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MRO Fee Challenges in the UK: Legal Battles, Court Rulings, and Regulatory Pressure

Updated: 2 days ago

In recent years, Medical Reporting Organisations (MROs) have come under intense legal scrutiny over the fees they charge for arranging expert medical evidence in litigation. Insurers, defendant law firms, and NHS bodies are increasingly challenging the recoverability of these fees, often referred to as "agency charges", in a series of cost disputes across the UK. As a result, the issue of MRO fee challenges in the UK has become one of the most contentious in medico-legal practice today.


Today we will discuss the latest developments, landmark cases, regulatory commentary, and the evolving position of courts and stakeholders on this rapidly unfolding issue.


Why Are MRO Fees Being Challenged?


MROs typically act as intermediaries between solicitors and medical experts, arranging reports, handling logistics, and invoicing on behalf of experts. However, their fees are frequently structured as a composite sum including both expert and administrative charges which has drawn criticism from insurers who claim they are opaque and excessive.


Prominent insurer-led challenges include:



These cases highlight a broader concern: MRO fees often lack transparency, making it difficult for paying parties to assess whether the charges are reasonable or inflated.


The Turning Point: JXX v Archibald [2025] EWHC 69 (SCCO)

Statue of Lady Justice and gavel on a green desk, set in a dark, book-filled library with a leather sofa in the background.

In what is arguably the most influential judgment so far, Costs Judge Rowley ruled in JXX v Archibald that if a claimant refuses to disclose a breakdown of expert and agency fees, the entire composite fee should be assessed as if the MRO were not involved.


Key Takeaways from the Judgment:


  • Claimants must provide a full breakdown of the expert’s fee and the MRO’s charges.

  • Failure to do so could result in the entire fee being capped at the expert’s direct rate.

  • The court recognised the wider importance of this issue and left the door open for appellate guidance.


This judgment has since become persuasive authority in lower courts, even in the absence of a binding appellate ruling.


Court Decisions Driving the Trend Toward Transparency


Several other rulings reflect a growing judicial demand for fee transparency:



Together, these decisions underscore a clear trajectory: the courts are increasingly unwilling to allow unrevealed mark-ups.


Regulatory and Industry Reaction


Ministry of Justice (MoJ) - In its 2024 consultation response, the MoJ:


  • Acknowledged concerns over “unregulated administration agencies”.

  • Increased the fixed MedCo report fee.

  • Indicated it will consider mandatory fee breakdowns in the 2025 Fixed Recoverable Costs (FRC) review.


Industry Groups:



One notable example: SK Medical, a major MRO, exited the MedCo system in April 2025, blaming delays and recoverability issues.


Perspectives from the Legal Sector


Defendant Lawyers - Legal experts from DWF, Kennedys, and other defence firms have welcomed the trend. They argue that composite fees without transparency fuel “fee-farming” and should not be recoverable without justification. DWF's costs team noted that the JXX ruling provides a “practical framework” to resolve these disputes fairly.



How to Stay Informed on MRO Fee Challenges in the UK?


Key decisions are available via:



While some rulings remain at county court level, there is anticipation that a Court of Appeal decision could soon settle the debate definitively.


What Happens Next?


The current legal landscape is unsettled but shifting rapidly. While JXX v Archibald stands as the strongest statement to date, the profession awaits a higher court ruling to unify the approach. In the meantime MROs should prepare to disclose breakdowns of their fees and insurers will likely continue to challenge composite invoices, citing JXX as authority.


Regulatory developments (such as the FRC review) may further entrench requirements for transparency or even set hard fee caps. The Ministry of Justice has explicitly stated in its 2025 FRC review that it’s considering rules to mandate breakdowns or cap agency fees. The MoJ will likely announce by early-to-mid 2026 that breakdowns of MRO invoices will be required for recovery under fixed costs regimes or that maximum mark-up limits will be imposed (e.g. a flat fee cap or percentage of expert’s fee). This would parallel reforms already made to MedCo report fees and plug regulatory gaps that currently allow some MROs to operate without scrutiny.


Courts are now consistently siding with insurers in requiring itemised breakdowns of MRO invoices (separating expert fees from agency mark-ups). That trend will almost certainly continue. MROs that refuse to disclose breakdowns will face widespread disallowance of their full fees.


The High Court’s decision in JXX v Archibald has laid the groundwork for an appellate challenge. Both sides signalled a willingness to appeal and Costs Judge Rowley has even invited it. A case like JXX, or a similar one, will likely reach the Court of Appeal in late 2025 or early 2026, and that court may set a definitive precedent on:


  • Whether MRO mark-ups are recoverable

  • What level of disclosure is mandatory

  • And how to assess reasonableness without a breakdown


With fees under pressure and regulatory scrutiny increasing, small or less diversified MROs may find it uneconomical to operate, especially those that rely on deferred payment or bulk mark-ups. By 2026, we may see some MROs exiting the market (as already seen with SK Medical in 2025), a few merging or restructuring, and a smaller number of high-volume Tier 1 MROs dominating the space, possibly offering clearer, MedCo-compliant pricing models.


Law firms (especially claimant solicitors) may shift toward direct instruction of experts, bypassing MROs for straightforward reports (like GP assessments or physiotherapy), to avoid disputes over fees. We'll see more litigation support platforms or case management providers offering direct-to-expert directories or digital booking systems, challenging the traditional MRO model.


Conclusion


The MRO fee challenges in the UK are reshaping the costs landscape for personal injury and clinical negligence litigation. With courts demanding transparency, regulators hinting at reform, and stakeholders polarised, the coming year may prove decisive. Whether via judicial precedent or policy change, it’s clear that composite MRO fees without breakdowns are no longer safe from scrutiny.


The judiciary, especially via the High Court (JXX v Archibald), has made it clear that unless Medical Reporting Organisations (MROs) disclose how much they’re charging on top of expert fees, their invoices risk being slashed or struck out entirely. That signals a major realignment of the costs landscape.


With the Ministry of Justice and MedCo both acknowledging the issue in recent consultations, it’s only a matter of time before rules are implemented to mandate breakdowns or cap MRO fees outright. The legal environment is moving toward cost certainty and itemised billing, which aligns with broader reforms in fixed recoverable costs (FRC).


Many MROs have operated for years on opaque mark-up models—bundling expert fees, admin costs, deferred finance charges, and overheads into one unrevealed lump sum. That model is now under direct attack. Without adaptation, some MROs will become non-viable, especially as courts, regulators, and insurers demand greater accountability.


This isn't just a technical billing dispute—it’s a test of credibility for the MRO sector. The legal system is asking: “If your charges are fair and reasonable, why not be transparent about them?” In the absence of a good answer, the system will likely answer for them.


Get in touch with us at info@apexexperts.co.uk, call us on 0203 633 2213 or visit our contact us page.



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