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As we discussed in our previous article – What are Claims Assessment Cases – a Claims Assessment Case is a personal injury case that an insurance company evaluates using claims assessment software to determine the payout they will give you. This type of claim accounts for approximately seventy percent (70%) of third party claims in the United States.
The complex claims assessment software uses up to 12,500 rules or factors to evaluate claims for insurance companies. Because of this incredibly high number of factors, there are a few considerations that injured drivers and their attorneys need to keep in mind when filing an injury assessment case:
For the most part, medical records and medical evidence are the only sources used to determine what information to enter into the software.
Injuries not diagnosed by a doctor will not increase the recovery for the injured driver. That being the case, it is extremely important that any physician examining the injured driver consider the full extent of the driver’s injuries to ensure that all injuries are fully accounted for.
The factors used by the software create a total number that suggests the severity of the damage. The “difficulty points” are allocations of these factors that, when combined, are assigned a monetary value.
Finally, it is crucial to remember that all information entered as part of a claim assessment case must be absolutely true.
Understanding how software-based claims analysis works can help ensure that claims are fully evaluated when processed by this type of software. It is extremely important that you have an experienced personal injury attorney guide you through the process to ensure that you remain in compliance with the software evaluation requirements and to ensure that you receive the compensation you deserve for this requirement.
The content of this article is intended to provide a general guide to the topic. Specialist advice should be sought regarding your specific circumstances.
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