Claims Audits and Investigation  2012

Insurance Claims Audits Federal State, Third Party Administrator

ICC has extensive experience in working closely with Insurance Companies in the determination and comparison of those claims that are work related.

ICC provides these services:

1) Investigation of all Workers’ Comp Claims

a) obtain recorded statements
b) medical review for casual relationship to a workers compensation injury
c) accident site investigation
d) surveillance to determine extent of injury
e) fraud investigation
f) recommendations

2) Expert Witness and Testimony;

3) Recommendation or Denial of Workers’ Comp payments in accordance with federal regulations and state regulatory statutes;

4) Recommendation of safety programs to reduce Workers’ Comp Injuries;

5) Conduct Workers’ Comp Seminars for Employees on proper procedures in  negotiating claims;

6) Work with State’s Work Comp Division to reducee complaints and injuries;

7) Conduct Safety Inspections;

CALL ICC TODAY  1 (316) 683-0170

WHAT WE OFFER YOU

Services to the Insurance Profession

There have been requests for this page world-wide.

1) Accident Reconstruction

We provide you with a comprehensive and detailed reconstruction of the accident. This includes introductions, summaries, conclusions, exhibits, photos, medical review, medical illustration of injuries, medical records , physicians notes, police reports, photos of the damage, recorded statements, interviews, and scaled drawings.

ICC Claims Audits

2) Injury Reconstruction

In our Injury Reconstruction you receive a comprehensive and detailed report. This report will include introductions, summaries, conclusions, exhibits, appropriate photos of where the injury took place, medical review, medical illustration of the injuries, illustrations of the medical procedures, recorded statements, interviews, to determine whether medical evidence is causally related to an injury .

3) Medical Review

Our Medical Reviews are professionally prepared and presented. Our Medical Reviews take the complicated language of the medical profession and make it understandable for insurance companies, courts, arbitrators, and mediators. We incorporate medical illustrations and photos of the injury and of the medical procedures. These medical reports explain in detail what happened to cause the injury, what the injury consisted of, what is currently happening with the injury, the medical procedures for the injury, and the future problems with the injury. We also delve into the considerations of pre-existing conditions, aggravation of pre-existing conditions, and activation of pre-existing conditions.

In federal/ state and general  workers' compensation, casual relationship is a medical issue, and the medical evidence required to establish a casual relationship is considered rationalized medical evidence.  Rationalized medical evidence is medical evidence which includes a physician's rationalized medical opinion on the issues of whether there is a casual relationship between the claimant's diagnosed condition and the implicated employment factors. The opinion of the physician must be: (1) based on a complete factual and medical background of the claimant; (2) be one of  reasonable medical certainty; and (3) be supported  by medical  rationale explaining  the nature of the relationship between  the diagnosed condition and the specific employment  factors identified by the claimant .  Neither  the mere fact that a disease or condition manifests itself during a period of employment nor the belief that the disease or condition was caused or aggravated by employment factors or incident is sufficient to establish casual relationship.

4) Insurance Review for Coverage Question Disputes

Our Insurance Review program gives you the option of sending us your reports and claims that you would normally handle through interoffice claims review. We review these reports and claims. We then submit back to you our opinion, corrections, suggestions, and evaluations as to the success of the report and claim. This is effective on disputes on whether a claim is a Workers' Comp, Health, PIP  or liability claim.

5) Subrogation and Arbitration

ICC provides services in Subrogation and prepare arbitration arguments to be heard by inter-arbitration insurance panels.

6) Subrogation under ERISA

ICC provides services to Self-Insurers under the ERISA act who are entitled to subrogate their loss against a third party tortfeasor.

7) Expert Testimony and Expert Witness

When you use our services, we will provide you the option of using our Expert Testimony and our Expert Witnesses.

Contact ICC

Select the Button for the Response Form provided below. Fill out the information and electronically forward to ICC and an experienced consultant will contact you.

Or contact the Main Office directly . . .

"CLICK HERE" FOR THE RESPONSE FORM

Insurance Claims Consultants

Call us today for more information . . .

ICC Services

Risk Management Risk Profile Workers’ Compensation Bad Faith Claims Property & Casualty Errors & Omissions Claims Health Insurance Product Liability Fraud Investigations Claim Review & Investigation Accident Reconstruction Safety Inspections Third Party Admin Unions Medical Review Medical Malpractice Legal Malpractice SEMINARS

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