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FIRST-PARTY BAD FAITH CLAIM FILE REVIEW

Bad faith cases are proved on dates, not adjectives.

First-party bad faith claim file review services build the cited timeline the claim is argued on: when each medical record reached the carrier, what the file already contained at each decision, which reviews were obtained, and what the insured was told. The bad faith conclusion belongs to counsel and the court.

Click any row → the source page it cites
Claim file chronology · Case #IME-4812 documented
Adams, Timothy · claim file
342 pp / 2 packets received logged
11 duplicate pages removed free
p.140 — wrong patient quarantined
Pages 342 Documents 27 Cited 100%

Claims handling has published standards. The regulator examines against them.

We do not build for a case type until we can name the standard that defines a correct output and the person who grades the file against it. In first-party bad faith litigation, both are already published.

The standard and the referee
The rulebook
  • The forum state’s unfair claims settlement practices act, adopted from the NAIC Unfair Claims Settlement Practices Model Act, which sets investigation and communication timeframes
  • The NAIC Market Regulation Handbook, whose claims examination standards state regulators use when they examine a carrier’s handling
  • The policy itself, including its proof of loss, cooperation and appraisal provisions
  • The carrier’s own claims manual and internal guidelines, produced in discovery and measured against its conduct
The referee
  • The state department of insurance on a market conduct examination or a consumer complaint
  • The trial court and the jury on the bad faith count, including any statutory penalty or fee-shifting provision
  • The appraisal umpire or the appeal reviewer, where the policy or statute routes the dispute there first
A denial dated before the record that would have supported the claim was even opened From 10¢ to as low as 5¢/page here, duplicates free
Claim file chronology · Case #IME-4812 cited 100%
Packet342 pp / 2 packets · 11 deduplicatedlogged
Record receipt datesWhen each document reached the filecited
Decision pointsWhat the file held on each decision datecited
Unaddressed recordsIn the file, absent from the rationaleflagged
Chronology delivered · cited 100% · no bad faith conclusion
How it works

3 steps between the claim file and the timeline.

01

Send the claim file as produced

Adjuster notes, correspondence, the medical records as received, peer and vendor reviews, the denial letters and the policy, in any format.

02

We return the chronology, page-cited

One timeline: what arrived when, what the file contained at each decision, which reviews were ordered, and what the insured was told, each entry linked to its page.

03

Counsel argues the standard

Whether the handling breached the duty of good faith is your argument and the jury’s finding. The chronology is the cited record beneath it.

The boundary, in writing

A chronology of the file, not a verdict on the carrier.

We sequence and cite what the produced claim file documents. We do not conclude that a carrier acted in bad faith, score claims handling, opine on whether an investigation was reasonable, or decide coverage. Those determinations belong to counsel, the regulator, the court and the jury.

In the demo case, page 140 turned out to belong to a different patient. A misfiled record in a claim file changes what the carrier is said to have known on a given date, so it is quarantined rather than dated into the timeline.

Audit trail · Case #IME-4812 exportable
08:12Packet received · 342 pp / 2 packetssystem
08:3111 pages deduplicatedsystem
08:44p.140 flagged — wrong patientsystem
08:54Claim file chronology complete · chronology delivered · cited 100%system
09:20Claim file chronology reviewed · citations verifiedreviewer
09:26Claim file chronology exported · trial exhibit assembled by counselreviewer
Every access logged · file deleted 30 days after delivery
Why Medrecords AI

The rules the platform never breaks.

Medrecords AI EVERY LINE CITED
CASE #IME-4812 · ADAMS, T.342 pp
2/14 — ER visit, right knee p.4
4/18 — arthroscopic surgery p.61
p.140 — wrong patient quarantined
Medrecords AI
Read every page · cite every line

HIPAA, under a signed BAA

Every file is handled under our Business Associate Agreement, from the first byte.

Never trains a model

Your records are never used to train any AI model — ours or anyone else's.

Every line cited

If we can't cite it, we don't say it. Every sentence links to its source page.

Deleted after delivery

Files are deleted 30 days after delivery, with a full audit log of every access.

Powered by the platform

7 capabilities behind every claim file chronology.

The claim file chronology is one deliverable of the same platform that reads, sorts, and cites the whole record.

Medical Records OCR

Every page of the produced file read in full, including fax banners and mail logs, which is where receipt dates actually live.

IN ACTION · 342 pp / 2 packets, read in full

Medical Chronology

Correspondence, records and decisions merge into one timeline, so what was known on each date is visible rather than reconstructed.

IN ACTION · first notice → final decision, one timeline

Verifiable AI Citations

Every entry carries its page, including records that arrived before a decision and were never mentioned in it.

IN ACTION · chronology → cited 100%

Medical Summary Reports

It exports into the summary judgment exhibit or the deposition outline in your format.

IN ACTION · chronology → trial exhibit

Medical Record Deduplication

Forty charts pulled from multiple practices and EHR migrations carry their share of duplicate visit notes. Each is matched and collapsed to one canonical record, so the prescribing pattern is read once per real encounter.

IN ACTION · 40 charts → duplicate visit notes collapsed to 1 record each

Missing Records Identification

A prescribing pattern read across 40 charts is only as sound as the file behind it. When a chart references a visit, refill, or referral that never made it into the production, the gap is flagged before the pattern goes to the board.

IN ACTION · prescribing pattern cross-checked → gaps flagged before submission

Cross-Exam Simulator

A board investigator or defense counsel builds a case from the chart abstraction. This tool maps the questioning a physician facing that hearing is likely to face on the gaps and pattern in their own record. A rehearsal tool, not legal advice.

IN ACTION · prescribing pattern → likely hearing questions mapped
FAQ

Bad faith claim file review, answered.

No. We build the cited timeline: what reached the file and when, what it held at each decision, and what the insured was told. Whether that conduct breached the duty of good faith is argued by counsel and decided by the court and the jury.

Yes, and the output does not change. A carrier defending its handling needs the same page-cited timeline showing what the file held at each decision. The record is the record regardless of who ordered the review.

Because the whole dispute is usually about what the carrier knew and when. A record that arrived three weeks before a denial and went unmentioned in it is a different fact from one that arrived after, and only the dates, with pages, settle which it was.

No. Medrecords AI does not retrieve records from providers or facilities. You bring the records you already have — review starts in minutes from upload. Retrieval vendors take days; you can keep yours and still cut the review to minutes.

Send one file. We'll tell you what we can read.

No obligation. If the case type is buildable we'll scope it; if it isn't, we'll say so.