Insurance claims, compensation and health impairment

In insurance and compensation matters, disputes often concern the degree and permanence of health impairment, its effect on capacity for work, or its relationship to an earlier accident. In a forensic medical assessment, I evaluate the condition and its consequences on the basis of the available documentation and the relevant professional standards.

An independent forensic medical opinion can help determine the medical basis of an insurer’s assessment, whether the degree of health impairment was assessed correctly, and whether the current symptoms may be related to an earlier injury or illness.

What questions can I address professionally?

Below I summarise the most common questions that may arise in a forensic medical assessment in this field.

Do the medical findings support the insurer’s assessment?

An insurer’s decision is based on the terms of the relevant policy and its assessment of the available medical records. As an independent forensic medical expert, I can assess the medical findings against the stated assessment criteria; interpretation of the policy and entitlement are legal or contractual questions.

Is the degree of my health impairment really this low?

Determining the degree of health impairment is a complex forensic medical task. In the expert opinion, I assess the loss of function, the permanent consequences and their extent in accordance with the relevant professional standards.

Has permanent health impairment or lasting functional limitation developed?

The two concepts are not identical. A forensic medical assessment can determine the degree of health impairment and functional limitation represented by the condition and the consequences it may have.

Is my current condition related to the earlier accident?

This is one of the most common questions in insurance and compensation cases. The expert examines whether the current documented impairment is causally related to the earlier injury or illness.

Could the medical evidence support a reassessment of the degree of impairment?

If you dispute the degree of health impairment determined by the insurer, an independent forensic medical opinion can assess whether the records support a different medical impairment rating.

I can no longer perform the same work because of the accident. Is this medically relevant?

Yes. The effect of injuries and illnesses on capacity for work is highly relevant in many insurance, employment and compensation matters. Its medical aspects can be assessed as part of a forensic medical examination.