Thursday, 10 November 2011

The insurance industry might not like it, but whiplash is a genuine condition


Whiplash is controversial. On the one hand, there is the injured person – the individual suffering varying degrees of neck pain, usually as a consequence of his or her car being shunted in the rear. On the other, there is the insurance industry. From its vantage point on high – a long, impact-free way from the scene of the accident – it tends to lament the number of whiplash claims made by British citizens. In fact, it doesn’t always just lament them: if it had its way, some parts of the insurance industry would prefer whiplash to be clinically diagnosed as a wholly fabricated condition for which no compensation is ever payable.

Certainly, there are examples that some whiplash claimants exaggerate the extent of their suffering. It is also undeniable that whiplash claims represent a high number of motor accident claims. But before we jump on the bandwagon which is being piloted by the Association of British Insurers (ABI) – members of which have  started using software privately dubbed as a ‘whiplash lie detector test’ to expose what it believes are almost always bogus claims – we should pause and consider the latest thinking on the nature of pain.

I recently attended a presentation to the Association of Personal Injury Lawyers (APIL) by Dr Jannie van der Merwe, a consultant clinical psychologist who specialises in cognitive-behavioural therapy. Dr van der Merwe’s talk, on emotional responses to pain, was fascinating. Among many interesting observations – not least, that the brain of a person with chronic pain shows functional, structural and molecular findings which suggest that pain can be understood as a disease state – Dr van der Merwe tackled whiplash. Insurers won’t like what he said: namely that whiplash, albeit that it may not be accompanied by physiological evidence, is a tangible condition.

This contention was illustrated by some remarkable case studies of people who either should have been in terrible pain (for example, a street performer from Pakistan who habitually put knives through parts of his body, exhibiting no discernible pain) or should not have experienced any pain at all. In the latter category, there was a man whose boot had been pierced by a six-inch nail. Unsurprisingly, he exhibited the kind of pain that one would expect, were a nail to be driven through one’s foot. However, upon examination it was revealed that the nail had missed his foot entirely, travelling through the boot and between his toes. Nevertheless, the man’s experience of pain was real, his symptoms identical to those that would be expected had the nail pierced his foot.

I believe that we need to be cognisant of cutting-edge psychological research such as that presented by Dr van der Merwe. His findings show that even if physically verifiable trauma does not accompany whiplash, it is no less debilitating for its sufferer.

Instead, then, of devising a system whose very title betrays the insurance industry’s attitude to whiplash (viz, its ‘lie detector test’), the ABI would do well to halt its bandwagon and enter into a genuine debate about whiplash. For those at the sharp end, knowing that those to whom they pay their premiums treat their pain and suffering seriously, rather than with contempt, would be a source of some comfort – if not an end to the pain they are unfortunate enough to experience.