MIRO (Medical Insurance Review & Opinion) is an independent medical and insurance advisory service that provides expert clinical, administrative, and legal analysis to support objective decision-making in health and life insurance claims.

MIRO operates as a multidisciplinary review platform integrating expertise in medical specialties, health law and administration, and insurance underwriting and claims management to deliver evidence-based assessments for insurers.

The service is designed to enhance transparency, fairness, and operational efficiency in insurance claim evaluation, while helping insurers mitigate fraud, manage risk, and ensure compliance with clinical and regulatory standards.

Through independent expert opinions and structured claim investigations, MIRO assists insurance companies in making accurate and accountable claim decisions based on medical evidence, policy provisions, and applicable regulations.

Core Service Areas
1.⁠ ⁠Medical Insurance Review & Expert Opinion
Providing independent medical and administrative analysis of insurance claims conducted by a panel of medical specialists and insurance experts.
Key outputs include:
Evidence-based medical opinion reports
Clinical guideline validation
Medical necessity evaluation
Administrative and regulatory compliance review
This service supports insurers in making objective claim decisions without bias or internal conflict of interest.

2.⁠ ⁠Claim Investigation
Conducting comprehensive investigations of submitted insurance claims to verify medical accuracy, documentation validity, and policy compliance.
Scope includes:
Verification of medical records and documentation
Identification of potential fraud or discrepancies
Medical treatment appropriateness assessment
Policy compliance evaluation

3.⁠ ⁠Inforce Policy Investigation
Monitoring active insurance policies to identify potential risk factors or inconsistencies that may affect future claims.
Activities include:
Policy data validation
Risk identification in active policies
Compliance review with updated medical information

4.⁠ ⁠Litigation & Legal Assistance
Providing expert medical and administrative opinions to support legal processes involving insurance disputes.
Services include:
Expert witness opinion
Medical-legal documentation analysis
Litigation support for insurance claims cases