How IOP reports are misinterpreted

Here is a list of phrases commonly found in IOP reports where the technical or legal interpretation differs from the industrial psychologist’s intention. While IOPs may assume that the actuary will rely on the overall context of their report, the court insists that actuaries should use source material literally to avoid influencing the claim.

All losses should be addressed via contingencies. Often, industrial psychologists specify losses in their reports (such as a lower career ceiling or loss of benefits), but conclude that all losses should be calculated by applying higher than normal contingencies. This implies that the injured earnings should be the same as the uninjured earnings in the calculation, and that a higher contingency deduction should be applied to the injured earnings to estimate the loss. Upon consultation, many industrial psychologists have stated that this is not the intention, but due to the wording in their report, the actuary is required by court to apply this interpretation literally. This results in the claim being undervalued.

The claimant might retire early. Since the wording does not signify that it is probable, the actuary will ignore this in the calculation. If a percentage chance was provided the actuary would use it.

The claimant will retire early. If this statement is provided without the age of early retirement, the actuary cannot include it in the calculation.

Should they lose their current employment they will remain unemployed. Since the probability of losing their job is not provided, the actuary will include the earnings until retirement age.

They were paid while off after the accident, and therefore did not suffer a past loss. Since the past period is calculated from the date of the accident to the date of the expert report, the past loss should include any potential losses, such as not progressing as stated in the uninjured state.

They would have reached their career ceiling at age 45, with 3-5 year intervals between Paterson levels. These are conflicting statements, since 3-5 year intervals do not necessarily result in a career ceiling at age 45.

The claimant will progress slower / to a lower career ceiling. Unless the age / lower career ceiling value is provided, the actuary will use the same career ceiling in the injured progression.

The claimant was off for X after the accident. Unless it is specified that the claimant was not paid, the actuary may assume they received sick leave pay, and suffered no loss.

The claimant can secure work in the future. Unless the date is specified, the actuary may assume they can secure work immediately. If the potential earnings are not specified, the actuary may assume the injured earnings will be the same as the uninjured earnings.

The claimant's earnings would have increased by CPI plus X%. The actuary will assume this means salary inflation only. If the industrial psychologist is suggesting that the claimant’s earnings will increase with real growth, it is best to suggest a career ceiling earnings and age.

The claimant received medical aid and provident fund contributions. Unless the value of fringe benefits are provided, they cannot be valued by the actuary, and the claim will be undervalued.

The claimant will earn in line with Paterson level X. Often the industrial psychologist will not specify which quartile or whether the basic salary or total package should be used. The assumptions that the actuary makes in these cases have a significant impact. 

The claimant is sympathetically employed. If the claimant is truly sympathetically employed, and thus adds no value to their employer, these earnings should be ignored (Santam Versekeringsmaatskappy BPK v Byleveldt). However, if it is a sympathetic employer, but the claimant is still working and adding some value to the employer, earnings should be considered. Industrial psychologists should therefore clarify what is meant by sympathetic earnings.

 

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