Claims card

• US 8,494,938 B1
• Filed: 12/10/2010
• Issued: 07/23/2013
• Est. Priority Date: 12/10/2010
• Status: Active Grant

• Current Assignee: United Services Automobile Association
• Original Assignee: United Services Automobile Association
• Inventors: Kazenas, Joseph A.
• Primary Examiner(s): Havan, Thu Thao
• Application Number:
  US12/965,477
• Time in Patent Office: 956 Days
• Field of Search: 705/4, 705 35- 40
• US Class Current: 705/35
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

Systems and methods for processing insurance claims using a claims card are provided. In accordance with some embodiments, a notice of loss is received. The notice of loss can contain information regarding the insured property, policy information, member information, witness names and contact information, witness statements, police report numbers, date of loss, time of loss, nature of the loss, and/or other information. A determination of liability coverage can then be made by accessing a membership database to retrieve the insurance policy. If the loss is determined to be covered by, or at least within the coverage of, the insurance policy, a claims card can be activated, delivered, or given to an insured accident victim under conditions where liability coverage, claims record, and the liability issues for the accident are sufficiently clear that to indicate that the insurance company will be paying for loss related items.

Claims

1. A method comprising:

receiving a notice of loss relating to a member with insurance coverage provided by a membership institution, wherein the insurance coverage has a coverage amount;

withdrawing an amount from a reserve account of the membership institution upon receiving the notice of loss, wherein the amount to be withdrawn is based on historical claim data from similar losses and the coverage amount;

activating a payment device with access to the amount withdrawn from the reserve account to allow the member to directly make loss related payments consistent with the insurance coverage; and

refunding a reserve refund amount to the reserve account, wherein the reserve refund amount is the difference between a final settlement amount and the amount withdrawn from the reserve.

2. The method of claim 1, wherein the payment device is a membership card provided by the membership institution or an insurance card.

3. The method of claim 1, wherein the notice of loss is automatically generated by a remote diagnostic system.

4. The method of claim 3, wherein the remote diagnostic system is installed in an automobile and the notice of loss is automatically generated in response to a notice generating event, the notice of loss providing automobile information, membership information, and accident information gathered by the remote diagnostic system.

5. The method of claim 1, further comprising monitoring the use of the payment device while a determination of liability is pending to ensure the payments are loss related payments.

6. The method of claim 5, wherein monitoring the use of the payment device includes using merchant category code (MCC) data and level 3 data.

7. The method of claim 5, further comprising:

accessing a membership database to determine liability coverage, the coverage amount, and a member banking account at the membership institution; and

withdrawing from the member banking account any payment made with the payment device that is determined to not be a loss related payment.

8. A system comprising:

a notice receiving module to receive a notice of loss with information about a loss relating to a member with insurance coverage provided by a membership institution;

an estimation module to receive information about the loss from the notice receiving module, the estimation module to determine an expected loss amount based on historical claim data for similar losses;

a reserve module to withdraw the expected loss amount from a reserve account of the membership institution;

an activation module to activate a payment device with access to the expected loss amount withdrawn from the reserve account to allow the member to directly make loss related payments consistent with the insurance coverage; and

a refund module to determine a reserve refund amount by taking the difference between a final settlement amount and the expected loss amount withdrawn from the reserve account, and the refund module to refund the reserve refund amount to the reserve account.

9. The system of claim 8, further comprising:

a member database having stored thereon information regarding the insurance coverage of a plurality of members and a member banking account at the membership institution; and

an account module to identify the banking account associated with the member and withdraw any payment made with the payment device that is determined to not be a loss related payment.

10. The system of claim 8, further comprising a spending module to monitor the use of the payment device while a determination of liability is pending to ensure the payments are loss related payments.

11. The system of claim 10, wherein the spending module monitors the use of the payment device with merchant category code (MCC) data and level 3 data.

12. The system of claim 10, wherein the estimation module generates a set of typical claim categories and typical claim amounts for each category that associated with the loss, wherein the monitoring module categorizes each transaction generated by the payment devices and notifies an auditor when spending within one or more of the claim categories exceeds a percentage of the typical claim amounts.

13. The system of claim 8, wherein the payment device is a membership card provided by the membership institution.

14. The system of claim 8, further comprising:

a payment device generation module to create a payment device in response to a generation indicator provided by the estimation module; and

a mailing module to mail the payment device to the member.

15. A computer-readable storage medium containing a set of instructions to cause one or more processors to:

receive a notice of loss relating to a member with insurance coverage provided by a membership institution, wherein the insurance coverage has a coverage amount;

withdraw an amount from a reserve account of the membership institution upon receiving the notice of loss, wherein the amount to be withdrawn is based on historical claim data from similar losses and the coverage amount;

activate a payment device with access to the amount withdrawn from the reserve account to allow the member to directly make loss related payments consistent with the insurance coverage; and

refund a reserve refund amount to the reserve account, wherein the reserve refund amount is the difference between a final settlement amount and the amount withdrawn from the reserve.

16. The computer-readable storage medium of claim 15, wherein the set of instructions further cause the one or more processors to monitor the use of the payment device while a determination of liability is pending to ensure the payments are loss related payments.

17. The computer-readable storage medium of claim 16, wherein monitoring the use of the payment device includes using merchant category code (MCC) data and level 3 data.

18. The computer-readable storage medium of claim 16, wherein the set of instructions further cause the one or more processors to:

access a membership database to determine liability coverage, the coverage amount, and a member banking account at the membership institution; and

withdraw from the member banking account any payment made with the payment device that is determined to not be a loss related payment.

19. The computer-readable storage medium of claim 15, wherein the set of instructions further cause the one or more processors to:

generate a set of typical claim categories each having a typical claim amount associated with the loss;

categorize each transaction generated by the payment device; and

notify an auditor when spending within one or more of the claim categories exceeds a percentage of the typical claim amount.

20. The computer-readable storage medium of claim 15, wherein the set of instructions further cause the one or more processors to:

receive a transaction request to process a payment to a merchant generated by use of the payment device;

determine if the payment is a loss related payment; and

denying the transaction request if the payment is determined to not be a loss related payment.