Independent Complex Claim Review
An independent read on your most expensive, difficult claims
InQuery's Independent Complex Claim Review service helps organizations understand their most expensive, delayed, or difficult claims.
For high-exposure claims, the problem is rarely a lack of documents. The problem is knowing what the documents actually mean, what is missing, why the claim is still open, and what should happen next.
What an Independent Complex Claim Review covers
- Review high-exposure and long-duration claim files
- Identify medical, legal, settlement, SIU, and return-to-work issues
- Surface missing information and unresolved questions
- Provide an independent view of claim status and next steps
- Help self-insured employers and public entities better understand TPA-managed claims
- Support claim reviews, stewardship meetings, and settlement planning
Deliverables
A structured action plan for your hardest claims
Executive claim summary
Claim status and exposure review
Medical timeline
Missing records and open questions
Action plan
Settlement blockers
Recommended next steps for TPA, counsel, SIU, medical management, or employer
Have a complex claim file you want reviewed?
Send us a sample file and we will show you what InQuery can surface, with human-reviewed outputs your team can put to work.