As specialized as the diagnosis and treatment of shoulder injuries are, so are questions surrounding insurance law (professional liability insurance association law). Unfortunately, insurers often dismiss the consequences of shoulder accidents as pre-existing wear and tear, leaving the injured person at a disadvantage.
Especially in the case of the frequently occurring tears of shoulder tendons (e.g., tears of the supraspinatus tendon or subscapularis tendon), statutory accident insurance providers (professional liability insurance association BG) are particularly quick to reject claims. The result is a rejection notice.
Without a well-founded objection, the insured person often has no chance.
As an expert witness for the social court, private insurers, and statutory accident insurance (employer's liability insurance associations, BG), I am confronted with legal questions every day. The often outdated level of knowledge surrounding various shoulder disorders and the consequences of accidents continues to shock me.
This lack of knowledge leads to accident consequences being rejected far too frequently, even though, based on current knowledge, many claims should be accepted. We often find that medical reports or BG statements submitted to us for assessment contain errors. In particular, lesions (tears) of the supraspinatus tendon or subscapularis tendon are incorrectly assessed based on current knowledge.
To ensure that you, too, receive your due process, we offer an assessment service.
As part of this assessment service, we will first prepare a feasibility analysis for you.
We will review all available findings, expert opinions, accident descriptions, and other documents relating to your case. You will then receive an analysis, based on the most current state of knowledge, regarding the likelihood of success in your medical insurance claim. For this service, it is not necessary to visit us in person. Copies of your documents are absolutely sufficient.
If there is a reasonable likelihood of success, we are happy to prepare objection letters and corresponding detailed reports, with or without a thorough examination.
For the feasibility analysis, we are entitled to charge €101.99 plus VAT (total: €121.37). The calculation is based on the German Medical Fee Schedule (GOÄ) item 85, with a rate increase of 3.5. Detailed explanations for an objection or medical reports will be billed according to Section 85 of the German Medical Fee Schedule (GOÄ).