System and method of administering, tracking and managing of claims processing
First Claim
Patent Images
1. A computer comprising:
- a processor; and
a memory, coupled to the processor and having computer program code embodied therein for enabling the processor to;
receiving data related to the insurance claim, the data comprising a plurality of data elements, a data element serving as an assignment criterion;
assign a score to first and second data elements of the plurality of data elements based on scoring rules, wherein each data element includes one or more data from the group consisting of policy information, vehicle information, number of vehicles involved, repair cost, number of parties involved, time of incident, and location of incident;
determine an overall score of the insurance claim based on the assigned scores;
determine a class of the insurance claim according to classing rules;
anddetermine a type of assignee to whom to assign the insurance claim according to the application of business rules to the overall score of the insurance claim and the class of the insurance claim, wherein the business rules weight the class more highly than the score.
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Abstract
A system and method of administering, tracking and managing of claims processing.
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Citations
19 Claims
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1. A computer comprising:
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a processor; and a memory, coupled to the processor and having computer program code embodied therein for enabling the processor to; receiving data related to the insurance claim, the data comprising a plurality of data elements, a data element serving as an assignment criterion; assign a score to first and second data elements of the plurality of data elements based on scoring rules, wherein each data element includes one or more data from the group consisting of policy information, vehicle information, number of vehicles involved, repair cost, number of parties involved, time of incident, and location of incident; determine an overall score of the insurance claim based on the assigned scores; determine a class of the insurance claim according to classing rules; and determine a type of assignee to whom to assign the insurance claim according to the application of business rules to the overall score of the insurance claim and the class of the insurance claim, wherein the business rules weight the class more highly than the score.
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2. A computer comprising:
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a processor, and a memory, coupled to the processor and having computer program code embodied therein for enabling the processor to; determine, based on data elements of the insurance claim, a claim score for first and second data elements, wherein each data element includes one or more data from the group consisting of policy information, vehicle information, number of vehicle involved, repair cost, number of party involved, time of incident, and location of incident; determine an overall score for the insurance claim using each of the claim scores; determine, based on the insurance claim, a class of the insurance claim; determine, based on the overall claim score and the class, the type of assignee; and assign the insurance claim to the determined assignee. - View Dependent Claims (3, 4, 5, 6, 7, 8, 9, 10)
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11. A computer program product comprising a computer useable medium having computer program logic embodied therein for enabling a computer system to select a type of assignee from a plurality of types of assignees, said computer program logic comprising:
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computer readable program code for determining, based on data elements of the insurance claim, a claim score for first and second data elements, wherein each data element includes one or more data from the group consisting of policy information, vehicle information, number of vehicles involved, repair cost, number of parties involved, time of incident, and location of incident; a second computer readable program code for determining an overall score for the insurance claim using the claim scores; a third computer readable program code for determining, based on the insurance claim, a class of the insurance claim; and a fourth computer readable program code for determining, based on the claim score and the class, the type of assignee. - View Dependent Claims (12, 13, 14, 15, 16, 17, 18, 19)
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Specification