CLAIMS DATA ANALYSIS
First Claim
1. A method for claims data analysis, the method comprising:
- receiving, via a computing device, claims data, wherein the claims data comprises a plurality of claims, each claim pertaining to an abnormal event related to at least one customer account held at an entity;
determining, via a computing device processor, which individuals associated with the entity interacted with the customer accounts in the claims data during a predetermined time period prior to the abnormal event or notification of the abnormal event; and
providing, via a computing device processor, for a suspect list that includes the individuals determined to have interacted with a customer account in the claims data.
1 Assignment
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Accused Products
Abstract
Embodiments of the invention provide for claims data analysis. The methods, apparatus and computer program products provide for receiving claims data pertaining to an abnormal event related to at least one customer account held at an entity and determining which individuals associated with the entity interacted with the customer accounts in the claims data. In addition, several embodiments described herein contemplate analysis of additional information associated with each claim to detect relationships amongst and between claims, customer accounts, and individuals who interacted with customer accounts that are the subject of claims. In such embodiments, investigation of claims may be targeted and allow for a more efficient identification of potentially culpable individuals and rapid exoneration of innocent individuals.
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Citations
22 Claims
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1. A method for claims data analysis, the method comprising:
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receiving, via a computing device, claims data, wherein the claims data comprises a plurality of claims, each claim pertaining to an abnormal event related to at least one customer account held at an entity; determining, via a computing device processor, which individuals associated with the entity interacted with the customer accounts in the claims data during a predetermined time period prior to the abnormal event or notification of the abnormal event; and providing, via a computing device processor, for a suspect list that includes the individuals determined to have interacted with a customer account in the claims data. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. An apparatus for analyzing a customer claim, the apparatus comprising:
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a computing device comprising a memory and at least one processor; and a claims data analysis application stored in the memory, executable by the processor, and configured to; receive claims data, wherein the claims data comprises a plurality of claims, each claim pertaining to an abnormal event related to at least one customer account held at an entity; determine which individuals associated with the entity interacted with the customer accounts in the claims data during a predetermined time period prior to the abnormal event or notification of the abnormal event; and provide for a suspect list that includes the individuals determined to have interacted with a customer account in the claims data. - View Dependent Claims (14, 15, 16, 17)
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18. A computer program product comprising:
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a non-transitory computer-readable medium comprising; a first set of codes for causing a computer processor to be configured for receiving claims data, wherein the claims data comprises a plurality of claims, each claim pertaining to an abnormal event related to at least one customer account held at an entity; a second set of codes for causing a computer processor to be configured for determining which individuals associated with the entity interacted with the customer accounts in the claims data during a predetermined time period prior to the abnormal event or notification of the abnormal event; and a third set of codes for causing a computer processor to be configured for providing for a suspect list that includes the individuals determined to have interacted with a customer account in the claims data. - View Dependent Claims (19, 20, 21, 22)
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Specification