The work of Dr Charles Galasko and colleagues [8] in this issue of the BCMJ outlines some of the claims rates in various parts of the world. However, a claims rate is difficult to estimate, partly due to different administrative processes in gathering such data; the costs of whiplash is an even greater puzzle, given many hidden costs and how to factor in the legal expenses. Given these provisos, there are some general statistics that may be of interest. The whiplash rate in various Western countries has varied so widely that a norm cannot be postulated; it has grown dramatically over the last 15 years, the period for which these data have been estimated. Overall, the rate of whiplash as a percentage of all other injuries in motor vehicle collisions hovers around 35% worldwide, but in BC it was about 70% before dropping recently to just under 60% (see the Table). (Lorne Halabisky, Insurance Corporation of British Columbia, oral and written communications, June and July 2001.)

In BC, the whiplash claims rate is currently about 900 per 100 000 population, twice the rate of the next highest known rate of a Western country (see the Table and Figure 1 [9]).[1]

It is possible that part of the high claims behavior in BC may be explained by the high legal costs (see Figure 2 [10]). Unfortunately, comparable costs in other jurisdictions are not known.

Competing interests

During the years about 1996 to 1999 Dr Allen received honoraria, fees for speaking, fees for organizing education, and reimbursement from the Physical Medicine Research Foundation (PMRF) for matters related to the British Columbia Whiplash Initiative. PMRF was funded by a research grant from the Insurance Corporation of BC. Dr Allen is no longer involved with PMRF or ICBC.

Table. Relative whiplash claims costs from the Insurance Corporation of British Columbia.

*estimated
Total per patient health costs are taken from the health insurance billings of the four licensed health professions in BC: medical represented an average of 24% of the health claims over 8 years, physiotherapy 46%, chiropractic 13%, and massage therapy 17%. Fees by plaintiff lawyers were conservatively estimated as being 35% of the gross payable claim cost based only on represented cases. Costs for disbursements by lawyers were not calculated in this estimate, but would tend to increase the lawyer’s net and reduce the claimant’s net. Conservatively, the claimant’s net has been further reduced by $1000 to account for possible unaccounted health costs.

Murray Allen, MD

Dr Allen is a senior fellow in Health Policy with The Fraser Institute in Vancouver. He was an associate professor of kinesiology at Simon Fraser University where he researched and published in the area of injury dynamics, including the dynamics of whiplash, and lectured internationally on this topic. He also conducts a private consulting clinical practice on injury management and rehabilitation, and conducted independent examinations for injury assessment. He chaired the Physical Medicine Research Foundation 1998 Banff International Symposium entitled Musculoskeletal Pain Emanating from the Head and Neck, and edited the published proceedings. He co-chaired the BC Whiplash Initiative and was principal content author for its syllabi. Dr Allen was co-chair of the Traffic Safety and Engineering section of the World Congress on Whiplash 1999 in Vancouver, and senior editor for the Congress publication on diagnosis and treatment of whiplash-associated disorders