Dynamic system and method for automated checking and transmitting of damage reports and damage claims

• US 8,583,458 B2
• Filed: 12/21/2005
• Issued: 11/12/2013
• Est. Priority Date: 12/27/2004
• Status: Active Grant

• Current Assignee: Swiss Reinsurance Company
• Original Assignee: Swiss Reinsurance Company
• Inventors: Bolano, Manuel, Van Eeden, Loraine, Glogg, Arnold
• Primary Examiner(s): RANKINS, WILLIAM E
• Application Number:
  US11/793,545
• Publication Number:
  US 20090119132A1
• Time in Patent Office: 2,883 Days
• Field of Search: 705/4, 705/1
• US Class Current: 705/4
• CPC Class Codes: G06Q 10/087 Inventory or stock management, e.g. order filling, procurement or balancing against orders
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

The present invention relates to a dynamic system and a corresponding method for automated checking and transmitting of damage reports and damage claims in multi-level damage coverage systems. The dynamic system comprises decentralized, cellular capturing units with assigned areas for capturing damage records, a central unit being bidirectionally connected via a network to the capturing units. The central unit comprises a filter module for selecting first and second damage records based on assigned threshold values, an analysis module for detecting and eliminating first damage records wrongly captured by means of the capturing units, and a regulator module for dynamic adjustment of the threshold values assigned to the respective areas based on the filtered first damage records. Finally, the filtered first damage records, without wrongly captured first damage records, are transmitted to the processing device and are released for multi-level damage coverage, by means of the central unit.

Claims

1. A dynamic system for automated checking and transmitting of damage reports in multi-level damage coverage systems, the system comprising:

a plurality of capturing units configured to capture damage records and transmit the damage records to a central unit, the damage records having assigned respective areas for capturing damage records based on first control parameters, a damage record comprising at least one event parameter for the respective area, the capturing units configured to perform an administrative accounting on the damage records including a verification of formal requirements of the damage records, and configured to verify contractual relationships of the damage records and to check whether a damage record is related to an isolated damage event or to additional damage events; and

the central unit bidirectionally connected via a network to the capturing units, at least event parameters being transmittable from the capturing units to the central unit, wherein the central unit includes,

a filter module for selecting first and second damage records from among the captured damage records based on at least one threshold value associated with a respective area assigned to the first and second damage records,

an analysis module for detecting and eliminating, based on second control parameters, first damage records wrongly captured by means of the capturing units,

a regulator module for dynamic adjusting and storing of the at least one threshold value, associated with the respective area associated with the first and second damage records, based on the filtered first damage records, excluding the wrongly captured first damage records, and

a transmission module for transmitting the filtered first damage records to an external processing device, the filtered first damage records being released for multi-level damage coverage.

2. The dynamic system according to claim 1, wherein the central unit further comprises:

a calculation module for determining premiums for customer parameters assigned to an area.

3. The dynamic system according to claim 2, wherein the calculation module comprises means for iterative adjustment of the premiums based on the filtered first and second damage records.

4. The dynamic system according to claim 1, wherein the second control parameters comprise at least one of data for automated checking of cash call, countersigning, policy, period of validity, risk threshold for the respective area, and ex-gratia payments.

5. The dynamic system according to claim 1, wherein the central unit further comprises:

an expert module for checking medical information data after the medical information data has been assigned to a damage record.

6. The dynamic system according to claim 1, wherein the second control parameters comprise:

at least one upper claim threshold value, all damage records above the upper claim threshold value being automatically assigned to the first damage records.

7. The dynamic system according to claim 1, wherein the central unit further comprises:

means for checking multiple claims, all damage records above the threshold value being automatically assigned to the first damage records.

8. The dynamic system according to claim 1, wherein during said performing the administrative accounting on the capturing units, it is verified whether an underlying policy of the damage record is sufficient, whether a damage sum of the damage record exceeds a threshold, and whether a reinsurance covers the damage record.

9. A method for automated checking and transmitting of damage reports in multi-level damage coverage systems, the method comprising:

capturing damage records by a capturing unit from among a plurality of capturing units, the damage records having assigned respective areas for capturing damage records based on first control parameters, a damage record comprising at least one event parameter for the respective area;

performing an administrative accounting on the damage records at the capturing unit including a verification of formal requirements of the damage records;

verifying contractual relationships of the damage records at the capturing unit and checking whether a damage record is related to an isolated damage event or to additional damage events;

transmitting the damage records from the capturing unit to a central processing unit via a network, after the performance of said administrative accounting;

transmitting the at least one event parameter from the capturing unit to the central processing unit;

filtering the damage records at a filter module of the central processing unit for selecting first and second damage records from among the captured damage records based on at least one threshold value associated with a respective area assigned to the first and second damage records;

analyzing the first damage records at an analysis module of the central processing unit, for detecting and eliminating wrongly captured damage records by means of the capturing units, based on second control parameters;

adjusting and storing the at least one threshold value associated with the respective area associated with the first and second damage records by a regulator module at the central processing unit, based on the filtered first damage records, thereby excluding the wrongly captured first damage records; and

transmitting, by a transmission module at the central processing unit, the filtered first damage records to an external processing device, the filtered first damage records being released for multi-level damage coverage.

10. The method according to claim 9, further comprising:

determining premiums for customer parameters assigned to an area by using a calculation module at the central processing unit.

11. The method according to claim 10, further comprising:

adjusting premiums iteratively based on the corrected first and second damage records at the calculation module.

12. The method according to claim 9, wherein the second control parameters comprise at least one of data for automated checking of cash call, countersigning, policy, period of validity, risk threshold for the respective area, and ex-gratia payments.

13. The method according to claim 9, further comprising:

checking medical information data by using an expert module at the central processing unit after the medical information data has been assigned to a damage record.

14. The method according to claim 9, wherein the second control parameters comprise at least an upper claim threshold value, all damage records above the upper claim threshold value being automatically assigned to the second damage records.

15. The method according to claim 9, further comprising:

checking the damage records for multiple claims at the central processing unit, wherein all damage records above the threshold value being automatically assigned to the second damage records.

16. The method according to claim 9, wherein the performing the administrative accounting includes verifying whether an underlying policy of the damage record is sufficient, whether a damage sum of the damage record exceeds a threshold, and whether a reinsurance covers the damage record.