The “Rise of Colossus” Seminar by James J. Mathis & 10 Things You Should Know About How Insurance Companies Process Auto Accident Claims
I attended the "Rise of Colossus" seminar by James J. Mathis last Friday. Here are 10 things you need to know about COLOSSUS and how insurance companies process auto accident claims:
1. In 1990, Allstate paid $15,800.00 on average for "soft tissue" cases; in 2001 Allstate reduced this amount to $5,800.00 on average for the same "soft tissue" type case. "This reduction in claim severity was a direct result of the changed process and programs such as "MIST", "MINOR IMPACT" and "NO DAMAGE / NO INJURY."
2. "Through the use of Colossus, insurance companies have taken the valuation of claims out of the hands of humans and placed it under the watchful eye of computers; [claims] adjusters continue to use the same reasons for low settlement offers, they will say: *There was little to no damage to the car; *The claimant didn't seek immediate care; *The claimant only saw a chiropractor; *it is only a soft tissue claim/injury. None of these are the real reason. The primary reason your offer is low depends upon the valuation from Colossus. The adjuster has no authority to exceed the value of the claim set by Colossus."
3. "Colossus is a computer system for assessing general damages for bodily injury claims. While all adjusters have their own personal authority levels, they are required by specific guidelines to not deviate from the values arrived at through the use of Colossus."
4. "Colossus is an equation without any human intuitive abilities. The process depends on the input ofthe claim handler alone. All information not included in the equation has no value. The equation is made of variables which are weighted depending on the injuries identified, treatment, duration of complaints, disability and impairment. The weighted values are determined by the insurance industry during the process of tuning and calibration with the assistance of Accenture."
5. "COLOSSUS = A knowledge-based system for assessing general damages for bodily injury claims. Colossus assigns general damage values within four categories -each comprised of many elements. These categories include 1. Trauma (pain and suffering); 2. Permanent Impairment; 3. Disability (performing "Duties Under Duress"); 4. Loss of Enjoyment of Life. Permanent Impairment is one of the two most powerful factors driving value of a claim. The other factor is the actual injury code itself."
6. "Methods used in the AMA Impairment Rating System: The five impairment-rating methods COLOSSUS accepts: 1. Amputation; 2. Ankylosis; 3. Diagnosis-Based Estimates (DBE); 4. Diagnosis-Related Estimates (DRE); 5. Range of Motion (ROM)."
7. "Claims representatives do not read most [demand] packages…. Colossus questions the claim representative about different aspects of the case and, depending on the answers derived from the chart notes and records as well as their impact on severity, adjusts the base profile rating up and/or down."
8. "Understanding which process is being used to determine the value of your client's claim is essential. … Knowing which process is being used provides for clearer insight as how to construct the demand so as to maximize the range of value for settlement. This allows the adjuster to increase the authority, which he/she has to negotiate settlement of the claim…. The current electronic process for evaluation of claims has specific value drivers imbedded within the equation for general damages. Clearly pointing out these value drivers and the supporting medical chart entries proves for a maximum claim value range."
9. "After the claim has been evaluated most companies are encouraging at least one initial offer. This is usually 85% of the top value of the range of authority for the claim. So if the initial offer is $8,500.00 inclusive that would indicate to you the top value in the range of authority for the claim is $10,000.00 inclusive."
10. "In discussing most soft tissue injuries, filing a lawsuit will not automatically increase the value of the claim. Most adjusters are being taken out of the loop where allocated costs are concerned. They are told the cost of litigation is not a consideration for increased offers. Most insurance companies have moved to a flat rate defense."
For more information about Colossus and the way insurance companies handle claims, please visit www.sequoiavisions.com.
For more information or a free consultation on your legal issue contact The Law Offices of Charles D. Scott PLLC, your injury law and family law attorneys, at 727-300-4878. http://www.yourstpetelawyers.com