SYSTEM AND METHOD TO SCREEN INSURANCE CLAIMS TO IDENTIFY SUBROGATION POTENTIAL

• US 20130304517A1
• Filed: 05/14/2012
• Published: 11/14/2013
• Est. Priority Date: 05/14/2012
• 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: Florence, Jeffery K.
• Granted Patent: US 8,799,031 B2
• Time in Patent Office: Days
• US Class Current: 705/4
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

Systems and methods are disclosed herein for screening insurance claims to identify subrogation potential. According to some embodiments, a loss report associated with a plurality of insurance claims, includes, for each insurance claim: (i) a claim identifier, (ii) a claim date, (iii) a claim loss amount, and (iv) a claim description. Data from the loss report may be loaded into a subrogation engine, such as by loading the data into cells of a spreadsheet application. The spreadsheet application may then automatically calculate a subrogation potential score for each insurance claim in the loss report based on the claim date, claim loss amount, claim description, and a library containing keywords and associated keyword values. The spreadsheet application may then output an indication of the claim identifier and associated subrogation potential score for each insurance claim in the loss report.

Claims

1. A system for screening insurance claims to identify subrogation potential, the system comprising:

a computer memory for storing a loss report associated with a plurality of insurance claims, wherein the loss report includes, for each insurance claim;

(i) a claim identifier, (ii) a claim date, (iii) a claim loss amount, and (iv) a claim description; and

a processor in communication with the memory, wherein the processor is configured for;

loading data from the loss report into a subrogation engine;

automatically calculating, by the subrogation engine, a subrogation potential score for each insurance claim in the loss report based on the claim date, claim loss amount, claim description, and a library containing keywords and associated keyword values, wherein the claim description includes at least one keyword in the library; and

outputting, via the subrogation engine, an indication of the claim identifier and associated subrogation potential score for each insurance claim in the loss report.

2. The system of claim 1, wherein the subrogation engine comprises a spreadsheet application and said loading comprises loading the data from the loss report into cells of the spreadsheet application.

3. The system of claim 1, wherein the loss report further includes, for each insurance claim, a claim jurisdiction.

4. The system of claim 3, wherein the processor is further configured for:

determining, for each insurance claim in the loss report, a statute of limitation time period based on the claim jurisdiction,

wherein said calculation of the subrogation potential score is further based on the claim date and the statute of limitation time period.

5. The system of claim 3, wherein the loss report further includes, for each insurance claim, a claim type and said determining is further based on the claim type.

6. The system of claim 5, wherein the claim type is associated with at least one of:

(i) medical loss, (ii) property damage, (iii) rental reimbursement, and (iv) personal injury protection insurance.

7. The system of claim 3, wherein the claim description includes a plurality of keywords in the library and said automatically calculation is based on a plurality of keyword values

8. The system of claim 3, wherein the processor is further configured for:

determining, for each insurance claim in the loss report, a negligence rule based on the claim jurisdiction,

wherein said calculation of the subrogation potential score is further based on the negligence rule.

9. The system of claim 1, wherein the loss report further includes, for each insurance claim, an amount previously recovered and said calculation of the subrogation potential score is further based on the claim loss amount and the amount previously recovered.

10. The system of claim 1, wherein each keyword value represent a likelihood of determining fault for accidents associated with each keyword.

11. The system of claim 1, wherein the subrogation potential score comprises at least one of a numerical value, an expected dollar amount, and a classification.

12. The system of claim 1, wherein the processor is further configured for:

generating a summary report associated with a plurality of the insurance claims in the loss report.

13. The system of claim 1, further comprising:

a recovery platform coupled to the processor, wherein the recovery platform is to receive the claim identifiers and associated subrogation potential scores and is further to automatically initiate a recovery process.

14. The system of claim 13, wherein the recovery platform is to automatically create a demand letter.

15. The system of claim 1, wherein the loss report is associated with at least one of:

(i) property insurance, (ii) automobile insurance, and (iii) workers'"'"' compensation insurance.

16. A computer-implemented method for screening insurance claims to identify subrogation potential, the method comprising:

loading data from a loss report into a subrogation engine, the loss report being associated with a plurality of insurance claims and including, for each insurance claim;

(i) a claim identifier, and (ii) a claim description;

calculating, by the subrogation engine, a subrogation potential score for each insurance claim in the loss report based on the claim description and a library containing keywords and associated keyword values; and

outputting, via the subrogation engine, an indication of the claim identifier and associated subrogation potential score for each insurance claim in the loss report.

17. The method of claim 16, wherein the loss report further includes, for each insurance claim, a claim jurisdiction.

18. The method of claim 16, further comprising:

determining, for each insurance claim in the loss report, a statute of limitation time period based on the claim jurisdiction,

wherein said calculation of the subrogation potential score is further based on the claim date and the statute of limitation time period.

19. The method of claim 16, further comprising:

determining, for each insurance claim in the loss report, a negligence rule based on the claim jurisdiction,

wherein said calculation of the subrogation potential score is further based on the negligence rule.

20. A non-transitory computer readable medium having stored therein instructions for, upon execution, causing a computer to implement method for screening insurance claims to identify subrogation potential, the method comprising:

loading data from a loss report into cells of a spreadsheet application, the loss report being associated with a plurality of insurance claims and including, for each insurance claim;

(i) a claim identifier, (ii) a claim date, (iii) a claim loss amount, and (iv) a claim description;

calculating, by a subrogation engine, a subrogation potential score for each insurance claim in the loss report based on the claim date, claim loss amount, claim description, and a library containing keywords and associated keyword values; and

outputting, via the spreadsheet application, an indication of the claim identifier and associated subrogation potential score for each insurance claim in the loss report.

21. The medium of claim 20, wherein the loss report further includes, for each insurance claim, a claim jurisdiction.

22. The medium of claim 21, wherein the method further comprises:

determining, for each insurance claim in the loss report, a statute of limitation time period based on the claim jurisdiction,

wherein said calculation of the subrogation potential score is further based on the claim date and the statute of limitation time period.