System and method for processing insurance claims using a table of contents

• US 7,430,514 B1
• Filed: 06/23/2000
• Issued: 09/30/2008
• Est. Priority Date: 06/23/2000
• Status: Expired due to Term

• Current Assignee: Computer Sciences Corporation (DXC Technology Company)
• Original Assignee: Computer Sciences Corporation (DXC Technology Company)
• Inventors: Childress, Allen B., Jones, Gregory
• Primary Examiner(s): Zeender; F.
• Assistant Examiner(s): Frenel; Vanel
• Application Number:
  US09/603,307
• Time in Patent Office: 3,021 Days
• Field of Search: 705/4, 705/9, 705/2, 707/203
• US Class Current: 705/4
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

An improved method and system to process insurance claims using a graphical user interface with structured data collection. The insurance claims processing software provides the user with an estimated value for a user specified insurance claim. An insurance claims processing software user uses a table of contents (TOC) display screen to display the steps associated with the processing of the insurance claim. The user selects any intermediary step from a structured list of steps, included in the table of contents, to view a display screen associated with the selected intermediary step and to provide user inputs. The structured list of steps, included in the table of contents, is dynamically and automatically updated in response to business rules and/or user inputs. As a final step, the insurance claims processing software displays the estimated value for the specified insurance claim.

Claims

1. A method for processing an insurance claim on a computer system to estimate a value of the insurance claim, the method comprising:

displaying a first insurance claim processing step on a display device coupled to the computer system;

receiving input regarding the first insurance claim processing step;

automatically determining a table of contents based at least in part on input received regarding the first insurance claim processing step;

automatically displaying the table of contents on the display device, wherein the table of contents comprises an ordered list of the steps associated with the processing of the insurance claim, and wherein the ordered list of steps comprises the first insurance claim processing step, and one or more additional insurance claim processing steps;

selecting a second insurance claim processing step, wherein the second insurance claim processing step comprises at least one of the additional insurance claim processing steps from the table of contents;

automatically displaying the second insurance claim processing step on the display device;

receiving input regarding the second insurance claim processing step; and

automatically adding or deleting one or more steps from the table of contents in response to the received input from the first or second insurance claim processing step or automatically modifying the sequence of processing steps listed in the table of contents in response to the received input from the first or second insurance claim processing step.

2. The method of claim 1,

wherein displaying the second insurance claim processing step comprises displaying a report on the display device, wherein the report comprises a value of the insurance claim, and wherein the report is determined based on information input in the first insurance claim processing step and on any insurance claim processing steps in between the first insurance claim processing step and the second insurance claim processing step.

3. The method of claim 1, further comprising:

redisplaying the first insurance claim processing step after displaying the second insurance claim processing step.

4. The method of claim 1, further comprising:

redisplaying the first insurance claim processing step after displaying the second insurance claim processing step; and

receiving input regarding the first insurance claim processing step after redisplaying the first insurance claim processing step.

5. The method of claim 1,

wherein the insurance claim comprises a bodily injury claim, and wherein processing the insurance claim to estimate the value of the insurance claim comprises processing the bodily injury claim to estimate a bodily injury general damages value.

6. The method of claim 1,

wherein insurance claim processing steps comprise steps for entry of information relevant to the estimate of the value of the insurance claim.

7. The method of claim 6,

wherein the information relevant to the estimate of the value of the insurance claim comprises bodily injury treatment information.

8. The method of claim 6,

wherein the information relevant to the estimate of the value of the insurance claim comprises bodily injury damages information.

9. The method of claim 1,

wherein the table of contents further comprises pointers to display screens associated with the insurance claim processing steps.

10. The method of claim 1, further comprising:

storing information input at one or more insurance claim processing steps.

11. The method of claim 1,

wherein insurance claim processing steps are associated with table of contents properties, and wherein determining the table of contents comprises determining insurance claim processing steps that are associated with the table of contents properties.

12. The method of claim 1,

wherein insurance claim processing steps are associated with table of contents properties, wherein determining the table of contents comprises determining insurance claim processing steps that are associated with the table of contents properties, and wherein the table of contents properties comprises a condition which specifies when an associated insurance claim processing step should be included in the table of contents.

13. A method of processing an insurance claim on a computer system using an insurance claim processing system comprising:

receiving a request to estimate an insurance claim, wherein the request comprises a claim identifier associated with the insurance claim;

determining a table of contents associated with the claim identifier, wherein the table of contents represents one or more steps for processing the insurance claim, and wherein at least one step comprises an end step;

displaying the table of contents on a display device coupled to the computer system, wherein the table of contents comprises an ordered list of the steps associated with the processing of the insurance claim;

selecting at least one step associated with the insurance claim;

if the selected step is not the end step then;

providing a display on the display device coupled to the computer system associated with the selected step;

receiving input associated with the selected step;

storing the input received;

automatically adding or deleting one or more steps from the table of contents in response to the received input from the selected insurance claim processing step or automatically modifying the sequence of processing steps listed in the table of contents in response to the received input from the selected insurance claim processing step; and

if the selected step is the end step then;

providing a display on the display device comprising an estimated value of the insurance claim.

14. A computer system for processing an insurance claim to estimate a value of the insurance claim, the computer system comprising:

a CPU;

a display device coupled to the CPU;

a memory coupled to the CPU, wherein the memory stores program instructions which are executable by the CPU to;

display a first insurance claim processing step;

receive input regarding the first insurance claim processing step;

automatically determine a table of contents in response to input received regarding the first insurance claim processing step;

automatically display the table of contents, wherein the table of contents comprises an ordered list of the steps associated with the processing of the insurance claim, and wherein the ordered list of steps comprises the first insurance claim processing step, and one or more additional insurance claim processing steps;

select a second insurance claim processing step, wherein the second insurance claim processing step comprises at least one of the additional insurance claim processing steps from the table of contents;

automatically display the second insurance claim processing step on the display device; and

automatically add or delete one or more steps from the table of contents in response to the received input from the first or second insurance claim processing step or automatically modify the sequence of processing steps listed in the table of contents in response to the received input from the first or second insurance claim processing step.

15. The system of claim 14,

wherein displaying the second insurance claim processing step comprises displaying a report on the display device, wherein the report comprises a value of the insurance claim, and wherein the report is determined based on information input in the first insurance claim processing step and on any insurance claim processing steps in between the first insurance claim processing step and the second insurance claim processing step.

16. The system of claim 14, wherein the program instructions are further executable to:

redisplay the first insurance claim processing step after displaying the second insurance claim processing step.

17. The system of claim 14, wherein the program instructions are further executable to:

redisplay the first insurance claim processing step after displaying the second insurance claim processing step; and

receive input regarding the first insurance claim processing step after redisplaying the first insurance claim processing step.

18. The system of claim 14,

wherein the insurance claim comprises a bodily injury claim, and wherein processing the insurance claim to estimate the value of the insurance claim comprises processing the bodily injury claim to estimate a bodily injury general damages value.

19. The system of claim 14,

wherein insurance claim processing steps comprise steps for entry of information relevant to the estimate of the value of the insurance claim.

20. The system of claim 19,

wherein the information relevant to the estimate of the value of the insurance claim comprises bodily injury treatment information.

21. The system of claim 19,

wherein the information relevant to the estimate of the value of the insurance claim comprises bodily injury damages information.

22. The system of claim 19,

wherein the table of contents further comprises pointers to display screens associated with the insurance claim processing steps.

23. The system of claim 19, wherein the program instructions are further executable to store information input at one or more insurance claim processing steps.

24. The system of claim 19,

wherein insurance claim processing steps are associated with table of contents properties, and wherein determining the table of contents comprises determining insurance claim processing steps that are associated with the table of contents properties.

25. The system of claim 19,

wherein insurance claim processing steps are associated with table of contents properties, wherein determining the table of contents comprises determining insurance claim processing steps that are associated with the table of contents properties, and wherein at least one display in table of contents properties comprises a condition which specifies when an associated insurance claim processing step should be included in the table of contents.

26. A carrier medium comprising program instructions for processing an insurance claim on a computer system to estimate a value of the insurance claim, wherein the program instructions are computer-executable to implement:

displaying a first insurance claim processing step;

receiving input regarding the first insurance claim processing step;

automatically determining a table of contents based at least in part on input received regarding the first insurance claim processing step;

automatically displaying the table of contents, wherein the table of contents comprises an ordered list of the steps associated with the processing of the insurance claim, and wherein the ordered list of steps comprises the first insurance claim processing step, and one or more additional insurance claim processing steps;

selecting a second insurance claim processing step, wherein the second insurance claim processing step comprises at least one of the additional insurance claim processing steps from the table of contents;

automatically displaying the second insurance claim processing step on the display device; and

automatically adding or deleting one or more steps from the table of contents in response to the received input from the first or second insurance claim processing step or automatically modifying the sequence of processing steps listed in the table of contents in response to the received input from the first or second insurance claim processing step.

27. The carrier medium of claim 26,

wherein displaying the second insurance claim processing step comprises displaying a report, wherein the report comprises a value of the insurance claim, and wherein the report is determined based on information input in the first insurance claim processing step and on any insurance claim processing steps in between the first insurance claim processing step and the second insurance claim processing step.

28. The carrier medium of claim 26, wherein the program instructions are further computer-executable to implement:

redisplaying the first insurance claim processing step after displaying the second insurance claim processing step.

29. The carrier medium of claim 26, wherein the program instructions are further computer-executable to implement:

redisplaying the first insurance claim processing step after displaying the second insurance claim processing step; and

receiving input regarding the first insurance claim processing step after redisplaying the first insurance claim processing step.

30. The carrier medium of claim 26,

wherein the insurance claim comprises a bodily injury claim, and wherein processing the insurance claim to estimate the value of the insurance claim comprises processing the bodily injury claim to estimate a bodily injury general damages value.

31. The carrier medium of claim 26,

wherein insurance claim processing steps comprise steps for entry of information relevant to the estimate of the value of the insurance claim.

32. The carrier medium of claim 31,

wherein the information relevant to the estimate of the value of the insurance claim comprises bodily injury treatment information.

33. The carrier medium of claim 31,

wherein the information relevant to the estimate of the value of the insurance claim comprises bodily injury damages information.

34. The carrier medium of claim 26,

wherein the table of contents further comprises pointers to display screens associated with the insurance claim processing steps.

35. The carrier medium of claim 26, wherein the program instructions are further computer-executable to implement:

storing information input at one or more insurance claim processing steps.

36. The carrier medium of claim 26,

wherein insurance claim processing steps are associated with table of contents properties, and wherein determining the table of contents comprises determining insurance claim processing steps that are associated with the table of contents properties.

37. The carrier medium of claim 26,

wherein insurance claim processing steps are associated with table of contents properties, wherein determining the table of contents comprises determining insurance claim processing steps that are associated with the table of contents properties, and wherein at least one display in table of contents properties comprises a condition which specifies when an associated insurance claim processing step should be included in the table of contents.