Personal injury
Colossus
Claims-evaluation software some liability insurers use to suggest a settlement range for bodily injury claims from coded injury and treatment data.
What it is
Colossus is a computer program that some auto insurers use to evaluate bodily injury claims. It was sold for many years by Computer Sciences Corporation (CSC). An adjuster enters coded information about the injuries, diagnoses, treatment, its duration and other factors, and the program returns a suggested settlement range. Each insurer configures, or "tunes," its own installation using claims it has settled. Colossus is one of several tools of this kind, and not every insurer uses it.
What regulators and critics have said
In 2010, Allstate agreed to pay $10 million to 45 states to close a multistate market conduct examination of its use of Colossus, led by Florida, Illinois, Iowa and New York. Regulators said they found no systemic underpayment of bodily injury claims, but that Allstate hadn't tuned the software consistently across its regions. Allstate agreed to tell claimants Colossus might be used, strengthen oversight and audits, and not require adjusters to settle at the program's recommended value. Allstate said the review confirmed the technology adds objectivity and efficiency. The Consumer Federation of America, a consumer advocacy group, argued in a 2012 report that injury evaluation software can be tuned to lower payments.
Why it matters to a plaintiff firm
Whatever tool a carrier uses, its evaluation starts from what is in the file. Clear diagnoses, objective findings, consistent treatment without unexplained gaps, documented work restrictions and complete bills all feed the number. A medical chronology and a complete demand make sure the evaluator sees the whole case.
Sources
- Insurance Journal: Allstate settles claims software complaint with states for $10M (Oct. 2010)
- Utah Insurance Department: order adopting the Allstate multistate regulatory settlement
- Consumer Federation of America: report on computerized claims evaluation (advocacy)
General information about California and federal rules, not legal advice. Rules change and every case turns on its facts: check the statute and your own analysis before relying on a date or a figure.