What should I do?


 
The first thing to do is to determine whether or not the company you are dealing with uses Colossus for any purpose in its claims process. Here is a list obtained through the media, of companies that will admit to using Colossus for some purpose in their claims valuation process.
 
The following companies are known to license COLOSSUS:

  • Aetna
  • Allstate (since 1997)
  • American National Property and Casualty (since 1997 in 38 states)
  • American Family Group of Madison (since 1996)
  • Arrow Claims Management (since 1997)
  • AXA Insurance (based in UK, one of the world's largest insurance group) (2001)
  • Bishopsgate Insurance (since 2000)
  • Explorer Insurance Company (1997)
  • Farmers Insurance Group of Companies (2000)
  • Federated Mutual Insurance Company (1998)
  • General Casualty Insurance Companies (1998)
  • Grange Mutual Casualty Companies (1998)
  • Great American Insurance Company (1998)
  • Hartford Financial Services (2000)
  • Keystone Insurance Companies of Philadelphia
  • Metropolitan Group, Rhode Island Norwich Union
  • Motorist Mutual -American Hardware Insurance Group (1998)
  • Ohio Casualty Group of Insurance Companies (1998)
  • State Auto Insurance Companies of Columbus (1996)
  • 20th Century Industries (1997)
  • Travelers/Aetna Property Casualty (1996)
  • United Services Automobile Association (USAA) (1997)
  • Utica Mutual Insurance Company (2000)
  • Zurich Personal Insurance (1998)

Therefore, we recommend that you follow carefully our advice on this topic to avoid allowing the insurance company an upper hand in resolution of your claim. How could this valuation software allow them the upper hand? First, as documented above, and as more thoroughly set forth in the Colossus Reference Links Go to COLOSSUS REFERENCES, this is a software program that will produce a result that is in favor of the insurance industry. It does not include factors that may cause real interference with healing, or which may result in many nights of disturbed sleep.
Be it the tortfeasor's company or your own insurance company, if the company that you are going to deal with for a general damages award has licensed Colossus, we recommend that you consider that in your negotiations. For example, since Colossus produces only an "expected" result based upon an "average" from input verdicts and settlements, you would want to call to the attention of the adjuster any facts that put your situation outside of the norm.
 
Let's say that you are a waitress and you sustained a soft tissue injury to your neck and low back. No matter how good and helpful your medical treatment or no matter how much healing you achieve from a couple of days off of work, your condition will worsen just as soon as you again start carrying those trays full of food or drinks. The weight of that tray on one side or the other will make your injuries worse, and it will be much more difficult for you to obtain healing.
 
Another example might be a single mother who has to pick up her 11 month old baby frequently. She will suffer continued pain from her accident injuries a lot longer than a person who does not otherwise burden healing tissue. Think of how many times a day she has to pick up that child, and what a strain that puts on her neck and back.
 
Now do you think there is any way that either of these-or like-situations will be covered or considered in the Colossus result? Of course there isn't. This is the old adage of: "Garbage In-Garbage Out". Since the computer was not queried or programmed to consider either of these circumstances, then it is your job to provide sufficient information to the adjuster to allow her to modify the result from Colossus by making another set of information inputs to the program.
 
What you have to do is to think about your situation and come up with some aspect of your case that may be a little different than the norm. Then you will make note of that situation in a letter to the adjuster and ask her to confirm that in her evaluation she will make allowance for your situation notwithstanding the result suggested by Colossus. We have prepared a form Letter To Adjuster Regarding Colossus Go to LETTER TO THE ADJUSTER REGARDING COLOSSUS.
 
If she does not respond, or if she does not agree to make allowance for your particular situation, we suggest you warn her that you will write to the insurance commissioner. See Follow-up Letter to Adjuster Regarding Colossus Go to FOLLOW-UP LETTER TO ADJUSTER RE: COLOSSUS. As a next step, we suggest that you write to your state insurance commissioner Members onlyMembers only and complain about the use of Colossus. Finally, we think that your state Trial Lawyers Association may have some information or suggestions on legislation to curtail the total reliance on Colossus.
 
Another key to working with an adjuster who is using Colossus is to make sure your medical record documents everything in a way that the software will reward. There are three key elements to this requirement, and you control only one of them: the other two are held by your doctor (who may not wish to make adequate documentation) and the adjuster (who may not cooperate to let you know what format is required for information to be understood by Colossus).
 
You will need the cooperation of the adjuster to tell you what format would be helpful to him in getting you full value for your claim. Ask him about the quality of your medical records. Which records were most useful, and which records were virtually useless. He should be able to tell you. This person is not an actual enemy; he has a job to do in this mission, and so do you; you need each other to ensure the case is settled fairly and amicably.
 
Solicit the adjuster's cooperation to let you know the specific injuries and specific complaints used to evaluate the claim. Since each complaint and injury must be documented in a medical report to be considered by Colossus, ask him to help you by telling you which doctor needs to make a supplementary record in this case.
 
If you don't have a good medical record, you will have to obtain a narrative from your doctor, or get him to make specific findings that are translatable to input into Colossus.
 
Please consider the information provided at the following links in this site:

  • Essential Documentation in the Medical Records Members onlyMembers only
  • Background on Keeping Your Doctor's Records Accurate Members onlyMembers only
  • "No Medicine-No Money" Go to NO MEDICINE - NO MONEY