As we discussed in our prior article – What Are Claims Assessment Cases – a claims assessment case is a personal injury claim that an insurance company evaluates using claims assessment software to determine the payout they will give you. This type of claim makes up approximately seventy percent (70%) of third-party claims in the United States.
The complex claims assessment software uses upwards of 12,500 rules or factors to evaluate claims for insurers. Due to this incredibly high number of factors, there are a few considerations that injured drivers and their attorneys must keep in mind when filing a claims assessment case:
For the most part, medical records and medical evidence are the only sources that are used to determine what information will be input into the software.
Injuries that are not diagnosed by a doctor will not increase the recovery of the injured driver. Since that is the case, it is extremely important that any doctors who examine the injured driver take into consideration the full extent of the injuries of the driver to ensure that all injuries are entirely accounted for.
The factors that the software uses create a total number that suggests the severity of the injuries. The "severity points" are allocations of these factors that, when combined, are assigned a monetary value.
Finally, it is crucial to remember that all information entered as a part of a claims assessment case must be absolutely true.
Understanding how software-based injury analysis works can help ensure that claims are fully evaluated when processed by this type of software. It is extremely important that you have an experienced personal injury attorney guiding you through the process to ensure you remain compliant with the software's evaluation requirements, and to ensure that you receive the compensation you deserve for this claim.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.