CLE Injury Courses
METHODS TO COUNTER INSURERS USE OF; "RUBBER STAMP","RISK MANAGEMENT" AND "STACKING THE DECK" TACTICS TO LOWER SETTLEMENT VALUATION

CLE COURSES AVAILABLE FOR PRESENTATION IN PLAINTIFF'S ATTORNEYS OFFICES AT NO COST.

When a personal injury client entrusts their well-being into your hands, you formulate a demand based on the medical, administrative, economic and legal factors of the claim. However, for 27 years we've been competing against the insurers' computers as Colossus and the computer often won, until now!

The CLE Courses present data that plaintiff's attorneys are using today in bodily injury claims to:

  • Overcome Colossus And Other Software's Insurers Use
  • Maximize Settlement Valuation In A Bodily Injury Claim
  • Eliminate Adjuster & IME Varying Opinions and Disputes
  • Win The Greater Weight Of The Evidence Challenges
  • Save 50% Of The Legal Time & Spend To Formulate A Demand
  • Determine Vital Differences Medical Examiners Have On An Injury Claim
  • Identify Bodily Injury Severity Types That Are Often Overlooked
  • Counter The 13 Unfair Claims Settlement Practice Acts (UCSPA's)
  • Understand The Formula Insurers Use To Determine Settlement Valuation
  • Access And Use Zeus - A FREE Online Tool To Counter Colossus

SUBJECTS INCLUDE:

  • What is being done to effectively compete against the insurer's software's (as Colossus).
  • The process that follows precedents and authority set by previous court rulings, judicial decisions and administrative findings to eliminate adjuster and IME disputes.
  • How to identify the 13 Unfair Claims Settlement Practice Acts (UCSPA's) and counter insurers and adjusters when they engage one or more of them.
  • How to recognize vital differences between medical experts that ultimately lessen or enhance medical valuation parameters.


Please peruse our courses to determine which ones would be of highest interest and contact a course presenter to arrange a CLE Accredited Presentation in your office.

Each Course Contains Data To Identify & Counter These 4 Major Areas of Risk Management Insurers Use To Contain Costs As;

1.) Colossus

Overcoming Colossus & Other Software's

  1. The Insurers Decision Points for Determining Settlement Valuation
    Decision Points translate into a settlement dollar amount based on each insurer’s rate & formula. Learn the 26 Decision Points that should be in the B.I. demand

  2. Procedural Intelligence Codes Revealed and Used To Add Valuation
    Insurer’s software’s can engage 67,880 codes that determine settlement valuation, making it difficult for plaintiff attorneys to oppose, without specific knowledge of how the system works. We reveal how to exchange complex code data, interface and input added valuation into a Colossus claim.

  3. Value Driver Checklist
    Compare the checklist of 48 value drivers to include in the demand against those value drivers you currently incorporate.

  4. The Formula That Insurers Use To Determine Settlement Valuation Insurers do use a formula to calculate a range of values for the claim's worth which we expose and show how to use to the plaintiff’s advantage.

  5. How To Maximize Settlement Valuation In A Colossus Environment
    Software’s as Colossus “Operate in a Systematic Way to Deny Policyholders Legitimate Benefits”. We reveal “Zeusclaim”, the plaintiff’s online tool you can access FREE to counter Colossus and save 50% of your legal time & spend.

2.) Significant Differences in the Medical Records That Adversely Affects Injury Settlement Valuation

Harmful Factors to be Aware of in the Medical Assessment of the Injured

  1. Difference in examination level CPT codes
    CPT code 99204, is for use on a Medicare Evaluation & Management (E&M) cases while code 1191M Impairment Rating by Attending Physician –Standard 1-3 Body Parts, Performed at (MMI) Discharge - is for use in bodily injury claims.

  2. Physician qualifications and diagnosis methods that lead to loss of valuation
    Medical records are based on Center for Medicare Services (CMS) Guidelines and those physicians who still use the standard 99204 Medicare code, will miss valuation that is only discoverable in the 1191M Injury Model assessment.

  3. Several key "Injury Severity Types" that are routinely overlooked, especially in ER Rooms
    There are 7 Injury Severity Types we reveal that are often overlooked, including a $66,000 spine injury that cannot be seen by the human eye, missed 45% of the time. Also a neck fracture when the head is turned that takes 2 months to show.

3.) The 13 Unfair Claims Settlement Practice Acts (UCSPA's) & Rebuttal When There are Violations of the Ethics Codes of the Adjuster (this is not Bad Faith)

Identifying and Countering UCSPA’s & Violations of the Ethics Codes of the Adjuster That Lower Valuation

  1. Identifying the 13 Unfair Claims Settlement Practice Acts (UCSPA's)
    We expose when adjusters fail to provide the “Legal & Factual” basis for undervaluation, an admission that they engaged one-or-more of the UCSPA’s as their method of unfair settlement valuation.

  2. Countering the 13 Unfair Claims Settlement Practice Acts (UCSPA's)
    You may not realize that UCSPA’s carry up to a $25,000 regulatory fine each…we reveal how to counter when a UCSPA is used to discount claim valuation.

  3. Rebuttal and Demand for Admissions with Interrogatories
    We demonstrate an online tool available for FREE to produce a Rebuttal with interrogatories to compel adjusters to pay at-or-near their software’s determination for the range of worth of a bodily injury claim.

4.) Adjuster & IME Disputes

Using Authority to Overcome Varying Opinions & Win the Great Weight Challenges

  1. How The Process Of IMV Is Being Used To Prevent Unfair Settlements
    The question is no longer; “By whose standard is it determined whose opinion carries the greater weight”. The Courts have appointed the process of IMV to have greater weight over adjuster and IME opinions.

  2. How IMV is Used to Eliminate Varying Adjuster & IME Opinions
    A 3rd party, disinterested, trained independent medical provider is called upon to utilize the process of IMV to confirm the accuracy and conformity to facts and evidence-based data to eliminate the varying opinions of adjusters and IME’s

  3. Using IMV to Win the Greater Weight Of The Evidence Challenges
    Previous court rulings, judicial decisions and administrative findings assign greater weight to the process of IMV to establish the preponderance and win the evidence challenges

Select the Course You are Most Interested In And Notify A Course Presenter

Course #1

Formulating an Injury Claim to Prevent Disputes and Maximize Settlement Valuation

This program is accredited as Follows:
CLE Credits: General 1.0

Effective demand formulation methods plaintiff's attorneys are using to prevent, even reverse discounted bodily injury valuations, eliminate varying adjuster & IME opinions, win the greater weight of the evidence challenges, counter the 13 unfair claims settlement practice acts and identify bodily injury severity types that are often overlooked and can damage the injured as well as the claim.

A demand is formulated on the medical, administrative, economic and legal factors of the claim and for 27 years we've been competing against the insurer's computers as Colossus and the computer usually wins, until now!

This presentation contains data that plaintiff's attorneys are using in bodily injury claims to;

  • Maximize Bodily Injury Settlement Valuation in a Colossus Environment

  • Determine the Vital Differences between Medical Examiners and Their Effect Upon The Claim

  • Identify Bodily Injury Severity Types That Are Often Overlooked

  • Counter the 13 Unfair Claims Settlement Practice Acts (UCSPA'S)

  • Eliminate Adjuster & IME Disputes & Win the Greater Weight Challenges

  • Use Zeus - The Plaintiff's Attorney FREE Online Tool to Counter Colossus & Save 50% Of Legal

  • Time & Spend In Formulating a Demand

 

SUBJECTS INCLUDE:

  • What Is Being Done To Effectively Compete Against The Insurer's Software's (As Colossus).

  • The Process That Follows Precedents and Authority Set By Previous Court Rulings, Judicial Decisions and Administrative Findings To Eliminate Adjuster And IME Disputes And Win The Great Weight Challenges

  • How to Identify The 13 Unfair Claims Settlement Practice Acts (UCSPA's) And Counter Insurers And Adjusters When They Engage One Or More Of Them

  • How to Recognize Vital Differences Between Medical Experts That Ultimately Lessen Or Enhance Medical Valuation

  • The Seven (7) Most Commonly Overlooked Injuries and How Not To Misrepresent Them

 

When a personal injury client entrusts their well-being into your hands, you have to compete against the insurers software's (as Colossus), counter adjuster and IME disputes and the engagement of any of their 13 Unfair Claims Settlement Practice Acts (UCSPA's), place yourself at the mercy of medical experts who utilize different examination levels that make a big difference in bodily injury valuation parameters and you may never consider that there are injuries that go undetected, especially ones that can severely damage the injured party and the claim when overlooked.

Course #2

Lessen the Necessity Of Trial In a Bodily Injury Claim

This program is accredited as Follows:
CLE Credits: General 2.5
Civil Trial Credits: 2.00

Identifying Unfair Claim Settlement Practice Acts And Making An Effective Rebuttal To Reduce Unfair Bodily Injury Valuation And Lessen The Incidence Of The Need For Trial

When a personal injury client entrusts their well-being into your hands, you are up against a barrage of insurance company tactics designed to contain costs by lowering the valuation of a bodily injury claim.

Despite a 2012 report released by the CONSUMER FEDERATION OF AMERICA that stated;

"computer claims software's are now being used by all insurers and can be manipulated to produce unjustifiably low injury payments to consumers and tens of millions of dollars in illegitimate 'savings' for insurers"

...insurers' are no respecters of your skill, experience or knowledge. You face "Unfair Claims Settlement Practice Acts" (UCSPA), software's as Colossus (with now 80 versions)," Business Process Improvement" (BPI), IME's who dispute and deny, varying opinions, violations of the Ethics Codes of the Adjuster, claims omissions and 12 Unfair Claim Settlement Practice Acts (UCSPA).

These are the cost containment measures used by insurers that have resulted in unfair, unrealistic, low settlement valuations for the injured.

It's been stated that only 2% of bodily injury claims go to court. Insurers are fully aware of this statistic and will challenge plaintiff's attorney to the maximum as a result.

This presentation will aid to protect your injury clients' rights with effective methods now being used to counter unfair claims tactics and reduce the need for trial by countering the UCSPA's with methods to:

  • Reduce unfair, low settlements

  • Establish the preponderance

  • Eliminate varying opinions

  • Win the "Greater Weight" of the evidence challenges to Identify the USCPA's

  • Counter the UCSPA's Seminar Presentation Overview and Timed Syllabus

 

However, if you go to trial, we will discuss strategies to:

  • Prepare your own barrage of evidence to be used against the UCSPA's of the adjuster & IME

  • Draft a different (35 page) Rebuttal with interrogatories to seek the legal and factual basis for undervaluation's that adjusters are not used to encountering and can't answer truthfully

  • Obtain a memorialized copy of the diary of the claim to expose UCSPA's

  • Reveal key questions to ask adjusters to surface blatant lies

  • Prepare Direct and Cross Exam line of medical questioning for trial

  • Have the option to go to different agencies for investigation of UCSPA's

Course #3

How To Prevent Unfair Injury Settlements

 

This program is accredited for
3.00 total credits.
Verified participation entitles attendee to
3.00 total credits.

Effective Tools to Prevent Unfair Settlements, Eliminate Varying Opinions and Win the "Greater Weight" of the Evidence Challenges for Plaintiff Injury Attorneys.

The insurance companies first engaged Colossus, now there are 80 different versions with 67,880 procedural intelligence (PI) codes to determine the range of value for a BI Claim used by all insurers. Now they created "Business Processing Improvement", more recently introduced, (BPI) a culture that contains additional cost containment measures to limit bodily injury settlements which is making it difficult for plaintiff's attorneys to oppose, without specific knowledge of how the system works.

Even though a Superior Court has issued an order to the insurers to release their PI codes, they have ignored the order in lieu of paying a ten million dollar regulatory fine for civil disrespect.

There are 12 Unfair Claim Settlement Practice Acts (UCSPA's) all designed to dispute, deny and lower settlement valuation and it continues as yet another Superior Court ruled that one unfair claims settlement practice act known as "Core Claim Process Redesign" ratchets down claim value by 2/3rd's and was ruled "harmful to public interest".

While many plaintiff's attorneys have systems in place for representing B.I. claims, unfortunately, the advent of B.P.I. has changed the relevance and signifcance of demand components that many have been using for years and are no longer as effective since B.P.I. We will reveal effective methods to counter Colossus, UCSPA's, explain and suggest how to navigate BPI to prevent unfair, unrealistic settlements, eliminate varying opinions, establish preponderance and win the "Greater Weight" of the evidence challenges.

In our effort to help plaintiff's attorneys serve at"Best Practice"against insurers in BI claims this presentation will present;

  1. Effective methods some plaintiff's attorneys are now engaging to prevent unfair settlements. Data that can quickly be incorporated to aid in the prevention of undervaluation and more effectively counter insurance company UCSPA tactics, identify and counter violations of the ethics codes of the adjuster as well as what can be done to counter IME opinions.

  2. A method of assembling the 4 corners of the medical claim, as well as certain administrative, legal and economic aspects of the case by using the insurance companies own codes against them to counter Colossus and prevent unfair settlements.

  3. A checklist of the 48 items that should be incorporated in ever y demand to meet BPI requirements, counter Colossus and offer increased efficiency of demand formulation, improve response time and reduce staff and legal spend.

Course #4

Law and Ethics - In Bodily Injury Claims

 

This program is accredited for
3.00 total ethics credits.
Verified participation entitles attendee to
3.00 total ethics credits.

ETHICS; LEARNING OBJECTIVES

Every claim on which an adjuster works has the potential to raise ethical questions and concerns. At times while performing these roles, claim adjusters fail to uphold the ethical requirements imposed upon them, which can be considered a deviation from the standard of care in claim handling.

ATLANTA, Georgia (CNN) -- If you are injured in a minor car crash, chances are good that you will be in the fight of your life to get the insurance company to pay all the medical costs you incur -- even if the accident was no fault of your own.

Also Published On CNN Website:

  • State Farm, Allstate employ consultant's strategy. CNN research finds the theme of strategy is "deny, delay, defend"

  • Former employee says Companies convince juries that claims are fraudulent

  • Insurers deny treating claimants unfairly

 

CNN reported seeing several of Allstate's policy documents during a court hearing in Lexington, Kentucky. Playing off Allstate's signature slogan, one document recommends the insurer put boxing gloves on its "good hands" for those who insist on going to court.

There are regulatory actions, fines, investigations and accounting's of unfair claim settlement practice acts (UCSPA), violations of the ethics codes of the adjuster and deceptive trade practices going on in the insurance industry when bodily injury claims are involved.

It's not just Allstate. Today, all insurers use software's to determine bodily injury claim settlement valuation and there are 80 different versions. As if Colossus and UCSPA's weren't enough to contain costs, the insurers also created "Business Process Improvement" (BPI), by which insurers have made it even more difficult to understand and navigate a bodily injury claim without having specific knowledge of how their system works.

Even though a Superior Court has issued an order to the insurers to release their coveted secrets, they have ignored the order claiming their right to withhold their "intellectual property" and opted to pay a ten million dollar regulatory fine for civil disrespect.

There are 12 Unfair Claim Settlement Practice Acts (UCSPA's) all designed to dispute, deny, omit and lower settlement valuation on bodily injury claims and it continues as yet another Superior Court ruled that one unfair claims settlement practice act known as "Core Claim Process Redesign" ratchets down claim value by 2/3rd's and was ruled "harmful to public interest" by a Superior Court.

In this presentation we will reveal effective methods to counter Colossus, UCSPA's, explain and suggest how to navigate BPI to prevent unfair, unrealistic settlements, eliminate varying opinions, establish preponderance and win the "Greater Weight" of the evidence challenges.

In our effort to help plaintiff's attorneys serve at "Best Practice" against insurers in BI claims this presentation will;

  • Identify the 12 Unfair Claims Settlement Practices and ethics codes of the adjuster

  • Reveal methods to counter USCPA's and violations of the ethics codes of the adjuster

  • Present effective methods some plaintiff's attorneys are now engaging to prevent unfair settlements

  • Show information on what can be done to counter IME disputes, denials and varying opinions

Course #5

Maximizing Settlement Valuation in a Bodily Injury (Colossus) Claim and How To Identify and Overcome Ethics Codes Violations

This program is accredited for
3 Hrs General and 2 Hrs Ethics
Verified participation entitles attendee to
5.00 total credits.

This presentation contains data that plaintiff’s attorneys are using in bodily injury claims to;

  • Maximize Bodily Injury Settlement Valuation In A Colossus Environment

  • Determine the vital differences between medical examiners and their effect on the claim

  • Identify Bodily Injury Severity Types That Are Often Overlooked

  • Counter the 13 Unfair Claims Settlement Practice Acts (UCSPA's)

  • Eliminate Adjuster & IME Disputes & Win the Greater Weight Challenges

  • Use Zeus – the plaintiff’s attorney FREE online tool To Counter Colossus & save 50% of legal time & spend in formulating a demand

 

SUBJECTS INCLUDE:

  • What is being done to effectively compete against the insurer’s software’s (as Colossus).

  • The process that follows precedents and authority set by previous court rulings, judicial decisions and administrative findings to eliminate adjuster and IME disputes and win the great weight challenges

  • How to identify the 13 Unfair Claims Settlement Practice Acts (UCSPA’s) and counter insurers and adjusters when they engage one or more of them

  • How to recognize vital differences between medical experts that ultimately lessen or enhance medical valuation.

As if Colossus wasn’t enough. 27 years of fighting against a computer and then insurers created "Business Processing Improvement" (BPI). This more recently introduced process of BPI is described as a “culture” that contains additional cost containment measures to further impose limitations on representing bodily injury claims, making it difficult for plaintiff's attorneys to oppose, without specific knowledge of how the system works.

Attorney and Colossus experts have reported that BPI imposes demands to format injuries into a TABLE listing the body parts, organs, systems or functions that have been involved and cite their degree of impairment by edition, chapter, table and page of AMA Guides, referred to as “Table Formatting” as well as mirror the medical file in the demand and eliminating demands formatted in narrative styles.

With all of this, it’s difficult to keep up with the news and changes and insurers are not eager to reveal it all as a Superior Court ordered them to release information and after they refused, the court ruled that one claim settlement practice act was "harmful to public interest".

The advent of B.P.I. has changed the relevance and significance of the demand components that involves different language, sequencing and formatting requirements.

This cite offers CLE Courses that reveal effective methods to; counter Colossus, UCSPA's, explain and suggest how to navigate BPI to prevent unfair, unrealistic settlements, eliminate varying opinions, establish preponderance and win the "Greater Weight" of the evidence challenges using the insurance companies own codes against them to counter Colossus and prevent unfair settlements


We reveal effective methods to use against insurers in BI claims and this presentation will present;

  • Effective methods some plaintiff's attorneys are now engaging to prevent unfair settlements.

  • Identify and counter violations of the ethics codes of the adjuster as well as what can be done to counter them and prevent unfair valuation 

  • A method of assembling the 4 corners of the medical claim

  • A checklist of the 48 items that should be incorporated in every demand to meet BPI requirements, counter Colossus and offer increased efficiency of demand formulation, improve response time and reduce staff and legal spend.

  • Data that can quickly be incorporated to aid in the prevention of undervaluation and effectively counter insurance company UCSPA tactics

  • Differentiate Between Laws And Ethics

  • Describe The Functions Of And Relationships Among Codes of Ethics and

  • Regulations Among Adjusters In Assessing Bodily Injury Claims

  • Identify National Ethics Codes Of Conduct Of The Insurance Adjuster

  • Explain Unfair Claim Settlement Practice Acts And Unfair Trade Practices And How To Counter Them

  • Common Litigation Ethics Obstacles

  • Ethics Among Varying Medical & Professional Opinions

  • Ethics in Medical Determinations & Decisions

  • The Golden Rule Of Ethics

  • The Practical Results of Applying The “Golden Rule” in Ethical Behavior