Colossus: When your opponent is a computer algorithm

October 2017 • Louisiana Advocates

Colossus: When your opponent

is a computer algorithm

By Kristi S. Schubert; Kristi S. Schubert LLC; Metairie, Louisiana

It is common knowledge

that insurance companies

increasingly are relying on

such claims evaluation soft-

ware as Colossus, Claims

Outcome Advisor, Injury

Claims Evaluations, and

Injury IQ to evaluate per-

sonal injury claims.

Colossus has historically

been the most widely used of

such programs. According to

the DXC Technology

web-

site, “Colossus® is currently

the insurance industry’s

leading expert system for assisting adjusters

in the evaluation of bodily injury claims.”

The DXC Technology website provided

this description of Colossus:

Through a series of interactive questions,

Colossus guides your adjusters through

an objective evaluation of medical treat-

ment options, degree of pain and suffer-

ing, degree of permanent impairment to

the claimant’s body, and the impact of

the injury on the claimant’s lifestyle. At

the conclusion of a Colossus consulta-

tion, a summary of the claim is pro-

vided, including a recommended

settlement range.”

Since the settlement of a class action

lawsuit filed in Arkansas state court in 2005

titled Hensley v. Computer Sciences Corpor-

ation, et. al., Colossus is no longer explicitly

advertised as a program to help insurance

companies reduce payouts. Here are ex-

cerpts from recent promotional materials:

• The DXC Technology website currently

claims, “Colossus ensures consistency

in how bodily injury claims are

evaluated across your entire claims

organization, thereby reducing payout

variance.”

• A promotional flyer for

Colossus currently avail-

able on the Computer

Services Corporation

(CSC) website

claims:

“[Colossus] consolidates

entry for whiplash

claims to require only

one screen of medical

data, allowing for rapid

recommendation of

whiplash claims.”

“CSC has an exclusive

alliance with the American Medical

Association. The AMA periodically

reviews Colossus and the Colossus

reference system to ensure accuracy

and up-to-date medical information.”

• As of May 8, 2016, a different promo-

tional flyer, “Colossus Software:

Myths and Facts,”

was available on

CSC’s website. It said:

“Most insurance companies will show

the claims recommendation from

Colossus to a consumer, if requested.”

“None of CSC’s customers have used

Colossus to establish cash reserves.”

“The court-approved settlement in the

Hensley case did not require CSC to pay

any damages to the class. As a result of

the settlement, CSC now provides addi-

tional information about the Colossus

software through a public website

(www.colossuseducation.com).”

With regard to accusations that

Colossus saves insurance companies

money at the expense of consumers:

“CSC’s marketing materials and in-

surer interactions today consistently

Kristi Schubert

22 Louisiana Advocates • October 2017

tout to insurers the ability of the Colossus product to

establish consistent recommended settlement ranges.

To the extent that CSC’s past marketing materials

from a decade ago or more suggested otherwise, they

were wrong.”

• In January 2014, a promotional document titled “P&C

Organization Improves Bodily Injury Evaluation

and Settlement Consistency”

available on the CSC

website said:

The vice president of claims for “one of the United

States’ oldest property and casualty insurers” is

quoted as saying “[w]here in the past about 20 percent

of claims were being settled above the recommended

high in Colossus, now only about 10 percent exceed

that value.”

“Not only can claim handlers compare the values of

similar closed claims but they can analyze the details

and settlement amounts for all cases filed by each

plaintiff ’s attorney.”

For copies of the promotional flyers discussed, contact

me at [email protected].

How Colossus works

The program prompts the adjuster to input specific

information, or “factors,” into the software. According to

Dr. Aaron DeShaw, Esq., individual factors in a case are

assigned “severity points,” and the total number of severity

points determines the final value of the case as calculated

by Colossus.

The Colossus software does not assign a dollar value to the

severity points.

Instead, the insurance company using the

software determines the value of each severity point.

As an

example, Farmers Insurance assigned a value of 67 cents per

severity point for the cases with the lowest amount of total

severity points, according to DeShaw.

Why understanding Colossus is important

When we negotiate with adjusters using claims evaluation

software, we are negotiating with an algorithm. In such

cases, it is important to keep in mind that while a human

can look at the big picture and take soft factors into account

when coming to a decision, by its nature, an algorithm can

only account for the information that it is programmed to

consider. In addition, that information must be presented in

the format the algorithm can recognize.

If we don’t learn to present all the relevant information

in a format that the algorithm recognizes, we risk having

our client’s claim undervalued. Being undervalued by

Colossus can seriously diminish our clients’ ability to

attain a fair resolution of his or her claim.

Some insurance companies only give adjusters the

authority to settle a claim at or below the value suggested

by Colossus.

Even in companies where the adjuster is not

specifically limited to the value suggested by Colossus,

Colossus’ suggestions will be a powerful anchoring point

that affects the adjuster’s assessment of the case.

How Colossus can undervalue claims;

what to do about it

1. The client should accurately describe every

accident-related symptom to the provider.

Colossus awards each separate diagnosis its own severity

points, and for certain diagnosis, it awards additional sever-

ity points for each symptom/complaint the client experi-

ences.

Colossus only recognizes diagnoses and symptoms

that are specifically listed by the treatment provider in the

medical records.

If the treatment provider doesn’t write it down, it doesn’t

matter whether the client writes it down on an intake form

or whether the doctor has personally told the client that a

particular diagnosis is appropriate. This means we need to

inform our client that he or she must clearly identify every

single accident-related symptom to ensure that each one is

accurately represented in the written medical records.

Even if the condition or symptom cannot be treated (e.g.,

a contusion), if it is accident related, the client should

mention it to the provider and the provider should note it in

the records.

2. The client should discuss the status of each

accident-related symptom at every visit.

For many symptoms, Colossus awards severity points

based on the duration of the symptoms.

So the client

should be instructed to specifically and accurately inform

the treatment provider on every visit of the updated status

of each accident-related symptom of which he or she previ-

ously complained.

Even if the only update on a symptom is that the client

no longer suffers from it, the client must provide this infor-

mation to the treatment provider. If your client doesn’t feel

confident that he or she will remember to mention every

symptom, perhaps you can suggest the client make a list to

take to the provider’s office.

3. You must specifically request compensation for

“duties under duress” in your demand letter.

According to DeShaw, Colossus awards severity points

for what it calls “duties under duress.”

These are activities

that the client continues to perform, but suffers pain while

doing so. Generally, these duties include work duties, indoor

and outdoor household activities, and educational activities

if the client is a student.

To recover for these, not only must the doctor note in his

records the specific activity being performed with pain, but

also the attorney must specifically request that the client be

compensated for performing that duty with pain.

October 2017 • Louisiana Advocates

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4. When appropriate, your client should request an

impairment rating from the treating physician.

Colossus awards severity points for “loss of enjoyment

of life” only when a treatment provider performed a perma-

nent impairment rating in accordance with the 5th edition

of the AMA Guides and determined that the client suffers

from a permanent impairment of 2 percent or more.

While not all doctors routinely perform such an evalua-

tion, most doctors will perform such an evaluation if asked

to do so by the patient.

5. You must specifically request compensation for

“loss of enjoyment of life” in your demand letter.

As with duties under duress, the lawyer must specifically

request compensation for loss of enjoyment of life for

Colossus to assign any severity points.

Loss of enjoyment

of life, as recognized by Colossus, includes the work, educa-

tional, and household activities, as well as hobbies, social

activities, and sports.

According to Dr. DeShaw, in one case where treatment

involved only $2,650 in chiropractic bills, Colossus valued

the loss of enjoyment of the client’s hobbies as being worth

between $11,000 and $17,800.

Endnotes

1. DXC Technology is the current owner of Colossus. DXC Tech-

nology arose out of the April 2017 merger between Colos-

sus’ prior owner, Computer Sciences Corporation, and the

Enterprise Services business of Hewlett Packard Enterprise.

2. http://www.dxc.technology/insurance/offerings/

11097/57637-colossus.

3. Id.

4. Id.

5. http://assets1.csc.com:80/p_and_c_general_insurance/

downloads/Colossus.pdf.

6. https://assets1.csc.com/p_and_c_general_insurance/

downloads/Colossus_Myths_Facts.pdf.

7. On the date I wrote this article, said website no longer

appeared active.

8. http://assets1.csc.com/p_and_c_general_insurance/

downloads/Org_Improves_Bodily_Injury_Eval_CS.pdf.

9. DeShaw, Dr. Aaron. Colossus: Understanding Auto Insurance

Claims, Trial Guides, LLC, 2011.

10. Id.

11. Id.

12. Id.

13. Id.

14. Id.

15. Id.

16. Id.

17. Id.

18. Id.

19. Id.

20. Id.

21. Id.