The Advocate, Journal of the Nevada Trial Lawyer’s Association, August 2006 issue.

This month’s column is a mixture of two items that came to my attention recently.

The first concerns the computer software program "Colossus." As everyone is aware by now, most of the insurance carriers are now using Colossus, or one of its software cousins, to evaluate motor vehicle injury claims.

I went to a two hour seminar on August 4, at which the speaker was a gentleman named Aaron DeShaw. Mr. DeShaw is an attorney in Portland, Oregon. Interestingly, he previously was a chiropractor in Las Vegas. He went to law school and became a lawyer, and now is a big authority on Colossus. The seminar was offered as a free service by Nevada Rehabilitation Centers (headed by Dr. Ian Yamane), and I want to thank Dr. Yamane for putting on this and other interesting seminars. Apparently Dr. Yamane and Mr. DeShaw were chiropractic colleagues many years ago in Las Vegas, and have since kept in touch.

(A few years ago, the NTLA sponsored a seminar on Colossus which was given by a former claims supervisor at a major insurance company. This particular former adjuster had prepared some computer programs to help guide the practitioner through writing Colossus-friendly demand letters. I ordered this product, and even though I created my own simplified version, it helped me to create demand packages that I think are Colossus- friendly, and has been a big help to my practice, insofar as auto cases are concerned. If you are not writing Colossus-tailored demand letters, I think you are making life much harder on yourself.)

I have spoken to many attorneys who have read an article or two about Colossus, and claim that they know how to write Colossus-friendly demand letters. However, I have seen some of the product they generate, and it is Colossus-friendly in certain respects, but they miss a lot of the major points. The main thing that everyone thinks they understand is to list a bunch of ICD-9 codes, but frankly, as Mr. DeShaw made clear, that is only a small part of the process; and Colossus itself does not use ICD9 codes.

After listening to Mr. DeShaw, I realized that my knowledge of the program is already out of date, as several changes have been made; and some of the things I had been doing in my demand letters are now pointless.

Seventy percent of all insurance claims involved in automobile accidents are now adjusted using a Colossus program, or one of its cousins. So, you cannot ignore it if you are doing auto cases. The old style demand letters that we used to write ten years ago, listing out the medical bills and giving bottom line descriptions of the accident and injuries, are just not going to get the job done, in my opinion.

Here are some of the points made by Mr. DeShaw of which I was not aware. They are listed in no particular order.

1. The adjusters are strictly required to only go by, injury-wise, what information is in the medical records. If it is not in the medical records, then they are not allowed to even consider it. So, for example, were you to say, "As a result of this accident my client can no longer play golf," Colossus will pay no attention to it unless the doctor says exactly the same thing in his records. (And interestingly, if such a thing were said in the medical records, it probably would add several thousand dollars value to the claim.) When it comes to discussing the damages issues re injuries, the lawyer must stick to the four corners of the medical records documents.

2. Many of the Colossus type programs will only consider the seven most serious diagnostic code-type injuries. So if you list out thirty diagnostic codes, it is to some extent spinning your wheels, because Colossus is only going to take the top seven (as determined by the adjuster, unless you highlight things somehow.) So you need to put some care into listing, in order, the seven most serious injuries in the diagnostic code section. And hint: Colossus does not even go by ICD-9 codes. Another hint: codes merely for strain/sprain injuries get little value from Colossus. It translates the ICD-9 codes, or the adjuster does the translation, into one of 600 other codes that Colossus uses.

3. Colossus only recognizes two categories of discs: bulging discs and herniated discs. It gives no value for bulging discs. But here is the catch: the medical records actually have to use the word "herniation" to get added value for the herniated disc. This is very stupid, because if the record says something, for example, about an "extrusion" or "protrusion" from a disc, and does not use the magic word "herniation," it probably won’t get credited as a disc injury. I am even wondering if the term "annular tear" would count.

4. The headings of "Duties Under Duress" and "Loss of Enjoyment of Life" are two big value drivers for Colossus. This I knew. But what I didn’t know is that, again, unless the doctor mentions it in his records, they won’t pay attention to it. The doctor has to say something like "patient reports he is having pain doing his work," or "patient reports he is no longer able to play golf." If it is not in the medical records, it doesn’t count. Stupid rule, but that’s apparently how it’s done.

There are literally hundreds of counter-intuitive aspects to Colossus, and I did not want to go into all of them here. I just pointed out a hand full of them that I didn’t know about previously .

Apparently Mr. DeShaw has a couple textbooks available which you can order from www.trialguides.com.

Frankly, his is not the only how-to-do-it guide on Colossus out there, but the fellow did impress me as being intelligent and earnest, so I am sure his book must be a decent one.

On a second, totally different issue, I wanted to ask if anyone out there has some information on an interesting rumor that was passed along to me by Craig Murphy, one of our members who is going to write some articles for The Advocate. He has picked up on rumors through various trial lawyer chat rooms to the effect that several large insurance companies are putting together a joint venture to have a web site called "settleyourclaim.com." Supposedly, this will be advertised and will claim that injured persons can resolve their claims for decent money on-line and have the funds wired into their bank accounts within 48 hours, without an attorney. Allegedly, the plan is to pay good settlements at first to lure the public into the "trap," and after that the numbers will decrease dramatically.

I went on-line and did a "google" search as best I could, and I could not find anything about this project other than rumours from a few attorneys regarding this. I could find nothing to substantiate that there is such a project in the works. So I am wondering: is this basically one of those "urban legend" type situations; or is there something really to it? I would like any of our members who have any information on this other than rumours and attorney chat room gossip to forward same to me. It would be nice to see something like an article in a newspaper or magazine where insurance company publicists are talking about this project, or similar. I have to admit that on a gut level, this rumor doesn’t seem believable, but it is making the rounds on the trial lawyer gossip internet.