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Switching a Clinical Negligence case from legal aid to CFA/ATE insurance

legal aid

In switching a clinical negligence case from legal aid to CFA, the costs judgment in EPX v Milton Keynes University Hospital NHS Trust [2019] was an unhelpful decision for ATE insurance premium recovery. It is another win for the paying party – as the claimant lost the appeal against the Master’s initial ruling.

The High Court held that the burden of proof lay on the receiving party. It was noted that there was no evidence there was any informative communication as to the ‘swings and roundabouts’ of switching funding. There was also no evidence that the possibility of a lack of ATE insurance being available after April 2013 was ever taken into account.

Moreover, the solicitors had requested that the legal aid limit be increased; which suggested that, had funding been extended, the case could have been issued without recourse to a CFA/ATE insurance arrangement at the time it was entered into.

In addition, it was also found that obtaining quantum reports at the early stages of litigation without seeking LSC authority to do so ‘was done at their own risk’. The Master appeared correct to conclude that the solicitors were sufficiently experienced enough to have a ‘ball park figure’ for the value of the claim after medical evidence had been obtained. While it might not be unreasonable to obtain early quantum reports, it was also not unreasonable not to obtain them.

Currently we are in worrying times when it comes to switching funding from legal aid to a CFA with ATE insurance. With so many adverse decisions before us I firmly believe further and clearer guidance is needed from the judges. These rulings beg the question as to whether an ATE insurer will still be required to bear the claim had this case actually lost in its entirety? As the age-old saying goes, you cannot have your cake and eat it.

A couple of question for the lawyers out there:

1) Are you confident the advice you’re giving your client is enough?

The fact of the matter is that a client must be enabled to make fully informed decisions, particularly in circumstances where it is not a foregone conclusion that the recommended course of action is in the client’s best interests.

2) Have you informed your client that they are foregoing the 10% uplift?

This is a significant point and evidently comes at a cost to the solicitor if not – via the success fee and the ATE insurance premium.

This decision was, of course, fact specific; it does not necessarily follow that switching from legal aid to a CFA in other circumstances would not be perfectly reasonable.

As an ATE insurer ourselves, a big question is – will we insure these types of cases if the premiums cannot be recovered? Broadly speaking it has to be a no. Surely something has to change?

If you have a view on this, please do get in touch to share your thoughts. You can reach me via email to or a call to 01483 514804. I look forward to hearing from you.

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Matthew Best

Senior Underwriting Manager
Read articles by Matthew Best

Matthew Best

Matt has an insurance background and joined Temple in July 2011 having worked for 4 years in a leading insurance company where he was dealing with personal injury work.

Matt’s experience allows him to undertake a key role in Temple’s ATE insurance personal injury and clinical negligence teams. He also participates in the assessments of delegated schemes that Temple provide with the objective of helping our customers make the most beneficial and appropriate use of ATE insurance.

He has started studying for this CII exams which he will sit in the near future, which he will then use to develop himself, further into the company in order to provide Temple’s customers with the excellent service they expect.


Read articles by Matthew Best