Insurance claim association method and apparatus

• US 8,447,631 B2
• Filed: 03/22/2005
• Issued: 05/21/2013
• Est. Priority Date: 03/22/2005
• Status: Active Grant

• Current Assignee: Guidewire Software Incorporated
• Original Assignee: Guidewire Software Incorporated
• Inventors: Ren, Sandia, Morano, Allen, Henrickson, Jeremy Shawn, Burton, James Michael
• Primary Examiner(s): Hammond, III, Thomas M
• Application Number:
  US11/086,889
• Publication Number:
  US 20060218017A1
• Time in Patent Office: 2,982 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

A computer-based insurance claim processing system (500) provides for the formation and segregated storage of associations (510) that link various active insurance claims (506) to one another. In addition, if desired, the associations can comprise additional information regarding, for example, the nature or type of association and/or other information as a user may wish to include to inform, control, or otherwise characterize the association and/or the associated claims.

Claims

1. A method for managing insurance claims in conjunction with a computer-based insurance claim processing system, the method comprising:

storing, in a computer system, a plurality of discrete active insurance claims, wherein the computer system comprises at least a computer processor, a memory coupled to the computer processor, and a user interface;

providing, using the computer system, at least one association to each of the plurality of discrete active insurance claims, wherein the associations are stored in memory separate from their corresponding discrete active insurance claims;

selecting, using the computer system, a first association criteria related to an event, wherein the first association criteria links a subset of the plurality of discrete active insurance claims based on their provided at least one association;

presenting, using the computer system, the subset of discrete active insurance claims based on the selected first association criteria;

adding, using the computer system, an additional discrete active insurance claim to the presented subset of discrete active insurance claims by inputting an association for the additional discrete active insurance claim that links it to the presented subset based on the first association criteria;

providing, using the computer system, additional information to each one of the presented subset of discrete active insurance claims, wherein the additional information is stored in a memory separate from the discrete active insurance claims and corresponds to the at least one association of the presented subset of discrete active insurance claims, and further wherein the additional information is linked to each of the presented subset of discrete active insurance claims based on an entry of the additional information and the at least one association;

receiving, using the computer system, an indication that the status of all of the discrete active insurance claims in the subset of discrete active insurance claims has been changed from active to inactive; and

automatically deleting, by the computer system, any associations and additional information linked to the subset of discrete active insurance claims based on the indication.

2. The method of claim 1 wherein the first association criteria comprises at least one of:

master and subordinate insurance claim relationship;

a shared casualty event;

a primary and excess payment amount relationship;

claims across multiple temporal reporting periods relating to a single loss event; and

a shared insured entity.

3. The method of claim 1 further comprising storing information regarding the at least one association in a relational database table.

4. The method of claim 1 wherein using the at least one association when presenting the subset of discrete active insurance claims to a user via the user interface comprises presenting information regarding associated insurance claims in combination with a presently presented insurance claim.

5. The method of claim 4 wherein presenting information regarding associated insurance claims in combination with a presently presented insurance claim further comprises providing a user-assertable link that leads directly to information regarding one of the associated insurance claims.

6. The method of claim 4 wherein presenting information regarding associated insurance claims in combination with a presently presented insurance claim further comprises displaying information from an associated master insurance claim as if it formed part of a presently displayed subordinate insurance claim.

7. The method of claim 1 further comprising:

receiving from a user via the user interface supplemental content regarding a specific active insurance claim;

automatically adding the supplemental content to another specific active insurance claim that is associated with the specific active insurance claim by that association such that the supplemental content is available to a user via the user interface when accessing an associated insurance claim.

8. The method of claim 7 wherein automatically adding the supplemental content to another specific active insurance claim comprises storing the supplemental content in common with a discrete active insurance claim as corresponds to the specific active insurance claim.

9. The method of claim 7 wherein automatically adding the supplemental content to another specific active insurance claim comprises displaying at least a portion of the supplemental content in common with discrete active insurance claim information as corresponds to the specific active insurance claim.

10. The method of claim 7 wherein the supplemental content comprises an activity to be accomplished with respect to processing the specific active insurance claim.

11. The method of claim 7 wherein the supplemental content comprises a user note regarding the specific active insurance claim.

12. The method of claim 7 wherein the supplemental content comprises a document.

13. The method of claim 1 wherein providing at least one association further comprises providing a characterization regarding a type of association.

14. The method of claim 13 wherein using the at least one association further comprises presenting the characterization to a user via the user interface.

15. The method of claim 13 wherein providing a characterization regarding a type of association further comprises:

presenting to a user via the user interface an opportunity to enter the characterization;

receiving from the user an entered characterization;

using the entered characterization as the characterization.

16. The method of claim 15 wherein presenting to a user via the user interface an opportunity to enter the characterization further comprises presenting to the user a plurality of candidate characterizations.

17. The method of claim 1 further comprising:

receiving from a user via the user interface a search request as specifically relates to the at least one association; and

providing to the user in response to the search request information regarding active insurance claims as correspond to the at least one association.

18. The method of claim 1 wherein the user interface comprises a browser-based interface.

19. The method of claim 1

further comprising providing the at least one association comprises storing the additional information in conjunction with the at least one association, wherein providing at least one association further comprises providing additional information in conjunction with that association.

20. The method of claim 19 wherein providing additional information in conjunction with that association further comprises collecting the additional information from a user upon establishing the at least one association.

21. The method of claim 19 wherein providing additional information in conjunction with that association further comprises collecting the additional information from a user with respect to an already existing association.

22. The method of claim 19 further comprising automatically providing at least a portion of the additional information to an external component.

23. The method of claim 1 further comprising using information contained in the at least one association to influence, at least in part, a manner by which a given discrete active insurance claim as is linked to the at least one association is to be processed.

24. The method of claim 1 further comprising using information contained in the at least one association as input to an automated rules-based portion of the computer-based insurance claim processing system.

25. The method of claim 1 further comprising:

using the at least one association to identify financial information for each discrete active insurance claim as is linked to the at least one association;

using the financial information to calculate an aggregate value.

29. The method of claim 1 wherein the additional information relating to the at least one association comprises at least one of:

an association name;

a characterization;

a type of association;

a geographic region;

an information regarding a shared point of factual pertinence;

a shared legal context;

a sequence number;

financial transactions;

accounting information; and

temporal information.

26. An apparatus comprising a computer-based insurance claim processing system comprising:

a memory having discretely stored therein a plurality of discrete active insurance claims;

a user interface;

a computer processor operably coupled to the memory and to the user interface, wherein the processor is programmed to;

store a plurality of discrete active insurance claims;

provide at least one association to each of the plurality of discrete active insurance claims, wherein the associations are stored in memory separate from their corresponding discrete active insurance claims;

select a first association criteria related to an event, wherein the first association criteria links a subset of the plurality of discrete active insurance claims based on their provided at least one association;

present the subset of discrete active insurance claims based on the selected first association criteria;

add an additional discrete active insurance claim to the presented subset of discrete active insurance claims by inputting an association for the additional discrete active insurance claim that links the additional discrete active insurance claim to the presented subset based on the first association criteria;

provide additional information to each one of the presented subset of discrete active insurance claims, wherein the additional information is stored in a memory separate from the discrete active insurance claims and corresponds to the at least one association of the presented subset of discrete active insurance claims, and further wherein the additional information is linked to each of the presented subset of discrete active insurance claims based on an entry of the additional information and the at least one association;

receive an indication that the status of all of the discrete active insurance claims in the subset of discrete active insurance claims has been changed from active to inactive; and

automatically delete any associations and additional information linked to the subset of discrete active insurance claims based on the indication.

27. The apparatus of claim 26 wherein the processor is further programmed to:

receive from a user via the user interface supplemental content regarding a specific discrete active insurance claim;

automatically add the supplemental content to another specific discrete active insurance claim that is associated with the specific discrete active insurance claim by the at least one association such that the supplemental content is available to a user via the user interface when accessing an associated insurance claim.

28. The apparatus of claim 26 wherein the at least one association further comprises at least one of:

a characterization regarding a type of association; and

additional information as corresponds to the association.

30. The apparatus of claim 26 wherein the additional information relating to the at least one association comprises at least one of:

an association name;

a characterization;

a type of association;

a geographic region;

an information regarding a shared point of factual pertinence;

a shared legal context;

a sequence number;

financial transactions;

accounting information; and

temporal information.