ARTICLE
23 November 2023

What Factors Do Claim Analysis Software Consider?

KL
KI Legal
Contributor
KI Legal focuses on guiding companies and businesses throughout the entire legal spectrum. KI Legal’s services fall under three broad-based practice group areas: Transactions, Litigation, and General Counsel. Its extensive client base is primarily made up of restaurant and hospitality owners and operators, real estate developers and family offices, and lending institutions and investment funds.
If you are dealing with a claims assessment case, then there are certain factors the claim analysis software will consider. In most cases, the only documents that the insurance companies...
United States Litigation, Mediation & Arbitration
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If you are dealing with a claims assessment case, then there are certain factors the claim analysis software will consider. In most cases, the only documents that the insurance companies will use are the actual medical records and evidence that you submit, such as doctors' reports. Since this is the case, it is important that your doctor properly document all of the injuries that you may have sustained during your car accident that are relevant to your claim. If the doctor fails to diagnose or record an injury that was caused by your crash, it is highly unlikely that it will be included in the claim that is analyzed by the software.

The specific factors of a claims assessment case will be discussed more in depth in following articles, but there are a few things to note before considering these factors. First, each factor in the system has an allocation of "severity points." What are severity points? Severity points represent the severity of a personal injury, with higher points indicating a higher value of the claim; the monetary value that is assigned to these points varies on a company-by-company basis. Because this is the process that is used, it is crucial that you submit information regarding as many of the factors as possible so that 1) your case represents the true value of your claim and 2) it possibly leads to a higher settlement. Second, the claim assessment software uses more than 12,000 factors in determining the value of the claim. Some of the general categories of factors include:

  • Injuries,
  • Complaints,
  • Delays and gaps in treatment,
  • History of treatment,
  • Imaging,
  • Duties under duress,
  • Prognosis,
  • Permanent impairment, and
  • Loss of enjoyment of life.

If you are concerned about whether your documents are sufficient to make a claim, or need help ensuring that your demand letter to the insurance company is properly formatted so that your claim is fully evaluated, it is extremely important that you find an experienced personal injury attorney to help you. Our personal injury attorneys at KI Legal Personal Injury are ready and able to handle this process for you. With a strong attention to detail and years of experience advocating for clients, our personal injury attorneys will do everything they can to help you succeed with your lawsuit.

The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.

ARTICLE
23 November 2023

What Factors Do Claim Analysis Software Consider?

United States Litigation, Mediation & Arbitration
Contributor
KI Legal focuses on guiding companies and businesses throughout the entire legal spectrum. KI Legal’s services fall under three broad-based practice group areas: Transactions, Litigation, and General Counsel. Its extensive client base is primarily made up of restaurant and hospitality owners and operators, real estate developers and family offices, and lending institutions and investment funds.
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