In the general medical practice, when your doctor provides you with a prognosis, they are essentially giving you an explanation of how they expect your condition or disease to advance in the future. There are general prognosis categories, such as excellent, good, fair, poor, etc. When it comes to claims assessment cases, the categories may differ, depending on the software that the insurance company is using.

For example, the most prevalent software – Colossus – uses the following categories:

  1. Resolution undetermined,
  2. No complaint/no further treatment required,
  3. Complaint/no further treatment required,
  4. Complaint/further treatment required,
  5. Guarded

With all this being said, the most important thing that you can do when filing your claims assessment case is to ensure that your doctor gives each of your injuries a prognosis. If you are aware of the type of claims assessment software your insurance company uses, then make sure that your doctor adopts the terminology that the software prefers. To give your claim the best chance of success with a high settlement, it is important that all of the documents are properly filed with attention to the details of each injury sustained. If you are concerned about whether your documents are sufficient to make a claim, or need help with properly formatting your demand letter to the insurance company, our personal injury attorneys at KI Legal Personal Injury are here to help. With a strong attention to detail and a focus on dedicated advocacy, our team will do everything it can to help you succeed with your claim. Give us a call at (212) 404-8605 or email to set up a free consultation today.

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.