How adjusters actually value a claim
Understanding the process on the other side of the phone changes how you present your file.
Software sets the opening range
Most large carriers run claim data through valuation software that scores treatment codes, duration and injury type. The output is a range, and the adjuster negotiates inside it.
Treatment gaps cost real money
The software penalises breaks in treatment. Two weeks of missed physical therapy can move a claim down a band, regardless of why the sessions were missed.
Specials drive non-economic damages
Because pain and suffering is usually derived from medical specials, the documentation of the treatment drives both halves of the claim.
Presentation matters
A demand package with organised records, a clear narrative and a specific number is treated differently from a phone call asking what they will offer.
Tools for this topic
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