Insurance Medical examinations
An insurance medical assessment is a specialist medical examination in which an independent insurance physician prepares a report based on his or her specific expertise. The insurance medical examination consists of a detailed interview with the client at a Sazyes location, supplemented by physical examination and file review. The report is thereby based on the insurance medical examination and assessment of relevant data. An insurance medical assessment revolves around the objectification of complaints, limitations and the determination of taxability. In an insurance medical assessment, a statement is always made about the capacity of the person involved and a standard FML (Functional Capabilities List) is completed.
Insurance medical expertise in absenteeism and disability
An insurance medical assessment is often requested in cases of absenteeism or disability. As a rule, a diagnostic opinion is requested. However, it is the limitations and taxability that have the most important consequences. Indications include complex absenteeism problems, a stagnating recovery, the substantiation of a claim assessment, the substantiation of a WIA file, wage penalty prevention or wage penalty repair.
Our insurance physicians are familiar with the legal assessment frameworks and in that context have knowledge of insurance medical instruments such as the FML.
Insurance medical expertise as a second opinion
An insurance medical expertise can be used as a second opinion, to assess ongoing treatment. For example, to check it against the most current treatment guidelines. In addition, insurance medical examinations are increasingly being used in objection and appeal proceedings when the outcome of an earlier expertise or assessment is in dispute. Our insurance physicians are familiar with the legal assessment frameworks and in that context have knowledge of insurance medical instruments such as the FML. In the event of a conflict between an insured and the insurer, the insured can also initiate a medical report himself. Some policies have the possibility of arbitration. The insurance physician may be appointed as an "arbitrator" in that context.
An insurance medical assessment provides clarity at:
An insurance medical assessment provides clarity at:
- questions about the presence or absence of limitations
- the role of recovery impeding factors
- determining limitations in personal and social functioning
- determining usable possibilities
- stagnating recovery or reintegration
- evaluating of previous treatments and reintegration pathways
- identifying treatment options
- determining taxability
- determining the prognosis
And are requested by, among others:
- Medical advisors
- Company doctors
- Employers
- Courts
- (Labor) lawyers
