METHOD AND SYSTEM FOR CLASSIFYING DOCUMENTS

• US 20110047168A1
• Filed: 10/29/2010
• Published: 02/24/2011
• Est. Priority Date: 05/31/2006
• Status: Active Grant

• Current Assignee: Martin E. Ellingsworth
• Original Assignee: Martin E. Ellingsworth
• Inventors: Ellingsworth, Martin E.
• Granted Patent: US 8,255,347 B2
• Time in Patent Office: Days
• US Class Current: 707/749
• CPC Class Codes: G06F 16/313 Selection or weighting of terms for indexing
• CPC Class Codes: G06F 16/353 into predefined classes

Abstract

The invention provides a method and system for classifying insurance files for identification, sorting and efficient collection of subrogation claims. The invention determines whether an insurance claim has merit to warrant claim recovery efforts utilizing software code for partially describing a set of documents having unstructured and structured file data containing terms and phrases having contextual bases, code for transforming the terms and phrases, code for iterating a classification process to determine rules that best classify the set of documents based upon context, code for incorporating the rules into an induction and knowledge representation, thesauri taxonomies and text summarization to classify subrogation claims; code for calculating a base score and a concept vector to identify the selected claims that demonstrate a given probability of subrogation recovery.

Claims

1. A computer system for analyzing an electronic claim file, comprising:

an indexing database storing groups of synonyms, each synonym associated with a concept, wherein each concept forms an element in a vector;

an indexing engine, receiving an electronic claim file for analysis and comparing data in said electronic claim file to said elements in said vector to determine whether said electronic claim file contains said element; and

a scoring engine, in communication with said indexing engine and to generate a score associated with said electronic claim file based on said comparison and to compare said score with a threshold to determine a destination of said electronic claim file.

2. The computer system of claim 1, further comprising:

a messaging system, in communication with said scoring engine, for transmitting said electronic claim file to a destination based on said score.

3. The computer system of claim 2, wherein said destination is a subrogation claim processing system.

4. The computer system of claim 1, wherein said indexing engine is operable to update said indexing database based on an analysis of said electronic claim file.

5. The computer system of claim 1, wherein said destination is one of a plurality of collection processing destinations.

6. The computer system of claim 1, wherein the electronic claim file is an insurance claim file.

7. The computer system of claim 1, wherein each concept in said vector form a pattern.

8. The computer system of claim 7, wherein said comparing data in said electronic claim file to said elements in said vector further comprise comparing said pattern to a stored set of patterns.

9. The computer system of claim 1, wherein a score above said threshold indicates a destination associated with a subrogation processing system.

10. The computer system of claim 1, wherein a score below said threshold indicates a destination associated with a filing system.

11. A computer system for determining whether an insurance claim has merit to warrant recovery comprising:

a file input module, for receiving an electronic claim file;

a search and indexing engine coupled to receive said electronic claim file, for creating a dictionary of term data having synonyms relating to said electronic claim file, said search and indexing engine storing said term data in a database, wherein the database stores the synonyms in association with one or more concepts, each of said concepts forming into an element in a vector, said search and indexing engine comparing said synonyms against elements of said vector to determine whether said electronic claim file contains a stored concept element; and

a scoring engine, in communication with said search and indexing system, for generating a score based on said determination of whether said electronic claim file contains said stored concept element.

12. The computer system of claim 11 wherein if the electronic claim file contains one of an element of the concept vector or a business rule it is not further tested.

13. The computer system of claim 11 wherein a score derived from an N-Gram analysis forms an element for deciding if a claim has merit to warrant claim recovery efforts.

14. The computer system of claim 13 wherein each concept contained in a vector forms a pattern.

15. The computer system of claim 14 wherein each pattern forms an element for deciding if a claim has merit to warrant claim recovery efforts.

16. The computer system of claim 13 wherein the score and the pattern is compared against a pre assigned threshold.

17. The computer system of claim 13 wherein the score and the pattern is compared against a pre assigned threshold and if the score is greater then the pre assigned threshold the electronic claim file is referred to one or more destinations.

18. The computer system of claim 13 further including the step of incorporating term data in a dictionary of phrases.

19. The computer system of claim 14 wherein the search and indexing engine is further operable to point through a trace to a claim in which the phrases occur and linking them to the concepts that are indicative of a collection claim.

20. A computerized method for determining whether an insurance claim merits recovery comprising:

receiving an electronic claim file via a communications network;

compiling said electronic claim file in a processor to develop a dictionary of term data having synonyms relating to said electronic claim file via a search and indexing engine;

storing said term data in a database, wherein the database stores the synonyms in association with one or more concepts, each of said concepts forming into an element in a vector, said search and indexing engine comparing said synonyms against elements of said vector to determine whether said electronic claim file contains a stored concept element;

generating a score in said processor based on said determination of whether said electronic claim file contains said stored concept element; and

routing the score to one or more recipients via said communications network.

21. The computerized method of claim 20 wherein if said electronic claim file contains one of an element of the concept vector or a business rule it is not further tested.

22. The computerized method of claim 20 wherein said score is derived from an N-Gram analysis to form an element for deciding if a claim merits claim recovery efforts.

23. The computerized method of claim 20, wherein said score is produced as part of an electronic report document which includes information related to a status of the claim file.