Automated claim processing and attorney referral and selection

• US 20010041993A1
• Filed: 02/02/2001
• Published: 11/15/2001
• Est. Priority Date: 02/03/2000
• Status: Abandoned Application

• Current Assignee: Elegius Incorporated
• Original Assignee: Elegius Incorporated
• Inventors: Campbell, Richard L.
• Application Number:
  US09/776,016
• Publication Number:
  US 20010041993A1
• Time in Patent Office: Days
• US Class Current: 705/4
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 40/02 Banking, e.g. interest calculation or account maintenance credit or loans G06Q40/03
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

A computer-based method and system for managing insurance claims enables a claimant (with or without an attorney) and an insurance carrier to initiate, document, value, and negotiate an insurance claim in a timely manner while minimizing expense associated therewith. The claimant accesses the system over a network and is guided systematically from claim initiation to claim resolution. The claimant is provided with information on the credibility of the insurance claim and easy to use tools to help determine the value of the insurance claim. Additionally, the claimant is provided with an option to “auction” the insurance claim to an attorney in the event negotiations between the claimant and the insurance carrier do not lead to a settlement.

Claims

1. A computer-based method of managing an insurance claim, comprising:

(A) sending over a network to a claimant a questionnaire about an incident;

(B) receiving over the network a response to the questionnaire;

(C) sending over the network to the claimant a request for at least one document associated with the incident, the request based on at least some of the received response to the questionnaire;

(D) receiving, storing, and maintaining the at least one document requested of the claimant;

(E) creating the insurance claim which includes the at least one document and the at least some of the response to the questionnaire; and

(F) assigning a credibility rating to the insurance claim based on the at least one document and at least some of the response to the questionnaire.

2. The method of

claim 1

further comprising estimating a monetary value associated with the insurance claim.

3. The method of

claim 1

further comprising submitting the insurance claim to an insurance company on behalf of the claimant.

4. The method of

claim 1

further comprising negotiating terms of a claim settlement with the insurance company.

5. The method of

claim 1

further comprising requesting an attorney to represent the claimant.

6. The method of

claim 1

further comprising generating an abstract of the insurance claim.

7. The method of

claim 1

further comprising editing the at least one document.

8. The method of

claim 1

further comprising electronically generating and storing notes associated with the insurance claim.

9. The method of

claim 1

wherein the network comprises the Internet.

10. A computer-based system for managing an insurance claim, comprising:

(A) an electronic questionnaire module for sending over a network to a claimant a questionnaire about an incident;

(B) a receiving module for receiving over the network a response to the questionnaire;

(C) a document request module for sending over the network to the claimant a request for at least one document associated with the incident, the request based on at least some of the received response to the questionnaire;

(D) a receiving, storage, and maintenance module for receiving, storing, and maintaining the at least one document requested of the claimant;

(E) an insurance claim creation module for creating the insurance claim which includes the at least one document and the at least some of the response to the questionnaire; and

(F) an insurance claim credibility assessment module for assigning a credibility rating to the insurance claim based on the at least one document and at least some of the response to the questionnaire.

11. The system of

claim 10

further comprising an insurance claim valuation module for estimating a monetary value associated with the insurance claim.

12. The system of

claim 10

further comprising an insurance claim submission module for submitting the insurance claim to an insurance company on behalf of the claimant.

13. The system of

claim 10

further comprising an insurance claim negotiation module for negotiating terms of a claim settlement with the insurance company.

14. The system of

claim 10

further comprising an attorney request module for requesting an attorney.

15. The system of

claim 10

further comprising a claim abstract module for generating an abstract of the at least one insurance claim.

16. The system of

claim 10

further comprising an editing module for editing the at least one document.

17. The system of

claim 10

further comprising a note module for electronically generating and storing notes associated with the insurance claim.

18. The system of

claim 10

wherein the network comprises the Internet.

19. A method of evaluating the credibility of an insurance claim, comprising:

(A) sending over a network to a claimant a questionnaire about an incident;

(B) receiving over the network a response to the questionnaire;

(C) sending over the network to the claimant a request for at least one document associated the incident, the request based on at least some of the received response to the questionnaire; and

(D) determining a credibility score based on the at least one document and the at least some of the received response to the questionnaire.

20. The method of

claim 19

further comprising reporting over the network to the claimant the credibility score and how the credibility score was calculated.

21. The method of

claim 20

further comprising informing the claimant over the network about any documents not yet received that affect the calculation of the credibility score.