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What Factors Do Claim Analysis Software Consider?

men looking at data on a computer

If you are dealing with a claims assessment case, then there are certain factors the claim analysis software will consider. In most cases, the only documents that the insurance companies will use are the actual medical records and evidence that you submit, such as doctors' reports. Since this is the case, it is important that your doctor properly document all of the injuries that you may have sustained during your car accident that are relevant to your claim. If the doctor fails to diagnose or record an injury that was caused by your crash, it is highly unlikely that it will be included in the claim that is analyzed by the software.

The specific factors of a claims assessment case will be discussed more in depth in following articles, but there are a few things to note before considering these factors. First, each factor in the system has an allocation of “severity points.” What are severity points? Severity points represent the severity of a personal injury, with higher points indicating a higher value of the claim; the monetary value that is assigned to these points varies on a company-by-company basis. Because this is the process that is used, it is crucial that you submit information regarding as many of the factors as possible so that 1) your case represents the true value of your claim and 2) it possibly leads to a higher settlement. Second, the claim assessment software uses more than 12,000 factors in determining the value of the claim. Some of the general categories of factors include:

  • Injuries,
  • Complaints,
  • Delays and gaps in treatment,
  • History of treatment,
  • Imaging,
  • Duties under duress,
  • Prognosis,
  • Permanent impairment, and
  • Loss of enjoyment of life.

If you are concerned about whether your documents are sufficient to make a claim, or need help ensuring that your demand letter to the insurance company is properly formatted so that your claim is fully evaluated, it is extremely important that you find an experienced personal injury attorney to help you. Our personal injury attorneys at KI Legal Personal Injury are ready and able to handle this process for you. With a strong attention to detail and years of experience advocating for clients, our personal injury attorneys will do everything they can to help you succeed with your lawsuit. Contact KI Legal Personal Injury today at (212) 404-8605 or by emailing to set up a free consultation and learn about the next steps available to you.




This information is the most up to date news available as of the date posted. Please be advised that any information posted on the KI Legal Blog or Social Channels is being supplied for informational purposes only and is subject to change at any time. For more information, and clarity surrounding your individual organization or current situation, contact a member of the KI Legal team.


KI Legal Personal Injury fights for victims of a wide array of personal injury claims, from Motor Vehicle Accidents to Scaffolding and Ladder Falls to Slip/Trip & Falls, amongst others. By leveraging its multidisciplinary foundation and, with the help of its experienced litigators, KI Legal Personal Injury can fight for the results and compensation that victims deserve without pushing for premature settlements due to financial reasons. This financial paradigm shift swings the pendulum in our favor when it comes to negotiating with insurance carriers, inherently leading to better results for clients. For the latest updates.

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