Episode 32: The First 7-Minutes For A Claims Adjuster and What To Expect

Here's What Happens in Those 7 Minutes:

1. First Impression Scoring Adjusters quickly review: • Type of accident (rear-end, T-bone, etc.) • Property damage photos (is it severe?) • Emergency room reports • Gaps in care (delays in initial treatment) • Pre-existing conditions or comorbidities; If documentation is weak or inconsistent, this moment sets a low reserve—often under $7,500—and it becomes hard to overcome later.

2. Colossus-Style Inputs These software tools rely on checklist-driven data points: • Specific diagnosis codes • Recognized body parts (Colossus Body Parts like shoulder, cervical spine) • Treatment timelines and provider types • Narrative reports and impairment ratings if included Adjusters are looking for algorithmic triggers to justify reserves. No trigger = no value.

3. Reserve is Set Once the evaluation is complete: • An internal reserve is established (usually the max they think the case is worth) • That number shapes future negotiation thresholds and settlement authority

Why It Matters for Paralegals and PIsciences: • Speed & Structure Matter — Records, reports, and referrals need to be organized early. • Frontload the Value — Include key diagnoses, body part codes, treatment summaries, and prognosis in the first records upload. • Use Provider Networks that Understand This — Many physicians don't realize their charts are being used this way.