Indemnity Costs in Medical Negligence Claims: A Missed Opportunity in WA

Unlike the historic position, Plaintiffs' (patients) who have claims proceed to trial in medical negligence claims in WA, cannot generally recover what is known as indemnity costs, if they win and are awarded more by way of damages than they had earlier offered to accept in settlement of their claim.

The consequence of this, is that from a costs perspective, there is no advantage in a Plaintiff (patient) making a settlement offer before trial and particularly, there is no real incentive to put an 'acid test' offer. If the Plaintiff (patient) wins their trial and beats any offer made by the Defendant (the hospital/medical practitioner etc), they will generally recover the same costs, whether they beat their earlier offer or not.

The flip-side is that from the Defendant's perspective, rejecting an offer and proceeding to trial does not generally worsen their position, if the Plaintiff wins.

The situation that commonly follows is that a Plaintiff succeeding at trial will have a significant part of their legal costs they will need to pay for their own representation, not covered by the costs paid by the Defendant hospital, medical practitioner etc, even in this situation where they had been prepared to take less to settle.

In my opinion this is a lost opportunity to further encourage settlement in such claims.

The capacity for an order requiring a 'losing' Defendant to pay the overwhelming majority of legal costs for the Plaintiff if the claim proceeds to trial (which is what happens when 'indemnity' rather than 'contribution' costs are required to be paid), and the Plaintiff wins more than they (the patient) had been prepared to settle for is:

  • much fairer to the Plaintiff,
  • perhaps more importantly on a practical day to day basis, a very significant practical incentive for Defendants to do their very best to settle claims and to 'sweat' when a 1/2 decent compromise offer is made by the patient.

I understand amendments to our Court Rules are in train, which will re-introduce this discretion for a Trial Judge. It can't come too soon.....

For a recent example in NSW where such indemnity costs were ordered and our 'old' approach continues, see Paul Harris v Dr Michael Bellemore (No 3) [2010] NSWSC 907, delivered on 3 August 2010.

While it is a 'wild guess,' had no indemnity costs order been made in such case, my guess is the difference in legal costs the patient Mr Harris would have had to pay for his claim, not covered by the Defendant, would have increased by > $100,000.00.


Northam Tragedy: An Addendum

As the media coverage continues, another thought that occurred to me today, is why is it not possible for there to be a well-recognised easy to follow chart for Accident and Emergency staff at remote hospitals (accepting for present purposes Northam would be accepted as such), as to observation or triage findings which should mandate a medical consultation?

For example, why should a temperature greater than a set limit in a teenager not be something that mandates such a review? As I understand the media reports, Andrew had a temperature of 40 degrees at attendance.

Why is it too hard to have simple guiding 'sign post' protocols to assist staff across the State?

I do not suggest that medicine can be run by computer software. There is obviously no substitute for an experienced, skilled clinician's evaluation of a patient. When this is not available however, why not assist the staff to avoid tragic mistaken calls...?


Andrew Allan: Northam Tragedy Accident Emergency - Questions to be Asked

I, along with probably a large portion of the West Australian adult population read with horror the story in this weekend's papers, concerning the tragedy relating to Andrew Allan who died within hours of being seen and sent home at Northam Hospital's accident and emergency on Thursday evening. The cause of death for young Andrew seems likely to be determined only after autopsy etc. It would seem likely that a Coroner's Inquest may follow.

While it is to be applauded that acting CEO Wayne Savage from the WA Country Health Service has indicated a 'full and thorough' investigation will follow, what is not reported as having been said is whether the full findings and report of such investigation will be:

1) made public;
2) made known to the family.

Far too often in my experience, in cases like this, investigations and their conclusions are withheld, with claims of legal privilege (sometimes I suspect 'retrospectively') asserted.

It is to be hoped that in this instance, appreciating that this is a matter primarily requiring investigation because of the need to ensure it does not occur again, no such grounds for secrecy will be asserted.

It is certainly true that the relevant hospital's insurer may well wish to conduct an investigation in terms of its potential legal liability. This should however in my view (predictably) be an entirely separate investigation from that undertaken in accordance with Mr Savage's undertaking to the family

Legal compensation or liability is not the primary issue at this point. What I am sure is the primary issue for the Allans is an explanation how this could happen to their son. Perhaps equally important to them and for the rest us, an assurance and explanation why we can be sure that this will not happen next time...


Medical negligence lawyers (lawyers generally) and 'plain english'

For the last decade or so, 'plain english' has been a buzz word for lawyers and other professionals.

One of the areas I have always thought we (lawyers) have failed to deliver is in the area of client retainers / costs agreements with our clients. For understandable, if flawed reasons, these have always seemed to me to be incredibly cumbersome and convoluted documents, covering every conceivable eventuality (and a few others..)

Like many law firms we have traditionally used an agreement based upon a Law Society form recommended and published 10 years or so ago. It certainly caters for every contingency, but at a high cost in terms of readability.

I just came across a neat bit of software, very '2001: A Space Odyssey' called 'Flesh' which for free will evaluate the readibility of a given document and assign a score.

Needless to say, my fee agreement did not do well.... Any Nobel laureates looking for a medical negligence lawyer, I've got an agreement for you, but otherwise...

So it's back to the drawing board, to come up with something that spells out the key points of client engagement, is easy to understand and in under 2 pages.

After all, my relationship with a client has to be based on trust. If I don't trust you (or you don't trust me)' why am I involved in the claim again?

Heresy I know...

Colleagues, give it a try. It's free. If anyone's fee agreement shines under the 'Flesh' test, let me know your secret..


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