A medical reporting organisation, often shortened to MRO, is a business that arranges and administers medico-legal reports by coordinating instructions, appointments, records, expert allocation, report production and follow-up questions between the instructing party, the claimant and the independent medical expert. In personal injury work, a medical reporting organisation helps solicitors and insurers obtain medical evidence while keeping the expert's opinion separate from the administration around it.
In plain terms, an MRO medico-legal service is the organising layer around the medical expert. The MRO does not examine the claimant, diagnose injury, decide causation or give the opinion in the medical legal report. That work belongs to the expert who signs the report.
What does an MRO actually do?
An MRO administers the medico-legal reporting process from instruction to report delivery. Its role usually starts by receiving instructions, checking that the required information is present, identifying the relevant medical discipline, checking conflicts and arranging an appointment with a suitable expert.
The work can include obtaining or collating medical records, sending documents to the expert, confirming claimant identity requirements, managing cancellations, chasing outstanding material, formatting the report, running non-clinical quality checks, issuing invoices and keeping a clear audit trail. Where appropriate, the MRO also coordinates addendum reports and answers to written questions under CPR Part 35.
For MedCo work, the Ministry of Justice qualifying criteria define an MRO as an organisation whose principal function is medico-legal reporting services, which is independent, properly staffed and resourced, and directly and solely responsible for all work associated with receiving instructions via the MedCo portal and instructing a medical expert to provide the initial medical report.
How does an MRO differ from the medical expert?
An MRO is the organiser of the instruction, while the medical expert is the person who gives the opinion. CPR 35.2 defines an expert as a person instructed to give or prepare expert evidence for proceedings, and a single joint expert is also an expert, not an organisation.
This distinction matters. An MRO can arrange and administer an expert instruction, including a single joint expert instruction where the parties or the court require one. It can coordinate questions, records and report logistics. It cannot be the expert, be the single joint expert or adopt the expert's professional opinion as its own.
The expert's duty is to the court. CPR 35.3 says experts must help the court on matters within their expertise, and that this duty overrides any obligation to the person instructing or paying them. Practice Direction 35 requires the report to be the independent product of the expert and to include the expert's own statement of that duty. MedCo has also stated, in its guidance on the quality of medical reports, that the duty is the expert's alone and cannot be passed on to the MRO or instructing solicitor. An MRO may check process, clarity and completeness, but the expert must check and sign the medico-legal report as their own professional opinion.
Where does MedCo fit, and where does it not?
MedCo fits where the rules require the first fixed-cost RTA medical report to be sourced through the MedCo system. MedCo is used for relevant low value road traffic accident injury claims in England and Wales, including soft-tissue and whiplash claims, under the Low Value RTA Pre-Action Protocol and the RTA Small Claims Protocol.
The MedCo process is not a free choice of any preferred provider for the first report. MedCo says the authorised user searches for either an accredited Direct Medical Expert or an audited Medical Reporting Organisation, and the system returns a random but fair offer from which a selection is made. For represented claims, the offer in force since 6 April 2025 is eight MROs, made up of two Tier 1 and six Tier 2, where the user searches for an MRO, or seven DMEs where the user searches for a Direct Medical Expert.
A MedCo registered MRO is therefore an MRO that is registered and audited for that MedCo work. MedCo publishes the current list of operational MROs, and records which of them hold Tier 1 status. Expert Medical Examination Ltd is a MedCo registered MRO and is not a Tier 1 provider.
Many types of medico-legal instruction sit outside MedCo. Clinical negligence, workplace injury, public liability, industrial disease and other report types are normally instructed directly, subject to the relevant court rules, directions, protocols and the terms of the instruction.
How are experts matched to a case?
Experts are matched to a case by discipline, suitability, location, availability, independence and the issues the report must address. The starting point is the medical question, such as orthopaedics, general practice, physiotherapy, psychology, dental injury or another relevant field. Our specialist reports page sets out the disciplines we cover.
The expert should be registered with the relevant UK professional regulator, such as the GMC or HCPC, and must have suitable expertise for the issues in dispute. In a MedCo case, the expert must also have the MedCo status required for that work. In a non-MedCo case, the MRO should still check professional registration, conflicts, records needed, appointment arrangements and whether the expert can answer the questions asked.
Matching is not the same as steering the opinion. The MRO may select an expert with the right discipline and availability, but the diagnosis, prognosis, causation opinion and any comment on treatment or records must remain the expert's own work.
What does an MRO not do?
An MRO does not give legal advice, medical treatment or expert evidence in its own name. It should not advise on limitation, funding, Part 36, settlement strategy, liability, valuation or the amount of compensation.
An MRO also does not decide whether a report will be admitted as evidence. CPR 35.4 says a party may not call an expert or put an expert's report in evidence without the court's permission. A report may be prepared in accordance with CPR Part 35 and Practice Direction 35, but permission to rely on expert evidence remains a matter for the court.
An MRO should not promise that a report will be accepted, error-free or decisive. Its proper role is to manage the reporting process, preserve independence, keep records moving and make sure the expert has what they need to prepare their own opinion.
Why would a solicitor or insurer instruct an MRO rather than an expert directly?
A solicitor or insurer may instruct an MRO to reduce the administrative burden of obtaining medical evidence. One instruction can involve appointment booking, claimant communications, record handling, expert selection, report chasing, amendments, invoices and Part 35 questions.
Direct instruction of an expert can be suitable where the instructing party already knows the right expert and wants to manage every step itself. An MRO is useful where the case needs a managed process, a documented audit trail, access to different disciplines or a single administrative point of contact between the parties and the expert.
For insurers and solicitors handling repeat medical evidence work, the practical value is control of process rather than control of opinion. The expert remains independent. The MRO keeps the instruction organised. Our guide to medico-legal report costs sets out how fees usually work outside MedCo.
How do you instruct an MRO?
You instruct an MRO by first deciding whether the case is a MedCo case or a direct instruction. For a MedCo first report, the authorised user should use MedCo search and selection, choose whether to search for an MRO or a Direct Medical Expert, select from the offer returned by MedCo and send instructions with the MedCo reference.
For work outside MedCo, the instructing party can contact the MRO directly with the claimant details, accident or incident summary, alleged injuries, medical discipline required, questions for the expert, relevant records, court directions if any and any deadline. The MRO can then confirm whether it can arrange a suitable expert and what further material is needed.
In short, a medical reporting organisation exists to make the medico-legal report process orderly, traceable and independent from the expert's opinion. A compliant MRO is clear about that boundary: it manages the instruction, but the expert owns the evidence.
Contact Expert Medical Examination
To instruct Expert Medical Examination, or to discuss a case, visit www.expertmedical.co.uk, call 0203 8233 222 or email info@expertmedical.co.uk.