Why You Need a Partner Using BIG Data to Forecast Medical Care for Litigated Claims Now!

Life care planners assess the medical needs of people who have typically incurred a catastrophic injury or suffer from a chronic health condition. They write detailed plans that include granular forecasts of future medical care and the costs of those procedures. Cost estimates, as we will see in the following example, can vary widely. Care Bridge International integrates clinical expertise with insights from our massive claims database, providing a differentiated approach to formulating medical damages or life care plans.

A recent plan completed at Care Bridge International illustrates the power of experience and data. The service retained by the plaintiff, a young individual with an above the knee amputation, forecasted costs of almost $1.9M over lifetime. But because each element of future medical care was broken out by the line item, our Nurse Life Care Planner identified inappropriate or unnecessary care, as well as overly aggressive assumptions, that would have created very high costs for our client.

Three key areas explain how our transformative results are radically lower than our competition and still stand on solid ground. First, our opposition used a simple life expectancy value, but our rated age calculation factoring in the amputation as well as several comorbidities lowered life expectancy, according to actuarial life tables, in our forecast. This alone translated to fewer instances of the recurring prosthetic and socket replacements that were the key cost drivers in the opposition plan. Second, the medical plan authored by our opposition included a top of the line sports-grade prosthetic. This prosthetic was neither appropriate or medically necessary given the individual’s activity level and twice as expensive as what he needed to support his level of function and independence.

Finally, we were able to use our claims database to find claimants with the same type of amputation so we could validate the medical treatments most often rendered and the frequencies of care. Using facts to validate our proposal rather than opinion,

The net impact of more appropriately calibrating life expectancy, ensuring appropriate services were rendered, and deriving the recurrence of services from the claims data took estimated costs of $1.9M down to a more statistically reliable, probable estimate of just over $600K. That is the value of bridging clinical experience and data together. Data is Power! Data offers transparency into medical predictions that eliminate arguments between expert opinions on both sides of the litigation table.

The use of data, in forecasting medical exposure for litigated claims, is critical now more than ever as case law related to Sargon Enterprises, Inc. v. Univ. of S. California and People v. Sanchez are being used in the courts to undermine and/ or exclude expert testimony among those plans which rely on traditional Life Care Planning methodology.

Interested in learning more about our transformational approach to claims which will enable and empower attorneys and claim professionals to maximize their results and achieve BIG wins for settlements?


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