System and process for electronic subrogation, inter-organization workflow management, inter-organization transaction processing and optimized web-based user interaction
First Claim
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1. A method for issuing and negotiating and settling insurance subrogation claims between at least two parties through an electronic subrogation network, said method comprising:
- providing at least one electronic subrogation file, capable of containing structured claim information and unstructured supporting documents in a form that can be accessed by multiple parties;
permitting entry, through electronic communication means, by one or more of said multiple parties of one or both of claim information and supporting documents to said subrogation file based on party-specific rules; and
permitting access, through electronic communication means, by one or more of said multiple parties to one or both of said structured claim information and said unstructured supporting documents based on party-specific rules.
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Abstract
An intelligent electronic subrogation network (“ESN”) automates intra-organization workflow, inter-organization workflow and collaboration for insurance subrogation. This ESN is facilitated by a novel system architecture and process that includes an inter-organizational workflow management system, an inter-organizational transaction processing system, and a unique mechanism for optimizing and enriching web-based user interaction within any such system.
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Citations
116 Claims
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1. A method for issuing and negotiating and settling insurance subrogation claims between at least two parties through an electronic subrogation network, said method comprising:
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providing at least one electronic subrogation file, capable of containing structured claim information and unstructured supporting documents in a form that can be accessed by multiple parties;
permitting entry, through electronic communication means, by one or more of said multiple parties of one or both of claim information and supporting documents to said subrogation file based on party-specific rules; and
permitting access, through electronic communication means, by one or more of said multiple parties to one or both of said structured claim information and said unstructured supporting documents based on party-specific rules. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21)
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22. A method for organizing and modeling subrogation-specific business information comprising:
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providing entities, attributes and relationships specific to subrogation workflow;
translating incoming data formats to a unified data model format; and
maintaining consistency in said translating.
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23. A method for managing the workflow between two or more organizations within a subrogation process, said method comprising:
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providing a subrogation-specific workflow model that includes inter-organization workflow states, transitions, conditionality, status and action flags; and
managing organization-specific workflow within the context of community workflow. - View Dependent Claims (24, 25)
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26. A system for issuing and negotiating and settling insurance subrogation claims between at least two parties through an electronic subrogation network, said system comprising:
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at least one electronic subrogation file, capable of containing structured claim information and unstructured supporting documents in a form that can be accessed by multiple parties;
means for permitting entry, through electronic communication means, by one or more of said multiple parties of one or both of said structured claim information and unstructured supporting documents to said subrogation file based on party-specific rules; and
means for permitting access, through electronic communication means, by one or more of said multiple parties to one or both of said structured claim information and said supporting documents based on party-specific rules. - View Dependent Claims (27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46)
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47. A system for organizing and modeling subrogation-specific business information comprising:
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means for providing entities, attributes and relationships is specific to subrogation workflow;
means for translating incoming data formats to a unified data model format; and
means for maintaining consistency in said translating.
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48. A system for managing the workflow between two or more companies within a subrogation process, said system comprising:
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means for providing a subrogation-specific workflow model that includes inter-organization workflow states, transitions, conditionality, status and action flags; and
means for managing organization-specific workflow within the context of community workflow. - View Dependent Claims (49, 50)
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51. A method for optimizing and enriching an interaction between a client and a server as compared to a server-based HTML approach, said method comprising:
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reducing the bandwidth requirement for the transmission of data between a client and a server;
reducing the number of interactions required to between a client and a server by a factor of two or more;
reducing response time as experienced by an end-user operating the client; and
reducing a number of processing cycles required by the server for communication of application information between a server and a client. - View Dependent Claims (52, 53, 54, 55, 56, 57)
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58. A system for optimizing and enriching an interaction between a client and a server as compared to a server-based HTML approach, said system comprising:
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means for reducing the bandwidth requirement for the transmission of data between a client and a server;
means for reducing the number of interactions required to between a client and a server by a factor of two or more;
means for reducing response time as experienced by an end-user operating the client; and
means for reducing a number of processing cycles required by the server for communication of application information between a server and a client. - View Dependent Claims (59, 60, 61, 62, 63, 64)
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65. A method for determining and maintaining workflow states of a business process/transaction involving multiple independent parties, said method comprising:
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defining said workflow states and communicating at least one of said workflow states upon demand to each of said organizations in a framework that is generic to a specific business process/transaction;
defining one or more valid workflow completion targets and maintaining state information related to the progression towards a given workflow target;
tracking the state of one or more activities occurring simultaneously within said business process/transaction;
maintaining state data independently for each of the organizations involved within said business process/transaction;
maintaining data for each activity within said business process/transaction specifying which of said organizations is responsible for performing the next action related to said activity; and
maintaining a deterministic framework for all valid workflow conditions, states and transitions between states related to said business process/transaction. - View Dependent Claims (66, 67, 68)
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69. A system for determining and maintaining workflow states of a business process/transaction involving multiple independent parties, said system comprising:
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means for defining said workflow states and communicating at least one said workflow states upon demand to each of said organizations in a framework that is generic to a specific business process/transaction;
means for defining one or more valid workflow completion targets and maintaining state information related to the progression towards a given workflow target;
means for tracking the state of one or more activities occurring simultaneously within said business process/transaction;
means for maintaining state data independently for each of the organizations involved within said business process/transaction;
means for maintaining data for each activity within said business process/transaction specifying which of said organizations is responsible for performing the next action related to said activity; and
means for maintaining a deterministic framework for all valid workflow conditions, states and transitions between states. - View Dependent Claims (70, 71, 72)
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73. A method for carrying out a business process/transaction involving multiple independent parties through an electronic network, said method comprising:
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providing at least one electronic file, capable of containing structured information and unstructured supporting documents in a form that can be accessed by multiple parties;
permitting entry, through electronic communication means, by one or more of said multiple parties of one or both of said structured information and said supporting documents to said electronic file based on party-specific rules; and
permitting access, through electronic communication means, by one or more of said multiple parties to one or both of said structured claim information and said unstructured supporting documents based on party-specific rules. - View Dependent Claims (75, 76, 77, 78, 79, 80, 81, 82, 83, 84, 85, 86, 87, 88)
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74. A method for processing an application specific request, and generating an associated response, based on receipt of a message based-transaction request containing a collection of interrelated business objects, said method comprising:
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providing a processing framework that does not rely on any specific message format from the originating system;
validating the identity and authority of an arbitrary requester that will be submitting transaction requests, and, upon said validating, establishing a “
requester context”
that will be used to validate any transaction requests;
validating whether or not a specific transaction request can be processed based on the requester context and, upon said validating, establishing a “
transaction context”
based on the specific request;
ensuring that any response to the transaction request contains correct business objects and related attributes based on a requester and transaction context;
ensuring that the input portion of any transaction request that will result in data modification contains only the business objects and attributes that are allowed to be modified based on the requester and transaction context;
allowing the application specific processing logic to be defined without regard to input or output filtering of objects and attributes that are indicated by a specific requester and transaction context;
ensuring that the transaction request can only access data objects within the database that are allowed based on the specific requester and transaction context;
supporting transaction requests from a plurality of originating systems and interfaces including, online HTML interface, background, automated electronic interface, and wireless device; and
enabling authorized requesting systems to automatically determine the types of requests that can be submitted and their associated request/response structures.
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89. A method for organizing and modeling application-specific business information comprising:
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providing entities, attributes and relationships specific to the given business process;
translating incoming data formats to a unified data model format; and
maintaining consistency in said translating.
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90. A method for managing the workflow between two or more organizations within a business process, said method comprising:
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providing a process-specific workflow model that includes inter-organization workflow states, transitions, conditionality, status and action flags; and
managing organization-specific workflow within the context of community workflow. - View Dependent Claims (91, 92)
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93. A method for modeling the business practices of each member of a network, and for handling workflow exception conditions, said method comprising:
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permitting said members to configure company-specific business rules;
auditing files based upon the business rules of all members involved in the transaction; and
triggering alerts in response to exception conditions and violations of said business rules based upon member-specific parameters. - View Dependent Claims (94)
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95. A system for carrying out a business process/transaction involving multiple independent parties through an electronic subrogation network, said system comprising:
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at least one electronic file, capable of containing structured information and unstructured supporting documents in a form that can be accessed by multiple parties;
means for permitting entry, through electronic communication means, by one or more of said multiple parties of one or both of said information and unstructured supporting documents to said electronic file based on party-specific rules; and
means for permitting access, through electronic communication means, by one or more of said multiple parties to one or both of said structured claim information and said supporting documents based on party-specific rules. - View Dependent Claims (97, 98, 99, 100, 101, 102, 103, 104, 105, 106, 107, 108, 109, 110)
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96. A system for processing an application specific request, and generating an associated response, based on receipt of a message based-transaction request containing a collection of interrelated business objects, said system comprising:
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means for providing a processing framework that does not rely on any specific message format from the originating system;
means for validating the identity and authority of an arbitrary requester that will be submitting transaction requests, and, upon said validating, establishing a “
requester context”
that will be used to validate any transaction requests;
means for validating whether or not a specific transaction request can be processed based on the requester context and, upon said validating, establishing a ‘
transaction context’
based on the specific request;
means for ensuring that any response to the transaction request contains correct business objects and related attributes based on a requester and transaction context;
means for ensuring that the input portion of any transaction request that will result in data modification contains only the business objects and attributes that are allowed to be modified based on the requester and transaction context;
means for allowing the application specific processing logic to be defined without regard to input or output filtering of objects and attributes that are indicated by a specific requester and transaction context;
means for ensuring that the transaction request can only access data objects within the database that are allowed based on the specific requester and transaction context;
means for supporting transaction requests from a plurality of originating systems and interfaces including, online HTML interface, background, automated electronic interface, and wireless device; and
means for enabling authorized requesting systems to automatically determine the types of requests that can be submitted and their associated request/response structures.
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111. A system for organizing and modeling application-specific business information comprising:
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providing entities, attributes and relationships specific to the given business process;
translating incoming data formats to a unified data model format; and
maintaining consistency in said translating.
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112. A system for managing the workflow between two or more organizations within a business process, said system comprising:
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providing a process-specific workflow model that includes inter-organization workflow states, transitions, conditionality, status and action flags; and
managing organization-specific workflow within the context of community workflow. - View Dependent Claims (113, 114)
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115. A system for modeling the business practices of each member of a network, and for handling workflow exception conditions, said system comprising:
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means for permitting said members to configure company-specific business rules;
means for auditing files based upon the business rules of all members involved in the transaction; and
means for triggering alerts in response to exception conditions and violations of said business rules based upon member-specific parameters. - View Dependent Claims (116)
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Specification