Claims Outcome Advisor is a computer software program developed by Insurance Services Office, and it is used by many insurance companies across California, and the United States, that helps determine for a claims adjuster "settlement value" on a given injury claim. It is marketed for both bodily injury and workers comp claims. It is considered one of four of the most often used computer programs an insurance company has at its disposable to ascertain claim value; among the four, Colossus is the oldest and biggest:
1. Colossus by Computer Sciences Corporation (CSC);
2. Claims Outcome Advisor by Insurance Services Office;
3. Injury Claims Evaluation by Automatic Data Processing, Inc. (ADP);
4. Injury IQ by Claim IQ;
The computer system contains over 18,000 medical conditions (injuries), including illustrations, 3-D images, and a glossary for the claims adjuster who is imputing data on a person's given injury case. It is a program used to compute the monetary value of a change in a human being's quality of life. The goal of the program is to be a cost containment measure on a given accident claim. It uses a different coding system and algorithm than any of the other three programs mentioned above. A Personal Injury Attorney should have working knowledge of this system and an idea, at least, of which insurance companies license it and actively use it on specific accident claims. The reason: if a claims adjuster misses a specific medical "value driver" on a injured client's claim, or ignores it, the attorney should be aware of this potential problem and have a system in place with his or her law office to combat it. Sure, filing a lawsuit is one way to have an insurance company take responsibility for reviewing injury value, but what about knowing about the computer program and what the adjuster needs to do in order to get the settlement value to where it needs to go? This can sometimes avoid the costs of a lawsuit all together which benefits the client.
1. Colossus by Computer Sciences Corporation (CSC);
2. Claims Outcome Advisor by Insurance Services Office;
3. Injury Claims Evaluation by Automatic Data Processing, Inc. (ADP);
4. Injury IQ by Claim IQ;
The computer system contains over 18,000 medical conditions (injuries), including illustrations, 3-D images, and a glossary for the claims adjuster who is imputing data on a person's given injury case. It is a program used to compute the monetary value of a change in a human being's quality of life. The goal of the program is to be a cost containment measure on a given accident claim. It uses a different coding system and algorithm than any of the other three programs mentioned above. A Personal Injury Attorney should have working knowledge of this system and an idea, at least, of which insurance companies license it and actively use it on specific accident claims. The reason: if a claims adjuster misses a specific medical "value driver" on a injured client's claim, or ignores it, the attorney should be aware of this potential problem and have a system in place with his or her law office to combat it. Sure, filing a lawsuit is one way to have an insurance company take responsibility for reviewing injury value, but what about knowing about the computer program and what the adjuster needs to do in order to get the settlement value to where it needs to go? This can sometimes avoid the costs of a lawsuit all together which benefits the client.