INTERACTIVE INFORMATION MANAGEMENT SYSTEM AND METHOD

• US 20090326989A1
• Filed: 09/08/2009
• Published: 12/31/2009
• Est. Priority Date: 03/23/2005
• Status: Abandoned Application

• Current Assignee: Premier Cleaning Services Limited (Jones Lang LaSalle (Puerto Rico), Inc.)
• Original Assignee: Premier Cleaning Services Limited (Jones Lang LaSalle (Puerto Rico), Inc.)
• Inventors: Schmitt, Brett A., Gladman, Jamie E.
• Application Number:
  US12/555,557
• Publication Number:
  US 20090326989A1
• 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

A method is provided for interactively managing insurance claim information using a web site with an insured side and an insurer side. An insured provides information pertaining to lost or damaged items associated with a property loss claim. Upon submitting a claim to the claim management system, the insurer has access to the information from the insurer side of the website to process the claim. The adjuster can verify the information associated with each item, and can adjust the estimated replacement values for each item before reimbursing the insured for the claim and memorialize a justification for the adjustment. The adjuster can assist an insured with submission of the claim by remotely accessing the insured'"'"'s claim on the insured'"'"'s side of the website and either completing the claim information on their behalf, or coach the insured during completion of the claim.

Claims

1. A method for interactively processing a property insurance claim, which comprises the steps of:

providing a claims management system including a website;

providing the website with an insured side and an insurer side;

providing a claim information submission subsystem on the insured side of the website;

providing a claim information management subsystem on the insurer side of the website;

providing an insured with a property loss claim with access to the insured side of the web site;

the insured creating a property loss claim on the insured side of the website;

the insured submitting information relating to lost or damaged items pertaining to the property loss claim;

receiving in the claims management system property-specific information relating to lost or damaged items associated with the property loss claim;

the insured submitting the property-specific information relating to lost or damaged items to the claims management system;

the insured submitting the property loss claim to the claims management system;

the insurer accessing the submitted property loss claim on the insurer side of the website;

providing predetermined claim item lost parameters;

comparing the property-specific information relating to lost or damaged items in the submitted claim to cost parameters; and

providing the adjuster on the insurer side of the website with an indication when a submitted claim item exceeds cost parameters.

2. The method of claim 1, which includes the additional step of the insured returning to the insured side of the website to inventory property-specific information relating to lost or damaged items associated with the property loss claim before submitting the property loss claim to the claims management system.

3. The method of claim 1, which includes the additional steps of:

the insured providing the adjuster remote access to the insured'"'"'s side of the website while the insured is creating a property loss claim; and

the adjuster submitting the property specific information relating to insured'"'"'s loss or damaged items to the claims management system on the insured'"'"'s side of the website.

4. The method of claim 2, which includes the additional steps of:

the adjuster adjusting the submitted property loss claim by providing an adjusted replacement cost;

the adjuster providing an adjustment note in connection with the adjusted replacement cost; and

displaying the adjusted replacement cost and the adjustment note on the insured'"'"'s side and insurer'"'"'s side of the website.

5. The method of claim 3, which includes the additional steps of providing two-way audio and video communication between insured and adjuster.

6. A method for interactively processing an insurance claim, which comprises the steps of:

providing a web site with an insured side and an insurer side;

providing a claims management system with claim-related information including predetermined categories relating to insurance claims;

providing an insured with a loss with access to the claims management system from the insured side of the web site;

providing the insurer with a unique identification;

displaying said insurer'"'"'s unique identification on the insured and insurer sides of the web site;

providing the insured with a password for accessing the insured'"'"'s side of the web site;

receiving in the claims management system item-specific information relating to lost or damaged items associated with the claim;

providing an inventory of said lost or damaged items associated with said claim in said predetermined categories;

inventorying the items with the claims management system;

generating an inventory of items from said item-specific information;

tabulating, verifying and reviewing said inventory in connection with said transaction;

providing an insurance company with access to the claims management system from the insurer side of the web site;

displaying said predetermined categories on said insured side of said web site;

receiving the item-specific information in said predetermined categories displayed on the insured side of the web site;

adjusting the claim from the insurer side of the web site;

the insurer assigning the claim to an adjuster;

the adjuster obtaining from the insured and submitting to the insurer claim-related information;

adjusting said claim using criteria chosen from a list including;

purchase date;

item age;

original cost;

actual cash value (ACV);

replacement cost (RC);

insurance policy reserves; and

depreciation;

linking said claims management system to vendors for replacement cost information for said lost or damaged items;

providing a shopping cart type procedure for placing replacement items in a virtual shopping cart using such vendor-provided cost information;

indicating to said insured a full shopping cart type condition when the inventory procedure is complete;

said insured purchasing the shopping cart contents from said vendors;

said vendors compensating the claims management system administrator for being linked to said claims management system and for said referrals of insureds with property losses;

generating periodic reports pertaining to said claim to said insurer and said insured;

applying predetermined claim adjustment guidelines by the insurer to the submitted claim-related information;

submitting predetermined types of pre-replacement information pertaining to lost or damaged items prior to replacement of same via the insurer side of the web site;

submitting predetermined types of post-replacement information pertaining to lost or damaged items after replacement via the insurer side of the web site;

the claims management system listing the open or active claim files of an adjuster on the insurer side of the web site;

the adjuster accessing said open or active claim file list;

the adjuster archiving claim files on the claims management system;

providing the adjuster with an indication when a claim item exceeds predetermined claim adjustment guidelines;

the claims management system including guidelines for total yearly purchases of certain categories of property;

examining the insured'"'"'s claim for total yearly purchases of lost or damaged items in such categories prior to said property loss occurrence;

comparing the insured'"'"'s total yearly purchases of lost or damaged items in such categories with said guidelines;

flagging for further inquiry unusually high total purchase amounts or total purchase amounts which exceed such guidelines for further inquiry, verification and/or adjustment;

the adjuster making further inquiry, verification and/or adjustment with respect to said claim amounts exceeding said guidelines;

the adjuster manually overriding said guidelines;

the adjuster submitting to the claims management system information explaining such manual overrides based on his or her further inquiry cover vacation and/or adjustment with respect to said claim amounts exceeding said guidelines; and

updating a property and casualty industry database with information from said claim, said information including items damaged or lost by category and the replacement costs thereof.

7. The method of claim 6, which includes the additional step of the insured returning to the insured side of the website to provide item-specific information relating to lost or damaged items associated with the claim.

8. The method of claim 6, which includes the additional steps of:

the insured providing the adjuster remote access to the insured'"'"'s side of the website while the insured is creating a property loss claim; and

the adjuster submitting the item-specific information relating to insured'"'"'s loss or damaged items to the claims management system on the insured'"'"'s side of the website.

9. The method of claim 7, which includes the additional steps of:

the adjuster adjusting the submitted property loss claim by providing an adjusted replacement cost;

the adjuster providing an adjustment note in connection with the adjusted replacement cost; and

displaying the adjusted replacement cost and the adjustment note on the insured'"'"'s side and insurer'"'"'s side of the website.

10. The method of claim 8, which includes the additional steps of providing two-way audio and video communication between insured and adjuster.

11. A method for interactively processing an insurance claim, which comprises the steps of:

providing a web site with an insured side and an insurer side;

providing a claims management system with claim-related information including predetermined categories relating to insurance claims;

providing an insured with a loss with access to the claims management system from the insured side of the web site;

providing the insurer with a unique identification;

displaying said insurer'"'"'s unique identification on the insured and insurer sides of the web site;

providing the insured with a password for accessing the insured'"'"'s side of the web site;

receiving in the claims management system item-specific information relating to lost or damaged items associated with the claim;

providing an inventory of said lost or damaged items associated with said claim in said predetermined categories;

inventorying the items with the claims management system;

generating an inventory of items from said item-specific information;

tabulating, verifying and reviewing said inventory in connection with said transaction;

providing an insurance company with access to the claims management system from the insurer side of the web site;

displaying said predetermined categories on said insured side of said web site;

receiving the item-specific information in said predetermined categories displayed on the insured side of the web site;

adjusting the claim from the insurer side of the web site;

the insurer assigning the claim to an adjuster;

the adjuster obtaining from the insured and submitting to the insurer claim-related information;

adjusting said claim using criteria chosen from a list including;

purchase date;

item age;

original cost;

actual cash value (ACV);

replacement cost (RC);

insurance policy reserves; and

depreciation;

linking said claims management system to vendors for replacement cost information for said lost or damaged items;

providing a shopping cart type procedure for placing replacement items in a virtual shopping cart using such vendor-provided cost information;

indicating to said insured a full shopping cart type condition when the inventory procedure is complete;

said insured purchasing the shopping cart contents from said vendors;

said vendors compensating the claims management system administrator for being linked to said claims management system and for said referrals of insureds with property losses;

generating periodic reports pertaining to said claim to said insurer and said insured;

applying predetermined claim adjustment guidelines by the insurer to the submitted claim-related information;

submitting predetermined types of pre-replacement information pertaining to lost or damaged items prior to replacement of same via the insurer side of the web site;

submitting predetermined types of post-replacement information pertaining to lost or damaged items after replacement via the insurer side of the web site;

the claims management system listing the open or active claim files of an adjuster on the insurer side of the web site;

the adjuster accessing said open or active claim file list;

the adjuster archiving claim files on the claims management system;

providing the adjuster with an indication when a claim item exceeds predetermined claim adjustment guidelines;

the claims management system including guidelines for total yearly purchases of certain categories of property;

examining the insured'"'"'s claim for total yearly purchases of lost or damaged items in such categories prior to said property loss occurrence;

comparing the insured'"'"'s total yearly purchases of lost or damaged items in such categories with said guidelines;

flagging for further inquiry unusually high total purchase amounts or total purchase amounts which exceed such guidelines for further inquiry, verification and/or adjustment;

the adjuster making further inquiry, verification and/or adjustment with respect to said claim amounts exceeding said guidelines;

the adjuster manually overriding said guidelines;

the adjuster submitting to the claims management system information explaining such manual overrides based on his or her further inquiry cover vacation and/or adjustment with respect to said claim amounts exceeding said guidelines;

updating a property and casualty industry database with information from said claim, said information including items damaged or lost by category and the replacement costs thereof,

the insured returning to the insured side of the website to provide item-specific information relating to lost or damaged items associated with the claim;

the insured providing the adjuster remote access to the insured'"'"'s side of the website while the insured is creating a property loss claim;

the adjuster submitting item-specific information relating to insured'"'"'s loss or damaged items to the claims management system on the insured'"'"'s side of the website;

the adjuster adjusting the submitted property loss claim by providing an adjusted replacement cost;

the adjuster providing an adjustment note in connection with the adjusted replacement cost;

displaying the adjusted replacement cost and the adjustment note on the insured'"'"'s side and insurer'"'"'s side of the website; and

providing two-way audio and video communication between insured and adjuster.