Senior Costs Judge Establishes 25% Markup Cap for Medical Reporting Organisation Fees

The Senior Courts Costs Office has determined that Medical Reporting Organisation fees are disbursements, not outsourced solicitors’ work, rejecting the long-applied *Stringer* comparison test. A 25% markup on expert fees represents the reasonable amount recoverable between parties.

MRO fee markup cap 25% detailed assessment personal injury Senior Courts Costs Office
JXX (a Protected Party by his Litigation Friend ABB) v Archibald & Anr and HLA (a Protected Party by her mother and Litigation Friend HDA) v LXA & Ors concerned the correct approach to assessing Medical Reporting Organisation (MRO) fees on detailed assessment. Senior Costs Judge Rowley held that such fees are properly characterised as disbursements, not outsourced solicitors’ profit costs, meaning the long-applied ‘Stringer cap’ requiring comparison with hypothetical solicitor costs was not the correct test. The court rejected the defendants’ argument that deferred payment or write-off facilities constituted irrecoverable funding costs under Hunt v R.M. Douglas (Roofing) Ltd, finding these were commercial terms inherent to the market rather than credit arrangements. However, the court equally rejected the claimants’ contention that aggregate fees were immune from scrutiny, noting that tripartite market tensions meant competition imperfectly regulated reasonableness between parties. On evidence showing markups of 30% to 53% calculated on a macro-business basis, the judge was not persuaded the full amounts were reasonable between the parties. Applying a cautious approach under the CPR and overriding objective, he concluded that a 25% markup on experts’ fees (including associated disbursements) represented a reasonable and proportionate amount recoverable. The decision provides important guidance on assessing third-party disbursements where conventional time-recording breakdowns are unavailable.

[137] Where there is a limitation to the receiving parties' evidence, the court needs to take a cautious approach. I think that is the situation here and I am not persuaded that even the range of 30% to 53% generally charged can be considered reasonable, let alone the outlier percentages, some of which result from fixed sums having been claimed. The general range of 30% to 53% plainly reflect variations resulting from ongoing commercial relationships between the solicitors and MROs rather than any case specific factors. There is nothing wrong with those relationships but they are not any basis on which to allow any particular percentage between the parties. Having spent a considerable time reviewing the evidence and submissions in this case, both as documentation and in this decision, in my judgment, a mark up figure of 25% between the parties would be a reasonable percentage. More than that would be a matter for the claimants, their solicitors or the MROs. Any mark up claimed of less than 25% would be limited to that percentage.

Citations

Stringer v Copley (2002) This case establishes that medical agency fees are recoverable provided their charges do not exceed the reasonable and proportionate costs of the work if it were done by solicitors. This principle is often referred to as the “Stringer Cap” in costs assessments. Prosser v British Airways Plc [2019] EWCA Civ 547 The case confirms that VAT is chargeable not only on the agency’s own fees but also on medical expert fees when provided as part of a broader service, following the principle that the provision of a service requires VAT on the medical report element. Claims Direct Test Cases [2003] EWHC 9005 (Costs) Judge Hurst considered whether payments to a medical reporting organisation (MRO) were reasonable and proportionate, concluding that MRO fees should be treated as disbursements rather than outsourced solicitors’ work. Northampton General Hospital NHS Trust v Hoskin (2023) In this case, the need for proper documentation to support MRO fees was emphasised, underscoring the role of detailed assessments in challenging the absence of documentation. Crane v Canons Leisure Centre [2007] EWCA Civ 1352 This case set the principle that the classification of outsourcing costs depends on whether the work is solicitors’ work and where responsibility for that work lies, which is crucial for determining if costs should be treated as profit costs or a disbursement. Hunt v R.M. Douglas (Roofing) Limited (1987) NLJ 1133 The court decided that costs of funding litigation, such as bank loans for disbursements, have never been included under legal costs, reinforcing that funding costs require primary legislation to be recoverable. Jones & Ors v Secretary of State for Energy and Climate Change [2014] EWCA Civ 363 The case discussed the award of pre-judgment interest specifically on disbursements, changing the traditional rule that funding costs were not recoverable. Federal Republic of Nigeria v Process & Industrial Developments Ltd [2025] UKSC 36 – The Supreme Court upheld that costs awards should exclude costs of litigation funding, aligning with the long-standing principle that such costs are not included in legal costs. Rogers v Merthyr Tydfil County Borough Council [2006] EWCA Civ 1134 The Court of Appeal emphasized the importance of not interfering with ATE insurance premium decisions barring unusual circumstances, highlighting the intricacies involved in costs assessments in litigation. Motor Insurers’ Bureau v Santiago [2026] EWHC 513 (KB) The judge opted to assess the interpreter fee note in its entirety without deconstructing it, drawing a line on how detailed cost breakdowns should be handled in court assessments.

Key Points

  • Fees charged by a Medical Reporting Organisation for arranging and administering the procurement of medical evidence are properly characterised as a disbursement, not as outsourced solicitors’ profit costs. The correct test for assessing their reasonableness is therefore not a comparison with the hypothetical cost of a solicitor performing the same tasks. [57-60]
  • Commercial terms between a solicitor and a third-party provider, such as deferred payment or write-off facilities, do not constitute irrecoverable “funding costs”. Such terms are a legitimate feature of the service within a market where delayed reimbursement is inherent, reflecting the commercial relationship between the parties. [76-78, 85]
  • In assessing the reasonableness of a percentage-based fee charged by a service provider, the court will consider whether the percentage is justified by the overall service offered. The court may determine a maximum reasonable percentage where the evidence does not support the full percentage claimed, particularly where the charging model is based on macro-business calculations rather than case-specific factors. [125, 137]
  • The absence of detailed, time-recorded evidence from a service provider does not preclude the court from assessing the reasonableness of their fees. The court may adopt a broad, pragmatic approach to quantification, setting a recoverable percentage that reflects the value of the service while acknowledging the impracticality of a detailed deconstruction in every case. [121-122, 138]
  • Where a disbursement is charged as a global or aggregate fee without a time-based breakdown, the court may assess its reasonableness by reference to a percentage uplift on the underlying cost, provided this reflects a fair and proportionate charge for the service between the parties. A percentage uplift is to be applied to the entire expert’s invoice, including disbursements, for reasons of simplicity and practicality. [136-137]

[60] "For the reasons given to this point, I have concluded that the MRO fees are a disbursement rather than outsourced solicitors' work. It flows from that conclusion that I do not consider the fees are limited by a comparison with a hypothetical solicitor's work in obtaining the medical evidence and as such there is no purpose in requiring an MRO to provide a breakdown equivalent to that produced by solicitors in their bill of costs."

Key Findings In The Case

  • The fees charged by Medical Reporting Organisations were characterised as disbursements rather than outsourced solicitors’ profit costs. Therefore, their reasonableness should not be compared to a hypothetical solicitor’s costs for performing the same tasks [57-60].
  • Deferred payment and write-off facilities included in the commercial terms between solicitors and the Medical Reporting Organisations were considered legitimate market features and did not automatically make the associated fees unreasonable [76-78, 85].
  • The absence of a time-based breakdown for fees charged as a global or aggregate disbursement does not prevent the court from assessing their reasonableness. The court evaluated the reasonableness by considering a percentage uplift on the underlying cost [136-137].
  • In assessing the percentage-based fees charged by service providers, the court determined a maximum reasonable percentage based on the overall service offered. This was done where evidence did not fully support the percentage claimed, accounting for the provider’s macro-business calculations rather than specific case factors [125, 137].
  • The lack of detailed, time-recorded evidence from Medical Reporting Organisations did not prevent the court from reaching a decision on the reasonableness of their fees. The court adopted a broad, pragmatic approach to quantification, determining a recoverable percentage reflecting the service’s value [121-122, 138].

[129] "But in a between the parties' assessment, the court's task is to determine what a reasonable (and proportionate) sum for the paying party to pay would be. That does not generally mean that the court considers that the costs have not actually been incurred. Normally, it is a matter of whether all or only some of those costs claimed between the parties should be laid at the paying party's door."

The Senior Courts Costs Office’s decision in JXX v Archibald & Anr [2026] EWHC 630 (SCCO) establishes a new framework for assessing Medical Reporting Organisation fees in personal injury litigation, rejecting both parties’ primary submissions and crafting a novel middle path.

Background

This matter concerned the recoverability of Medical Reporting Organisations fees (MROs) in personal injury litigation. The Senior Costs Judge was required to determine the approach to assessing such fees following the settlement of all other costs in two lead cases: JXX v Archibald & Anr and HLA v LXA & Anr.

In JXX, a reserved judgment was handed down on 17 January 2025. This judgment put the claimant to an election regarding providing further information on medical evidence fees. The claimant chose to provide that information with the agreement of the MRO involved, Medical and Professional Services Limited (MAPS), which was subsequently joined as a Third Party. Given the significance of the issues, an application was made in the related case of HLA for it to be heard concurrently. This was granted, and the MRO in that case, Premex Services Limited (Premex), was also joined as a Third Party. An application by the Association of Medical Reporting Organisations (AMRO) to intervene was refused in July 2025.

By early October and November 2025 respectively, the bills of costs in both the JXX and HLA cases were agreed save for the fees attributable to the MROs. The experts’ own fees were also agreed. Consequently, the hearing between 17 and 20 November 2025 constituted a detailed assessment focused solely on the recoverability and quantum of the MRO fees. The parties, including the third-party MROs, filed 27 witness statements, with half a dozen witnesses cross-examined on behalf of the defendants.

Costs Issues Before the Court

The central issue was how the court should assess the reasonableness of fees charged by an MRO for its services in arranging and administering the procurement of medical expert evidence. The dispute crystallised around two competing legal and evidential approaches.

The first, advocated by the defendants, was based on the county court decision in Stringer v Copley (2002). This approach, sometimes called “the Stringer Cap”, required the receiving party to demonstrate that the MRO’s charges did not exceed the reasonable and proportionate cost of the work if it had been done by the instructing solicitors themselves. This necessitated a detailed breakdown distinguishing the expert’s fee from the MRO’s charges.

The second approach, advanced by the claimants and the MROs, argued that MRO fees should be treated as a disbursement and assessed for reasonableness in amount on a holistic basis, looking at the aggregate invoice. They contended that a retrospective, time-based breakdown was artificial and impossible as MROs do not record time like solicitors. Their model involved applying a percentage markup to the expert’s fee, calculated on a macro, business-wide basis rather than being specific to individual cases.

The court was therefore required to determine: (1) the correct characterisation of MRO fees (as outsourced solicitors’ work or a disbursement); (2) the appropriate legal test for assessing their reasonableness; (3) whether any elements of the fee (such as costs associated with deferred payment or write-off facilities) were irrecoverable as “funding costs”; and (4) if recoverable, how to quantify a reasonable fee.

The Parties’ Positions

The Defendants’ Position: The defendants, represented by Roger Mallalieu KC, argued that the court should follow the approach established in Stringer v Copley and affirmed in subsequent cases such as the Claims Direct Test Cases and CXR v Dome Holdings Ltd. They submitted that MRO fees were only recoverable if shown not to exceed the cost of a solicitor doing the work. This required a clear breakdown separating the expert’s fee from the MRO’s administrative charges. The defendants contended that the claimants had failed to provide sufficient evidence to satisfy this test. They also argued that elements of the MRO fee relating to deferred payment terms and write-off facilities constituted irrecoverable “funding costs” pursuant to the principle in Hunt v R.M. Douglas (Roofing) Ltd. In the absence of a breakdown to excise these irrecoverable elements, the entire MRO fee should be disallowed.

The Claimants’ and MROs’ Position: The claimants and the joined MROs (represented by Benjamin Williams KC, Robert Marven KC and Nicholas Bacon KC) contended that the Stringer approach was flawed. They argued that MRO fees were properly characterised as a disbursement, not outsourced profit costs. The correct test was simply whether the aggregate fee for the medical evidence (expert’s fee plus MRO charge) was reasonable and proportionate. They emphasised the valuable services provided by MROs, including maintaining expert databases, ensuring compliance, and managing administration efficiently. They denied that their commercial terms involved providing “funding”, arguing that deferred payment was an inherent part of the personal injury costs landscape, analogous to a solicitor’s retainer. They submitted that the fees were set by a competitive market and that the court should not engage in an artificial “deconstruction” of a globally priced service. In the absence of evidence from the defendants showing the fees were unreasonable, they should be allowed in full.

The Court’s Decision

Senior Costs Judge Rowley handed down a detailed judgment which departed from both parties’ primary submissions and established a new framework for assessing MRO fees. The significance of the decision lies in its rejection of both the defendants’ Stringer-based approach and the claimants’ holistic aggregate approach, crafting instead a novel percentage-based cap.

Characterisation and Legal Test: The judge held that MRO fees are a disbursement, not outsourced solicitors’ work. This was the fundamental legal holding that distinguished the judgment from previous approaches. Applying the test from Crane v Canons Leisure Centre, which focuses on the nature of the work done (whether it is solicitors’ work) and where responsibility for the work lies, the judge concluded that the work was not “solicitors’ work” in the requisite sense. The work done by MROs was described in Stringer as “administrative work”, which could be carried out by non-fee earning staff. Furthermore, once the expert was chosen, the MRO was left to organise matters until the report was provided, with responsibility for the report’s contents lying with the expert, not the solicitor. Consequently, the Stringer “cap” – requiring a comparison with a hypothetical solicitor’s cost – was not the correct legal test to apply. The court rejected the defendant’s argument that a quasi-solicitor breakdown was necessary because such a breakdown would be vulnerable to the challenge that the work was administrative rather than legal work in any event, and because the responsibility for the work did not lie with the solicitor in the manner described in Crane.

Recoverability of “Funding Costs”: The court rejected the defendant’s argument that deferred payment terms and write-off facilities rendered the fees irrecoverable. It found these were commercial features of the relationship between solicitors and MROs in a market where all participants typically waited for reimbursement until the end of a case. They did not constitute “funding costs” of the type prohibited by Hunt v Douglas Roofing. The judge’s reasoning was strengthened by a comparative analysis: he noted that experts who were instructed directly also effectively deferred payment, and solicitors operating under CFAs similarly delayed receipt of their fees. The purpose of the MRO terms was to provide medical evidence, not to provide credit, even though deferred payment was a byproduct of the agreement. This was entirely different from a disbursement loan from a bank or other litigation funder. The write-off facility was similarly a commercial element of the wider contractual relationship, not a separate service constituting funding. The judge emphasised that the MRO arrangement was consistent with the broader personal injury costs landscape, where staggered payment was an inherent feature affecting all participants.

Assessment of Reasonableness and Quantum: While rejecting the Stringer breakdown, the judge also rejected the claimants’ argument that the court could do no more than accept the aggregate fee as reasonable based on market competition. The evidence demonstrated that MROs applied a percentage markup to the expert’s fee – the judge accepted this evidence from the MROs themselves. Premex charged 35% or 45% for most evidence, and MAPS most commonly charged 53% but also 30%, with outliers ranging from 20% to 104%. However, the judge rejected the argument that these percentages were made reasonable by market competition or that they should be allowed in full between the parties.

The judge found the “tripartite tension” (where the payer is not the service chooser) meant market competition was an imperfect regulator of reasonableness between the parties. Those ultimately paying for the fees had no say in the competition between MROs. The judge also rejected the claimants’ assertion that MROs negotiated discounted rates with experts. The evidence, save for one expert (Professor Cosker) whose testimony the judge did not find convincing on this point, showed that expert fees were consistent regardless of whether instruction came via an MRO or directly from solicitors. In a market where the MRO placed a percentage markup on the expert’s fees, it would be self-defeating to seek to reduce the figure on which the markup would be applied. The MROs’ own evidence therefore showed that their fees inflated the experts’ fees by the percentage markups claimed.

The judge reached the 25% figure by applying a “cautious approach” based on several factors:

(i) limitations in the receiving parties’ evidence;

(ii) the lack of detailed cost analysis from the MROs demonstrating their cost base;

(iii) the tripartite tension which meant market competition was an imperfect regulator of reasonableness between the parties; and

(iv) the variation in percentages (ranging from 30% to 53% generally, with outliers beyond this) which reflected ongoing commercial relationships between solicitors and MROs rather than case-specific factors justifying different rates.

The 10% increase in Premex’s markup during the HLA case suggested later cases were making up for previous shortfalls rather than reflecting current case profitability.

On this basis, the judge held that a markup of 25% on the expert’s fee represented a reasonable amount recoverable between the parties. Any markup claimed below 25% would be allowed as claimed; any claimed above 25% would be reduced to that figure. Importantly, the judge held that this percentage should apply to the entire expert invoice, including disbursements such as expert travel costs, for reasons of simplicity and practicality. As the judge explained, “the percentage mark up is intended to achieve an overall sum” and allowing it only on certain elements would simply justify a higher percentage on those elements.

The judge concluded that this percentage-based approach provided a practical and fair method of quantification, avoiding the disproportionate cost of detailed deconstruction in every case while ensuring paying parties were not liable for unreasonable charges. He suggested that stating this maximum recoverable percentage on future invoices would assist transparency and contrasted this simple disclosure with the impractical “quasi-solicitors’ breakdown” that would not be workable in practice.

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JXX V ARCHIBALD II [2026] EWHC 630 (SCCO) | SENIOR COSTS JUDGE ROWLEY | INDEMNITY BASIS | CPR 44.2(6)(G) | STRINGER V COPLEY (2002) | PROSSER V BRITISH AIRWAYS PLC [2019] EWCA CIV 547 | CLAIMS DIRECT TEST CASES [2003] EWHC 9005 (COSTS) | CRANE V CANONS LEISURE CENTRE [2007] EWCA CIV 1352 | MEDICAL REPORTING ORGANISATION | MRO FEES | STRINGER CAP | REASONABLE AND PROPORTIONATE COSTS | DISBURSEMENT FUNDING | ATE INSURANCE | INDEMNITY COSTS CLAUSE | RECOVERABILITY OF MRO FEES | HUNT V R.M. DOUGLAS (ROOFING) LIMITED | OUTSOURCED SOLICITORS WORK | DEFERRED PAYMENT | WAIVE FACILITY | PREMIEX SERVICES LIMITED | EXAM WORKS UK LIMITED | LEGAL COST ASSESSMENT | MARKET COMPETITION IN MRO FEES | QUANTIFICATION OF MRO FEES | MEDICAL REPORTS IN PERSONAL INJURY CLAIMS | EXPERT DISCOUNT | AMRO’s APPLICATION FOR JOINDER | IMPACT ON MROs BUSINESS MODELS | JUDGE COOK | JUDGE HURST | FIXED COSTS ENVIRONMENT | STRINGER TEST | LIABILITY FOR EXPERTS’ FEES | THIRD PARTY LIABILITY | AD HOC REASONS FOR REDUCTIONS