UK Medico-Legal & Insurance Services Market Report 2024

This is the eighth annual edition of a report analysing the Medico-Legal and Insurance Services (MLIS) market. MLIS are a range of medical and medical-related services offered to legal services companies, insurers and possibly to employers. For this reason, MLIS companies are often staffed and run by doctors, nurses and physiotherapists.

The range of services offered can be split into two broad categories:

• Medical evidence (ME)
• Rehabilitation and allied medical services (RAMS)

Report Scope

• The report estimates that the overall MLIS market, including payments to individual, freelance and self-employed medical experts and case managers, is estimated at £648 million in 2023. This is the second year of market value increases after slowdowns in 2022 and 2021.
• The market value is expected to grow more strongly in 2024 with a 4% increase. The increase in total personal injury claims registered in 2023/24 (excluding motor claims where numbers fell) will drive this growth and particularly the 10% increase in the volume of clinical negligence claims registered compared to the previous year.
• The MLIS market is populated by many small companies but these companies may still deal with thousands of medical reports and significant volumes of patients requiring treatment and rehabilitation services. This is because many MLIS companies use self-employed, freelance contractors as expert witnesses, case managers and treatment providers. The overwhelming majority of companies may be small but a few larger groups are increasing their share of the market, often through acquisitions.
• Until recently, i.e. the last two years, the provider population has been growing with barriers to entry for some suppliers such as expert witnesses and individual rehabilitation specialists relatively low. In the last two years there has been some reversal of this trend with some MROs and individual specialists exiting the market given a general decline in claims numbers (until the latest year) and weaker margins at the lower end of the claims market, i.e. margins for work on lower value claims.
• The number of users registered on Medco has been declining since its launch. In October 2024, there were 35 companies acting as MedCo medical reporting organisations (MRO)s decreasing from 37 in the previous year and 47 in June 2021. The number of medical experts registered on MedCo has decreased to 508 from 513 in October 2023 and from 583 in May 2022. Registered users on Medco slipped to 1,206 in October 2024 from 1,328 in October 2023.

This report looks at the market structure, recent developments and market drivers, the key players (18 are profiled), the market size and historical trends, and the future.