Method and apparatus for performing insurance insolvency operations

• US 7,509,265 B1
• Filed: 12/20/2000
• Issued: 03/24/2009
• Est. Priority Date: 12/20/2000
• Status: Expired due to Term

• Current Assignee: Guaranty Fund Management Services
• Original Assignee: Guaranty Fund Management Services
• Inventors: Anderson, Karen, Angelone, Linda, Winskowicz, James, Amigo, Denise, Gulko, Paul, Lavin, Kathleen
• Primary Examiner(s): Frenel; Vanel
• Application Number:
  US09/745,011
• Time in Patent Office: 3,016 Days
• Field of Search: 705/4, 705/35, 705/36
• US Class Current: 705/4
• CPC Class Codes: G06Q 10/087 Inventory or stock management, e.g. order filling, procurement or balancing against orders
• CPC Class Codes: G06Q 40/00 Finance; Insurance; Tax strategies; Processing of corporate or income taxes
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G06Q 50/18 Legal services

Abstract

Described are techniques used in connection with providing insolvency services in connection with guaranty finds, such as property and casualty guaranty funds, upon the occurrence of an insurance company insolvency. A client/server system provides for creating and maintaining a database of state and insurance company member information. Operations, such as calculations, are performed in accordance with different rules that are associated with varying state laws and rules that may vary with insurance account. A range of functions are performed by the system including report generation, unearned premium calculations, assessment calculation, claim entry and management, administrative tasks, and other related operations. The system which provides services and operations in connection with managing insolvency funds may interact with other applications and systems, such as an accounting system, word processing system, and the like by generating data used as input in these other systems. Also described is a database schema representing a relationship between the different data entities that may be stored in a database in connection with performing insolvency operations.

Claims

1. A method executed in a computer system for managing an insurance insolvency comprising:

performing a transaction in connection with one of an insurance claim and an unearned premium;

determining in a computer system a corresponding insurance account in accordance with information about the one of the insurance claim and the unearned premium, the information including a relationship to at least one state and at least one line of insurance associated with the corresponding insurance account;

automatically identifying and designating a state fund for each state associated with the insurance insolvency;

associating with at least one of the state funds the corresponding insurance account with the corresponding relationship to at least one of the states associated with the insurance insolvency in the computer system;

associating with the insurance account the at least one line of insurance;

identifying in the computer system at least one of a state statute, regulation and rule relating to the at least one line of insurance associated with the insurance account; and

adjusting in the computer system an amount associated with the corresponding insurance account with the corresponding relationship to at least one of the states associated with the insurance insolvency in accordance with the transaction based on the identified at least one of a state statute, regulation and rule and the at least one line of insurance associated with the insurance account.

2. The method of claim 1, further comprising:

associating at least one industry standard code with said insurance account and said at least one line of insurance in the computer system.

3. The method of claim 2, wherein said insurance account is associated with a plurality of lines of insurance.

4. The method of claim 3, wherein said insurance account is associated with at least two lines of insurance each being of type commercial automobile, worker'"'"'s compensation, homeowner'"'"'s and fire.

5. The method of claim 2, wherein said insurance account is associated with one line of insurance being of type commercial automobile, worker'"'"'s compensation, homeowner'"'"'s and fire.

6. The method of claim 2, further comprising:

associating a group with a first of said each states having a corresponding state fund; and

associating at least one member with said group.

7. The method of claim 6, further comprising:

storing information in the computer system representing a relationship between said state fund and said associated insurance account and said at least one line of insurance.

8. The method of claim 7, further comprising:

representing a merger of at least two members by combining portions of said information stored in the computer system.

9. The method of claim 8, further comprising:

modifying a relationship between said at least two members represented in the computer system.

10. The method of claim 7, further comprising:

representing a split of one member into at least two entities using portions of said information stored in the computer system.

11. The method of claim 10, further comprising:

modifying a relationship represented in said computer system of said one member corresponding to said split into said at least two entities.

12. The method of claim 1, further comprising:

determining an insurance account from which a payment is made in the computer system.

13. The method of claim 12, wherein said payment is made in connection with at least one of:

a claim and an unearned premium.

14. The method of claim 13, further comprising:

tracking payments; and

displaying an accounting of said payments with respect to a predetermined estimated amount of payments.

15. The method of claim 14, further comprising:

tracking total payments made prior to said insolvency.

16. The method of claim 15, further comprising:

tracking monies in connection with a recovery amount.

17. The method of claim 16, wherein said recover amount comprises at least one of:

a salvage amount a subrogation recovery, a second injury amount, a cost of living adjustment and net worth.

18. The method of claim 1, further comprising:

creating a diary entry in the computer system including information about one of;

a claim and unearned premium; and

sending said diary entry to at least one user.

19. The method of claim 18, wherein said sending said diary entry is performed automatically in response to an occurrence of a predefined event.

20. The method of claim 19, wherein said predefined event is one of:

deleting a pending payment closing one of a claim and an unearned premium, upon rejection of a closing one of a claim and unearned premium, modifying a line of insurance, deleting a line of insurance, sending a note to a reviewer, adjusting a reserve, adding a new taxpayer, and modifying an existing taxpayer.

21. The method of claim 19, wherein the method further comprises:

creating an account for a user specifying a predetermined limit;

specifying, by said user, a reserve amount above said predetermined limit; and

sending said diary entry to a manager for approval in response to said user specifying said reserve amount.

22. The method of claim 18, wherein said sending said diary entry is performed in response to a first user creating said diary entry, and the method further comprises:

said first user selecting at least one other user to which said diary entry is sent.

23. The method of claim 1, further comprising:

associating in the computer system at least one note with an insurance claim;

associating in the computer system a blocked status with said insurance claim; and

generating in the computer system, in response to setting said blocked status, a note to at least one user indicating why said insurance claim has a blocked status.

24. The method of claim 23, further comprising:

automatically notifying a first user when a second user attempts to perform a predetermined operation on said insurance claim having said blocked status.

25. The method of claim 1, further comprising:

generating a data file including information about at least one of an unearned premium and a claim, said data file being used as an input file into an accounting system.

26. The method of claim 25, further comprising:

generating general ledger entries, said general ledger entries being included in said data file.

27. The method of claim 1, further comprising:

associating information about an insurance claim with said corresponding insurance account;

entering a note associated with an insurance claims, said note including descriptive information about said claim entered by a claim handler; and

providing for said note to be available for reading by another user.

28. The method of claim 1, further comprising:

recording information about an error in a log file included in a client system.

29. The method of claim 28, further comprising:

auditing said transaction by recording audit information about said transaction.

30. The method of claim 29, wherein said audit information comprises at least one of:

date and time information, transaction type, data values prior to modification by said transaction, and user performing said transaction.

31. The method of claim 1, further comprising:

generating in the computer system an incomplete status of a record including information about a claim, obtaining additional information about said claim;

modifying in the computer system said record to include said additional information; and

converting in the computer system said incomplete status associated with said record to a claim status.

32. The method of claim 1, further comprising:

assigning in the computer system at least one role to a first user have a first set of security permissions and access limits; and

determining in the computer system, using said first set of security permissions and access limits, whether to allow a user to perform an operation in connection with said insurance account.

33. The method of claim 1, wherein the performing at least one insolvency related service in connection with said insurance solvency further comprises:

entering one or more claims from said insurance solvency into the computer system; and

processing the entered one or more claims from said insurance insolvency based on the identified at least one of a state statute, regulation and rule and the insurance account and the at least one line of insurance associated with each of the one or more entered claims.

34. The method of claim 1, wherein the performing at least one insolvency related service in connection with said insurance solvency further comprises:

determining if an assessment is needed based on a size of said insurance solvency, at least an amount in the designated state fund, and the identified at least one of a state statute, regulation and rule; and

performing an assessment based on the determination of the need of the assessment.

35. The method of claim 1, wherein the performing at least one insolvency related service in connection with said insurance solvency further comprises issuing a refund for each policy in the at least one line of insurance based on a calculation of an unearned premium and the identified at least one of a state statute, regulation and rule.

36. The method of claim 1, wherein the performing at least one insolvency related service in connection with said insurance solvency further comprises processing one or more additional claims in the at least one line of insurance for a first period of time after said insurance solvency based on the identified at least one of a state statute, regulation and rule.

37. A computer readable medium having stored thereon instructions for managing an insurance insolvency which when executed by a processor, cause the processor to perform the steps comprising:

performing a transaction in connection with one of an insurance claim and an unearned premium;

determining a corresponding insurance account in accordance with information about the one of the insurance claim and the unearned premium, the information including a relationship to at least one state and at least one line of insurance associated with the corresponding insurance account;

automatically identifying and designating a state fund for each state associated with the insurance insolvency;

associating with at least one of the state funds the corresponding insurance account with the corresponding relationship to at least one of the states associated with the insurance insolvency;

associating with the insurance account the at least one line of insurance;

identifying in the computer system at least one of a state statute, regulation and rule relating to the at least one line of insurance associated with the insurance account; and

adjusting an amount associated with the corresponding insurance account with the corresponding relationship to at least one of the states associated with the insurance insolvency in accordance with the transaction based on the identified at least one of a state statute, regulation and rule and the at least one line of insurance associated with the insurance account.

38. The computer readable medium of claim 37, further comprising:

associating at least one industry standard code with said insurance account and said at least one line of insurance.

39. The computer readable medium of claim 38, wherein said insurance account is associated with a plurality of lines of insurance.

40. The computer readable medium of claim 38, wherein said insurance account is associated with at least two lines of insurance each being of type commercial automobile, worker'"'"'s compensation, homeowner'"'"'s and fire.

41. The computer readable medium of claim 39, wherein said insurance account is associated with one line of insurance being of type commercial automobile, worker'"'"'s compensation, homeowner'"'"'s, and fire.

42. The computer readable medium of claim 38, further comprising:

associating a group with a first of said each states having a corresponding state fund; and

associating at least one member with said group.

43. The computer readable medium of claim 42, further comprising:

storing information in a computer system representing a relationship between said state fund and said associated insurance account and said at least one line of insurance.

44. The computer readable medium of claim 43, further comprising:

representing a merger of at least two members by combining portions of said information stored in the computer system.

45. The computer readable medium of claim 44, further comprising:

modifying a relationship between said at least two members represented in the computer system.

46. The computer readable medium of claim 43, further comprising:

representing a split of one member into at least two entities using portions of said information stored in the computer system.

47. The computer readable medium of claim 46, further comprising:

modifying a relationship represented in said computer system of said one member corresponding to said split into said at least two entities.

48. The computer readable medium of claim 37, further comprising:

determining an insurance account from which a payment is made.

49. The computer readable medium of claim 48, wherein said payment is made in connection with at least one of:

a claim and an unearned premium.

50. The computer readable medium of claim 49, further comprising:

tracking payments; and

displaying an accounting of said payments with respect to a predetermined estimated amount of payments.

51. The computer readable medium of claim 50, further comprising:

tracking total payments made prior to said insolvency.

52. The computer readable medium of claim 51, further comprising:

tracking monies in connection with recovery amounts.

53. The computer readable medium of claim 52, wherein said recovery amounts comprises at least one of:

a salvage amount, a subrogation recovery, a second injury amount, a cost of living adjustment, and a net worth.

54. The computer readable medium of claim 48, further comprising:

automatically notifying a first user when a second user attempts to perform a predetermined operation on said insurance claim having said blocked status.

55. The computer readable medium of claim 37, further comprising:

creating a diary entry including information about one of;

a claim and unearned premium; and

sending said diary entry to at least one user.

56. The computer program of claim 53, wherein said machine executable code for sending said diary entry is executed automatically in response to an occurrence of a predefined event.

57. The computer readable medium of claim 56, further comprising detecting said predefined event wherein said predefined event is one of:

deleting a pending payment closing one of a claim and an unearned premium, upon rejection of a closing one of a claim and unearned premium, modifying a line of insurance, deleting a line of insurance, sending a note to a reviewer, adjusting a reserve, adding a new taxpayer, and modifying an existing taxpayer.

58. The computer readable medium of claim 56, further comprises:

creating an account for a user specifying a predetermined limit;

specifying, by said user, a reserve amount above said predetermined limit; and

sending said diary entry to a manager for approval in response to said user specifying said reserve amount.

59. The computer readable medium of claim 55, wherein said sending said diary entry executes in response to detecting a first user creating said diary entry, and the computer readable medium further comprises:

said first user selecting at least one other user to which said diary entry is sent.

60. The computer readable medium of claim 37, further comprising:

associating at least one note with an insurance claim;

associating a blocked status with said insurance claim; and

generating, in response to setting said blocked status, a note to at least one user indicating why said insurance claim has a blocked status.

61. The computer readable medium of claim 37, further comprising:

generating a data file including information about at least one of an unearned premium and a claim, said data file being used as an input file into an accounting system.

62. The computer readable medium of claim 61, further comprising:

generating general ledger entries, said general ledger entries being included in said data file.

63. The computer readable medium of claim 37, further comprising:

associating information about an insurance claim with said corresponding insurance account;

entering a note associated with an insurance claims, said note including descriptive information about said claim entered by a claim handler; and

providing for said note to be available for reading by another user.

64. The computer readable medium of claim 37 further comprising:

recording information about an error in a log file included in a client system.

65. The computer readable medium of claim 64, further comprising:

auditing said transaction by recording audit information about said transaction.

66. The computer readable medium of claim 65, wherein said audit information comprises at least one of:

date and time information, transaction type, data values prior to modification by said transaction, and user performing said transaction.

67. The computer readable medium of claim 37, further comprising:

generating an incomplete status of a record including information about a claim;

obtaining additional information about said claim;

modifying said record to include said additional information; and

converting said incomplete status associated with said record to a claim status.

68. The computer readable medium of claim 37, further comprising:

assigning at least one role to a first user have a first set of security permissions and access limits; and

determining, using said first set of security permissions and access limits, whether to allow a user to perform an operation in connection with said insurance account.

69. The computer readable medium of claim 37, wherein the performing at least one insolvency related service in connection with said insurance solvency further comprises:

entering one or more claims from said insurance solvency into the computer system; and

processing the entered one or more claims from said insurance insolvency based on the identified at least one of a state statute, regulation and rule and the insurance account and the at least one line of insurance associated with each of the one or more entered claims.

70. The computer readable medium of claim 37, wherein the performing at least one insolvency related service in connection with said insurance solvency further comprises:

determining if an assessment is needed based on a size of said insurance solvency, at least an amount in the designated state fund, and the identified at least one of a state statute, regulation and rule; and

performing an assessment based on the determination of the need of the assessment.

71. The computer readable medium of claim 37, wherein the performing at least one insolvency related service in connection with said insurance solvency further comprises issuing a refund for each policy in the at least one line of insurance based on a calculation of an unearned premium and the identified at least one of a state statute, regulation and rule.

72. The computer readable medium of claim 37, wherein the performing at least one insolvency related service in connection with said insurance solvency further comprises processing one or more additional claims in the at least one line of insurance for a first period of time after said insurance solvency based on the identified at least one of a state statute, regulation and rule.

73. A computer system for managing an insurance insolvency, the system comprising:

a transaction system that performs a transaction in connection with one of an insurance claim and an unearned premium;

an insurance account identification system that determines a corresponding insurance account in accordance with information about the one of the insurance claim and the unearned premium, the information including a relationship to at least one state and at least one line of insurance associated with the corresponding insurance account;

a designation system in the computer system that automatically identifies and designates a state fund for each state associated with the insurance insolvency;

a state fund association system in the computer system associates with at least one of the state funds an insurance account with the corresponding relationship to at least one of the states associated with the insurance insolvency;

an insurance account association system in the computer system that associates with the insurance account the at least one line of insurance;

an identification system that identifies in the computer system at least one of a state statute, regulation and rule relating to the at least one line of insurance associated with the insurance account; and

an insolvency processing system that adjusts an amount associated with the corresponding insurance account in accordance with the transaction based on the identified at least one of a state statute, regulation and rule and the at least one line of insurance associated with the insurance account.

74. The system of claim 73, further comprising an industry code association system that associates at least one industry standard code with the insurance account and the at least one line of insurance.

75. The system of claim 74, wherein the insurance account is associated with a plurality of lines of insurance.

76. The system of claim 75, wherein the insurance account is associated with at least two lines of insurance each being of type commercial automobile, worker'"'"'s compensation, homeowner'"'"'s and fire.

77. The system of claim 74, wherein the insurance account is associated with one line of insurance being of type commercial automobile, worker'"'"'s compensation, homeowner'"'"'s and fire.

78. The system of claim 74, further comprising:

a group association system in the computer system that associates a group with a first of the each states having a corresponding state fund; and

a member association system in the computer system that associates at least one member with the group.

79. The system of claim 78, further comprising:

a storage system in the computer system that stores information representing a relationship between the state fund and the associated insurance account and the at least one line of insurance.

80. The system of claim 79, further comprising:

a representation system in the computer system that represents a merger of at least two members by combining portions of the information stored.

81. The system of claim 80, further comprising:

a modification system in the computer system that modifies a relationship between the at least two members represented.

82. The system of claim 79, further comprising:

a representation system in the computer system that represents a split of one member into at least two entities using portions of the information stored in the computer system.

83. The system of claim 82, further comprising:

a modification system in the computer system that modifies a relationship represented in the computer system of the one member corresponding to the split into the at least two entities.

84. The system of claim 73, further comprising:

a determination system in the computer system that determines an insurance account from which a payment is made in the computer system.

85. The system of claim 84, wherein the payment is made in connection with at least one of:

a claim and an unearned premium.

86. The system of claim 85, further comprising:

a tracking system in the computer system that tracks payments; and

a display system that displays an accounting of the payments with respect to a predetermined estimated amount of payments.

87. The system of claim 86, wherein the tracking system tracks total payments made prior to the insolvency.

88. The system of claim 87, wherein the tracking system tracks monies in connection with a recovery amount.

89. The system of claim 88, wherein the recovery amount comprises at least one of:

a salvage amount a subrogation recovery, a second injury amount, a cost of living adjustment and net worth.

90. The system of claim 73, further comprising:

a diary system in the computer system that creates a diary entry including information about one of a claim and unearned premium; and

a communication system that sends the diary entry to at least one user.

91. The system of claim 90, wherein the communication system automatically sends the diary entry in response to an occurrence of a predefined event.

92. The system of claim 91, wherein the predefined event is one of:

deleting a pending payment closing one of a claim and an unearned premium, upon rejection of a closing one of a claim and unearned premium, modifying a line of insurance, deleting a line of insurance, sending a note to a reviewer, adjusting a reserve, adding a new taxpayer, and modifying an existing taxpayer.

93. The system of claim 91, wherein the system further comprises:

an account system in the computer system that creates an account for a user specifying a predetermined limit and specifies, by the user, a reserve amount above the predetermined limit; and

wherein the communication system sends the diary entry to a manager for approval in response to the user specifying the reserve amount.

94. The system of claim 90, wherein the communication system sends the diary entry in response to a first user creating the diary entry, and the system further comprises a user selection system in the computer system that allows the first user to select at least one other user to which the diary entry is sent.

95. The system of claim 73, further comprising:

an insurance claim association system in the computer system that associates at least one note with an insurance claim;

a status system in the computer system that associates a blocked status with the insurance claim; and

a communication system in the computer system that generates, in response to setting the blocked status, a note to at least one user indicating why the insurance claim has a blocked status.

96. The system of claim 95, wherein the communication system automatically notifies a first user when a second user attempts to perform a predetermined operation on the insurance claim having the blocked status.

97. The system of claim 73, further comprising:

a data file system in the computer system that generates a data file including information about at least one of an unearned premium and a claim, the data file being used as an input file into an accounting system.

98. The system of claim 97, further comprising a ledger system in the computer system that generates general ledger entries, the general ledger entries being included in the data file.

99. The system of claim 73, further comprising:

a corresponding insurance account association system in the computer system that associates information about an insurance claim with the corresponding insurance account;

a note system in the computer system that enters a note associated with an insurance claims, the note including descriptive information about the claim entered by a claim handler, and

providing for the note to be available for reading by another user.

100. The system of claim 73, further comprising:

a recordation system in the computer system that records information about an error in a log file included in a client system.

101. The system of claim 100, further comprising:

an audit system in the computer system that audits the transaction by recording audit information about the transaction.

102. The system of claim 101, wherein the audit information comprises at least one of:

date and time information, transaction type, data values prior to modification by the transaction, and user performing the transaction.

103. The system of claim 73, further comprising:

a status system in the computer system generating in the computer system an incomplete status of a record including information about a claim, obtaining additional information about the claim;

a modification system in the computer system that modifies the record to include the additional information; and

a conversion system in the computer system that converts the incomplete status associated with the record to a claim status.

104. The system of claim 73, further comprising:

an assignment system in the computer system that assigns at least one role to a first user have a first set of security permissions and access limits; and

a security determination system in the computer system that determines, using the first set of security permissions and access limits, whether to allow a user to perform an operation in connection with the insurance account.

105. The system of claim 73, wherein the insolvency processing system performs at least one insolvency related service in connection with said insurance solvency further comprises an input processing interface that enters one or more claims from said insurance solvency into the computer system and processes the entered one or more claims from said insurance insolvency based on the identified at least one of a state statute, regulation and rule and the insurance account and the at least one line of insurance associated with each of the one or more entered claims.

106. The system of claim 73, wherein the insolvency processing system performs at least one insolvency related service in connection with said insurance solvency further comprises an assessment processing system that determines if an assessment is needed based on a size of said insurance solvency, at least an amount in the designated state fund, and the identified at least one of a state statute, regulation and rule and performs an assessment based on the determination of the need of the assessment.

107. The system of claim 73, wherein the insolvency processing system performs at least one insolvency related service in connection with said insurance solvency further comprises an unearned premium processing system that issues a refund for each policy in the at least one line of insurance based on a calculation of an unearned premium and the identified at least one of a state statute, regulation and rule.

108. The system of claim 73, wherein the insolvency processing system performs at least one insolvency related service in connection with said insurance solvency further comprises a claims processing system that process one or more additional claims in the at least one line of insurance for a first period of time after said insurance solvency based on the identified at least one of a state statute, regulation and rule.