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Contact Details

Phone: 01684 580798

Emergency Claims: 07918 941497
*This if for Emergencies only

E-mail: claims@balens.co.uk

The foundation of our business revolves around trust and top quality service. Nowhere is this more important than in the realm of Claims Handling. The following information has been complied to assist you with where you may need to notify us of an incident and what to do in the event of a client's complaint. If you wish to notify us of a claim, please e-mail us at claims@balens.co.uk

The range of classes of business that Balens handle is diverse, so that different types of claim will be handled slightly differently and with differing timescales involved. Recent legislation changes the procedure for Employers Liability and Public Liability injury claims. The time scales within which a claim is to be managed, the way a claimant's claim is funded and the amount in costs which will be recoverable by the claimant from the defendant.

The changes impose much stricter timescales for the investigation and handling of Employers Liability and Public Liability Injury claims, therefore we will now need:

  • A Full record of any incident that may lead to a claim. With immediate notification.
  • You should collate photos, statements, training records, risk assessments, wages information and CCTV Records as relevant.
  • You must contact us immediately if you should receive a claim notification form.

If your claim involves Buildings or Contents damage, then we need full details, estimates for replacement or repair, and if the loss or damage is serious, Insurers will appoint a representative to survey, compute and discuss your claim. You have a common law duty to mitigate losses, so temporary repairs and prompt action to prevent further deterioration loss or damage are advisable. Please keep relevant receipts and documentation. Always let us know immediately something happens rather than delay matters and we will guide you through the process.

Claims involving Injury, accidents, illness or death will require different proof of loss and we will of course support you through these potentially distressing times. You must contact us immediately in the event of such claims.

Business Losses can come from a variety of causes. Our experienced team have many years of helping reimbourse businesses and helping them to keep going despite adverse situations.

For Malpractice and Professional Indemnity Claims we have a range of educational and risk management material to help you avoid these wherever possible. Below are a few key points, please contact us for more detailed information if required.

Malpractice claims handling and procedures

Situations can arise that may be a cause for complaint from the patients' perspective. Some of these may not be your fault, and are more to do with the patient's attitude and process than you. How you handle such complaints is critical in ensuring that it does not develop into a disciplinary or a malpractice claim. Complaints very often arise from a miscommunication and can enhance your goodwill if judiciously handled.

There are of course many ways one can head off complaints, for further suggestions please see our article How to manage complaints and CPD Lectures on Handling difficult client relationships.

Below are some procedures to be followed to ensure that you have the full back up of Balens and the Insurers as quickly as possible and hopefully to avoid making matters worse.

 

This Table should help you decide when to notify us...

 

Verbal Complaint

Do

  • Listen. Regarding pain or perceived lack of progress – empathise, explain, reassure, make earlier follow-up appointment, maintain goodwill.

  • Consider whether the complaint is about a "notifiable safety incident" thereby triggering the statutory duty of candour (see below).

  • Notify Balens if customer appears still not to be happy – remember to also note this information on your Insurance Renewal Form.

Don't

  • Panic, get defensive, admit liability, indicate you are insured, show annoyance or anger.

Letter of Complaint

Do

  • Acknowledge receipt of the patients complaint in writing and confirm that the complaint is receiving your full attention and that a response will be provided shortly.

  • Notify Balens and Your Association if you have one, and pass on all correspondence unanswered together with patient notes and your response to the allegation.

Don't

  • Admit legal liability.

  • If you are concerned that an apology may amount to an admission of fault or liability, contact Balens for further advice in advance of the meeting

No show - misses appointment

Do

  • Ring patient to identify reason for no show. Most common reasons are that patients feel better, it did not help, or they forgot.

  • Treat as a verbal complaint if any concerns are raised as a reason for missed appointment (see above).

Don't

  • Do nothing.

Refund request

Do

  • Ask why. Request that they put the nature of the complaint in writing to the Therapist so that it can be fully investigated. Contact Balens for further advice.

  • Consider whether there has been a "notifiable safety incident" thereby triggering the statutory duty of candour (see below).

Don't

  • Get annoyed, angry or defensive.

No Payment

Do

  • Ask why. If the patient is not happy, give reassurance and explanation – offer another appointment complimentary if necessary as a gesture of goodwill.

  • Consider whether there has been a "notifiable safety incident" thereby triggering the statutory duty of candour (see below).

Don't

  • Get annoyed, angry or defensive.

Request to see Notes

Do

  • Give access, offer copy or write report from notes.

  • Ask why, although this request is rarely to do with a complaint, usually patient is moving or has an insurance claim as a result of an accident.

  • Consider whether there has been a "notifiable safety incident" thereby triggering the statutory duty of candour (see below).

 

Don't

  • Get annoyed, angry or defensive.

Notifiable Safety Incident - Statutory Duty of Candour

Do

  • Notify Balens of the incident immediately

  • Arrange to meet with the patient (or, if they are deceased or lack capacity, someone able to lawfully act on their behalf) as soon as reasonably practicable. At that meeting the patient/service user should be provided with:
    • A factual account of what has occurred to the best of your knowledge at that time.
    • Details of the further enquires that will be undertaken;
    • An apology which expresses sorrow or regret that the incident has occurred.
  • Ensure that there is a record of this meeting and that the patient is subsequently written to confirming what was discussed.

  • Provide Reasonable support for the patient/service user in relation to the incident.

  • At the conclusion of the investigation write to the patient confirming the outcome of this and ensure that a detailed record of this is kept.

 

Don't

  • Speculate about what may have occurred when you first meet the patient; instead keep to the facts as known at the time.

  • If you are concerned that an apology may amount to an admission of fault or liability, contact Balens for further advice in advance of the meeting.

 

You may also be aware that there is now a Duty of Candour requirement for health professionals to be open and honest in the event of a serious or significant event as a result of treatment or advice. Please see the Government website for full details of this. The main risk we were concerned when this came to our attention, was the possibility of breaching policy conditions if it were seen that you may have admitted liability before involving your insurer. Fortunately Insurers have been reviewing their responses and procedures to factor this new requirement in. Ultimately,they will be interpreting any responses issued by Therapists under the duty of candour softly. Unless there has been a significant prejudice caused by the Therapist in admitting legal liability, it is likely that they will view matters favourably. Apologies are Ok, but it is suggested that you contact Balens if you are in any doubt as to how to respond. Also, it may not always be clear whether it was your work that caused the serious problem in the first place.