Insurance claim monitoring

• US 20060106651A1
• Filed: 10/29/2005
• Published: 05/18/2006
• Est. Priority Date: 10/29/2004
• Status: Abandoned Application

• Current Assignee: LexisNexis Risk Solutions, Inc. (RELX PLC)
• Original Assignee: Choicepoint Asset Company
• Inventors: Madison, Bill, Trocheck, Jeanne, Gillard, Stephen
• Application Number:
  US11/261,302
• Publication Number:
  US 20060106651A1
• Time in Patent Office: Days
• US Class Current: 705/4
• CPC Class Codes: G06Q 10/06 Resources, workflows, human or project management; Enterprise or organisation planning; Enterprise or organisation modelling
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

Automated generation and output of customized reports based on the insurance claim records of insured persons. Insurance carriers can automatically obtain customized reports for use in monitoring insured persons'"'"' insurance claim records for previously-unavailable claim information. Each insured person can be insured on a recently-executed insurance policy of an insurance carrier. An insurance carrier'"'"'s customized report can include, for each insured person, claim information related to the insured person that was unavailable to the insurance carrier before execution of the insurance policy. The customized report can also include claim information related to the insured person that was unavailable before a specified period of time before execution of the insurance policy. The insurance carriers can designate the reports'"'"' format and content. Allowing insurance carriers to designate how, and in what format, they wish to receive the reports permits for more effective and more efficient monitoring of insured persons'"'"' claim records.

Claims

1. A computer-implemented method for identifying previously-unavailable claim data corresponding to an insured person insured on an insurance policy of an insurance carrier, comprising the steps of:

creating claim data comprising information regarding at least one insurance claim;

identifying any of the claim data that corresponds to the insured person by comparing the claim data to at least one of policy data and insured data, the policy data comprising information regarding at least one insurance policy of the insurance carrier, the insured data comprising, for each insurance policy, information regarding at least one person insured on the insurance policy; and

determining whether the identified claim data was unavailable to the insurance carrier during a specified time period comprising an execution date of an insurance policy corresponding to the insured person and the insurance carrier.

2. The computer-implemented method of claim 1, wherein the step of determining whether the identified claim data was unavailable to the insurance carrier during the specified time period comprises the steps of:

identifying policy data corresponding to the insurance carrier and the insured person;

determining an execution date of an insurance policy corresponding to the identified policy data;

determining a date on which the identified claim data was created; and

determining whether the date on which the identified claim data was created is within a specified number of days of the execution date of the insurance policy corresponding to the identified policy data.

3. The computer-implemented method of claim 1, wherein the claim data comprises, for each insurance claim, at least one of a claim type, a claim loss amount, a name of an insured person corresponding to the claim, and a date on which the claim data corresponding to the claim was created.

4. The computer-implemented method of claim 1, wherein the step of creating the claim data comprises the steps of:

obtaining the claim data from a claim data source; and

storing the claim data in a claim database.

5. The computer-implemented method of claim 1, further comprising the step of generating a report comprising information regarding whether the identified claim data was unavailable to the insurance carrier during the specified time period.

6. The computer-implemented method of claim 5, further comprising the step of creating rule data designating at least one of the format of the report and the content of the report, wherein the step of generating the report comprises applying the rule data to at least one of the policy data, insured data, and claim data.

7. A computer-implemented method for generating a report based on whether previously-unavailable claim data corresponds to an insured person insured on an insurance policy of an insurance carrier, comprising the steps of:

creating claim data comprising information regarding at least one insurance claim;

identifying any of the claim data that corresponds to the insured person by comparing the claim data to at least one of policy data and insured data, the policy data comprising information regarding at least one insurance policy of the insurance carrier, the insured data comprising, for each insurance policy, information regarding at least one person insured on the insurance policy;

determining whether the identified claim data was unavailable to the insurance carrier during a specified time period comprising an execution date of an insurance policy corresponding to the insured person and the insurance carrier; and

generating a report in accordance with rule data comprising a formatting designation designating at least one of the format of the report and the content of the report, the formatting designation based on whether the identified claim data was unavailable to the insurance carrier during the specified time period.

8. The computer-implemented method of claim 7, wherein the step of determining whether the identified claim data was unavailable to the insurance carrier during the specified time period comprises the steps of:

identifying policy data corresponding to the insurance carrier and the insured person;

determining an execution date of an insurance policy corresponding to the identified policy data;

determining a date on which the identified claim data was created; and

determining whether the date on which the identified claim data was created is within a specified number of days of the execution date of the insurance policy corresponding to the identified policy data.

9. The computer-implemented method of claim 7, wherein the claim data comprises, for each insurance claim, at least one of a claim type, a claim loss amount, a name of an insured person corresponding to the claim, and a date on which the claim data corresponding to the claim was created.

10. The computer-implemented method of claim 7, wherein the step of creating the claim data comprises the steps of:

obtaining the claim data from a claim data source; and

storing the claim data in a claim database.

11. A computer-implemented method for identifying previously-unavailable claim data corresponding to an insured person insured on an auto insurance policy of an insurance carrier, comprising the steps of:

creating claim data comprising information regarding at least one auto insurance claim;

identifying any of the claim data that corresponds to the insured person by comparing the claim data to at least one of policy data and insured data, the policy data comprising information regarding at least one auto insurance policy of the insurance carrier, the insured data comprising, for each insurance policy, information regarding at least one person insured on the insurance policy; and

determining whether previously-unavailable claim data corresponds to the insured person by

identifying policy data corresponding to the insurance carrier and the insured person,

determining an execution date of an insurance policy corresponding to the identified policy data,

determining a date on which the identified claim data was created, and

determining whether the date on which the identified claim data was created is within a specified number of days of the execution date of the insurance policy corresponding to the identified policy data.

12. The computer-implemented method of claim 11, wherein the claim data comprises, for each insurance claim, at least one of a claim type, a claim loss amount, a name of an insured person corresponding to the claim, and a date on which the claim data corresponding to the claim was created.

13. The computer-implemented method of claim 11, wherein the step of creating the claim data comprises the steps of:

obtaining the claim data from a claim data source; and

storing the claim data in a claim database.

14. The computer-implemented method of claim 11, further comprising the step of generating a report comprising information regarding whether previously-unavailable claim data corresponds to the insured person.

15. The computer-implemented method of claim 14, further comprising the step of creating rule data designating at least one of the format of the report and the content of the report, wherein the step of generating the report comprises applying the rule data to at least one of the policy data, insured data, and claim data.