title: The relationship between insurance claim closure and recovery after traffic injuries for individuals with whiplash associated disorders.
abstract: The purpose of this study was to determine if time to claim closure was similar to time to self-reported recovery in a no fault motor vehicle collision insurance system.
  
  
  
  A prospective cohort of traffic injured adults with a whiplash-associated disorder (WAD) was assembled. We excluded participants who applied for benefits after 42 days of the collision, who were in hospital for more than two days and participants who were not followed up at least once after their injury. Questionnaires were completed at baseline, six weeks, three-, six-, nine- and 12-months after the collision.
  
  
  
  The mean age of the cohort was 39 years and 66% were female. The mean number of days until claim closure and for self-reported recovery was 291days and 134 days, respectively. We found those who had their claim closed at each follow-up period had lower levels of disability and were more likely to report they were recovered than participants with open claims.
  
  
  
  We conclude that time to claim closure could be used as an outcome measure in traffic collision; however, this measure should be used with caution since it over-estimates the true time to recovery. Implications for Rehabilitation Time to claim closure as an outcome measure for whiplash-associated disorders has been criticized in the literature because it is thought that closure is not reflective of the health status of the individual. We found that claim closure was associated with lower levels of disability, but the time to claim closure was significantly longer than the time to self-reported recovery. Time to claim closure may be used with caution as a "proxy" measure of recovery from an injury; however, it must be noted that it over-estimates the true time of recovery.
authors.affiliation: a Department of Sports Science and Clinical Biomechanics , University of Southern Denmark , Odense , Denmark.|b Dalla Lana School of Public Health , University of Toronto , Toronto , Canada.
authors.forename: Eleanor
authors.initials: E
authors.lastname: Boyle
authors.affiliation: a Department of Sports Science and Clinical Biomechanics , University of Southern Denmark , Odense , Denmark.|b Dalla Lana School of Public Health , University of Toronto , Toronto , Canada.|c Krembil Research Institute, University Health Network , Toronto , Canada.
authors.forename: J David
authors.initials: JD
authors.lastname: Cassidy
authors.affiliation: b Dalla Lana School of Public Health , University of Toronto , Toronto , Canada.|d Faculty of Health Sciences , University of Ontario Institute of Technology (UOIT) , Oshawa , Canada.|e UOIT-CMCC Centre for the Study of Disability Prevention and Rehabilitation , Toronto , Canada.
authors.forename: Pierre
authors.initials: P
authors.lastname: Côté
authors.affiliation: f School of Public Health and Injury Prevention Centre, University of Alberta , Edmonton , Canada.
authors.forename: Linda J
authors.initials: LJ
authors.lastname: Carroll
mesh_terms: D000063:Accidents, Traffic / Q000191:economics*; D000328:Adult; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D011446:Prospective Studies; D012525:Saskatchewan; D011795:Surveys and Questionnaires; D014911:Whiplash Injuries / Q000191:economics*
keywords: Claim closure; injury; insurance; recovery; whiplash-associated disorders