Kenneth J. Allen & Associates - Injury Attorneys

Illinois and Indiana Personal Injury Lawyers and Attorneys Trial and Civil Litigation Law Firm.

Passion. Commitment. Excellence.

Those three words best describe the driving forces behind Kenneth J. Allen & Associates. Our firm is devoted exclusively to the practice of Accident and Injury Law, and exclusively to the people - not corporations - seriously hurt or killed in incidents as varied as on-the-job accidents, semi-truck crashes, injuries from a defective product, or loss of life because of a doctor's medical malpractice.

As the only multi-state law firm in Valparaiso Indiana, Merrillville Indiana, Indianapolis Indiana, Northwest Indiana, Chicagoland, Joliet Illinois, Tinley Park Illinois, Chicago Illinois accepting serious injury and wrongful death cases, exclusively, Kenneth J. Allen & Associates is experienced and knowledgeable in the details and procedures that can make or break a case.

phone (219)465-6292 fax (219)477-5181
1109 Glendale Boulevard Valparaiso, IN 46383

Monday-Friday: 8:00 am - 5:00 pm

Saturday-Sunday: closed

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INSURANCE COMPANIES LOWBALL CLAIMS PAYMENTS ACCORDING TO NEW EXPOSE BY CONSUMER WATCHDOG

posted by kjalaw on Jun 17th, 2012 at 10:29 am

The biggest insurance companies in the country may have been cheating on the numbers, and injury victims may have been getting much less than what they are entitled to get under the language of their insurance policy contract. That’s according to a new expose from a consumer watchdog report, in a report issued last week.

If so, that is bad faith insurance abuse across the board.  That’s against state law —intentional bad faith by an insurance company is the basis of a cause of action by the injured person against the insurance company.  Expect the plaintiffs’ lawsuits to start being filed. Soon.

What is happening?  The Consumer Federation of America (CFA) warns that computerized systems for processing insurance claims’ by the nation’s largest insurance carriers can be “easily adjusted to make broad-scale “lowball” claims’ payments….”  Imagine that.  The entire report is available for download here.

From the CRA news release:

“This report is a wake-up call for consumers and regulators who are not aware of the many ways that computer claims’ software can be manipulated to produce unjustifiably low injury payments to consumers and tens of millions of dollars in illegitimate ‘savings’ for insurers,” said Mark Romano, CFA’s Claims Project Director. Romano was the “subject matter expert” on the Colossus injury claims’ evaluation system at Allstate and Encompass insurance companies for almost ten years. Colossus, which is the dominant claims’ system in the marketplace, is sold by Computer Sciences Corporation (CSC).

“When CSC and its competitors talk publicly about computer-based claims’ systems, they stress that the programs allow insurers to more consistently evaluate bodily injury claims,” said Romano. “Consistency is a legitimate goal, but these companies tell a different story behind closed doors. Software marketing representatives acknowledge that the real reason insurance companies are willing to invest millions in these systems is that they can dial down claims’ payments to thousands of consumers at a time, regardless of whether these payouts are fair.”

The report, “Low Ball: An Insider’s Look at How Insurers Can Manipulate Computerized Systems to Broadly Underpay Injury Claims”, details the history of the use of Colossus and similar software products by insurance companies. It provides considerable information about how these programs are set up, “tuned” to reach particular claims’ payment monetary goals and adjusted over time. The report also identifies specific techniques that insurers can use to directly and indirectly produce “lowball” claims:

  • Directly reduce payments by a predetermined amount across-the-board, without determining whether this will lead to unjustifiably low payments for individual claims.
  • Selectively remove higher-cost claims from data used to determine the acceptable range of payments for particular injuries. This has the effect of lowering payments for all claims of this type.
  • Require insurance adjusters without medical training or credentials to second-guess medical professionals by altering injury determinations, thus dictating lower payments for certain injuries.
  • Encourage adjusters to downplay or even ignore the likelihood that injured consumers will need future medical treatment or will be permanently impaired, thus lowering payouts.
  • Encourage adjusters to determine that drivers are partly at-fault for the auto accident that injured them, even when they may not be.

“Many of the concerns about Colossus and similar programs have focused on the potential for insurers to manipulate these systems directly in order to reduce claims’ payouts,” said Romano. “But insurers can also use many techniques to unjustifiably lower payments in a more subtle manner, by putting biased or incomplete information into the system.”

The report includes excerpts from recently released court records in a major class action lawsuit, Hensley v. Computer Sciences Corporation, that reveal disturbing information about how Colossus and similar products are marketed to and used by insurance companies:

  • Insurers could adjust Colossus to produce virtually any claims’ payment reduction they wanted, whether or not it was justified. One CSC executive told the court that Colossus could be “tuned” to potentially achieve a particular level of savings, such as 15 percent, for all claims.
  • CSC claimed insurers could produce huge reductions in claims’ payouts, which insurers achieved in many cases. A CSC executive told the court that Colossus achieved savings of around 19 percent on overall claims payouts for some its insurer clients. Meanwhile, CSC’s competitors, like the Insurance Services Office (ISO) claimed that they could maintain even higher savings over time.
  • CSC misled regulators about the purpose of Colossus, claiming that main function of the product was to achieve consistent payouts rather than enormous claims’ “savings,” which might be illegitimate.

 

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PAY AS YOU DRIVE CAR INSURANCE: THINK TWICE BEFORE YOU PLUG IN THAT MONITORING DEVICE INTO YOUR CAR

posted by kjalaw on Nov 2nd, 2011 at 9:19 am

Insurance companies are aggressively promoting the latest gizmo – a little device that you place on your car, provided for free by the insurance carrier – telling customers this is a great thing, it will save them money.  Saving money these days?  Of course, lots of people are listening.  But should they be taking up these offers?  Maybe not.

Thee insurance companies are for-profit companis and they want to keep claims down, because claims mean they have to pay money out of their pockets.  Serious personal injury claims mean lots of money they may have to pay to claimants; wrongful death claims, even more.

So when insurance companies point to saving lives, remember that they’ve got their own bottom line in mind.  This may be great news for their shareholders, but it may not be so great for you, their policy holder.

The Gizmo: Pay As You Drive or Pay As You Go Plans

Lots of companies are offering these programs, from Progressive to AAA.  They send you a small, cute electronic device to plug into your car or minivan or SUV, and once installed, this gizmo records data for the insurance company.  Lots of data: from how well or badly you use the brakes, to the amount of miles you drive each day, to how fast you drive, and what time of day you are driving your vehicle.  After a set amount of time, the carrier will let you know if your premiums are going to benefit from the data that has been collected via the device.

The gizmo doesn’t guarantee a lower premium.  The device collects a lot of information on your vehicle, and if it falls into certain categories, then you may be eligible for a discount.  This is important to remember.

The insurance company will argue that these gizmos help them assess risk and they can give discounts (here’s the saving money part) to customers who are low-risk for filing a claim.  For example, take two policyholders who drove a total of 5000 miles in 6 months: the one that drove 4800 of those miles in a single trip to take the kids to DisneyWorld over Spring Break is at lower risk than the driver who slowly built up that total in a daily commute on a heavily-trafficked interstate.

Sounds smart, but that’s not the whole story.  By collecting information on how you drive, when you drive, and where you drive, the insurance company sure is getting lots of personal information on you.

Privacy? Not only are consumer groups concerned about how these gizmos may be violations of your basic privacy rights, now and in the future, but consider this:  when a serious accident occurs, insurance adjusters appear on the scene to evaluate things – for the best interests of the insurance company.

Rest assured, the data collected by these gizmos is going to be used in the future by insurance companies not to lower premium costs but instead to try and deny coverage and forego paying out money on high dollar serious personal injury claims.  Watch, this is going to happen.

Be careful out there.

 

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