“How Insurance Companies Evaluate Your Injury Case”

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It used to be that insurance adjusters were highly trained experts who evaluated the likely jury verdict range of an injury claim and in generating a settlement offer.  Nowadays however, insurance companies use computer programs. The insurance adjuster simply plugs key words or codes found in the medical records into a computer program which then spits out an evaluation.  If the proper terms are not available or if the medical records are not in a format that is convenient, the full value of the case will not be recognized and settlement offers will be low or nonexistent.  To be compensated in this day and age, it is critical that medical providers not only treat you with skill and compassion but that they properly document each and every problem you have on each and every visit, with the exact terminology and codes required by these computer programs.

 

Injury attorneys must be fully aware of how these computer programs work and how injury information should be presented so that it can be recognized by the computer and generate reasonable compensation for the client.  This system is not fair and indeed was specifically designed to reduce the value of cases. However, it is the system that we deal with in settling cases. Not every case is settled of course and the computer program is not involved in taking your case to a jury and having a verdict your peers determine what you injury and impairments are worth. The injury lawyer should definitely make every possible attempt to get reasonable compensation through settlement before resorting to the expense, delay and uncertainty of litigation.

 

Knowing how these computer programs work and how to appropriately document your case is critical in this effort.

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