Systems and methods for providing real-time over-ride capability

• US 8,135,658 B1
• Filed: 04/22/2008
• Issued: 03/13/2012
• Est. Priority Date: 04/22/2008
• Status: Active Grant

• Current Assignee: United Services Automobile Association
• Original Assignee: United Services Automobile Association
• Inventors: Nicholson, James Elden, Watkins, Christopher J. Sr., Rankin, Vance E.
• Primary Examiner(s): Gaffin, Jeffrey A
• Assistant Examiner(s): Gonzales, Vincent
• Application Number:
  US12/107,311
• Time in Patent Office: 1,421 Days
• Field of Search: 706/47, 705/4
• US Class Current: 706/47
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

Decision software implements a decision process that handles and decides a request from a requestor in a generally automated manner. The decision software denies the request according to a predefined standard. Information relating to the request and the denial decision is stored as a quote, and it is determined that further consideration of the denial decision by a human reviewer of the organization is desired. The human reviewer is contacted and retrieves the stored quote by way of an actuated interface that presents the quote as a focused screen including information from the quote and a determination entry device. The human interviewer determines based at least in part on the focused screen whether to over-ride the denial decision and enters such determination into the determination entry device. The entered determination is stored with the stored quote and the request proceeds in accordance with the stored determination.

Claims

1. A method utilized in connection with a requestor requesting a particular action from an organization, the method comprising:

providing decision software to implement a decision process that handles and decides the request in a generally automated manner, the decision software determining whether to approve or deny the request according to predefined standards provided to the decision software, the decision software deciding at a decision point corresponding to a particular standard to deny the request based on the particular standard;

storing information relating to the request and the denial decision as a quote;

determining whether or not further consideration of the denial decision by a human reviewer of the organization is demanded by the requestor;

contacting the human reviewer to seek such further consideration when further consideration of the denial decision is demanded, the contacted human reviewer;

retrieving the stored quote by way of an actuated interface that presents the quote as a focused screen including information from the quote and a determination entry device;

determining based at least in part on the focused screen of the interface whether to over-ride the denial decision; and

entering such determination into the determination entry device of the interface;

storing the entered determination with the stored quote; and

proceeding with the request in accordance with the stored determination.

2. The method of claim 1 wherein the organization is an insurance company, the request from the requestor is for an insurance product offered by the insurance company, the requested product is one of originally issued according to the request and updated according to the request, and the human reviewer is an insurance underwriter.

3. The method of claim 1 wherein the quote includes information provided to the decision software for the requestor, an identification of the decision point that resulted in the denial decision, and the particular standard corresponding thereto.

4. The method of claim 1 wherein contacting the human reviewer and receiving the determination therefrom occurs while the requestor is in contact with a representative of the organization.

5. The method of claim 1 wherein the presented quote as retrieved by the interface includes facts relating to the nature and circumstances of the quote and the decision point that resulted in the denial decision.

6. The method of claim 1 wherein the entered determination over-rides the denial decision, and wherein the decision software continues with the request.

7. The method of claim 1 wherein the entered determination overrides the denial decision and wherein the entered determination is valid for a predetermined period of time for the requestor and with regard to the decision point that resulted in the denial decision.

8. A computer-readable storage medium having stored thereon computer-executable instructions implementing a method utilized in connection with a requestor requesting a particular action from an organization, the method comprising:

providing decision software to implement a decision process that handles and decides the request in a generally automated manner, the decision software determining whether to approve or deny the request according to predefined standards provided to the decision software, the decision software deciding at a decision point corresponding to a particular standard to deny the request based on the particular standard;

storing information relating to the request and the denial decision as a quote;

determining whether or not further consideration of the denial decision by a human reviewer of the organization is demanded by the requestor;

contacting the human reviewer to seek such further consideration when further consideration of the denial decision is demanded, the contacted human reviewer;

retrieving the stored quote by way of an actuated interface that presents the quote as a focused screen including information from the quote and a determination entry device;

determining based at least in part on the focused screen of the interface whether to over-ride the denial decision; and

entering such determination into the determination entry device of the interface;

storing the entered determination with the stored quote; and

proceeding with the request in accordance with the stored determination.

9. The medium of claim 8 wherein the organization is an insurance company, the request from the requestor is for an insurance product offered by the insurance company, the requested product is one of originally issued according to the request and updated according to the request, and the human reviewer is an insurance underwriter.

10. The medium of claim 8 wherein the quote includes information provided to the decision software for the requestor, an identification of the decision point that resulted in the denial decision, and the particular standard corresponding thereto.

11. The medium of claim 8 wherein contacting the human reviewer and receiving the determination therefrom occurs while the requestor is in contact with a representative of the organization.

12. The medium of claim 8 wherein the presented quote as retrieved by the interface includes facts relating to the nature and circumstances of the quote and the decision point that resulted in the denial decision.

13. The medium of claim 8 wherein the entered determination over-rides the denial decision, and wherein the decision software continues with the request.

14. The medium of claim 8 wherein the entered determination overrides the denial decision and wherein the entered determination is valid for a predetermined period of time for the requestor and with regard to the decision point that resulted in the denial decision.

15. A system utilized in connection with a requestor requesting a particular action from an organization, the system comprising:

decision software operating to implement a decision process that handles and decides the request in a generally automated manner, the decision software determining whether to approve or deny the request according to predefined standards provided to the decision software, the decision software deciding at a decision point corresponding to a particular standard to deny the request based on the particular standard;

a sub-system that stores information relating to the request and the denial decision as a quote, wherein it is determined whether or not further consideration of the denial decision by a human reviewer of the organization is demanded by the requestor, and wherein the human reviewer is contacted to seek such further consideration when further consideration of the denial decision is demanded;

a sub-system that retrieves the stored quote for the human reviewer by way of an actuated interface that presents the quote as a focused screen including information from the quote and a determination entry device, wherein the human reviewer determines based at least in part on the focused screen of the interface whether to over-ride the denial decision;

a sub-system that receives such determination into the determination entry device of the interface;

a sub-system that stores the entered determination with the stored quote; and

a sub-system that proceeds with the request in accordance with the stored determination.

16. The system of claim 15 wherein the organization is an insurance company, the request from the requestor is for an insurance product offered by the insurance company, the requested product is one of originally issued according to the request and updated according to the request, and the human reviewer is an insurance underwriter.

17. The system of claim 15 wherein the quote includes information provided to the decision software for the requestor, an identification of the decision point that resulted in the denial decision, and the particular standard corresponding thereto.

18. The system of claim 15 wherein contacting the human reviewer and receiving the determination therefrom occurs while the requestor is in contact with a representative of the organization.

19. The system of claim 15 wherein the presented quote as retrieved by the interface includes facts relating to the nature and circumstances of the quote and the decision point that resulted in the denial decision.

20. The system of claim 15 wherein the entered determination over-rides the denial decision, and wherein the decision software continues with the request.

21. The system of claim 15 wherein the entered determination overrides the denial decision and wherein the entered determination is valid for a predetermined period of time for the requestor and with regard to the decision point that resulted in the denial decision.