Method of expediting insurance claims

• US 7,203,654 B2
• Filed: 12/18/2003
• Issued: 04/10/2007
• Est. Priority Date: 01/04/2003
• Status: Active Grant

• Current Assignee: Ultimate Claim Solutions Incorporated
• Original Assignee: Ultimate Claim Solutions Incorporated
• Inventors: Menendez, Dale
• Primary Examiner(s): Morgan; Robert
• Application Number:
  US10/740,066
• Publication Number:
  US 20040148204A1
• Time in Patent Office: 1,209 Days
• Field of Search: 705/2, 705/3, 705/4
• US Class Current: 705/4
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: Y02A 90/10 Information and communication technologies [ICT] supporting adaptation to climate change, e.g. for weather forecasting or climate simulation

Abstract

A method and apparatus are provided for processing an insurance claim. The method includes the steps of receiving a claim for a loss from an insured through an Internet connection and determining a policy type from the claim. The method further includes the steps of retrieving a set of keywords based upon the policy type, matching the retrieved set of keywords with words contained within the received claim, assigning an adjuster to the claim when any matched words of the matching step meets a predetermined criteria and paying the claim without assigning the claim to an adjuster when the matching does not meet the predetermined criteria and any auxiliary criteria.

Claims

1. A method of processing an insurance claim related to property damage on a property and casualty insurance policy, except personal automobile and commercial automobile, as defined by the NAIC Uniform Property and Casualty Product Coding Matrix, such method comprising the steps of:

storing in memory plural sets of keywords, wherein each set of keywords is associated with at least one policy type and wherein the keywords in said plural sets of keywords are descriptive of property and causes of property damage;

receiving a claim from an insured for a loss to property, but not automobile property, and not a health care claim through an Internet connection, wherein the received claim contains a description of loss for determining a who, what, and why about how the loss occurred;

determining a policy type from said received claim;

identifying an insurance criteria based on said determined policy type, for evaluating the loss, wherein said insurance criteria is based upon insuring agreements, exclusions, coverage limits and terms and conditions selected from the group consisting of all risk of loss, named perils, accident to object, supplemental coverage, consequential loss, coverage extensions, exclusions, limitations and property not covered or limited;

retrieving from said memory a predetermined set of keywords that are associated with said determined policy type and with said identified insurance criteria;

matching said retrieved set of keywords with words contained within the description of loss of said received claim;

assigning the claim to an adjuster when any matched words of said matching step meets a predetermined criteria; and

paying the claim without assigning the claim to an adjuster when said matching step does not meet the predetermined criteria.