Audit Factors Used To Reverse Undervaluation

THE INJURY CLAIM AUDIT Presents Evidence-Based Data in the correct language, format, and sequence to exchange the listed decision points, interface and input added valuation into an undervalued injury claim.

NOTE: A Threshold Neck injury is being overlooked up to 65% of the time. This injury cannot be seen by the human eye therefore requires special radiographic analysis to detect. We offer to analyze the images of the cervical flexion & extension x-rays to detect a hidden, overlooked Threshold Injury which adds tremendous valuation to the injury claim. This procedure is normally billed at $540 however is included in the audit at no additional cost. If interested, we’ll help you upload the x-ray images.

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drma report cover

This neck injury is overlooked 65% of the time and carries a very high settlement reserve.

The Revised Demand is designed to open the ‘WINDOWS’of the insurer's software so you do not lose the compensation for the decision points and payment associated with the injuries and 60 claim factors. The adjusters are required to input the decision points. Failure to do so is omission of data which is grounds for bad faith, and we rarely see them deliberately omit data rather, we see missing data which is one of the reasons for the audit.

demand letter

Revised demand contains between 26 & 48 sections, each that will translate into added settlement valuation

Ten-page Independent Medical Validation report observes authorities to establish the preponderance, win the greater weight of the evidence challenges and reverse undervaluation of an injury claim.

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Ten-page Independent Medical Validation report

Court Process wins the greater weight of the evidence challenges

The audit assesses the following 60 factors of the medical, administrative, legal and economic decision point factors of the injury claim to open the ‘WINDOWS’ of the insurers software so there is no loss of compensation for these decision points and payment associated with these factors.

  1. Medical, Administrative, Legal & Economic Decision Points 
  2. Value Drivers of the Injury Claim
  3. CASE Maximizers 
  4. Prolonged Modifiers 
  5. Standard Multipliers 
  6. Additional Increase Multipliers 
  7. Injury Severity Points 
  8. Liability Drivers 
  9. Property Damage 
  10. Income Loss 
  11. Case Costs & Expenses 
  12. Total of All Economic Losses 
  13. Evidentiary Conclusion 
  14. Mileage Drivers 
  15. Medical Expenses 
  16. Future Medical Expenses
  17. Undisputed Statements of Fact 
  18. Memorandum of Points 
  19. Evidentiary Burdens of Proof & Authorities 
  20. Medical History 
  21. Medical Office Records 
  22. Diagnostic Procedures   
  23. Hospital Records 
  24. Records from Client 
  25. Records from Other Sources 
  26. Explanations for Delay in Seeking Care 
  27. Explanations for Gaps in Treatment 
  28. Functional Physical Examination Review 
  29. Whole person Impairment Rating [25% value of claim] 
  30. Symptoms (Documented)
  1. Laboratory Tests 
  2. Special Tests  
  3. Diagnostic Procedures 
  4. Specialist’s Evaluation 
  5. Clinical Evaluation
  6. Diagnoses (P.I. requires double Digits) 
  7. Complaints – (intensity, frequency, type, radiation, further effects) 
  8. Duties Under Duress  [25% value of claim] 
  9. Loss of Enjoyment [25% value of claim] 
  10. Loss of Function Score 
  11. Treatment utilization & necessity
  12. Medical Determination of Future Treatment 
  13. Prognosis Overall 
  14. Prognosis Each Body Area 
  15. Referrals
  16. Prescriptions
  17. Future Treatment Plan 
  18. Number of Future Visits (On stable injuries) 
  19. Static VS Stable Injuries
  20. Future Treatment Duration and Timelines 
  21. MMI For Each Body Part 
  22. MMI Overall
  23. Evidence-based data to establish soft tissue injuries meet “Serious Injury Thresholds” 
  24. Diagnostic Related Estimate (DRE) Categories 
  25. Diagnosis Based Injury (DBI) Categories 
  26. Spine Impairment Summary 
  27. Specific Disorders of the Spine 
  28. Abbreviated Injury Scale
  29. Independent 3rd Party Medical Validation Letter
  30. New Settlement Demand Valuation