© 2019 by Sandler Occupational Medicine Associates, Inc.

Claims Support Services

SOMA provides high-level claims support services to leading insurers and self-insured companies. We have earned an excellent reputation through the years due to the quality and breadth of expertise in critical claims support functions including medical review/analysis, data extraction, database development, and claims categorization for valuation and reserves purposes.

 

A particular area of SOMA’s experience involves large, multi-claimant projects where high volumes of information require expert analysis for identification of key claims data and claim classification. SOMA combines its experienced staff with advanced information technologies to deliver high-quality, efficient and responsive claims analysis services which have proven critical to our clients’ claim management and resolution efforts.

 

SOMA’s claims support services for our clients focus on issues of important claim management and financial impact including:

 

  • Complex Injury/Illness Claims - Analysis and Recommendations for Case Management and Resolution (e.g. chronic pain, severe trauma, degenerative disease)

  • Multi-claim Analysis for Injury Categorization and Valuation

  • Life Expectancy Estimation – Claim Reserves Assistance

  • Medical Treatment/Technology Assessment/Standard of Care

 

SOMA has broad experience and capabilities within each of these service areas. Our complex injury/illness claims services have been provided for a large variety of potential injury/illness types, with particular experience in difficult, non-responding cases. Multi-claim analyses include a comprehensive range of subjects such as occupational/environmental, product, and pharmaceutical/food claims. We have performed hundreds of life expectancy determinations spanning all key disease areas.

 

Treatment and standard of care assessments have included both invasive and non-invasive treatment as well as specific medical devices and novel care approaches.

 

Examples of SOMA’s multi-claim experience include:

  • Asbestos

  • Industrial Lung Disease

  • E. Coli Food Contamination

  • Community Toxic Release

  • Mold Exposure