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Why an Adjuster Can't Determine the Value of An Accident Case?

Dale Gribow June 1, 2022

Today, all insurance companies use a computer program called Colossus to determine the value of an Auto Accident case. It plugs in the severity of the injuries and the amount of the medical bills, loss of earnings, amount of property damages, how long the victim treated etc . It then spits out an amount, the adjuster can then offer.

Believe it or not I have received hundreds of calls, right after the accident, asking, “What determines the value of my Accident case and what is it worth?” It know it sounds silly but people who have been in an accident will call right after the accident and ask that question. One interpretation is that the party is in it for the money only, and not interested in getting medical help, or even needing it.

Common sense would dictate that a lawyer needs to know how bad the injuries were and how long a victim has treated with medical providers. Some medical providers have greater importance than others, and some medical bills are more important than others.

For instance $10,000 in Ortho and Neuro treatment bills are worth more than MRI and XRAYs etc. Many years ago the insurance company, on a soft tissue case, would just multiply the medical bills by 3 or 4 and offer that amount to settle. Then they realized a bill of $5,000 for MRI or X-rays etc. was not worth as much as $5,000 of physical therapy.

Because of this program it is more important than ever before that you hire a lawyer who focuses on accident cases… to guide you and your medical providers. An accident victim needs a doctor who specializes in both Treating AND Writing a medical report. Though it does not seem right, there is a difference between a doctor who says there is a 50% chance of a full recovery, and saying a 50% chance the patient will not make a full recovery. For years I lectured to the International College of Surgeons at their annual seminar, teaching them How to Write a Medical/Legal Report.

A patient needs a doctor who does not say “go home and soak in a hot bath and call in a month and to take aspirins if there is any pain.” When you call in a month it takes another 2-3 weeks to get a doctor’s appointment. Thus after a few months there is very little in medical bills. Thus Colossus and the insurance company argue that if the patient was really injured they would have treated on a regular basis. That is why we assist you in finding the right doctor…though it is more challenging in the CV.

When a client come into the office, I explain that a lawyer can no more tell you what your case is worth when s/he meets you, than a doctor can diagnose you without treatment and tests etc. A lawyer will not even begin to evaluate your case until your treatment has concluded and we know not only what the total amount of the bills are but also are advised what your med condition had been in the past and what it will be like in the future. Even then it is not a precise formula or process as we have to look at whether our client was partially at fault.

You are an individual and your injuries are as unique and as individual as are you. We can only assure you that our office will obtain the maximum amount of settlement possible given the individual facts of your personal situation.