Part III of damages in personal injury: Settlement versus trial, and what's a Colossus?
According to Black’s Law Dictionary, approximately 95 percent of personal injury cases in the U.S. settle. The other five (5) percent are cases where: (i) the insurance carrier thinks the demand is too high and the case defensible, or (ii) the plaintiff has an outstanding case that appears a sure winner and the offer is too low -- so the case goes to trial. Black’s tells us further that of the 5 percent that go to trial, approximately 90 percent of the time plaintiffs lose. Of those trial cases where a plaintiff does win, damages are better and paid at a higher monetary rate when the case is before a trial judge, rather than a jury. See:
So let’s talk settlement. What’s the injured party’s attorney up against?
In most “ordinary” personal injury cases, a computer.
Insurance carriers use computer-based modeling programs to evaluate claims. The 900-pound gorilla is Colossus, which is believed to be used by, among other insurance companies, Allstate, Esurance, CNA, Erie, Farmers, Great American, Metropolitan, Ohio Casualty, The Hartford, MetLife, Travelers, USAA and Zurich. But there are other brands of injury valuation software, including ClaimIQ and ISO Claims Outcome Advisor. Regardless of what software program is used, it has been estimated that up to 50 percent of all personal injury claims are assessed and valued by computerized claims programs.
It is generally understood that these computer-based modeling programs contain approximately 600 injury codes that represent the kinds of injuries that may occur. These injury codes have a severity value, and there are money calculations assigned for each “severity point.” After the program is run, the computer provides a settlement value. Priority is placed upon permanent injuries. However, it is important to note that the latest ICD-10 (a world-recognized medical classification list) has over 69,823 codes to classify injuries for medical identification and billing purposes. So it is safe to say programs like Colossus miss, ahh, a few injuries (irony intended) -- and therefore poorly quantify the nature, extent and depth of an injured client’s pain and suffering.
As a result, don’t be surprised if the insurance adjustor ignores your attorney’s repeated assertions that a particular injury is present and must be accounted for -- it may not even be present and quantified in Colossus or the other computerized claims modeling programs.
Stay tuned. Part IV of our damages in personal injury story addresses the various claims-modeling programs like Colossus used by insurance companies. It’s our next blog post: see, https://www.jimsnyderlaw.com/blog/2018/11/2/what-are-damages-in-personal-injury-part-iv-piercing-the-veil-on-computer-based-claims-modeling