Developed more than thirty years ago by Computer Sciences Corporation, registered in Australia, the software program Colossus is now used by more than 70 percent of insurers to generate a settlement value for personal injury claims. Several large insurers employ Colossus to value auto claims, including Aetna, Allstate, Farmers, MetLife, and Travelers.
How Does Colossus Estimate The Value Of A Claim?
To calculate the value of a personal injury claim, the software relies on information provided by adjusters. Generally, the data can be categorized into two groups – non-claim data and claim data.
Non-claim data includes information about a claimant’s lawyer (if they have one) as well as prior settlements in that person’s area.
Claim data includes information about a claimant’s injuries, medical treatments, and any disabilities due to the accident. The software also analyzes 10,400 “value drivers” to generate a finding. Understanding the value drivers is critical to presenting relevant evidence to adjusters who then input the data into the software.
Important Factors To Consider When Presenting To Adjusters
According to Florida Spine and Injury, there are ten important factors to consider:
Legible records: Colossus links a physician’s tax identification number or social security number and follows the value of the cases the physician treats. The treating physician must have legible and complete notes. Illegible and incomplete notes can bring down the value of a claim.
Second opinions: medical examinations by a secondary physician are a Colossus value driver and may increase the value of a claim.
Impairment rating: A permanent impairment diagnosis by a treating physician is a Colossus value driver. However, the rating must be two percent or more to be recognized by the software.
The Diagnosis: The most important value driver is the physician’s diagnosis. Physicians should provide the exact level of the injury and any radiating pain as a result of the injury. Certain injuries are valued higher such as concussions, herniations, and fractures.
Contusions: Although some physicians do not note contusions, they are important value drivers that should not be ignored. Claims are valued higher, the more contusions are present.
Dizziness: Physicians should note any dizziness experienced by an accident victim. Although some episodes may clear on their own, dizziness can be a symptom of something more serious like mild head trauma or instability in the upper cervical ligamentous.
Headaches: Any headaches experienced by the patient should be noted by the treating physician. Headaches may indicate damage to the upper cervical spine or cranium. Treatment notes should include the frequency and severity of the patient’s headaches.
Muscle Spasms: The software rates muscle spasms high, especially when the physician notes the location and severity level of the spasm. When a physician notes three or more locations where spasms are present, the software may rate the spasms higher than loss of motion.
Disc Lesions: Colossus only recognizes two types of disc lesions – bulges and herniations. Physicians should appropriately code disc lesions.
Speak To A Experienced Personal Injury Attorney
Presenting evidence to an adjuster in a way that improves an injured person’s chances of a higher settlement value requires an experienced personal injury attorney. For thirty years, the trial attorneys of Panter, Panter, and Sampedro have worked one on one with clients to get them the justice, recovery, and compensation they deserve. For a free case review, call (305) 662-6178.
Sources:
https://www.flspineandinjury.com/blog/educate/confronting-the-colossus-challenge
