and you wish to seek a further report from a different expert, the other side are unlikely to pay the cost of that and you would have to undertake to pay that cost.

My current solicitor is asking me to pay for a medical examination, by a surgeon, I was expecting no fees whatsoever.

If you are being represented on a conditional fee agreement (no win no fee) basis, you should not be paying for the medical assessment.