Medical reporting organisations could face more scrutiny over their costs after a court ordered a full breakdown of expert fees.

His Honour Judge Bird, sitting at Manchester Civil Justice Centre in Northampton General Hospital NHS Trust v Hoskin, found a duty on the receiving party to provide the fee note of any expert instructed and explain how much was kept by the medical reporting organisation instructed.

The judge said the language in practising direction 47 of the Civil Procedure Rules was ‘very clear and admits of no doubt.

'The receiving party is required to provide a copy of the expert’s fee note(s),’ said Bird. ‘The effect is that the precise cost charged by the expert (recorded in the fee note) is known. Seized of that information the paying party can make a decision about the fee. In doing so it may well consider what the “going rate” for a similar report is. Without the fee note the paying party cannot make a rational, evidence based decision, about whether to accept that aspect of the bill, reject it or make a counteroffer.’

The ruling, although not binding, will be closely scrutinised by all sides and could change how medical expert fees are calculated and presented.

The substantive claim was settled in 2020 when the claimant accepted the defendant’s part 36 offer. Items on the bill of costs were agreed except for around £14,000 claimed for two medical reports from consultant experts. An invoice for the two sums, issued by MRO Premex Services Limited, was served with the bill.

The court heard that Premex maintains a panel of medical experts and provides reports at a lower cost than those experts would charge if directly instructed by solicitors.

Premex rejected the defendant’s request for a breakdown on the basis the amounts were reasonable and proportionate. In July 2021, Deputy District Judge Harris, sitting as a regional costs judge, refused the defendant’s application to see details of the expert costs.

On appeal, the judge said the key question was whether it was permissible for the receiving party to submit a bill which simply includes the fee charged by  the MRO to provide a report.The claimant argued there was no such requirement for a breakdown, and that the Premex fee note as presented was sufficient.

But the defendant urged the court to distinguish between agency fees and expert fees. Given that Premex itself was not an expert, it was argued, its invoice could not be regarded as an expert fee note.

The judge ruled that Premex’s invoice ‘cannot be described in any sensible way as a fee note’. He added that it was not difficult, let along disproportionate, to provide a breakdown of costs.

He ordered the claimant to provide a breakdown between the Premex costs and expert costs within 14 days.

 

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