Today most major auto-crash insurane companies use some form of Computer Assisted Claim Evaluation Program to help them establish a “value” for a personal injury claim. These programs evaluate data about the injury claim and then provide the adjuster with a value or compensation amount they should pay the victim. Depending on the company, adjusters may have to strictly follow the evaluation or they may be able to offer more than the program’s “evaluation.”
Central to all of these programs are value-drivers. These are certain facts or factors that are input into the program. A value-driver can be either positive or negative. Meaning they can either increase the amount of compensation the victim receives or reduce the amount of compensation the victim receives. These programs can evaluate thousands of different value drivers. Even for a simple auto-crash injury claim there can be over 100 value drivers analyzed by these programs.
Obviously the diagnosis code for an injury is an important value driver but so are the treatment codes as well as the timing of the treatment. The “value” of a diagnosis code may also depend on what type of doctor made the diagnosis. A delay in care or a gap in treatment can be a negative value driver as well as inconsistent pain complaints in the medical records. Many times these negative value drivers can be limited or overridden by the adjuster but he or she has strict criteria or guidelines on what documewnts and/or facts must be presented to limit the negative value driver.
If you have a serious injury claim from a car crash, you need a law firm that understands Computer Assisted Claim Evaluation programs and knows how to properly document all of the positive value drivers and limit the negative value drivers. At Boteler, Finley & Wolfe we’ve been helping car crash victims present and prosecute their insurance claims for over 30 years. We know and understand Computer Assisted Claim Evaluation Programs better than most attorneys. We can help you. Give us a call today: 251 433-7766 or email Mark Wolfe at mark@bfw-lawyers today for a free consultation.