Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury

TITLE:	Effect of eliminating compensation for pain and suffering on the outcome of insurance claims for whiplash injury [see comments]
AUTHORS:	Cassidy JD; Carroll LJ; Cote P; Lemstra M; Berglund A; Nygren A
AUTHOR AFFILIATION:	Alberta Centre for Injury Control and Research, Department of Public Health Sciences, University of Alberta, Edmonton, Canada. dcassidy@ualberta.ca
SOURCE:	N Engl J Med 2000 Apr 20;342(16):1179-86
CITATION IDS:	PMID: 10770984 UI: 20218605
COMMENT:	Comment in: N Engl J Med 2000 Apr 20;342(16):1211-3
ABSTRACT:	BACKGROUND AND METHODS: The incidence and prognosis of whiplash injury from motor vehicle collisions may be related to eligibility for compensation for pain and suffering. On January 1, 1995, the tort-compensation system for traffic injuries, which included payments for pain and suffering, in Saskatchewan, Canada, was changed to a no-fault system, which did not include such payments. To determine whether this change was associated with a decrease in claims and improved recovery after whiplash injury, we studied a population-based cohort of persons who filed insurance claims for traffic injuries between July 1, 1994, and December 31, 1995. RESULTS: Of 9006 potentially eligible claimants, 7462 (83 percent) met our criteria for whiplash injury. The six-month cumulative incidence of claims was 417 per 100,000 persons in the last six months of the tort system, as compared with 302 and 296 per 100,000, respectively, in the first and second six-month periods of the no-fault system. The incidence of claims was higher for women than for men in each period; the incidence decreased by 43 percent for men and by 15 percent for women between the tort period and the two no-fault periods combined. The median time from the date of injury to the closure of a claim decreased from 433 days (95 percent confidence interval, 409 to 457) to 194 days (95 percent confidence interval, 182 to 206) and 203 days (95 percent confidence interval, 193 to 213), respectively. The intensity of neck pain, the level of physical functioning, and the presence or absence of depressive symptoms were strongly associated with the time to claim closure in both systems. CONCLUSIONS: The elimination of compensation for pain and suffering is associated with a decreased incidence and improved prognosis of whiplash injury.
MAIN MESH HEADINGS:	Insurance, Accident/utilization Insurance, Liability/utilization Neck Pain/economics Whiplash Injuries/economics
ADDITIONAL MESH HEADINGS:	Accidents, Traffic/economics Adult Comparative Study Female Human Incidence Insurance Claim Reporting/statistics & numerical data Insurance Claim Review/statistics & numerical data Insurance, Accident/economics Insurance, Accident/legislation & jurisprudence Insurance, Accident/statistics & numerical data Insurance, Liability/statistics & numerical data Male Neck Pain/etiology Prognosis Saskatchewan Support, Non-U.S. Gov't Time Factors Whiplash Injuries/complications Whiplash Injuries/epidemiology 2000/04 2000/25 09:00
PUBLICATION TYPES:	JOURNAL ARTICLE
LANGUAGES:	Eng

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