Your Insurance Claim is Decided by a Computer Program

In the past, insurance claims adjusters were experienced, trained professionals with ample knowledge about medical costs, economic losses, repair costs, and car accidents. Claims were handled on an individual basis, which worked well, because every auto accident is unique. The claims adjuster would tally repair costs, medical bill costs, future medical costs, lost income costs, and essentially, any other financial loss an insured individual may face following an accident. With the advent of cheaper, faster, and advance technology, there simply is not a need, at least to insurance companies, for the traditional in-person claims adjuster.

Today, insurance adjusters are not in the field, or even necessarily contacting you in person, but rather, these individuals are cubicle-dwellings who make very little assessments or decisions at all. In fact, these individuals now rely on the computer program known as "Colossus" to decide any pertinent aspect of your personal insurance claims. Naturally, this method saves insurance companies tons of money, but at what cost? Most accident victims will readily agree that they and their families, the people that have regularly paid the insurance company for coverage, are the ones losing out the most.

The Secrecy and Inaccuracy of Colossus and Your Insurance Claims

From press information on the Colossus website, the company’s program is intended to interpret, analyze, and categorize personal injuries according to the American Medical Association’s Fifth Edition. Adjusters simply utilize a series of questions prompted by the program to ascertain the cost, impact, and losses each medical injury will cause an individual. Unfortunately, that average individual used in their statistics, probably will not fit your unique personal needs at all.

Not only does Colossus generalize claims into inaccurate lump categories, but also, the program does not account for differences in lifestyle, work, and other human factors. For example, an office employee and a construction worker that suffer a broken leg on the job will receive the same claims amount, regardless of their lost income and other future concerns. Again, most people are aware that some broken legs are simple fractures resulting in minor medical care, while other fractures are heinous injuries requiring months of rehabilitation, screws, pins, and other surgical repairs. Well according to the inaccurate decisions of Colossus, a broken leg is a broken leg with no sliding scale for severity.

Furthermore, the generalizations and inaccurate averages of Colossus use cost data information to determine how much your total losses and care should cost, not what it actually does cost. Across each given state, there are wide geographic disparities in medical costs, repair costs, and other items, but Colossus simply uses an average settlement amount for each given injury in a claim. And realistically, no one even knows what that amount is going to be, because the owners of the Colossus program have earmarked the program as a trade secret and vigorously fight any courtroom litigation demanding more transparency from the company.

More Pitfalls of the Automated Insurance Claims Process

The Colossus program does not take into account suffering, pain, physical discomfort, emotional damage, stress, or even psychological trauma. Almost all of these things are associated with an accident; however, the software simply does not take any of these things into account, because realistically, there’s no way it could without a human to human interaction. But for insurance companies, that’s too expensive. In past claims adjusters could listen to reason, recognize more serious injuries than others, and in turn, make sure victims receive the coverage and protection they have been paying for all along. However, victims today must either accept the low settlement amounts, or face making their case in the courts.

• This page is provided for informational purposes only. If you need advice regarding an insurance claim,
  click here to talk to John J. Sellinger or an Accident Attorney near you.