This article is general information, not medical or legal advice.
When a personal injury or clinical negligence claim needs medical evidence, the solicitor usually needs a report from an independent medical expert. A medical reporting organisation, often shortened to MRO, sits between the solicitor, the claimant and the expert. It finds a suitable expert, gathers what the expert needs, arranges any appointment, checks the finished report and delivers it. This article explains how that works in practice, and what a firm might ask before it chooses one.
What a medical reporting organisation does
An MRO does not write medical opinions. It manages the work around them. The opinion in a medico-legal report always belongs to the independent expert who examines the claimant or reviews the records and signs the report. The MRO’s job is to make sure that expert has the right instruction, the right records and the right appointment, and that the solicitor receives a complete report and can ask follow-up questions.
For solicitors, using an MRO means one point of contact for the medical evidence on a case, rather than finding and chasing experts directly. For experts, it means someone else handles the administration, so they can concentrate on the clinical work and the report.
The steps from instruction to report
Instruction
The solicitor sends a letter of instruction. This sets out the claim, the type of report needed and the questions the expert should answer. The MRO checks that the instruction is complete, that the documents the claim type needs are there, and that there is no conflict of interest, before it instructs a suitably qualified expert. The expert confirms that they, too, have no conflict.
Records
Most medico-legal reports depend on medical records, such as GP notes, hospital records or occupational health files. The solicitor usually obtains these, and the MRO makes sure they reach the expert in a usable form. Records that are sorted, paginated (given page numbers) and indexed are much quicker for an expert to work through and to refer to in the report.
Appointments
Where the expert needs to see the claimant, the MRO arranges the appointment, sends reminders and deals with any change of plan. Some reports can be prepared from the records alone, without an examination.
The report and quality checks
The expert writes the report. Before it goes to the solicitor, a good MRO checks it for completeness and accuracy: are the questions in the letter of instruction answered, are the statements the court rules require present, and are names, dates and the list of records seen consistent? These checks look at the report’s form, not its medical conclusions. If something is missing, the MRO goes back to the expert, who decides how to deal with it.
Part 35 questions
Once the report has been served, the other side can put written questions to the expert to clarify it. These are known as Part 35 questions, after the part of the Civil Procedure Rules that allows them, and they must be sent within the time limit in CPR 35.6. The MRO passes the questions to the expert, tracks the deadline and returns the answers, which then form part of the report. For more on this, see our further evidence reports, including Part 35 questions and addendum reports.
Independence and the expert’s duty to the court
A medico-legal expert’s overriding duty is to help the court on matters within their expertise. Under Part 35 of the Civil Procedure Rules, that duty overrides any obligation to whoever instructs or pays them. So although the solicitor instructs the MRO, and the MRO instructs the expert, the expert’s opinion must be their own, given honestly and without pressure from anyone.
That is why independence matters at every level. An MRO should never alter an expert’s conclusions or steer them towards a particular answer. Probita is independent: we work for any instructing firm, with ties to none, and we pay and receive no referral fees. Probita itself gives no medical opinion; the opinion in every report is the instructed expert’s own.
MedCo and lower-value road traffic claims
MedCo is the system used to source initial medical reports in lower-value road traffic claims for whiplash and other soft tissue injuries (injuries to muscles, ligaments and tendons rather than bones). In those claims, solicitors must use the MedCo system, which offers a choice of medical experts or MROs that are registered with MedCo and meet its requirements. The solicitor then chooses from that list. You can read more on the MedCo website.
MedCo does not cover every road traffic claim, and it does not cover employer’s liability, public liability, clinical negligence or industrial disease claims. Probita is not a MedCo-accredited medical reporting organisation, so we do not take initial reports in lower-value road traffic whiplash claims that must be sourced through MedCo. We arrange personal injury reports for claims outside MedCo, and other types of report such as clinical negligence reports.
How to choose a medical reporting organisation
Every firm’s needs are different, but these are questions a firm might reasonably ask before it decides to instruct a medical expert through a particular MRO:
- Independence. Does it pay or receive referral fees? Does it have ties to any one firm or insurer? How does it make sure the expert’s opinion is never influenced?
- Experts. How does it check an expert’s registration with their regulator, indemnity insurance and training in the duties of an expert witness? Does it have experts in the specialties your cases need?
- Conflicts. How does it check for conflicts of interest, for both the organisation and the expert?
- Records. Who obtains the medical records, and how are they prepared for the expert? Is records review included, or charged separately?
- Quality checks. What does it check before a report is released, and what happens if something is missing?
- Visibility. Can you see where each case stands without phoning or emailing to ask?
- Part 35 questions. How are questions sent to the expert, and how is the deadline tracked?
- Security and data protection. Where is case data held, who can see it, and how are reports delivered? Can it provide data processing terms?
- Fees. Is the fee clear, and what does it include?
It is also worth asking which types of claim the MRO handles, from industrial disease to multi-track and complex injury, and how it manages cases that need experts from more than one specialty.
How Probita works
Probita Medical is an independent medical reporting organisation. Law firms instruct us online, we instruct a suitably qualified independent expert, and we manage each case through to the final report on our own secure case-management platform. Records are sorted, paginated and indexed for the expert, with a chronology and summary that the expert checks against the records themselves. Every report is checked against its claim type’s checklist before release, and Part 35 questions are raised and tracked in the same place. You can read more about how law firms instruct Probita, or, if you are an expert, about joining our panel of medical experts.