Medico-legal market remains strong despite MedCo decline

Researchers have raised their estimate for the value of the UK’s medico-legal market in 2024 to £677m, an increase of 4.5% on the previous year.

Meanwhile, there was a fall in the number of medical reporting organisations (MROs) registered at MedCo from 35 in October last year to only 32 in July 2025, while the number of registered experts fell from 508 to 408 in the same period.

Although the medico-legal market increased in value from £648m in 2023 to £677m in 2024, more than last year’s report had anticipated, this was still a long way from its peak of £791m in 2019 before the pandemic, which triggered a dramatic fall in value to a low point of £618m in 2021.

IRN Legal Reports predicted that market value would grow “at a slightly slower pace in 2025” to reach £704m, or an increase of 4%, before growing at a higher rate of up to 5% in the next three years.

The number of companies registered as MedCo users continued its decline – from 120 in 2017, there are now 32 and we reported in April that there were now just nine tier 1 MROs after SK Medical Practice resigned from the system citing payment delays among other issues.

IRN said MROs had been leaving “due to the difficulty of passing the tight criteria required to be a MedCo company (although MedCo has recently eased some of these), delays in payment, and the fees required”.

MedCo increased its annual registration fee this year for tier 1 providers from £90,000 to £112,500 and tier 2 providers from £12,000 to £15,000.

Medical experts saw no increase in their fixed fees for over a decade until April 2025, and “as business costs have increased, margins for many have been weak”. However, most of the larger players in the market saw improved profit growth in 2024.

In its report on the UK Medico-legal and Insurance Services Market 2025, IRN said “While the sector is still populated by numerous small businesses, most of the leading players are consolidating their position through acquisitions and service expansion with market concentration increasing.”

The total number of claims registered at the Compensation Recovery Unit (CRU) declined again in the year 2024/25 to just under 448,000 from over 477,000 a year earlier – a fall of more than half in the lats decade.

Claims registered decreased in most categories, except clinical negligence and public liability claims. Clinical negligence claims grew, by 3.5% to 16,395 in 2024/25, but at a slower rate than the increase of almost 10% in the previous year.

Total settlements recorded by the CRU decreased to 508,160 in 2024/25, from over 548,800 a year before. However, the value of compensation recovered reached £166m, an 18% increase on the previous year.

Looking to the future, IRN said “many of the larger players” had invested in technology to create cost efficiencies. Although margins were likely to remain tight particularly for the smaller providers, the leading players could benefit from economies of scale.

“The increase in fees for medical reports will help but there will still be providers facing poor returns and the larger players are expected to continue to purchase weaker players.

Artificial intelligence would be used in more services “not just for automating routine tasks but in other areas, for example predicting patient outcomes, personalising treatment plans. The larger providers are likely to be at the forefront of AI use”, the report added.