Medical Agency Fees

Background

Following service of the claimant’s bill of costs in January 2021, the defendant disputed the costs claimed for medical reports from Mr. Irons (£5,400 plus VAT) and Dr. Khan (£8,775 plus VAT), both issued by Premex Services Limited, a medical reporting organization.

The defendant asked for a breakdown of these costs to understand what part of the fee was for the individual medical report and what part was for Premex’s services. This request was rejected by Premex, who argued that the invoiced amount was reasonable and proportionate.

Detailed assessment proceedings were commenced in July 2021. On 9 July 2021, the defendant issued an application seeking an order that the claimant provide the breakdown that had been previously refused.

On 27 July 2021, the paying party served points of dispute in respect of the bill requesting details of the sums charged by the expert and those charged by Premex. Deputy District Judge Harris sitting as a Regional Costs Judge on 4 July 2022 refused the Defendant’s application.

This was the defendant’s appeal against that decision.

The Issue

The outcome of the appeal rested on the resolution of a single issue:

is a receiving party required to provide a breakdown in its bill between the cost of an expert report and the costs of a medical reporting organisation (“MRO”) approached to provide the report, or is it permissible for the receiving party to submit a bill which simply includes the fee charged by the MRO to provide the medical report?

The claimant’s position

For the claimant, it was argued that:

• there is no requirement for a breakdown of Premex’s fee.
• if there was such a requirement, the PD would spell it out.
• the Premex fee note as presented was sufficient.

The defendant’s position

For the defendant, it was argued that:

• in order to conduct a detailed assessment the Judge needs to be able to distinguish between agency fees and expert fees. PD 47 facilitates that exercise in plain and clear terms. Premex is not an expert and so its invoice cannot sensibly be regarded as an expert fee note.

The Decision

The judge ruled that the language of PD 47 was clear and necessitated the receiving party to provide a copy of the expert’s fee note(s) when asking the paying party to cover the cost of an expert. This allowed the paying party and the court to make an informed decision about the fee. The same principle was applied to fees of a medical reporting organisation.

The judge agreed with His Honour Judge Cook’s points made in the 2002 case of Stringer v Copley.

“A Judge faced with the task of assessing items 53 and 58 as they presently stand is faced with an impossible task. Absent a breakdown the Judge risks permitting the type of ‘extreme’ identified by His Honour Judge Cook.”

The judge found that PD 47 imposed a duty on the receiving party to provide the fee note of any expert instructed and the costs of any Medical Reporting Organisation (MRO) when such costs are claimed. Premex’s invoice was not considered a fee note in any sensible way.

“Once this conclusion is reached, in my view it follows that the appeal must be allowed. The Deputy District Judge was in my view wrong to refuse the order sought.”

By refusing the order, he found, the Deputy Judge left the Judge who would conduct the detailed assessment without the necessary information.

The judge concluded that the appeal must be allowed. He ordered that a breakdown be provided within 14 days and, in default of compliance, the fees in question be assessed at zero.