Medical Insurance Fraud Investigation
SERVICES THAT THE SECOND OPINION® MEDICAL-LEGAL CONSULTANTS GROUP INC. PROVIDES TO INSURANCE CLAIMS ADJUSTERS AND RISK MANAGERS:
- FORENSIC FILE ANALYSIS for evidence of medical fraud, claimant’s lack of compliance with treatment, secondary gain, illicit and prescription drug abuse, family doctor switching,...
- COST EFFECTIVENESS ANALYSIS for signs of improper or purposely prolonged treatment, suspicious prescribing patterns, inappropriate work restrictions, unnecessary diagnostics,...
- BACKGROUND CHECK for hidden WSIB and disability claims, pre-accident medical problems,...
- SETTLEMENT MEDIATION SERVICES during which a medical investigator conducts a forensic file analysis, a future cost care analysis, and a review of factums (case law, medical literature, etc.) supplied by each side. Then, a preliminary report is given to both the insurer and the claimant’s representative. A conference is held, either in person or by telephone, at which time all relevant issues are identified, all roadblocks are neutralized and a fair and equitable settlement is reached
- CREDENTIALS CHECK OF PRACTITIONERS AND FACILITIES to confirm that they are properly qualified, equipped and have never been in any professional trouble
- PUBLISHED ARTICLE SEARCH in order to find the specialist most qualified to counter a specific bogus diagnosis
- DEFENSE STRATEGY SESSIONS during which counsel is prepared for discovery
- ATTENDANCE AT DISCOVERY in order to help counsel direct their questioning
- TREATMENT PLAN REVIEW SERVICES to ensure proper type, cost and duration of treatment
The SECOND OPINION® Medical-Legal Consultants Group Inc. is one of a kind. We have a 95% file closure rate within three months of being retained by insurance adjusters. We handle files throughout the entire world, quickly and professionally.
The SECOND OPINION® Medical-Legal Consultants Group Inc. is the ONLY Medical Investigation company in Canada. We provide ALL of the services listed in EVERY COUNTRY and in EVERY LANGUAGE. We were founded in 1994 by North Americas top Medical Investigator, and our present Chief Executive Officer, DR. JAMES N. SEARS.