CASE Audit Settlement Evaluation
e-book

NOTICE TO ATTORNEYS:

I am a contributing author and trained Auditor whose sole purpose is to assist in the reversal of unfair, undervaluation of injury claims.

I am a member of a select group of chiropractic doctors trained as an Auditor and Knowledgeable Observer to independently audit and provide medical validation when it is believed there is an undervaluation of an injury claim with inadequate explanation of the legal and factual basis for so low a valuation. The independent audit is for the correction of any omissions or misstatements of the claim by either the claimant or defense or rebut the engagement of any “Unfair Claim Settlement Practice Acts” or violations of the “Ethics Codes of the Adjuster” that result in unfair, undervaluation of an injury claim.

I am available to audit, consult and provide data to assist plaintiffs' attorneys in the benefits of P.I. Claim Audits to reverse low ball injury claims. I offer free subscriptions to: eBulletin series, eBook, Audit Report, Audit Brochure, Audit Magazine and CLE Accreditation.

I can provide the most thorough education presentation with CLE credits available for Ethics, via screen share or "meet & greet" presentation.

Free Audit
Michelle Trumps, D.C.

Michelle Trumps, D.C.

(504) 915-9155 • CASE.Audit.Trumps@gmail.com

3925 N. I-10 Service Rd. W., Ste. 224, Metairie , LA 70002

The Medical Records Are the Insurance Company’s Primary Source of Data Which They Use to Determine Settlement Valuation. One of the Single Most Important Considerations That Determine Settlement Valuation is derived from “Value Drivers” and "Decision Points" that Insurance Companies Use to Determine the range of worth of an injury claim. There Are 26 Value Driver sections, and 67,880 decision points. The insurance companies refuse to release their decision points to the public making it difficult to navigate the claim. The audit however, contains a search engine to detect overlooked value drivers and decision points and exchange them in the correct language, format and sequence to interface and input added valuation into the injury claim, and reverse claims that have been undervalued.

We engage a proprietary softwarein our audit process to make the same medical determinations as the insurer's software's. Using ambient intelligence technology, our software features a rare Computer Aided Decision-making functionality (CAD) and Decision Support System (DSS). This ability is no match for the human mind and this technology advancement is a key component of our ability to reverse undervaluation's on injury claims.

As an auditor and 'Knowledgeable Observer', we apply MECE standards to our audits. MECE = Mutually Exclusive / Collectively Exhaustive. This essentially means that we are mutually exclusive as an injury claim auditor and exhaust all methods to audit 26 sections and 60 factors on each claim in order to reverse undervaluations of injury claims.

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Expert, unique skills for Injury CASE Audits and a keen eye for detail and clarity have been cultivated by many years of clinical experience. Professionally striving for excellence with a passion for service in unique and mutually rewarding ways.

Statement of Purpose

We care. We care about your image and how the quality of our work reflects to your practice as well as ours. We care about the people you are charged to represent.

Our office is local and I work directly with your office. We expect you to receive the best settlement possible for your case.

These are the thoughts we want our customers to associate with our service: 1st Class Service ~ Fast - Professional and Friendly ~ Cutting edge technology Delivers exceptional value ~ Services exceed expectation ~ Amazing Results

Injury Claim Audit Services

An Audit Refines your client's Diagnoses by thorough record integration. A 3rd Party Independent Medical Validation (IMV) is included in our fee to validate the Audit. An IMV provides Statements of Fact and Appropriate Declarations, Memoranda, Exhibits and Animations when indicated. We Provide Your Report in the Required Table Format of the AMA Guide's 5th Edition. This can improve Medical Value of the Injury Claim by 25%.

Our job is to provide details about injuries that optimize payment for the case. Audits:

  1. Identify and label any of the Decision Points that exist but have not been included in the claim. (Each carries added value in the insurers’ payment formula.)
  2. Ensure that every medical test has been performed that can document the proof of your client's injury experience.
  3. Address pre-existing conditions, 2nd accidents that complicate the case, gaps and interruption in care.
  4. Itemize Medical diagnoses, treatment, referrals, degree of stabilization of condition, future care and prognosis
  5. Provide MMI for each body part, % Impairment Rating, and % Whole Body Impairment.
  6. Overcome an IME and win the “Greater Weight of Evidence Challenges” by Providing a 2nd Opinion of our work. An Independent Medical Validation (IMV) of our Determinations are included in every Audit.
  7. Provide a comprehensive report including tables, exhibits and animations that validate the extent of the injuries and provide Whole Person Impairment Rating (WPI).
  8. Provide a comprehensive settlement package for your case with 26 sections using language and the format that compels the Adjuster to pay.
  9. Provide a Comprehensive Rebuttal. All 48 Ethics Codes of the Adjuster and the Unfair Claim Settlement Practice Acts are built into our software to counter any attempt by the Payor to Unfairly Treat your Claim.
  10. Include Statements of Fact and Declarations that Compel equitable settlement evaluation and discourage dispute, denial, discount and omission of value drivers of the claim.


Audits Uncover Evidence of Threshold Injuries which are often discounted as "soft tissue injuries" and routinely excluded in claims such as:

  • AOMSI - 25% Whole Body Impairment and $66k value to any case with this Threshold Injury
  • Uncinate Process Fracture - Delayed appearance on special x-ray following Rollover or T-Bone Injuries
  • TBI - Including Blood-Flow Loss to the Brain by Partial Muscular Occlusion of at least one Vertebral Artery
  • Accident Related Disorders - Stress Anxiety Fear Avoidance Driving Depression and Sleep Disorders

Answer any unreasonable settlement offer or any other attempt to diminish the value of your claim with an audit. Our services are Reasonable and they are Contract-free.

Curriculum Vitae

WORK EXPERIENCE

CURRENT: Injury CASE Auditor, CLE Provider, Contributing Author, New Orleans, Metairie, Mandeville and Covington, LA
Charter Member of the Vanguard Service: Injury Case Audits A comprehensive search process that examines the content of the injury case and medical record. Case audits are used to:

  1. Organize specific data and details of the injury case into 26 clearly labeled sections.
  2. Communicate injuries and sequelae using the terminology and format required by payors to receive consideration for full payment.
  3. Prepare for and bypass depositions and court proceedings.
  4. Police the practices of adjusters to ensure consideration of each detail of the case.

CLE Provider and Presenter to educate and entertain Co-Author of the E-Book When Insurers Pay Low, Say No 2000-present Private Practice, Chiropractor, Greater New Orleans, LA
Activator Methods Advanced Proficiency

https://www.activator.com/research/. The Activator Method is one of the most widely researched chiropractic techniques and the only instrument adjusting technique with 23 clinical trials to support its efficacy. Activator Methods has published hundreds of clinical and scientific peer-reviewed papers, worked with major academic research institutions, and received grants from recognized entities like the National Institute of Health.

Providing sequential and orderly care to clients using Torque Release Technique, Advanced Activator Methods Protocol, Cold Laser, Soft Tissue Release, Kineseotaping and coordination of care with the client’s circle of practitioners - medical and natural.

 

Owner, Total Health Network 1984-2000
Occupational Therapist, Greater New Orleans Area (GNO)

Contract Services provided with my clinical team of 15 Occupational/Physical Therapists in the GNO Area. Specific focus on Sensory Integration Therapy for Children & TBI. Rehab of multiple trauma patients of all ages. Providing therapy coverage as well as personal therapy services in the listed departments at the following facilities:

  • E. Jefferson Center for Head Injury Rehabilitation - Dr. Susan R. Andrews
    Also Inpatient, Acute, Skilled, and Rehab Units.
  • Rehab Institute of New Orleans - Dr. Howard Katz and Abi Maxwell, OTR/L
    TBI and Neurological Rehabilitation
  • W. Jefferson Hospital
    Burn Unit, Inpatient, Outpatient Departments
  • Mercy, Humana, St. Jude, Coliseum, Touro Hospitals
    Rehabilitation, Skilled and Outpatient Departments
  • Home Health Agencies and Outpatient Facilities
    in New Orleans, Metairie, Kenner, Northshore and Outlying Parishes including Terrebonne, Lafourche, and St. Mary.

Occupational Therapy Services Beverly Hills, CA 1982-1984
Staff Occupational Therapist part time/full time. Provided Ortho/Neuro Services to people of all ages covering these departments: ICU, Acute, Orthopedic and Neurological Rehab, Outpatient, and Home Health.

Kaiser Permanente, Van Nuys, CA 1982
Staff Occupational Therapist, assisted in creating Neonatal ICU Unit Therapy Program.

 

 

EDUCATION

Doctorate - Chiropractic, 2000
Parker Chiropractic College - Irving, TX

BS - Anatomy - 2000
Parker Chiropractic College

BS - Occupational Therapy - 1984
Louisiana State University School of Allied Health Professionals, Baton Rouge, LA Special training in Sensory Integration and TBI with focus on multiple trauma.

Special Information

When the Audited Case Record was presented at deposition - the deposition was abruptly cancelled. The case settled for full policy limit.

A recent testimonial from the CLE Chair of the Houston Trial Lawyers Association who reported she needed to reach the policy limits to go after UIM and used the data from our course:

  • "I can't believe how effortless it was. I just submitted a new demand using the material and the adjuster handed over the full policy limits within hours and didn't say a word."

This testimonial from Katherine T., Esq who tested the service:

  • "I decided to use the Audit on a trial basis. I was able to resubmit new demands using the new information to open value driver windows and I was able to get policy limits on all 5 test cases. I am very excited to add this new information to all of our cases."

Situations best served by Injury Case Audit Services:

  • Received an unreasonable settlement offer Case has become stale, injuries are unresolved Disruption in care, delay in seeking care Injuries that are considered beyond the reasonable forces of the accident Side-lash "T-Bone" Injury vector and roll overs Injuries that linger, are unresolved or seem mainly "soft tissue" Conflicting or multiple medical opinions Complications with multiple variables that seem confusing or disjointed

We provide a FREE REVIEW on this portal to learn if the case is a GOOD CANDIDATE for Audit. Simply go here: https://www.casereviews.info/trumps/index.php Provide us with your name and upload Medical, Legal and Liability Records at our Upload Portal. We will contact your office within 3 days to tell you if the Injury Case is appropriate for Audit.