Methods and structure for insurance industry workflow processing

• US 7,689,443 B2
• Filed: 12/31/2002
• Issued: 03/30/2010
• Est. Priority Date: 12/31/2002
• Status: Expired due to Fees

• Current Assignee: Swiss Reinsurance Company
• Original Assignee: Employers Reinsurance Corp. (Swiss Re AG)
• Inventors: Pepoon, Francesca Miller, Throop, Robert Jack, Kommineni, Aruna Babu, Francisco, Andrea M.
• Primary Examiner(s): Gilligan; C. Luke
• Assistant Examiner(s): NGUYEN, TRAN N
• Application Number:
  US10/334,883
• Publication Number:
  US 20040128182A1
• Time in Patent Office: 2,646 Days
• Field of Search: 705/4
• US Class Current: 705/4
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

Methods and structure for automated insurance workflow processing. Methods include receipt of a document to be entered into the workflow processing system. The document is either received initially in digital form or is digitized into a digital form for further processing in the workflow system. Subsequent flow of the document through various review processes of the insurance entity is in electronic form. Interaction with third parties including individual agents, agencies and underwriters may also be conducted in digitized, electronic form. The workflow processes and systems automatically may generate a sequence of tasks to be performed associated with a new document entered in the system and may track progress of the tasks. A central may database maintain information regarding all such tasks and documents.

Claims

1. A method for processing insurance automated workflow using a computer coupled to a database, said method comprising the steps of:

storing a plurality of tasks within the database, each task included within a workflow of insurance processing related matters, each workflow including a sequence of tasks from the plurality of tasks stored within the database;

associating at least one of a plurality of skill-oriented role attributes with each task stored within the database, each skill-oriented role attribute indicating a type of insurance review entity responsible for performing the corresponding task;

receiving an electronic document at the computer for processing, wherein the electronic document includes at least one attachment in a non-graphics image format;

automatically converting, using the computer, the electronic document including the at least one attachment in the non-graphics image format into a single page graphics image format;

automatically generating a first workflow based on the converted electronic document, the generated first workflow including a first sequence of tasks to be completed corresponding to processing of said converted electronic document;

displaying, on the computer, information regarding said converted electronic document and information regarding said first sequence of tasks;

forwarding, using the computer, each task of said first sequence of tasks to a select insurance review entity, wherein the select insurance review entity is selected for each task based on the skill-oriented role attribute associated with the corresponding task; and

automatically updating information in the database in response to completion of each task of said first sequence of tasks.

2. The method of claim 1 wherein the step of automatically generating a first workflow includes the step of generating a Review Document Task as a first task of said first sequence of tasks.

3. The method of claim 2 wherein information in the database includes status of each task of said first sequence of tasks and wherein tasks of said first sequence of tasks that follow said first task must await a Completed status to be associated with said first task in the database.

4. The method of claim 3 further comprising the steps of:

receiving acceptance of said Review Document Task by the insurance review entity;

presenting said document on a display for review of said document by the insurance review entity; and

updating the status associated with said Review Document Task in response to input from the insurance review entity.

5. The method of claim 4 wherein the step of automatically updating includes the steps of:

receiving input from the insurance review entity indicating successful completion of said Review Document Task; and

updating the status information associated with said Review Document Task to reflect said Completion status.

6. The method of claim 2 wherein the step of automatically generating a first workflow includes the step of:

receiving input from the insurance review entity indicating completion of the Review Document Task; and

automatically generating a next task in response to said completion.

7. The method of claim 6 wherein the step of automatically generating a first workflow further includes the steps of:

receiving input from the insurance review entity indicating completion of each task of said first sequence of tasks;

automatically generating another task in response to said completion of each task of said first sequence of tasks; and

repeating the steps of receiving input indicating completion of each task of said first sequence of tasks and generating said another task until all tasks are completed for processing of said document.

8. The method of claim 1 wherein the step of receiving includes the steps of:

receiving a paper copy of said electronic document; and

scanning said paper copy to produce a digitized version thereof.

9. The method of claim 1 wherein the step of receiving includes the steps of:

receiving said electronic document as a facsimile transmission from a facsimile machine; and

applying a security filter to verify the transmitting facsimile machine as an authorized source for said electronic document.

10. The method of claim 1 wherein the step of receiving includes the steps of:

receiving said electronic document as an e-mail message from an e-mail sender; and

applying a security filter to verify the e-mail sender as an authorized source for said electronic document.

11. The method of claim 1 further comprising the steps of:

whereupon completion of at least one task included within said first sequence of tasks, automatically generating a second sequence of tasks to be completed corresponding to processing of said electronic document;

displaying, on the computer, information regarding said converted electronic document and information regarding said second sequence of tasks;

forwarding each task of said second sequence of tasks to said select insurance review entity; and

automatically updating information in the database in response to completion of each task of said second sequence of tasks.

12. The method of claim 1

wherein each task of said first sequence of tasks comprises one of:

Review Document Task, New Appointment Task, License Copy Task, Initiate Background Investigation Task, Check Background Results Task, Review Background Results Task, Quality Check Task, Verify PIN Approval Task, Submit Appointment Paperwork Task, Verify Paper Approval Task, and Terminate Appointment Task, and

wherein the insurance review entity comprises one or more of Licensing Reviewer, Legal Reviewer and Data Entry Reviewer, and

wherein the step of forwarding comprises the steps of;

selecting said select insurance review entity as one having an associated skill-oriented role attribute of Licensing Reviewer for tasks including;

Review Document Task, Check Background Results Task, Quality Check Task, Submit Appointment Paperwork Task, and Verify Paper Approval Task;

selecting said select insurance review entity as one having an associated skill-oriented role attribute of Data Entry Reviewer for tasks including;

New Appointment Task, License Copy Task, Initiate Background Investigation Task, Verify PIN Approval Task, and Terminate Appointment Task; and

selecting said select insurance review entity as one having an associated skill-oriented role attribute of Legal Reviewer for the Review Background Results Task.

13. The method of claim 1 wherein the step of displaying further comprises the steps of:

receiving a request from a first user, the first user included within a first type of insurance review entity, the first type of insurance review entity responsible for performing at least one task included within said first sequence of tasks;

generating a queue of incomplete tasks from said first sequence of tasks associated with the first type of insurance review entity, the queue of incomplete tasks available to all users included within the first type of insurance review entity;

displaying, on the computer, the queue of incomplete tasks associated with the first type of insurance review entity;

receiving an acceptance of at least one incomplete task of the queue of incomplete tasks by the first user; and

wherein the step of automatically updating further comprises updating the queue of incomplete tasks to reflect the acceptance of the at least one incomplete task.

14. A computer readable storage medium tangibly embodying program instructions for a method for processing insurance automated workflow, the method performed using a computer, the method comprising the steps of:

storing a plurality of tasks within a database, each task included within a workflow of insurance processing related matters, each workflow including a sequence of tasks from the plurality of tasks stored within the database;

associating at least one of a plurality of skill-oriented role attributes with each task stored within the database, each skill-oriented role attribute indicating a type of insurance review entity responsible for performing the corresponding task;

receiving an electronic document for processing, wherein the electronic document includes at least one attachment in a non-graphics image format;

automatically converting, using the computer, the electronic document including the at least one attachment in the non-graphics image format into a single page graphics image format;

automatically generating a first workflow based on the converted electronic document, the generated first workflow including a first sequence of tasks to be completed corresponding to processing of said converted electronic document;

displaying, on the computer, information regarding said converted electronic document and information regarding said first sequence of tasks;

forwarding each task of said first sequence of tasks to a select insurance review entity, wherein the select insurance review entity is selected for each task based on the skill-oriented role attribute associated with the corresponding task; and

automatically updating information in the database in response to completion of each task of said first sequence of tasks.

15. The computer readable storage medium of claim 14 wherein the step of automatically generating a first workflow includes the step of generating a Review Document Task as a first task of said first sequence of tasks.

16. The computer readable storage medium of claim 15 wherein information in the database includes status of each task of said first sequence of tasks and wherein tasks of said first sequence of tasks that follow said first task must await a Completed status to be associated with said first task in the database.

17. The computer readable storage medium of claim 16 further comprising the steps of:

receiving acceptance of said Review Document Task by the insurance review entity;

presenting said document on a display for review of said document by the insurance review entity; and

updating the status associated with said Review Document Task in response to input from the insurance review entity.

18. The computer readable storage medium of claim 17 wherein the step of automatically updating includes the steps of:

receiving input from the insurance review entity indicating successful completion of said Review Document Task; and

updating the status information associated with said Review Document Task to reflect said Completion status.

19. The computer readable storage medium of claim 15 wherein the step of generating a first workflow includes the step of:

receiving input from the insurance review entity indicating completion of the Review Document Task; and

automatically generating a next task in response to said completion.

20. The computer readable storage medium of claim 19 wherein the step of generating a first workflow further includes the steps of:

receiving input from the insurance review entity indicating completion of each task;

automatically generating another task in response to said completion of each task of said first sequence of tasks; and

repeating the steps of receiving input indicating completion of each task of said first sequence of tasks and generating said another task until all tasks are completed for processing of said document.

21. The computer readable storage medium of claim 14 wherein the step of receiving includes the steps of:

receiving a paper copy of said electronic document; and

scanning said paper copy to produce a digitized version thereof.

22. The computer readable storage medium of claim 14 wherein the step of receiving includes the steps of:

receiving said electronic document as a facsimile transmission from a facsimile machine; and

applying a security filter to verify the transmitting facsimile machine as an authorized source for said electronic document.

23. The computer readable storage medium of claim 14 wherein the step of receiving includes the steps of:

receiving said electronic document as an e-mail message from an e-mail sender; and

applying a security filter to verify the e-mail sender as an authorized source for said electronic document.

24. The computer readable storage medium of claim 14 further comprising the steps of:

whereupon completion of at least one task included within said first sequence of tasks, automatically generating a second sequence of tasks to be completed corresponding to processing of said electronic document;

displaying, on the computer, information regarding said converted electronic document and information regarding said second sequence of tasks;

forwarding each task of said second sequence of tasks to said select insurance review entity; and

automatically updating information in the database in response to completion of each task of said second sequence of tasks.

25. The computer readable storage medium of claim 14

wherein each task of said first sequence of tasks comprises one of:

Review Document Task, New Appointment Task, License Copy Task, Initiate Background Investigation Task, Check Background Results Task, Review Background Results Task, Quality Check Task, Verify PIN Approval Task, Submit Appointment Paperwork Task, Verify Paper Approval Task, and Terminate Appointment Task, and

wherein the insurance review entity comprises one or more of Licensing Reviewer, Legal Reviewer and Data Entry Reviewer, and

wherein the step of forwarding comprises the steps of;

selecting said select insurance review entity as one having an associated skill-oriented role attribute of Licensing Reviewer for tasks including;

Review Document Task, Check Background Results Task, Quality Check Task, Submit Appointment Paperwork Task, and Verify Paper Approval Task;

selecting said select insurance review entity as one having an associated skill-oriented role attribute of Data Entry Reviewer for tasks including;

New Appointment Task, License Copy Task, Initiate Background Investigation Task, Verify PIN Approval Task, and Terminate Appointment Task; and

selecting said select insurance review entity as one having an associated skill-oriented role attribute of Legal Reviewer for the Review Background Results Task.

26. A method of processing insurance workflow, said method comprising:

(a) identifying a plurality of insurance workflows;

(b) identifying a plurality of tasks;

(c) for each workflow in step (a), associating one or more tasks in step (b) with the workflow in a computer;

(d) receiving an electronic document at the computer, wherein the electronic document comprises at least one attachment in a non-graphics image format;

(e) using the computer, automatically converting the attachment in an non-graphics image format into a single page graphics image format;

(f) using the computer, analyzing the converted attachment in the single page graphics image format to determine one or more insurance workflows associated with the converted attachment;

(g) using the computer, determining the one or more tasks associated with the converted attachment based on the results of step (f); and

(h) forwarding the one or more tasks associated with the converted attachment to a select insurance review entity for workflow processing.