Delays in treatment verification, unclear injury causation, or lack of objective medical data can all slow down claims and inflate costs.
In auto injury claims, time is money - but accuracy is everything.
As an auto insurer or third-party administrator, you’re tasked with balancing efficient claim resolution with fair outcomes for all parties. Delays in treatment verification, unclear injury causation, or lack of objective medical data can all slow down claims and inflate costs.
The good news? Independent Medical Assessments (IMAs) - when used strategically - can speed up timelines, reduce disputes, and help everyone move forward with confidence.
Here’s how you can leverage medical assessments to make your claims process faster, smarter, and more defensible.
One of the biggest contributors to delayed settlements is ambiguity. Was the injury as severe as reported? Is the treatment plan appropriate? Are there pre-existing conditions at play?
Requesting an early-stage medical assessment (within the first 4–6 weeks of a claim) can provide:
A clear diagnosis and prognosis
Recommendations for treatment and recovery
Insight into causation (was the injury related to the crash?)
Clarification around pre-existing vs. accident-related injuries
Why it matters: The sooner this information is available, the sooner you can determine claim direction - saving time, preventing unnecessary treatment delays, and avoiding prolonged disputes.
Not every case is straightforward. When a claim involves chronic pain, psychological trauma, soft tissue injuries, or inconsistent documentation, a thorough Independent Medical Examination (IME) can break the stalemate.
A well-structured IME provides:
An unbiased expert opinion
An evaluation of injury severity and functional impact
An analysis of whether treatment aligns with best practices
Recommendations on maximum medical recovery and return to function
At SOMA Medical, we work with auto insurers to match each case with the right specialist - whether it’s a physiatrist, neurologist, psychologist, or orthopedic surgeon - ensuring assessments are relevant and defensible.
In many claims, it’s not just about whether someone was injured, but how much the injury is limiting them. Functional Capacity Evaluations (FCEs) and Psychological or Neurocognitive Assessments can provide objective insight into:
What the claimant can and cannot do
Whether limitations align with the reported injury
If they are ready to return to work or regular activities
If ongoing care or accommodations are warranted
Why it matters: Accurate information reduces overpayment risk, supports fair compensation, and protects against litigation.
Tip: These assessments are especially useful in long-duration or high-value claims where functional limitations are disputed.
One of the most strategic uses of a medical assessment is to proactively support settlements - especially in claims where litigation risk is high. An objective medical opinion can validate (or challenge) ongoing impairment claims and provide a strong foundation for negotiation.
It also demonstrates that you’ve done due diligence, which can reduce legal exposure and foster goodwill with claimants and their legal representatives.
Insurers who consistently use assessments as a proactive tool - not just a reactive one - tend to resolve more claims without court involvement.
Turnaround time matters - especially when managing dozens or hundreds of open files.
At SOMA, we make the process seamless by offering:
Rapid booking and nationwide coverage
Tailored assessments for musculoskeletal, psychological, neurological, and cognitive claims
Clear, defensible reports within industry-standard timelines
Coordination with all parties involved (lawyers, rehab professionals, case managers)
Whether you’re handling a minor injury claim or a catastrophic case, we help you get the answers you need - without the administrative headache.
Medical assessments aren’t just a checkbox in the claims process. When used strategically, they become a powerful tool to:
Reduce uncertainty
Prevent claim inflation
Support timely, fair settlements
Protect against disputes and legal costs
If you're not currently integrating medical assessments early and consistently in your auto claims process, you could be missing an opportunity to improve outcomes for both claimants and your bottom line.
Need to speed up your auto claims process?
Contact us
to speak with our assessment coordination team or make a referral today.