Allstate continues to use a claims evaluation software to determine their insureds’ and claimants’ harms and losses.  Allstate uses a software called “Colossus” to assist their adjusters.  It is actually estimated that 70% of car accident claims are being evaluated by Colossus.  And it isn’t just Allstate – a helpful list of all known insurance companies with licensing rights to use Colossus can be found here (which insurance companies are authorized to use Colossus?).  Of course, the insurance companies claim that Colossus is just one aspect of their accident claims evaluation process.  But reports have shown that Allstate especially appears to be very wedded to the software and new adjusters especially are given less leeway to deviate from the software while evaluating the damages suffered by the injured claimant.

Most accident injury attorneys are familiar with Colossus.  We know how to submit a settlement demand to an insurance company known for using Colossus for claims evaluation.  We know that the more information that is contained within the medical records, the more “points” a claimant will receive and the more points the better.  What if the physician is a fantastic doctor but doesn’t list every single thing in his chart?  Does that mean the claimant is “less injured” just because the software wasn’t able to call the doctor or properly review the situation? We know that claimants with hospitalizations are given more points than those without – and not ER (emergency room) visits but actual admissions.  But we also know that typically, only 7 diagnostic codes can be entered into Colossus.  So what if the physician diagnoses a brain injury but enters the diagnosis last, as diagnosis #8?  We know that Colossus doesn’t know medicine and therefore, oftentimes ends up classifying things incorrectly – in other words, Colossus may classify different leg fractures as exactly the same even though some are more painful and some take longer to rehab with differing permanent restrictions.

A computer system cannot determine the emotional loss suffered by someone – the pain and suffering experienced by someone – the resulting disability suffered by an individual – the effect of the loss of a job on someone – the effect of the loss of a marriage on someone – the effect of a permanent scar on someone – the loss of the ability to dance or participate in school sports.  Why?  Because every individual is different.  Something that is minor to one person may be life and death to someone else.  This is one of the many important reasons that our judicial system provides the injured with access to a jury composed of their peers – a group of jurors who will listen to the individual facts, listen/watch and feel the effect of a car crash on someone’s life, and determine the value of such loss.  There are many components of the insurance industry that need regulation but using a computer software system, such as Colossus, to determine the effect of a tragedy on an individual human life should be strictly barred.

*This was originally posted on The Legal Examiner, August 28, 2013.