Things To Do If The Insurance Company Uses A Computer Program

In an insurance claim after an accident, if the insurance company is using a computer program to come up with settlement offer, there are some things you can do to help get a better offer.

1. Ask the adjuster how they are coming up with their numbers- specifically if they are using a computer program. (Many companies use “Colossus”).

2. Make sure your doctors document your symptoms. This can be tough because you don’t control what the doctor writes. However, consider bringing a list of symptoms or problems with you to your doctor appointment. The insurance adjuster inputs this information into the computer program.

3. Tell your doctor any activities (often referred to as “activities of daily living” or “ADLs”) that have been affected since your accident. Again, consider bringing a list to your appointment. These are important because the computer program used by the insurance company will give you ‘points’ or value for activities affected.

4. Resist the temptation to give the other person’s insurance company a medical authorization. It’s more work for you, but you should get your own medical records. When you submit them to the adjuster, highlight all of the symptoms, ADLs and other references you believe are important. Remember, the computer program is only as good as what the adjuster inputs into it. Highlighting will increase your odds.

5. Hire a lawyer. Most computer programs, and the insurance companies in general, value the case higher if you have a lawyer – because they know you are more likely to get a higher result (without a lawyer, you are not a threat to file a lawsuit, which increases their exposure).

6. If you have received an offer, consider submitting additional information along with a request that the adjuster run a re-evaluation.

7. If you have aggravated a previous condition in the accident, discuss that with your doctor. First, it’s being honest, which you should do anyway. Second, the insurance company will likely do what’s called a claims index search anyway to look for previous accidents. Third, and most important, computer programs such as Colossus actually give you ‘points’ for aggravation of a condition.

8. Make sure, whether you are submitting your own records or not, that the insurance adjuster has the billing records for your treating medical providers. In most states, including Pennsylvania, these are called HCFA 1500 forms. They are important because they contain the diagnostic billing code used by the doctor or medical provider and the computer program gives points for those.