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Chiropractic Research Review

Insurance Claims for Whiplash Injury

Whiplash injury is a common cause of chronic neck pain in industrialized countries, and a frequent motivation for the filing of insurance claims following motor vehicle accidents. The authors of this study suggest that an insurance system in which financial compensation is based on pain and suffering may actually promote persistent illness and disability.

This study investigated the potential relationship between incidence and prognosis of whiplash injury from motor vehicle accidents and eligibility for compensation for pain and suffering.

The study population included all Saskatchewan residents (18 years of age and older) who submitted a claim to Saskatchewan Government Insurance for traffic injuries occurring between July 1, 1994 and December 31, 1995. The study's outcome measure was the number of days from the date of injury to the date on which the claim was closed (payments stopped and final agreement between insurer and claimant reached).

The key element of the study involved the shift in Saskatchewan's compensation system on January 1, 1995, from a tort system that included payments for pain and suffering to a no-fault system that did not include such payments. Tort action was still available in the no-fault system if costs exceeded benefits, such as with medical costs over $500,000. Analysis of claim data before and after this change in policy revealed the following:

* The six-month incidence of claims in the last six months of the tort system was significantly higher than in the first and second six-month periods of the no-fault system.

* The average time from the date of injury to claim closure decreased significantly under the no-fault system. The average time under the tort system was 409 days, while the average time in the first and second six-month periods of the no-fault system was 194 days and 203 days, respectively).

* Intensity of neck pain, level of physical functioning, and presence or absence of depressive symptoms were strongly associated with time to claim closure in both systems.

The authors conclude that "Legislators may wish to consider the advantages of removing payments for pain and suffering from compensation systems."

Cassidy JD, Carroll LJ, Côté P, et al. Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury. The New England Journal of Medicine, April 20, 2000:342(16), pp1179-86.

Chiropractic Research Review

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