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Physicians Trained In The "Injury Model" To:
  • Reverse And Prevent Low Settlement Valuations In Injury Claims
  • Provide Independent Medical Validations (IMV) to Overcome Inept Independent Medical Examinations (IME)
  • Perform Impairment Ratings By Attending Physician - 1-3 Body Parts at Discharge
  • Prevent Claimant and Primary Care Provider Attacks
  • Utilize the proprietary Zeusclaim Injury Software to Counter Colossus
  • Collaborate with a 3rd party physician to share bright information to minimize insurance companies "Loss Probabilities."
Our physicians follow precedents and authorities set by judicial decisions and administrative legal findings & rulings to eliminate disputes, denials and undervaluations.

3 Key Elements

(Insurance Company Advantages) to know about insurance settlements of claims


Insurance Advantage #1:
Claims Evaluation Software Types Being Used To 
Evaluate Claims.
 
The insurance companies have created an advantage through the use of different types Of software to 'work-up' your claim and assess a dollar settlement value and it’s vital to recognize and counter which specific software is being used by the individual insurer to evaluate the claim. There are 35 different software programs in use for this purpose and there is also one manual evaluation program being used (named Peach, in use by State Farm). Other programs are; Colossus, Mitchell, MBRS, Medico, ACE - to name just a few. If your doctor and lawyer do not know the software type and work-up your case to combat it, your case will lose substantial merit and value.

Your Advantage:
Decision Points.
To address these software types, your case must reveal Decision Points that structure your settlement offer to offset the insurance company software advantage. If your doctor or lawyer do not use the Decision Points, you lose their value and will receive a lower offer.

Insurance Advantage #2:
Treatment Acceptance & Payment Software Types Being Used To Evaluate Treatment and doctors fees. 
There is a second software type being used by the individual insurer to determine what treatment will be accepted (duration/type/frequency) as well as the acceptable prevailing competitive price of that treatment. There are 45 different software programs in use for this purpose. If your doctor or lawyer do not work-up or format your case to meet the software protocol, your case will lose substantial merit and value.

Your Advantage:
Value Drivers 
Insurance Companies use Value Drivers to determine settlement offers. It is therefore imperative that both your lawyer and doctor know about, use and represent the ‘Drivers’ in your case that contribute to your case value. If your doctor or lawyer do not use the Valuer Drivers to work-up or format your case to meet the software protocol, your case will lose substantial merit and value.

Insurance Advantage #3:
Claims, Practice & Procedure Software Types Being Used To Evaluate Claims. 
Each individual insurance company uses their own Claims, Practice and Procedures Software that involves the EVALUATION, NEGOTIATION AND SETTLEMENT PROTOCOL. If your doctor or lawyer do not work-up or format your case to meet the software protocol, your case will lose substantial merit and value. (See section entitled ESTABLISHING ALLSTATE’S LIABILITY - Allstate’s Practice of Law under CCPR Harms the Public Interest). 

Your Advantage:
Medical Validating Letter And Liability Drivers Validating Letter;
Your case should include the use of a 9 Point Medical Position Validating Letter to respond to these Claims, Practice & Procedure protocols to influence settlement in your favor. If your doctor or lawyer do not work-up or format your case to INCLUDE THE 9 POINT MEDICAL VALIDATING lETTER, your case will lose substantial merit and value.

Liability Drivers;
The use of Liability Drivers is a tool to give you advantage. Even if liability is clear and there is no negligence to the party seeking settlement, if these liability drivers are not addressed there is up to a 20% reduction of settlement value. This is why your case needs to include the19 Liability 
Drivers that must be addressed by the attorney and presented to the insurance industry.

Anyone presenting a case to insurance companies must present 19 Liability Drivers for highest settlements. If your doctor or lawyer do not work-up or format your case to INCLUDE THE LIABILITY DRIVERS, your case will lose substantial merit and value.

IMPORTANT NOTE: 
If either your attorney or doctor do not incorporate these factors, the ‘windows’ of the software do not open and you lose the compensation for these factors associated with these injuries and factors. 
The software programs determine the value of settlement offer and if you do not have these factors, or your attorney does not include them in our representation, you lose the value.


It’s that simple.

KNOW YOU'RE RIGHTS - OR LOSE THEM!

Lady Justice

  • How to avoid unfair unrealistically low settlement offers
     
  • Mistakes that can cost you 85% of a settlement offer
     
  • “Value Drivers” that can add 20% to your settlement offer
     
  • Tactics insurance companies use to lower your settlement offer
     
  • Key factors that can increase your settlement offer up to 5 times
     
  • 14 aspects that lower the settlement offer without you knowing it
     
  • 17 questions to ask before selecting a lawyer or physician



Court Room
 

6 Key Questions to ask an attorney before you select one.

Select An Attorney Who Knows These Answers and Uses These Practice Procedures And Protocol To Represent Your Claim.

  1. Do you know the Claims Evaluation Software type my insurance company uses to evaluate my claim? 
     
  2. Do you know the Treatment Acceptance & Payment Software type my insurance company uses to evaluate treatment and doctors fees.
     
  3. Do you know the Claims, Practice & Procedure Software type my insurance company uses and the protocol it contains to evaluate my claim?
     
  4. Do you submit a 9 Point Medical Position Validating Letter?
     
  5. Do you present the 19 Liability Drivers for highest settlement offers? 
     
  6. Do you know and use the Value Drivers in representing claims? 

 

11 Key Questions to ask a physician before you select one.

Select A Physician Who Knows These Answers and Uses These Practice Procedures And Protocol To Represent Your Claim.

  1. Do you know what the Claims Evaluation Software type used by my insurance company is? 
     
  2. Do you know the name of Treatment Acceptance & Payment Software type used by my insurance company? 
     
  3. Do you use the “Duties Under Duress” and "Loss Of Enjoyment” forms
     
  4. Do you use "Supplemental HCFA" Diagnosis forms to incorporate the full extent of my diagnoses which I understand may range in the double digits?
     
  5. Do you know and use "Decision Points" and "Value Drivers" to “work up” the injuries in the specific format used by my   particular insurance company?     
     
  6. Will you make sure all treatment costs are accepted by the insurance industry so I won’t owe anything out of my settlement?
     
  7. Do you use the words Whiplash or Soft Tissue in the diagnosis? (Correct answer is NO).
     
  8. Do you list each involved body part, system, organ or function separately and do you make sure every injury has been diagnosed by body part not region part?
     
  9. Do you use specific terminology to ensure that any necessary future treatment in both active and passive capacity can be accepted and support the payment of my medical bills as well as support the evaluation of the injured claim both now and in the future if it is needed?
     
  10. Do you use the general term Maximum Medical Improvement (MMI) when you release me from care at treatment completion or do you assign the MMI term to one specific diagnosis or injury? (Correct answer is never to use it as a general term, and only use it to represent one diagnosis or one injury).
     
  11. Do you find that in accident cases you often assign double digit diagnoses? (Correct answer is yes. Double digit diagnoses (over 20) are normal statistics in auto accident cases and can increase settlement offers by 50%)

This process is so detailed & complex that the public must rely upon only those doctors and attorneys that are educated in this environment. To do otherwise would give back large portions of your settlement to the insurance industry & leave large amounts of dollars that were already determined to be paid in the settlemen