Marie M. Bismark, M.B., Ch.B., L.L.B., M.B.H.L., Troyen A. Brennan, M.D., J.D., M.P.H., Peter B. Davis, Ph.D., and David M. Studdert, L.L.B., Sc.D., M.P.H.
M. M. Bismark, T. A. Brennan, P. B. Davis et al., "Claiming Behaviour in a No-Fault System of Medical Injury: A Descriptive Analysis of Claimants and Non-Claimants," Medical Journal of Australia, Aug. 2006 185(4):203–7.
Most patients who sustain an injury as a result of negligent care never sue. Elderly, poor, or uninsured patients are especially unlikely to sue—perhaps because of the costs of negligence-based systems and the prevailing secrecy among health care providers. No-fault compensation systems, such as New Zealand's, may provide more rapid and equitable access to compensation than negligence-based systems, but there is little empirical evidence of this.
The authors of this Commonwealth Fund–supported study determined the proportion of New Zealand patients who claim compensation from the no-fault system after injury and identified the characteristics of insured patients least likely to file a claim. They found that:
"Despite few apparent institutional or economic barriers," the authors say, "the proportion of injured patients [in New Zealand] who seek compensation after sustaining a compensable injury is very low. Hence, substantial underclaiming occurs in both negligence and non-fault systems." Elderly, poor, and minority patients are less likely to file claims in both types of compensation systems.