Personal Injury Claims: What Are "Value Drivers?"
A quick summary about Computer Assisted Claim Evaluation programs used by most major insurance companies and the value drivers they use to calculate a victim's compensation.
Computer Assisted Claim Evaluation ProgramsToday most major auto-crash insurance 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."
Value DriversCentral 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 documents and/or facts must be presented to limit the negative value driver.
Info About AttorneysIf 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 any negative value drivers. The most common Computer Assisted Claim Evaluation program is Colossus and most experienced personal injury attorneys have a general knowledge of this program and how it works. When interviewing an attorney for your claim or case, ask him or her about these programs and how they work. You'll be able to tell from his or her response if they know about and understand this important tool used by the insurance companies.