Posted 14th January 2009
Norman W Cottington
Norman Cottington is the most significant individual driver behind the rehabilitation initiative that has accelerated so impressively in last decade. His experience in personal injury claims spans more than forty years, twenty five as Insurance Claims Manager.
In the mid 1980s he became concerned that serious injury claims were often presented years after the accident. Solicitors had spent the time building evidence for the highest possible award and insurers would then seek evidence to reduce it. Serious claims took years to settle during which no practical support or assistance was available to the claimant outside the NHS and/or Social Services. With the focus solely on damages, motivation for return to work or normal quality of life was lost.
In 1993, in discussion with the charity Rehab UK, Norman proposed a revolutionary business concept - funded early intervention with personal injury claimants. By joint agreement of the insurer and solicitor, the injured person and their situation would be assessed, including consultation with all involved in the injured person's care and support. A report sent simultaneously to both sides would outline the immediate needs with recommendations as to how they were best met. The report would under no circumstances become part of the litigation process.
In 1994 Norman held a conference at which the concept was aired. Of over one hundred personal injury solicitors and insurers, 86% signified support and over 50% volunteered for a working party to advance it.
Norman selected to ensure balance. The group comprised the President of APIL, the Chairman of MASS, claimant solicitors, defendant solicitors, and insurance claims managers. Norman chaired the group, which became known as The Disability Assessment Unit Working Party. Rehab UK established the Disability Assessment Unit (DAU) accepting instructions on the agreed principles.
The results were impressive but limited so a document entitled ‘The Early Assessment Agreement' was launched at a conference Norman held at the Liberal Club in March 1997.
At that conference Norman was invited by the Chairman of the IUA ABI Rehabilitation Working Party to join it. It had contributed to the first UK bodily injury award study. He agreed to join and presented The Early Assessment Agreement as a blueprint to build upon.
In 1998 the DAU working party formed the Bodily Injury Claims Management Association. Norman was elected President and BICMA expanded its remit to rehabilitation and pro-active claims handling generally
The second UK Bodily Injury Award Study was published in September 1999, and included the Rehabilitation Code of Best Practice, being an enhanced version of BICMA's Early Assessment Agreement, along with BICMA's "Practitioners Guide to Rehabilitation".
Norman, however, remained concerned about the requirements for those conducting assessments. He found that the concept of case management was well advanced in America where the Case Manager put the patient at the centre of the process and obtained the best outcome as economically as possible. Norman, seeing that this was the way forward, purchased on behalf of BICMA the franchise to establish the Case Management Society UK. He invited nurses and Case Managers to form the society that Case Managers would run for themselves. CMSUK now has about two hundred members, is growing fast, and is advancing the discipline of case management generally.
Meanwhile, there were still too few providers to implement the Rehabilitation Code. With the experience he had gained Norman left insurance in 1999 and developed a treatment and rehabilitation provider incorporating these new disciplines. His new venture was to offer a service operating exclusively under the Rehabilitation Code of Best Practice. The Injury Care Clinics Limited and TICCS Case Managers maintain their independence to this day and now offer fourteen Case Managers nation-wide. They have conducted over two thousand immediate needs assessments of claimants with severe injuries.
Awareness and acceptance of the Rehabilitation Code was slow to develop. Norman set about making a register of practitioners who supported the Code. He wrote on behalf of BICMA to every APIL and MASS member and every insurer inviting participation. He prepared and operates the register, which includes over five hundred personal injury solicitors and most insurers and is available on the BICMA website for all to access.
Under Norman's direction, BICMA has prepared a Model Agreement in support of the Rehabilitation Code requiring participants to agree in advance not only to assess a claimant's needs, but also to implement the recommendations. This ensures that the parties participate in the spirit of the Code and requires them to express reason/s for any failure to implement.
Having identified the lack of regulation in the rehabilitation arena BICMA, under Norman's direction has recently published "Quality Standards for Rehabilitation Providers". To which all providers of rehabilitation providers are being invited to adhere to. This initiative has been welcomed by all purchasers of such services.
Most recently BICMA has launched a mediation service to address rehabilitation disputes. Operating and controlled by the Civil mediation Council this scheme proposes to address rehabilitation issues at the telephone and within seven days so as to ensure delivery of services to the injured party at the earliest opportunity.
Norman is -
He continues to travel the country providing presentations to solicitors and insurers on rehabilitation, whilst having organised and run three successful BICMA conferences.
Norman was the first to adopt truly practical steps to overcome the adversarial block to rehabilitation. He is rehabilitation's champion!