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How Does An Adjuster Determine A Claim’s Value?

How Does An Adjuster Determine A Claim’s Value?

How Does An Adjuster Determine A Claim’s Value?  For starters at some level it depends on the insurance companies.  Some companies (Allstate, American Family, Farmers, USAA just to name a few) use a computer program named Colossus.  The company that sells the program, claims it is an effective way of assisting adjusters in determining the value of your claim.  The problem is it is designed to minimize the value of the claim.  It does not factor in the personal attributes of the injured party.  The program basis its value on certain key phrases the adjuster inputs.  The adjuster looks for these words in your medical records.

If your injury is more of an objective injury (broken bones, a herniated disc, lacerations) the program automatically gives it a higher value.  But if your injuries are more sprain and strains, the program is designed to lessen the value of the claim.  However if there a certain diagnosis in your record, the program will add value.  Some of these words are muscle spasms, dizziness or radiating pain just to name a few.

The problem is when a patient speaks to his/her doctor, the patient is focused on using these key phrases, rather the patient is just trying to convey how he/she feels.  Also your doctor may not always write or include these phrases in the record.   Another downside is that if the program differentiates and gives different weight to diagnosis depending on who your provider is.  Colossus considers a chiropractor’s diagnosis less credible than it does a family doctor.  It considers a family doctor’s diagnosis to be less credible than a specialist’s diagnosis.

So what does all this mean?

After the adjuster inputs all the information from your medical records (this will not include information you provide in your intake sheet), into the program, the program provides the adjuster with a settlement range.  The adjuster will not exceed this range, the settlement range is typically a spread of $1,000.00 to $1,200.00.  At the end of the day neither the adjuster or Colossus considers any human factors in determining the value of the claim.

So if you were injured in an accident and want to know more on how does an adjuster determine a claim’s value, you should contact an experienced personal injury lawyer.

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