To the President at the Court of Appeal of Naples
prot.ca.napoli@giustiziacert.it
prot.ca.salerno@giustiziacert.it
presidente.ca.salerno@giustiziacert.it
President of the Court of Naples
presidente.tribunale.napoli@giustiziacert.it
President of the North Naples Court
presidente.tribunale.napolinord@giustiziacert.it
President of the Avellino Court
presidente.tribunale.avellino@giustiziacert.it
President of the Torre Annunziata Court
presidente.tribunale.torreannunziata@giustiziacert.it
President of the Benevento Court
presidente.tribunale.benevento@giustizia.it
President of the Nola Court
presidente.tribunale.nola@giustiziacert.it
A gray area that becomes an institutional problem
In the Italian civil trial there is a gray area that affects citizens' rights, on the costs of justice, on the insurance system, on public spending and on the very credibility of the Courts: it is the area of technical office consultancy on healthcare matters, medico-legal, social security and compensation. The issue is no longer just technical. It's institutional. Because when a judge appoints a consultant without the required qualifications, when a President of the Court does not verify the distribution of duties, when the CTU books remain opaque, when the certifying doctor also becomes an office consultant in the same territorial context, the problem no longer concerns the individual process. It concerns the legality of the entire system.
A structural anomaly already reported
And this is precisely the most serious point: we are not faced with an emerging critical issue, but to a structural anomaly that has already been reported for some time, subject of reports, exposed, requests for intervention remained essentially without outcome. A battle that has dragged on for years, in which the critical issues are known, documented and even recognized institutionally, but despite this the practice does not change. This inaction transforms a technical problem into an organizational responsibility, ultimately, in possible damage to the community.
The law exists, but it is not applied
The law, of the rest, leaves no room for misunderstanding. In civil and criminal proceedings concerning healthcare liability and personal injury, the judicial authority must entrust the consultancy to a doctor specialized in forensic medicine, supported by one or more specialists in the discipline concerned, equipped with specific and practical knowledge of the subject of the proceeding. Nevertheless, in practice, exactly the opposite happens. In many trials the expert witness is not the medical examiner; in other cases he is not supported by any specialist; in still others the consultant has a specialization completely unrelated to the pathology to be evaluated: the urologist evaluates cardiological issues, the cardiologist pronounces on orthopedic damage, the general practitioner is called upon to decide on complex disabilities, traumatic outcomes, neurological lesions, permanent damage and causal links.
It's not discretion: it is bad administration
This is not technical discretion. It is maladministration of justice. If the legislator has provided for the centrality of the medical examiner supported by the specialist, this means that the assessment of personal injury requires two different and complementary skills: the medical examiner for the assessment of the causal link and the legal framework of the damage, the specialist for clinical analysis. Separating these levels means destroying the quality of the assessment. Confusing them means turning the CTU into an act of faith.
Who really controls CTU?
At this point the question is no longer technical, but institutional: the appointing judge really controls? The President of the Court is truly vigilant? The books are updated, verified, selected and purified of incompatibilities and conflicts of interest? The rules attribute precise control powers, but in reality the nominations often appear concentrated on the same subjects, with a continuity that cannot be explained by competence alone. A para-institutional position income is thus created: the “usual” CTU, the reference consultant, the professional who knows the system and who the system knows.
The crisis of thirdness
The risk, at this point, it is no longer just the technical error. It is the loss of third party status. A CTU who operates permanently in the same district, who also carries out private activity, who appears as a certifier in the files, who maintains relationships with healthcare facilities, lawyers and workers in the compensation chain, it is no longer a third party. It's a cog in the system. And in this system, technical consultancy tends to lose its verification function to become a hub for confirming assessments already formed upstream.
The most ignored point: invoicing
It is precisely here that a further profile emerges, often ignored but decisive: the fiscal one. Medical certifications frequently appear in judicial files without adequate fiscal confirmation, health services not documented by invoice, opaque or incomplete clinical pathways. And yet the CTU, in most cases, does not carry out any checks on these aspects, limiting themselves to using that documentation as the basis of the assessment. Even more serious, in some cases a lack of traceability emerges even in the consultant's activity itself.
This means that the CTU can be based on documentation that is not economically transparent and, at the same time, help legitimize it. Fiscal control is not an external element to the process: it is an integral part of the verification of reliability of the damage. Ignoring it means altering the final result, legitimize possible irregularities and generate direct fiscal damage. Here's why, in the presence of deficiencies in the tax documentation, effective control should be activated through the acquisition of data at the Tax Registry and the initiation of appropriate checks.
The Medical Association: clear directions, but without implementation
In this context, the position of the Medical Association also takes on particular importance, which - also following formal reports and institutional discussions - expressed clear and acceptable principles on the subject of professional competence, ethical correctness and distinction of roles.
On some occasions, these positions have gone beyond the merely declarative level, explicitly recognizing the existence of critical issues in the system of technical consultancy in the medico-legal field, including profiles linked to the quality of the appraisals, the coherence of skills and the fiscal aspects of healthcare services. A commitment to training professionals was also highlighted, collaboration with judicial offices and the activation of disciplinary tools in cases of non-compliant conduct.
These are important indications, which demonstrate how the problem is also known at the order level and how it exists, at least on a theoretical level, a willingness to face it.
However, these interventions do not appear to have had a significant impact on operational practices. The critical issues reported continue to recur on a systematic basis: appointments often remain without an effective verification of skills, the profiles of incompatibility and conflict of interest are not adequately monitored and the anomalies, also of a fiscal nature, they do not find concrete confirmation in the control mechanisms.
The result is a clear gap between the level of statements of principle and the reality of application. A formal recognition of the problem that, in the absence of actual operational impacts, risks remaining without impact on the functioning of the system.
And this is precisely one of the most critical elements: awareness of distortions does not translate, to the state, in an effective ability to correct them.
The criminal profile ignored
Then there is a further extremely serious profile, which concerns the possible criminal relevance of the facts ascertained. In cases of serious or very serious personal injury, also in the field of road accidents, Pursuant to art. 590 to c.p, exceeding certain illness thresholds requires an evaluation of the transmission of the report and the possibility of committing a crime. Nevertheless, in practice, the expert witness limits himself to quantifying the damage without questioning the origin of the documentation, on the clinical coherence or criminal relevance of the circumstances that emerged. In the event of criminal relevance of the fact, Instead, the transmission of the documents to the public prosecutor would be mandatory, obligation which in practice is frequently disregarded, with consequent risk of failure to reveal criminally relevant facts, of failure to comply with the obligations required by law and of compromising the public interest in the repression of crimes.
A damage that becomes collective
The overall result is a system in which the CTU, as a guarantee instrument, becomes a factor of distortion. The damage is not just individual. It's collective. The insured pay for it through the increase in premiums, Justice pays for it through pathological litigation, The treasury pays it when services are not invoiced, distorted assessments and opaque mechanisms generate undue economic effects.
An ignored battle: no more reminders are enough
And at this point the most serious fact becomes the initial one again: all this has already been reported. The battle against these distortions has already been fought on the level of complaints, of those exposed, of institutional discussions. But nothing has changed. And when a system knows its flaws but doesn't correct them, it stops being inefficient and becomes structurally distorted.
For this reason, generic references are no longer sufficient. Immediate and verifiable interventions are needed: effective application of the obligation to appoint a medical examiner supported by a specialist; real control over the skills of the CTUs; concrete supervision of the Presidents of the Courts on the distribution of tasks; transparency and traceability of appointments; tax verification of health documentation and consultants' activities; mandatory declaration of conflicts of interest; transmission of documents to the public prosecutor in the presence of anomalies; concrete implementation of the indications of the professional associations.
Profiles of legal relevance, systematic conduct and opportunities for activation in the competent offices
The picture that emerges does not end in an organizational dysfunction or an isolated bad practice. On the contrary, presents elements of reiteration and systematicity such as to require an evaluation also in terms of the legal relevance of the conduct described.
In this context, is perceived in a concrete and current way the opportunity to evaluate the proposition of complaints to the competent authorities, where the absence of effective controls and the validation of untracked documentation have contributed to determining undue disbursements or distortions in the compensation system, with possible prejudice to the treasury and consequent compensationrelevance before the Court of Auditors. Similarly, failure to activate control or reporting powers, in the presence of symptomatic elements of irregularity or possible types of crime, as well as inertia in following up on reports already made, require reflection also from the point of view of evaluation by the criminal judicial authority.
These are profiles that, precisely because of their nature not occasional but structural, they cannot be further ignored or confined within the scope of the individual proceeding, but which make the need for verification in the institutionally responsible bodies concrete and no longer postponable, in order to ascertain any responsibilities and re-establish conditions of legality and transparency.
Civic commitment and the need for a collective reaction
In front of this painting, a concrete commitment is necessary, systematic and continuous to bring office technical consultancy back to its original function as an instrument of truth and guarantee. In this perspective, civic action takes on a central role: not only in soliciting regulatory and organizational interventions, but also in promoting transparency, widespread control and accountability of system operators. It is essential that these critical issues go beyond the dimension of individual files and become the object of public and institutional attention. Only through constant and documented pressure is it possible to influence practices that, despite being known, they continue to reproduce without effective corrective measures.
This is why the contribution of citizens is fundamental, of professionals and all those who have directly experienced similar situations. Report anomalies, document inconsistent assignments, highlighting deficiencies in competence or transparency is not just a right, but an act of protection of the collective interest. Individual experiences, if collected and systematized, can contribute to the emergence of a phenomenon that, otherwise, remains confined to the fragmentation of individual proceedings.
The objective is not to delegitimize the function of technical consultancy, but give it back credibility, independence and rigor. Because without a truly competent and impartial technical assessment, effective justice cannot exist.
The final question
The CTU is an instrument of justice only if it is independent, competent and controllable. Otherwise it becomes the place where technical error is transformed into procedural truth. And when that happens, It's not just the citizen who loses a case who is betrayed. The community is betrayed.
The final question is no longer technical. It's institutional: the Courts really want to control their expert witnesses?
Because if the law requires a forensic doctor and a specialist, if it imposes updated registers, if it imposes transparency, rotation and absence of conflicts, then every wrong nomination is not an oversight. It's a failure of the system.
And a system that does not control its auxiliaries ends up being controlled by them.
Reports and contributions
The critical issues described do not appear to be attributable to individual episodes, but they fit into a framework that requires systematic and documented reconstruction.
In this perspective, the contribution of citizens and professionals who have found anomalies in the technical consultancy - in terms of skills, of thirdness, of health documentation or tax regularity - can be decisive in bringing out distortions that would otherwise be fragmented in individual proceedings.
The collection and analysis of these elements could also constitute a useful basis for the evaluation of any initiatives in the competent bodies, including those of an administrative-accounting and criminal nature.Documented reports can be sent to the following email address:
📩 riccardodenuncia@gmail.com
