Since its founding in 1931, Allstate has grown into a modern insurance giant. Today, it represents the second-largest personal insurance company in the United States. In 2017 alone, it brought in nearly $3.2 billion dollars in profit, ranking 79th on the Fortune 500 list.
Its tagline that customers are “in good hands,” seems less reassuring in light of its high profitability. Customers and third parties should be wary of Allstate’s desire to promote its corporate bottom line.
You only have to go so far as to Google “Allstate Allsnake” to see the online testimonials of hundreds of angry insurance claimants who believe that Allstate did not provide them fair settlements. When filing your claim, keep in mind that Allstate’s first offer will probably be highly unreasonable. Getting a fair settlement often requires firm, persistent negotiation.
The Role of the Insurance Claims Adjuster
Adjusters are tasked with evaluating the details of an accident in Colorado, reviewing medical records, and determining the extent of liability. Here are some important considerations regarding the claims adjuster’s role:
- Investigate Personal Injury Claims: Adjusters review all the details of a personal injury claim. This includes analyzing medical records, accident reports, witness statements, and any available evidence to determine liability and the extent of damages.
- Evaluate Damages: Adjusters assess various types of damages, such as non-economic damages, economic damages (medical bills and lost wages), physical impairment, scars, and loss of enjoyment of life. Understanding the nuances of these damages is crucial for effective negotiations.
- Negotiate Settlements: After the adjuster has a comprehensive view of the case, they proceed with negotiations. Their goal is to reach a settlement that minimizes the insurer’s financial liability while providing fair compensation to the injured party.
How Allstate Insurance Evaluates Personal Injury Claims
Understanding how Allstate assesses personal injury claims is essential for achieving a favorable outcome for your clients:
- Severity of Injuries: Allstate places an emphasis on the severity of injuries when evaluating claims. Cases involving substantial medical treatment, permanent impairment, and visible scars often result in higher settlements.
- Medical Bills and Treatment: The insurance adjuster closely reviews bills and the type of treatment received.
- Non-Economic Damages: Allstate recognizes non-economic damages, such as pain and suffering and loss of enjoyment of life, but these are often more challenging to quantify.
Allstate Uses Colossus for Insurance Settlements
Allstate uses an artificial intelligence computer software known as Colossus to calculate settlement value of all accident injury cases for at least half of the insurance claims in the United States. The genesis of the software can be traced back 1988 in Australia. During this period, the Australian Governmental Insurance Office was experiencing trouble paying claims. Accordingly, it commissioned a company named Computations (later rebranded as “Continuum”) to create a software solution. This software, later renamed Colossus, was intended to curtail claims payments.
Colossus was first licensed by Allstate in the 90s. Allstate purchased the right to use Colossus because they wanted to standardize the claims process. At the time, there was no rhyme or reason behind the valuation of claims. Allstate took the position that utilizing this software would help save money on payouts on bodily injury claims.
Colossus’ system has a hidden and secret rules-based system to convert a series of inputs about the nature and severity of injuries into a relative numeric score of conscious pain and suffering. At first blush, this seems legitimate as all civil claims are about reducing the human experience of suffering into a dollar amount. However, the use of Colossus to evaluate personal injury claims has proven to be an unfair practice to personal injury victims.
How Colossus Works
The specific algorithms used by Colossus are proprietary and not publicly disclosed. They are based on a wide range of data, including prior claim payouts and industry standards. While it is impossible to know with certainty how the platform works, the Colorado car accident attorneys at Bowman Law have been working with Allstate for over 13 years and have an idea about how it works.
Colossus considers some preliminary matters before looking at a case. It considers whether the attorney of record has a history of taking cases to court if they get an inferior offer or always accept the best offer presented. The software also considers the jurisdiction in which the claim arises. Colossus pays attention to the county where the accident happened because some counties, such as Boulder County and Denver County, offer a more plaintiff-friendly venue.
In addition, the software contains more than 600 injury codes to identify the various types of personal injuries that can occur. Moreover, the injury codes have a “severity value” and assign money for each severity point the injured party receives. It performs a calculation to attribute severity points to each claim. This insurance calculator also conveniently ignores that healthcare providers use over 12,000 ICD-9 codes to classify or categorize injuries.
The Premise Behind the Colossus Settlement Calculator
The premise behind the Colossus settlement calculator is theoretically sound. Human pain and suffering can be converted to a numeric score by a system of rules applied evenly so that the value of the case does not rely on the subjective judgments of the adjuster. Colossus has over 10,000 rules to determine the questions the system will ask the adjuster to generate a payout.
However, insurance companies do not understand the 10,000 rules or Allstate simply does not care. Simply put, the adjusters know Colossus calculates insurance payouts in a way that advances their mission of paying out as little as possible. After considering the attorneys involved and the venue, the system counts the points and computes a dollar value. There is no question a significant value driver for the formula – and for juries, incidentally – is whether there is a permanent injury.
How Adjusters Use Colossus
By using Colossus, adjusters will decrease the value of a personal injury claim. Unfortunately, this means the adjuster will not take into consideration in their evaluation factors such as stress, pain, inconvenience, loss of enjoyment of life, loss of consortium, inability to participate in the things most jurors consider when deliberating. The overwhelming problem with Colossus is that it cannot replace humans’ understanding of other people’s pain and suffering. There is no input for “unbelievable agony and horror.” Artificial intelligence is just that: artificial.
Occasionally, this issue paradoxically helps personal injury victims because the software incorrectly assumes a particular injury had a more significant impact on the patient than it did. The Colorado personal injury attorneys at Bowman Law have encountered situations where we submit a demand on behalf of an incredibly unsympathetic client who was not affected greatly by what happened to them despite the precise documentation of pain and hardship in the medical records. This client does better with such an unfeeling system.
But more likely, the opposite occurs. No calculator can value pain and suffering. How an injury impacts a person’s life is subjective. Accordingly, your Colorado personal injury attorneys must adequately articulate why a case differs or be prepared to file suit and begin the real battle. Judges and juries listen and consider many factors this software ignores because it does not understand them.
Juries make distinctions based upon whether or not they think the Plaintiff is an honest and kind person who has suffered due to their injuries. Tragically, this program barely distinguishes between a heroin addict and a nun. Juries get the difference. Mathematical calculators do not. Accordingly, juries are the antithesis of data-driven programs, such as Colossus. A jury might not award damages for an L4/L5 lumbar (back) herniated disc. The medical terminology and the treating doctor’s explanation of the injury might not resonate with them. But the jury comprised of human beings will award money damages because the injury victim’s back hurts so much that she cannot hold her 18-month-old daughter without pain. No rules-based computer program can compute that human suffering.
Fight Allstate’s Delay, Deny, Defend Strategy
It is important that personal injury victims do not fall victim to Allstate’s strategy to avoid paying a fair and reasonable settlement in a car accident injury claim. Fortunately, there are several ways to help counteract the three D’s, including the following:
- Get Medical Treatment Immediately
When a person is injured, they should seek medical treatment as soon as possible. It is best to proceed directly to the emergency room by way of ambulance. Of course, no one should fake an injury. They should only seek medical treatment if they are injured. If a claimant is not in pain immediately following a car accident in Colorado, that does not mean they are not injured. It could be that adrenaline is rushing through their body following a car accident, numbing them to pain. It is common for people who initially believe they are uninjured to wake up the next day or several days later with significant pain, soreness, or limited range of motion. Importantly, with no medical treatment or gaps in medical treatment, Allstate will devalue the claim.
- Do Not Give a Recorded Statement
Personal injury victims must understand there is no legal requirement they have to provide a recorded statement to the at-fault driver’s insurance company. If Allstate is the victim’s insurance company, they must provide a recorded statement.
- Reject a “Nuisance” Offer
A “nuisance” offer is an offer made to quickly settle a case for a low amount. These offers often range anywhere from the low hundreds to the low thousands of dollars. Additionally, the insurance adjuster may make it seem like a sweet deal by offering to pay a claimant’s emergency room bill or a few chiropractic sessions along with some money. Of course, the insurance adjuster fails to mention they would negotiate the bills down beforehand.
If Allstate is offering a nuisance offer, there is likely more money on the table. It is also possible the insurance adjuster does not have all relevant information and documentation. Once a claimant executes a settlement release, it is going to be extremely difficult, if not impossible, to continue with a personal injury claim. This is because a settlement is final. Prior to settling a claim, claimants should consult with a personal injury lawyer in Colorado.
- Understand the “Eggshell Plaintiff Doctrine”
The Eggshell Plaintiff Doctrine is a common law doctrine that says the at-fault party must take the injured victim as he finds him when he exacerbates a pre-existing condition. This means an at-fault party is liable for aggravating an issue that an injured party had prior to an accident in Colorado.
For example, an at-fault driver causes a minor accident with an elderly person with brittle bones and shatters her hip. Notwithstanding her pre-existing issues, the at-fault driver is responsible for worsening the condition. It does not matter the fender-bender would not have caused this type of injury to most people. Another example is when a man with an asymptomatic (i.e., no symptoms) herniated disc in his lower back becomes symptomatic. It does not matter that the careless driver did not cause the herniated disc. All that matters is that the careless driver aggravated a pre-existing injury, for which he is responsible under the Eggshell Skull Plaintiff doctrine.
Allstate will use a pre-existing injury or condition to argue their insured did not cause the injuries. The adjusters will claim there is no causal relationship to sort out a prior injury versus a potentially new or aggravated one. This is simply not how claims should be handled. It can be, however, complex to prove an aggravation of a pre-existing injury. Hence the importance of consulting with Colorado personal injury attorneys.
- Know the Factors Affecting Case Value
There are many factors that affect value in a personal injury case in Colorado. The following represents a non-exhaustive list of factors claimants should be aware of if attempting to settle a bodily injury claim with Allstate:
Facts Surrounding the Accident
While many facts are important, a crucial fact involves the property damage of the vehicles. This information is important because the more significant the property damage, the higher the likelihood of serious injuries. Another important fact is the location of the accident. Allstate pays attention to the county where the accident happened because some counties, such as Boulder County and Denver County, offer a more plaintiff-friendly venue.
Severity of Injuries
Allstate pays more money when the injuries are more severe. Soft tissue injuries, such as whiplash, are going to be valued lower than cases involving a broken bone or brain injury. It is helpful to keep in mind, simply because a person suffered a soft tissue injury, does not mean their injuries are not serious. The value of cases involving soft tissue injuries will come down to proper and consistent medical treatment.
If Allstate places any fault on the injured party, it could be problematic, especially if it is determined the parties share equal fault or that the injured party is more than 50% liable. In situations where a claimant is more than 50% liable, they may be barred from recovering all damages.
In all cases against Allstate, the potential compensation in a personal injury claim will be limited to the amount of the at-fault party’s policy limits. For example, if the at-fault party carried the state minimum in Colorado of $25,000.00 per person/ $50,000.00 per accident, that is the maximum Allstate will pay out. Another important note on Allstate is that when their insured has a large insurance policy and the claimant’s injuries are minor, the insurance adjuster will likely extend a nuisance offer.
In a personal injury case based on negligence, the claimant merely needs to prove the at-fault party failed to meet the reasonable person standard and, as a result, caused demonstrable damages, harms, and losses. In cases where the at-fault party acted with gross negligence or recklessness, both of which are elevated levels of culpability above regular negligence, they may be liable for punitive damages, which can be awarded in addition to compensatory damages (medical bills, lost wages, pain and suffering), and are intended to punish the at-fault driver for their conduct. An example of this is an accident caused by a drunk driver.
Allstate will also consider the profile of their insured. If a company is liable by way of a negligent employee, the corporation may be responsible for the damages under a theory of Respondeat Superior. In many counties in Colorado, juries and oftentimes Allstate will adjust numbers upwards when a corporate entity is involved, conceivably because they believe corporations have deeper pockets and because they may be less sympathetic to companies with sizeable assets. The at-fault driver’s profile is also relevant. If, for example, the insured has a significant criminal history or terrible driving record, such evidence may help increase the value of the case against Allstate.
- Negotiating Tips for Personal Injury Claims
Personal injury victims should start by extending a high offer to Allstate, a figure the carrier will not likely pay but one based in reality. A claimant should not begin negotiations at $750,000.00 when they suffered whiplash injuries and only treated with a chiropractor for two months. That said, claimants should not begin negotiations too low either, as this will reduce the amount of money Allstate will be willing to pay.
Personal injury victims should know the figure they want to settle before beginning negotiations. With each round of offers and counteroffers, it may be a good idea to match the movement of the insurance adjuster as they move from the previous offer. That said, it is also important not to bid against oneself by lowering an offer in response to the insurance adjuster not increasing the offer. Typically, Allstate will begin with a low-ball offer, especially if the claim involves soft tissue injuries.
Typically, Allstate will move from the initial offer anywhere between 3-5 times throughout negotiations. If the parties reach a point where the offers cease to increase, claimants should consider providing additional information and documentation in an effort to aid the insurance adjuster in increasing the reserves. It would also be helpful to review each line of damages with the insurance adjuster, including each line item of the medical bills. It is important to make sure the bill Allstate has is equal to the bill the claimant has. As highlighted above, keep in mind, Allstate will likely attempt to discount the medical bills based on an arbitrary calculation relating to geography, as well as what the adjusters will label “usually and customary.”
Ultimately, claimants should keep in mind the adjusters are simply doing their jobs within the confines of the policies and procedures dictated by Allstate. There is no point to be disrespectful or aggressive, or use foul language. All of this will be recorded in the claims file and, frankly, it will not help in the resolution of the claim. Personal injury victims should be kind and use facts to support the value placed on the claim.
If the case does not seem to be moving in the right direction, another option is to speak with the insurance adjuster’s supervisor. Allstate operates under an organizational hierarchy, just like most large corporations, with lower-level employees, middle management, and upper management. The adjusters that handle the vast majority of claims at Allstate, especially at the team level, do not have a significant amount of settlement authority. They are required to strictly adhere to the policies and procedures dictated by Allstate. It is possible to make further headway by circumventing the process by discussing the claim directly with the assigned insurance adjuster’s supervisor. It is possible Allstate will consider taking a second look at the evidence to see if the insurance adjuster missed something.
Of course, a claimant may get pushback from the assigned insurance adjuster. They may indicate their supervisor is unable to add any value to the claim. Personal injury victims should not take this statement at face value. They should continue to push until they speak with the supervisor directly. Also, as highlighted herein, if a claimant has additional information or documentation that may increase the value of the case, provide it immediately.
Consult with our Colorado Personal Injury Lawyers
While it is encouraging to see claimants attempt to settle their bodily injury claim directly with Allstate, the personal injury lawyers at Bowman Law have seen far too often how doing so creates issues. We have taken cases where clients have attempted to settle their cases directly with Allstate and have had to spend countless hours fixing problems that were unnecessarily created.
We have also rejected potential clients where the issues became too unsurmountable to overcome. The point is, claimants attempting to handle a claim themselves may actually make things worse. When the damage is done, there is not much our personal injury lawyers can do to get these cases back on track.
Why Work With a Personal Injury Law Firm?
This is why our personal injury lawyers try to educate members of the community on injury claims ahead of time, but also highlight the importance of consulting with our attorneys early in their cases.
A consultation is always free and may mean the difference between a case that had significant value versus a case that will only receive a nuisance offer. It is very rarely the case that a claimant will make more money by not hiring an attorney. In fact, a study by the Insurance Research Council revealed that attorney-represented claimants received 2-3 times more in settlements than those without a lawyer. Even when considering the contingency fee, claimants end up with far more money in their pocket when retaining qualified personal injury lawyers.
Get Started With Our Colorado Law Firm Today
Schedule a free consultation to speak to one of our personal injury attorneys about your claim. Our office is located in Denver and we serve Colorado Springs, Boulder, Fort Collins, Aurora, and the surrounding areas.
Owner and Managing Attorney
Jerry Bowman, J.D., M.A., Owner and managing attorney of Bowman Law LLC, takes his responsibility to the legal profession seriously and dedicates his time and effort to providing quality and competent legal representation to clients in Denver and throughout all of Colorado. He holds an MA in Political Science from Wayne State University and earned his law degree in two and a half years from Michigan State University College of Law.