Automated assignment of insurable events

• US 20040225535A1
• Filed: 05/09/2003
• Published: 11/11/2004
• Est. Priority Date: 05/09/2003
• Status: Active Grant

• Current Assignee: DUCK Creek Technologies Incorporated
• Original Assignee: Accenture Global Services Limited (Accenture PLC)
• Inventors: Hezarkhani, Hussein, Allogio, Joseph J., Benes, Cynthia S., Doyle, Josh, Bond, William E. Jr., Jackowski, Michael A., Krans, Michael R.
• Granted Patent: US 8,126,742 B2
• Time in Patent Office: Days
• US Class Current: 705/4
• 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

An automated assignment system may operate with a computer to automatically assigning insurable events to one or more organizational entities associated with an insurance organization. The automated assignment system may categorize the insurable event. In addition, the automated assignment system may identify at least one target organizational entity based on the categorization that is capable of handling the insurable event. Identification of the target organizational entity(s) may be a function of properties associated with the insurable event and the availability of the organizational entity(s). Automatic assignment may also be a function of the current workload of the target organizational entity(s).

Claims

1. A method of automated assignment of an insurable event, the method comprising:

storing data associated with an insurable event in a memory device that is accessible with a computer;

the computer categorizing the insurable event as a function of the stored data;

the computer selecting a target organizational entity with capability to handle the insurable event as a function of the categorization; and

the computer assigning the insurable event to the target organizational entity.

2. The method of claim 1, wherein categorizing the insurable event comprises the computer obtaining properties of the insurable event, wherein the properties include line of business and jurisdiction.

3. The method of claim 1, wherein categorizing the insurable event comprises the computer selecting an organizational entity category that includes the target organizational entity.

4. The method of claim 3, wherein categorizing the insurable event comprises the computer developing a list of a plurality of organizational entities within the selected organizational entity category.

5. The method of claim 1, wherein selecting a target organizational entity comprises the computer comparing properties determined as a function of the stored data to a plurality of assignment templates representative of a respective plurality of organization entities.

6. The method of claim 1, wherein assigning the insurable event to a target organizational entity comprises the computer considering the availability and workload of the target organizational entity and the computer assigning the insurable event as a function of the availability and workload.

7. The method of claim 1, further comprising the computer assigning the insurable event to an exception organizational entity when the insurable event is identified as an exception.

8. The method of claim 1, wherein categorizing the insurable event comprises:

the computer matching the properties of the insurable event with a plurality of patterns; and

the computer aggregating a respective outcome from each of the patterns to form a pattern result, wherein the pattern result is indicative of the target organizational entity.

9. An automated assignment system for automated assignment of an insurable event, the automated assignment system comprising:

a server computer; and

a database in communication with the server computer, wherein properties associated with an insurable event are storable in the database, the properties include entered data and categorization of the insurable event;

wherein the server computer is operable to identify an organizational entity as a function of the properties,

the insurable event assignable by the server computer to the identified organizational entity as a function of at least one of workload and availability of the organizational entity.

10. The automated assignment system of claim 9, wherein the insurable event is an insurance claim.

11. The automated assignment system of claim 9, further comprising a rules engine executable by the server computer, wherein the rules engine includes a properties identification module, an organizational entity identification module, an assignment module and an exception module.

12. The automated assignment system of claim 9, wherein the server computer is operable to determine an organizational entity category as a function of the properties, wherein the organizational entity is included in the organizational entity category.

13. The automated assignment system of claim 9, wherein the server computer is operable to trigger operation of a pattern analysis system, the pattern analysis system operable to provide pattern results as part of the properties, wherein the organizational entity is identified as a function of the pattern results.

14. The automated assignment system of claim 9, wherein the server computer is operable to compare a plurality of assignment templates with the properties of the insurable event to generate an organizational entity list that includes the identified organizational entity.

15. The automated assignment system of claim 9, wherein the server computer is operable to evaluate the insurable event in view of the identified organizational entity to determine if at least one of oversight, technical support and an additional organizational entity is needed.

16. The automated assignment system of claim 9, wherein the server computer is operable to allocate credit for handling the insurable event to a proper area of an insurance organization.

17. The automated assignment system of claim 9, wherein the server computer is operable to assign the insurable event to an exception organizational entity when the insurable event is identified as an exception by the server computer.

18. The automated assignment system of claim 9, further comprising a data entry terminal in communication with the server computer, the data entry terminal operable to initiate storage of data related to the insurable event in the database.

19. The automated assignment system of claim 9, further comprising an insurable event handler terminal in communication with the server computer, the insurable event handler terminal operable to communicate with the server computer and provide indication of assignment of the insurable event.

20. An automated assignment system for automated assignment of an insurable event, the automated assignment system comprising:

a memory device;

instructions stored in the memory device to store data associated with an insurable event;

instructions stored in the memory device to identify properties associated with the stored data, wherein the properties include line of business and jurisdiction;

instructions stored in the memory device to determine additional properties from the stored data that include categorization of the insurable event;

instructions stored in the memory device to identify a target organizational entity as a function of the properties; and

instructions stored in the memory device to assign the insurable event to the target organizational entity.

21. The automated assignment system of claim 20, further comprising instructions stored in the memory device to determine the status of the target organizational entity and assign the insurable event as a function of the status, wherein the status includes availability and workload of the target organizational entity.

22. The automated assignment system of claim 20, further comprising:

instructions stored in the memory device to identify the insurable event as an exception when identification of the target organizational entity fails; and

instructions stored in the memory device to identify and assign the insurable event identified as an exception to an exception organizational entity.

23. The automated assignment system of claim 20, further comprising instructions stored in the memory device to allocate credit for the insurable event to a proper area of an insurance organization as a function of the assignment of the insurable event to the target organizational entity.

24. The automated assignment system of claim 20, further comprising instructions stored in the memory device to segment the insurable event by matching the data to a plurality of patterns arranged in a plurality of pattern types to determine additional properties associated with the stored data.

25. The automated assignment system of claim 20, further comprising:

instructions stored in the memory device to match the data to a plurality of patterns; and

instructions stored in the memory device to determine outcomes from the patterns and aggregate the outcomes to generate a pattern result that is a property associated with the stored data.

26. An automated assignment system operating on a computer to perform automated assignment of an insurable event, the automated assignment system comprising:

a properties identification module executable with a computer, the properties identification module operable to determine properties associated with an insurable event as a function of data related to the insurable event and categorization of the insurable event;

an organizational entity identification module executable with the computer, the organizational entity identification module operable to identify a target organizational entity as a function of the properties determined with the properties identification module and availability of the target organizational entity; and

an assignment module executable with the computer, the assignment module operable to assign the insurable event to the target organizational entity identified with the organizational entity identification module as a function of the workload of the target organizational entity; and

an exception module executable with the computer, the exception module operable to assign insurable events identified as exceptions by the organizational entity identification module to an exception target organizational entity.

27. The automated assignment system of claim 26, further comprising an allocation module executable with the computer, the allocation module operable to allocate credit for an insurable event to a proper area of an insurance organization as a function of assignment of the insurable event by one of the assignment module and the exception module.

28. The automated assignment system of claim 26, wherein the properties identification module comprises a pattern analyzer module, the pattern analyzer module operable to analyze pattern results to determine properties associated with the insurable event.

29. A pattern analyzer system to analyze insurable events, the pattern analyzer system comprising:

a memory device;

instructions stored in the memory device to divide an insurable event into a plurality of segments by matching data associated with the insurable event to a plurality of patterns;

instructions stored in the memory device to determine outcomes from each of the segments as a function of the data associated with the insurable event; and

instructions stored in the memory device to aggregate the outcomes to generate a pattern result.

30. The pattern analyzer system of claim 29, further comprising:

instructions stored in the memory device to identify one of a plurality of pattern types for each of the segments; and

instructions stored in the memory device to match the patterns within each of the pattern types to the insurable event.

31. The pattern analyzer system of claim 30, further comprising instructions stored in the memory device to select an outcome from one of the patterns in each of the pattern types for aggregation to generate the pattern result.

32. The pattern analyzer system of claim 31, further comprising instructions stored in the memory device to generate a plurality of pattern results for the insurable event by sequential selection of each outcome from each of the pattern types for aggregation when a plurality of patterns within at least one of the pattern types are matched to the insurable event.

33. The pattern analyzer system of claim 29, wherein the insurable event is an insurance claim.

34. A method of analyzing insurable events, the method comprising:

matching data associated with an insurable event to a plurality of determined patterns to divide the insurable event into segments;

analyzing the data matched to each of the determined patterns to determine an outcome for each of the segments; and

aggregating the outcomes to generate a pattern result.

35. The method of claim 34, wherein matching the data comprises comparing characteristics included in each of the patterns to the data.

36. The method of claim 34, wherein analyzing the data comprises comparing variables in the data with characteristic attributes associated with each of the determined patterns.