Computerized Auto Injury Claims Systems Scrutinized
The specific protocols of insurance companies making auto injury payouts can have a big impact on the profits of medical providers, from surgeons and physical therapists to other alternative practitioners. With that in mind, many of those within the auto insurance industry, including third party attorney or chiropractic telemarketing firms, may be curious about the controversy around new “artificial intelligence” systems for calculating payments for auto injury claims.
A Chicago Tribune Business report from early this year took a look into these types of claims valuation systems used by insurance companies like Allstate, from the perspective of a former employee at that particular firm. What these types of reports show is that insurers often use a kind of “case precedent” system for figuring out injury payments. For example, past settlements for a lower back injury can help set the figures for a patient whose similar claim is currently working its way through claims adjustment.
Rigging Computerized Systems?
One prevalent criticism of these types of complex software is that the results can be skewed a certain way by case selection or omission. A consumer report co-written by Mark Romano, the main source in the CTB story, is called “Low Ball: An Insider’s Look at How Some Insurers Can Manipulate Computerized Systems to Broadly Underpay Injury Claims” – the idea presented is that by cherry-picking past results, insurers may be able to lower the typical amounts that injury victims are presented with. This in turn can affect providers as these accident victims do “financial triage” on what types of care they will be seeking to remedy the effects of a crash.
Doctors, Lawyers and Quick Responses
In response to many auto injury payout proposals from insurers, a network of professionals looks to educate accident injury victims on their rights. From front-line workers like medical office receptionists and chiropractic telemarketing reps, to qualified attorneys and medical doctors, local offices reach out to accident victims, urging them to seek care quickly, document all of their potential injuries, and avoid taking an initial claims payout offer or discussing too many details with insurance company representatives. The first way that a lot of patients hear about dubious insurance practices is from those individuals scheduling care or otherwise pointing the injury victim toward medical consultation. this means that in many cases, the accident victims don’t need to do a whole lot of research on their own to find out where they stand. By contacting qualified legal counsel and getting quality front-line medical care, accident victims can work toward securing the financial compensation that they need to deal with the aftermath of a collision injury. That said, various consumer advocacy groups will also show the public how some insurance offers can be adjusted below a fair and reasonable payout amount. For more information, individuals can call their state’s insurance commission office to ask about all of their options for resolving one of these unfortunate situations.