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METHOD AND COMPUTER SYSTEM FOR INSURANCE CLAIMS RECOVERY OPERATION

  • US 20100057498A1
  • Filed: 09/04/2008
  • Published: 03/04/2010
  • Est. Priority Date: 09/04/2008
  • Status: Abandoned Application
First Claim
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1. A method comprising:

  • receiving in a computer an electronic file that represents a claim paid by an insurance company, the electronic file containing indicia as to whether (a) said claim involves another insurance company and (b) said other insurance company has admitted or is likely to admit liability for said claim; and

    making a triage decision in said computer such that;

    (i) if said indicia indicate that another insurance company is involved and has admitted or is likely to admit liability for said claim, said computer generates a demand letter to said other insurance company with respect to said claim and defers further action relating to said demand for at least 20 days after generating said demand letter; and

    (ii) if said indicia either do not indicate that another insurance company is involved or indicate that the other insurance company has not admitted or is not likely to admit liability for said claim, said computer generates a demand letter to said other insurance company and routes the electronic file to an employee for further action.

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