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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.

Do You Know The Facts?

America Spinal Injury & Impairment ConsultantsConsumer Federation of America Released it's Report on Insurer's Utilization of Insurance Claims Evaluation Softwares

Former Industry Executive Details Claims’ Tactics That Shortchange Consumers Newly Released Court Documents Reveal Huge and Questionable Insurer Claims’ “Savings” 

Washington D.C. (June 4, 2012) -- A new report released today by the Consumer Federation of America (CFA) has found that computerized claims’ systems used by most of the nation’s largest insurance companies can be easily adjusted to make broad-scale “lowball” claims’ payments to injured consumers that are less than what they should receive under their insurance policies. The primary author of the report is an expert on insurance claims’ practices and was a longtime insurance executive.

“This report is a wake-up call for consumers and regulators who are not aware of the many ways that computer claims’ software can be manipulated to produce unjustifiably low injury payments to consumers and tens of millions of dollars in illegitimate ‘savings’ for insurers,” said Mark Romano, CFA’s Claims Project Director. Romano was the “subject matter expert” on the Colossus injury claims’ evaluation system at Allstate and Encompass insurance companies for almost ten years. Colossus, which is the dominant claims’ system in the marketplace, is sold by Computer Sciences Corporation (CSC).

“When CSC and its competitors talk publicly about computer-based claims’ systems, they stress that the programs allow insurers to more consistently evaluate bodily injury claims,” said Romano. “Consistency is a legitimate goal, but these companies tell a different story behind closed doors. Software marketing representatives acknowledge that the real reason insurance companies are willing to invest millions in these systems is that they can dial down claims’ payments to thousands of consumers at a time, regardless of whether these payouts are fair.” The report, “Low Ball: An Insider’s Look at How Insurers Can Manipulate Computerized Systems to Broadly Underpay Injury Claims”, details the history of the use of Colossus and similar software products by insurance companies. It provides considerable information about how these programs are set up, “tuned” to reach particular claims’ payment monetary goals and adjusted over time.
 

The report also identifies specific techniques that insurers can use to directly and indirectly produce “lowball” claims:
 

  • Directly reduce payments by a predetermined amount across-the-board, without determining whether this will lead to unjustifiably low payments for individual claims. 
     
  • Selectively remove higher-cost claims from data used to determine the acceptable range of payments for particular injuries. This has the effect of lowering payments for all claims of this type. 
     
  • Require insurance adjusters without medical training or credentials to second-guess medical professionals by altering injury determinations, thus dictating lower payments for certain injuries. 
     
  • Encourage adjusters to downplay or even ignore the likelihood that injured consumers will need future medical treatment or will be permanently impaired, thus lowering payouts. 
     
  • Encourage adjusters to determine that drivers are partly at-fault for the auto accident that injured them, even when they may not be.

“Many of the concerns about Colossus and similar programs have focused on the potential for insurers to manipulate these systems directly in order to reduce claims’ payouts,” said Romano. “But insurers can also use many techniques to unjustifiably lower payments in a more subtle manner, by putting biased or incomplete information into the system.”
 

The report includes excerpts from recently released court records in a major class action lawsuit, Hensley v. Computer Sciences Corporation, that reveal disturbing information about how Colossus and similar products are marketed to and used by insurance companies:
 

  • Insurers could adjust Colossus to produce virtually any claims’ payment reduction they wanted, whether or not it was justified. One CSC executive told the court that Colossus could be “tuned” to potentially achieve a particular level of savings, such as 15 percent, for all claims.  
     
  • CSC claimed insurers could produce huge reductions in claims’ payouts, which insurers achieved in many cases. A CSC executive told the court that Colossus achieved savings of around 19 percent on overall claims payouts for some its insurer clients. Meanwhile, CSC’s competitors, like the Insurance Services Office (ISO) claimed that they could maintain even higher savings over time. 
     
  • CSC misled regulators about the purpose of Colossus, claiming that main function of the product was to achieve consistent payouts rather than enormous claims’ “savings,” which might be illegitimate.

“These documents show that most of the nation’s top insurers used the Colossus system in ways that put millions of American consumers at risk of not getting the claims payments that they paid for with their premiums,” said J. Robert Hunter, CFA’s Director of Insurance and former Federal Insurance Administrator and Texas Insurance Commissioner. “The documents also reveal, unfortunately, that top executives at these companies violated their obligation to deliver fair claims’ payments to their own policyholders on a huge scale, in order to increase profits.”
 

The report offers a number of recommendations to state insurance regulators to better protect consumers from insurers that manipulate Colossus and similar systems to unjustifiably reduce claims’ payouts: 
 

  1. Regulate all companies that sell claims’ adjustment software products, such as CSC. Currently, neither the states nor the National Association of Insurance Commissioners (NAIC) does this for all vendors of these products.  
     
  2. Examine and monitor the use of computerized claims’ assessment systems by major insurers. The NAIC should thoroughly investigate methods that all large insurers can or do use to directly or indirectly reduce claims’ payouts in an illegitimate manner. (The NAIC and state-based regulators signed an agreement with Allstate in 2010 that required the company to make a few small changes in how it used Colossus.)  
     
  3. Require insurers to notify consumers in writing that a computerized claims’ assessment was used to process their claim and to provide a copy of the report generated by the system. This will help injured consumers to determine if they received a fair payment. 

“The NAIC examination of computer adjustment systems was incomplete and flawed,” said Hunter. “They only investigated how a single company, Allstate, which used only one of these systems, Colossus. And their agreement with the company did little to change how Allstate adjusted Colossus to make claims’ payments or to protect consumers from potential abuses.”

 

Can A Person Be Injured In A Low Speed Collission - Even If There Is No Damage To The Vehicles?

Absolutely YES!! 

Do Not be Misled or Intimidated As Insurers Would Want.  

CNN RESEARCH FINDS: Theme of [insurance company strategy] is; 

  1. Deny
  2. Delay
  3. Defend  

"Auto insurers play hardball in minor-crash claims":   
State Farm, Allstate, employ consultant's strategy, which CNN research finds the Theme of Strategy is; "deny, delay, defend". 

Former employee says companies convince juries that claims are fraudulent. 

ATLANTA, Georgia (CNN) -- If you are injured in a minor car crash, chances are good that you will be in the fight of your life to get the insurance company to pay all the medical costs you incur -- even if the accident was no fault of your own.

That's what CNN discovered in an 18-month investigation into minor-impact soft-tissue injury crashes around the country. Those are accidents in which there is little damage to the vehicle and the injuries to people are not easy to see by the naked eye or conventional medical tools like X-rays.

Read the article -  Click Here

Don't be a victim of both an auto accident AND the insurance companies. The insurance companies have changed the way they value claims. Changes occur so rapidly that even your doctor or lawyer may not have all the latest information to help you in your accident claim. We've created questions for you to ask both your doctor and lawyer to determine if they are trained in the practice and policies of the insuarnce companies. We also direct them to national symposiums where thye can get all the latest up to date information to help you. It takes committment and dedication and these highly trained medical and legal professionals are prepared to assist you. You can find knowledgeable doctors and lawyers in the directory on this site. These doctors and lawyers are known to be trained on the Collosus System. You can ask them a series of questions to interview them regards their knowledge. See 17 questions to ask in the section entitled 3 KEY ELEMENTS.

Whiplash Pain

Insurance Company Advantages;

3 Key Elements to know about insurance settlements of claims and how to combat them.

Insurance Advantage #1:
There are 35 Different Claims Evaluation Software Types Being Used To Evaluate Claims.

  • Your Combat Advantage:
    Use Decision Points.

Insurance Advantage #2:
There are 45 Treatment Acceptance & Payment Software Types Being Used To Evaluate Treatment and doctors fees.

  • Your Combat Advantage:
    Use Value Drivers 

Insurance Advantage #3:
They use Claims, Practice & Procedure Softwareto evaluate claims. 

  • Your Combat Advantage:
    Use 9 Point Medical Validating Letter And 19 Liability Drivers 
In The News

4 COSTLY MISCONCEPTIONS

Misconception #1: 
Thinking the term "Whiplash" idescribes your injury accurately.

  • WRONG: Using the words or diagnosis of “Whiplash” or “Soft Tissue Damage” will actually lower the settlement value.

Misconception #2:
Minor (lesser)Vehicle property damage or repair costs equates to a lesser bodily injury. 

  • WRONG: This has absolutely nothing to do with the severity of your injuries.

Misconception #3:
The number of diagnoses should fit onto the limited space on the insurance forms. 

  • WRONG: A supplemental form should be used to represent all, often up to double digit diagnoses. Failure to include all the diagnoses can cost up to 5 times the settlement value.   

Misconception #4:
When the patient is released from care, they are cured.

  • WRONG: The manner of representing the medical condition of the patient at time of discharge and the effect the injuries will have in the future, greatly affects the settlement value.

 

Know What To Do

Be Aware Of Changes

The insurance company determination procedures for arriving at settlement vlaues has changed. The reality is the creation of a software system with a set of factors that they don't readily reveal to most doctors and lawyers, designed to lower settlement values. The more you know and use this data, the higher your settlement value will be.

The law of physics called “The Magnification of Accelerated Forces,” along with testing utilizing various models including the infamous 'crash dummy', primates and human volunteers reveils even when the G force of acceleration in a car is as little as 2G’s, the force of acceleration is magnified and transferred to the head and neck of the vehicle occupants where it more than doubles to 5G’s. (Pilots pass out at 6G’s of force and cerebral contusion may occur in 50% of the incidents of 5G’s or more). This 2G force occurs in just an 8-mile-per-hour impact and may or may not cause any damage to the vehicle. You can be injured from low-impact forces without damage to the car and may not feel any symptoms.

How Do I Know If I Have Been Injured?

First, by being the recipient of a trauma to the neck—as in a car accident. This injury usually results in the neck being forcably thrust into extension (backwards) then flexion (forward), with either downward compression or upward distraction of the head and neck. This is a dynamic trauma which causes damage. The old soft tissue injury theory has been replaced by the understanding that the dynamic trauma causes 'connective tissue' damage with resultant ligament scarring, the end result being muscle atrophy.

Whiplash Symptoms
  • Pain in neck/across shoulder/arm/jaw
  • Discomfort aggravated by motion
  • Headache / Dizziness / Varying degrees of anxiety
  • Tightness / Limitation of motion
  • Duress, loss of enjoyment, joy & activities of living daily life
  • Difficulty concentrating or sleeping

If after an accident or trauma, you notice any of the above symptoms, you should see a doctor for an evaluation. Research from a study of 5,000 cases indicates that 25% of motor-vehicle accident cases develop chronic disability of some type. Review the section on the 11 Questions To Ask A Physician Before You Select One. Also review the section on the 6 Questions To Ask An Attorney before you hire one.