Forensic Medical Audit for PI Attorneys

A clinical–forensic injury audit that exposes overlooked damages.

Most undervaluation is not "negotiation." It’s missing medical value drivers. We close the gap between clinical care notes and legal valuation requirements with structured, defensible data.

Zero Workflow Disruption • Exhibit-Ready Outputs

When is "Just a Soft Tissue Case" NOT Just a Soft Tissue Case?

The Carrier Strategy

"Insurance carriers have a playbook: label the injury 'minor,' offer a nuisance settlement, and wait for the firm to 'turn and burn.'"

It works because 65% of injury claims lack the specific medical documentation required to prove otherwise. If you allow the carrier to value a case based solely on the injury code—ignoring the trauma inventories, overlooked threshold diagnoses, loss of function, impairments and clinical forensic economic present value—you are leaving heaps of money on the table.

The Valuation Shift

We translate Life Expectancy Data and Quality-Adjusted Life Years (QALY) into a hard present-day dollar value. This radically alters the internal compass of case valuation, turning 'low-impact' denials into policy-limit tenders by proving the case’s actual worth before you even send the demand.

The Valuation Gap

Why insurers win the
“value narrative” early.

Carriers know that standard medical records are written for treatment, not valuation. They exploit the "silence" in standard medical records and SOAP notes to label claims as "soft" or "speculative."

"If functional loss, impairments, loss of services, emotional and cognitive disorders, aren't quantified in the records, insurers and their software including AI and Colossus, treats it as if it didn't happen."

Symptom Under-Capture Cognitive, emotional, and sleep impacts are rarely documented with frequency/severity data required for higher multipliers.
Abstract Functional Loss "Pain & Suffering" are weak evidence. Aligning it with Federal Expectancy Data and Quality Adjusted Life Years provides present and future calculable value.
Missing Impairment Ratings Absence of AMA Guide-based ratings leaves permanent injury valuation entirely to adjuster opinion.

The Forensic Output

Everything is delivered in clean, modular sections so your team can lift it directly into demand letters, mediation briefs, or discovery strategy.

Expanded Diagnoses
Trauma-guided diagnostic expansion to surface overlooked injuries and connect them to causation logic.
Structured Impairment
Auto-supported impairment rating components formatted specifically for legal admissibility.
Functional Loss Anchor
Whole-person functional framework providing a clear "Before vs. After" impact narrative.
Loss-of-Services Valuation
Household, emotional & cognitive disorders, and non-market valuation support using recognized datasets and defensible inputs.
Exhibit Ready
The Forensic-Style Report
This isn't a medical summary. It's a valuation argument. Organized into exhibit-ready sections you can attach to a demand letter or use to guide expert deposition preparation.
CASE STUDY: #REDACTED-092 | FLORIDA / MVA REAR-END

A real outcome (redacted)

Initial Offer
$10,000
Based on raw records
Audit Delivered
Post-Audit Offer
$70,000
Movement in 8 Days
Final Resolution
$100,000
Policy Tender

“Carrier movement followed delivery of a structured, admissible valuation narrative supported by expanded diagnoses, impairment logic, and functional/economic anchors.”

Seamless Workflow Integration

This does not replace your demand process—it strengthens the evidentiary spine behind it.

Attach to Demand

Don't rewrite your demand template. Simply include the audit report as Exhibit A. It provides the structured data tables that adjusters need to justify higher reserves to their supervisors.

Guide Provider Documentation

Send the medical file to your local injury claim auditor to highlight "Clinical Gaps" and input missing functional loss data, allowing the plaintiff representative to issue an addendum before the case closes.

Mediation Leverage

Use the structured impairment ratings to anchor your position. When the defense argues "subjective complaints," you point to standardized AMA Guide data.

Ideal For

  • Disputed causation, priors, pr-existing or "gap in care" cases
  • Multi-site injuries or "complex" soft tissue
  • Surgery disputes or "degenerative" defenses
  • Cases undervalued due to missing quality-of-life anchors

Not Ideal For

  • Clear policy limits already tendered
  • Materially incomplete documentation that cannot be supplemented

Common questions

Clarifying the workflow fit for plaintiff attorneys, admissibility, and legal strategy.

Does this replace the treating provider?

No. The treating provider remains the sole medical authority. InjuryAuditIQ acts strictly as a quality assurance tool to verify documentation completeness. This ensures that the records you receive are legally defensible, meeting Daubert/Frye challenges and FRE's.

Does this require changing your provider network?

No. This can be used with your current providers. It effectively "audits" their existing work to find value gaps, and can also help providers improve their future documentation habits.

Is this admissible in court?

Yes. The audit is structured to support attorney evidentiary strategy by providing clear foundations, method transparency, and documentation anchors. Your firm controls legal use and presentation. Meets Daubert/Frye challenges and related federal rules of evidence.

Is this “demand writing”?

No. The clinic remains clinical. The system structures documentation and generates audit-level outputs that attorneys can use as an exhibit. It eliminates documentation gaps without replacing the human judgment required for credible medical testimony.

Does this replace a demand letter?

No. It is a clinical–forensic valuation package. You can attach it as an exhibit, or use its findings to write a much stronger demand letter, but it does not replace the legal demand itself.

Who creates the audit?

It is generated through a structured clinical audit workflow using standardized inventories, diagnostic expansion logic, impairment output, and economic valuation support systems. This distinction ensures the medical evidence remains admissible and that the provider can confidently defend their records during deposition or trial.

How fast can we get it?

Typically delivered on a short turnaround (24-48 hours) once records and intake inputs are complete.

How do we start?

Request access below. We’ll confirm fit, then provide onboarding plus a demo using the case proof structure shown above.

If you want stronger leverage, start with one case.

We’ll review whether your case is a fit and show you exactly what the audit would produce—before you commit.