Being involved in a compensation process is associated with higher mental health complaints but three-quarters of the difference appeared to be already present at baseline. The findings of this study should be interpreted with caution because of the limited quality of evidence. The difference at baseline may be explained by a selection bias or more anger and blame about the accident in the compensation group. The difference between baseline and follow-up may be explained by secondary gain and secondary victimisation. Future research should involve assessment of exposure to compensation processes, should analyse and correct for baseline differences, and could examine the effect of time, compensation scheme design, and claim settlement on (mental) health.

BackgroundMotor vehicle crashes (MVC) are associated with diminished mental health, and furthermore, evidence suggests the process of claiming compensation following an MVC further increases distress and impedes recovery. However, further research is required on why the compensation process is stressful. The aim of the current study is twofold. The first is to investigate whether the interaction with the insurance agency is associated with anxiety. The second is to explore qualitatively aspects of dissatisfaction with the compensation process.MethodsParticipants (N = 417) were injured people involved in a compensation scheme after a motor vehicle crash (MVC) in New South Wales, Australia. Interviews were conducted by phone at 2, 12 and 24 months after the MVC. A suite of measures were used including compensation related measures, pain catastrophising and the anxiety/depressed mood subscale of the EuroQol. The association between predictors and anxiety/depressed mood as the dependent variable were analysed using forward logistic regression analyses. The comments about dissatisfaction with the insurance company were analysed qualitatively.ResultsThe strongest predictor of mood status found was pain-related catastrophising, followed by dissatisfaction with the insurance company. Dissatisfaction was attributed to (1) lack of communication and lack of information, (2) delayed or denied payments of compensation, (3) slow treatment approval and discussions about causality, (4) too much complicated paperwork, and (5) discussions about who was at-fault.ConclusionsFactors were found that contribute to anxiety in the compensation process. The association between catastrophising and anxiety/depressive mood suggests it is worthwhile further investigating the role of negative cognitions in compensation processes. People who score highly on catastrophising after the MVC may benefit from early psychological interventions aiming at addressing negative cognitions. Another important stressor is the interaction with the insurance company. Stress is associated with problems of communication, medical treatment, and claim settlement. This study additionally draws attention to some under recognised problems such as delayed payments. Pro-active claims management could address some of the identified issues, which could improve health of injured people after a MVC.

The finding that the interaction with insurance companies was considered less fair than the interaction with lawyers may imply that insurers could improve their interaction with claimants, e.g. by communicating more directly. The result that claimants with mild injuries and with trunk/back injuries considered the compensation process to be less fair than those with respectively severe injuries and injuries to other body parts suggests that especially the former two require an attentive treatment. Finally, the fact that procedural justice was positively correlated with quality of life could implicate that it is possible to improve claimants' health in compensation processes by enhancing procedural justice, e.g. by increasing the ability for claimants to express their views and feelings and by involving claimants in the decision-making process.

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Legal systems differ markedly on how they treat the emotional harm suffered by close family members of crime or accident victims. This paper reports the results of two empirical studies examining how citizens whose child, partner, or parent was killed or seriously injured as a result of violent crime or tort (secondary victims) perceive a monetary award for their own non-economic harm relating to the death or injury of their loved one. The objective of our research was to test the Dutch legislator’s assumption that a (modest) monetary award for secondary victims’ emotional harm can have a meaningful symbolic value by providing recognition and satisfaction. Until then, no compensation was available for such harm under Dutch law. In addition, we examined whether victims’ relatives preferred standardization or individuation in determining the amount of the award, how they evaluated the amount, and the manner in which such awards might be offered. In a first quantitative survey study conducted in the Netherlands, 726 secondary victims were asked for their evaluations of such awards for the emotional harm they suffered as a result of the death or injury of their family member. We also asked our representative sample about their actual experience of the legal process in order to put their evaluations of such awards into context. In a second qualitative study, conducted in Belgium, interviews were held with 14 secondary victims who had actually received an award for their own emotional harm under Belgian law (study 2). Results suggest that secondary victims regard an award for emotional harm as a positive gesture and may interpret it as helping to satisfy relatives’ psychological concerns by seeing it, for example, as an acknowledgment of loss and responsibility. Overall findings suggest that victims’ relatives may be seeking acknowledgement of their emotional losses and the norm violation.