SYSTEMS AND METHODS FOR COLLECTING INSURANCE-RELATED DATA

• US 20120016693A1
• Filed: 07/15/2010
• Published: 01/19/2012
• Est. Priority Date: 07/15/2010
• Status: Active Grant

• Current Assignee: Hartford Fire Insurance Company (The Hartford Financial Services Group, Inc.)
• Original Assignee: Hartford Fire Insurance Company (The Hartford Financial Services Group, Inc.)
• Inventors: Haywood, John C., Morrison, Maureen A., Musgrove, Joseph E. Jr., Panitzke, Jeffrey D., Peine, Sheila M., Pelaez, Andres, Wilson, Ryan L.
• Granted Patent: US 8,805,718 B2
• Time in Patent Office: Days
• US Class Current: 705/4
• CPC Class Codes: G06Q 10/20 Administration of product repair or maintenance
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G06Q 50/18 Legal services

Abstract

Systems and methods are disclosed herein for collecting and processing auto insurance claim-related data. Initial data is collected from a customer or a third party appraiser via a user interface. The initial data is used to retrieve relevant compliance guideline and policy information, which is used to modify and/or populate fields in the user interface. Collected and/or retrieved information is then stored and/or used to adjust an insurance claim workflow process.

Claims

1. A system for managing an auto insurance claim workflow for a claims department with a plurality of claims processing applications, comprising:

a first data store storing auto insurance compliance guidelines for a plurality of jurisdictions;

a second data store storing policy data for a plurality of auto insurance policies; and

a processor configured to use a first of the claims processing applications to;

output an auto insurance data collection user interface containing at least one data field requesting information about an auto insurance claim for display on a display device;

receive first data associated with the auto insurance claim via the user interface;

retrieve auto insurance compliance guidelines applicable to the claim from the first data store, based on the first data;

modify the user interface by at least one of adding additional data fields or removing data fields based on the retrieved auto insurance compliance guidelines and the first data;

retrieve policy data applicable to the claim from the second data store, based on the first data;

populate data fields included in the user interface with the retrieved policy data;

output the first data, and

use a second of the claims processing applications to retrieve data representative of at least a portion of the first data output by the first claims processing application.

2. The system of claim 1, wherein the policy data comprises at least one of policy holder data, claim data, and policy provision data.

3. The system of claim 1, wherein the processor is configured to store data collected via the user interface in the second data store according to a common data format.

4. The system of claim 3, wherein the processor is configured to determine a compliance score based on the retrieved auto insurance compliance guidelines and the output data.

5. The system of claim 3, wherein the processor is configured to adjust an auto insurance claim workflow based on the output data.

6. The system of claim 5, wherein adjusting the auto insurance claim workflow comprises transferring the claim to a different claims department.

7. The system of claim 5, wherein adjusting the auto insurance claim workflow comprises providing recommendations for next steps in the workflow.

8. The system of claim 7, wherein the recommendations include items in a to-do list.

9. The system of claim 4, wherein the processor is configured to modify a relationship with at least one of a vendor, an employee, and a service provider based on the compliance score.

10. The system of claim 1, wherein the second data store comprises a plurality of databases including at least one of a policy holder information database, a policy provisions database, and a claims information database.

11. The system of claim 1, wherein the plurality of claims processing applications includes at least one of a call center application, an appraisal application, an instruction determination application, and a compliance calculator.

12. A computerized method for managing an auto insurance claim workflow for a claims department with a plurality of claims processing applications, comprising:

storing auto insurance compliance guidelines for a plurality of jurisdictions in a first data store;

storing policy data for a plurality of auto insurance policies in a second data store;

using a first of the claims processing applications to;

output, by a processor, an auto insurance data collection user interface containing at least one data field requesting information about an auto insurance claim for display on a display device;

receive, by the processor and via the user interface, first data associated with the auto insurance claim;

retrieve, by the processor, auto insurance compliance guidelines applicable to the claim from the first data store, based on the first data;

modify, by the processor, the user interface by at least one of adding additional data fields or removing data fields based on the retrieved auto insurance compliance guidelines and the first data;

retrieve, by the processor, policy data applicable to the claim from the second data store, based on the first data;

populate data fields included in the user interface with the retrieved policy data; and

output, by the processor, the first data; and

using a second of the claims processing applications to retrieve at least a portion of the first data output by the first claims processing application.

13. The method of claim 12, wherein the policy data comprises at least one of policy holder data, claim data, and policy provision data.

14. The method of claim 12, comprising storing, by the processor, data collected via the user interface in the second data store according to a common data format.

15. The method of claim 14, comprising determining, by the processor, a compliance score based on the retrieved auto insurance compliance guidelines and the output data.

16. The method of claim 14, comprising adjusting, by the processor, an auto insurance claim workflow based on the output data.

17. The method of claim 16, wherein adjusting the auto insurance claim workflow comprises transferring the claim to a different claims department.

18. The method of claim 16, wherein adjusting the auto insurance claim workflow comprises providing recommendations for next steps in the workflow.

19. The method of claim 18, wherein the recommendations include items in a to-do list.

20. The method of claim 15, comprising identifying for future modification, via the processor, a relationship to at least one of a vendor, an employee, and a service provider based on the compliance score.

21. The method of claim 12, wherein the second data store comprises a plurality of databases including at least one of a policy holder information database, a policy provisions database, and a claims information database.

22. The method of claim 12, wherein the plurality of claims processing applications includes at least one of a call center application, an appraisal application, an instruction determination application, and a compliance calculator.

23. A non-transitory computer readable medium storing computer executable instructions, which, when executed by a processor, cause the processor to carry out a method comprising:

storing auto insurance compliance guidelines for a plurality of jurisdictions in a first data store;

storing policy data for a plurality of auto insurance policies in a second data store;

using a first claims processing application to;

output, by a processor, an auto insurance data collection user interface containing at least one data field requesting information about an auto insurance claim for display on a display device;

receive, by the processor and via the user interface, first data associated with the auto insurance claim;

retrieve, by the processor, auto insurance compliance guidelines applicable to the claim from the first data store, based on the first data;

modify, by the processor, the user interface by at least one of adding additional data fields or removing data fields based on the retrieved auto insurance compliance guidelines and the first data;

retrieve, by the processor, policy data applicable to the claim from the second data store, based on the first data;

populate data fields included in the user interface with the retrieved policy data; and

output, by the processor, the first data; and

using a second claims processing application to retrieve at least a portion of the first data output by the first claims processing application.

24. The non-transitory computer readable medium of claim 23, wherein the method comprises storing, by the processor, data collected via the user interface in the second data store according to a common data format.

25. The non-transitory computer readable medium of claim 24, wherein the method comprises:

transferring, by the processor, the claim to a different claims department based on the output data.