In a context where costs related to professional injury claims are constantly increasing, opinions on case files emerge as a strategic lever for mutual insurance companies, employers, lawyers, and insurers. This medico-legal approach allows you to obtain expert, rapid, neutral, and well-documented advice based exclusively on the analysis of file documents.

What is a file review?

 An opinion on file is an in-depth medical analysis performed by an independent expert physician, without meeting the worker. It is ideal for evaluating:

• The causal relationship between an injury and an accidental event 
• The possibility of cost sharing (Article 329 ARIAOD) 
• The validity or proportionality of treatments (Article 326 ARIAOD)
  
  

This type of opinion can be requested at any time during a file's lifecycle to guide administrative, financial, or legal strategies.

Rigorous and multidisciplinary medical expertise 

The success of this approach relies on a network of over 200 physicians specialized in medico-legal expertise across more than 20 disciplines: orthopedics, psychiatry, neurology, general medicine, etc.

Each opinion is:

• Assigned to a physician whose expertise is directly related to the case specificity 
• Reviewed by our quality control department to verify clinical consistency and literature support 
• Written in clear language, even for non-healthcare professionals 
• Compliant with TAT expectations, integrating recent jurisprudence
  
  

Our consulting physicians receive continuous tutoring in medico-legal expertise and interpretation of ARIAOD laws from our medical management team, ensuring quality analysis supported by constant medical and legislative monitoring.

Concrete benefits for your files 

Here's a real example of the cost reduction achieved through an opinion on case files under Article 329 of the ARIAOD.

An employee suffered a lumbar fracture. The independent physician concluded that a significant portion of functional limitations (95%) was related to pre-existing foraminal stenosis, already documented in previous examinations. The employer obtained cost sharing, leaving only 5% of costs to their responsibility.

Corex360 : Technological efficiency at your service

The recent launch of the integrated request form directly on the Corex360 platform marks the end of a laborious process that required multiple email exchanges between different stakeholders.

This new tool offers concrete advantages that transform the user experience:

• Considerable time and efficiency savings 
• Simplicity and speed of use
• Structured information collection in a single step
• Easy upload of necessary documents 
• Real-time tracking of your request
  
  

24/7 accessibility to your secure client space completes this advanced technological offering, allowing you to submit requests according to your operational needs.

New upcoming service: Pre-analysis of your 329 requests

Before investing in a formal opinion, our clients will be able to opt for our pre-analysis service, conducted by our nurse specialized in cost-sharing files. This preliminary evaluation allows to:

• Determine the feasibility of a request according to Article 329 criteria 
• Identify missing or improvable elements to strengthen the request 
• Reduce initial costs by better directing files from the start 
  
  

This service is particularly appreciated by organizations wishing to validate a file's potential before proceeding further. Stay tuned!

Towards optimized claims management

Ducore Expertise offers organizations the medical expertise and technological efficiency necessary to make informed decisions. This solution transforms your approach to professional injury management by allowing you to more quickly identify cost-sharing opportunities.

File review is more than a medical analysis: it's a strategic tool for optimizing claims management.

Contact us today to discover how our opinions on files service can contribute to the efficiency and profitability of your operations.