Communication of insurance claim data

• US 8,725,543 B1
• Filed: 12/27/2012
• Issued: 05/13/2014
• Est. Priority Date: 10/13/2008
• Status: Active Grant

• Current Assignee: Allstate Insurance Company (Allstate Corporation)
• Original Assignee: Allstate Insurance Company (Allstate Corporation)
• Inventors: Ledder, James A., O'Halloran, Charles Ronald, Hanson, Randall Martin
• Primary Examiner(s): Le, Michelle L
• Application Number:
  US13/728,635
• Time in Patent Office: 502 Days
• Field of Search: 705/4
• US Class Current: 705/4
• CPC Class Codes: G06Q 10/06 Resources, workflows, human or project management; Enterprise or organisation planning; Enterprise or organisation modelling
• CPC Class Codes: G06Q 10/10 Office automation; Time management
• CPC Class Codes: G06Q 10/20 Administration of product repair or maintenance
• CPC Class Codes: G06Q 30/0283 Price estimation or determination
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

Aspects of the invention are directed to methods and systems for efficiently communicating data between an insurer and a non-referral repair shop, e.g., vehicle repair shops that are normally not preapproved by the insurer to perform the estimating and repair work. The methods and systems described herein are particularly useful for insurers utilizing non-referral repair shops for servicing vehicles involved in insurance claims. According to aspects of this invention, the insured may be able to select a non-referral repair shop, not delegated or preapproved by the insurer, thereby generally allowing the insured to select any available vehicle repair shop.

Claims

1. One or more computer storage media storing computer readable instructions that, when executed, provide a vehicle insurance claim management application, the application comprising:

a first set of instructions defined by the computer readable instructions, wherein the first set of instructions translates data between the vehicle insurance claim management application and a vehicle repair estimating system; and

a second set of instructions defined by the computer readable instructions, wherein the second set of instructions;

receives a set of assignment data from an insurance company pertaining to a plurality of work requests submitted to a non-referral vehicle repair shop, wherein the non-referral vehicle repair shop is not included within a pre-approved shop network associated with the insurance company,

receives a set of estimate data from the non-referral vehicle repair shop,

determines a rules-based intelligence score based on the estimate data,

determines an intervention level for the estimate based on the rules-based intelligence score, wherein the intervention level includes an automatic approval level, a desk adjuster level, and a field adjuster level,

wherein if the estimate data and the rules-based intelligence score correlates to the intervention level being the automatic approval level, the set of second instructions approves the estimate data,

wherein if the estimate data and the rules-based intelligence score correlates to the intervention level being the desk adjuster level, the set of second instructions transfers the estimate data to a desk adjuster for a desk review and the set of second instructions further receives one of an approved estimate data from the desk adjuster or a disapproved estimate data from the desk adjuster, and

wherein if the estimate data and the rules-based intelligence score correlates to the intervention level being the field adjuster level, the set of second instructions transfers the estimate data to a field adjuster for a field review and the set of second instructions further receives one of the approved estimate data from the field adjuster or the disapproved estimate data from the field adjuster.

2. The computer storage media of claim 1, wherein the determination of the rules-based intelligence score includes a line-by-line review of the estimate data.

3. The computer storage media of claim 1, wherein the determination of the rules-based intelligence score includes an aggregate review of the estimate data.

4. The computer storage media of claim 1, wherein the application further comprises a set of performance instructions defined by the computer readable instructions, the set of performance instructions storing and providing one or more performance metrics for the non-referral vehicle repair shop as compared to other vehicle repair facilities working with the insurance company.

5. The computer storage media of claim 4, wherein the performance metric comprises a tier level and a ranking.

6. The computer storage media of claim 1, wherein the estimate data provided to the insurance company comprises a photograph of a vehicle.

7. The computer storage media of claim 1, wherein the first set of instructions further provides a timeline indicating a plurality of milestone dates corresponding to a displayed vehicle work request.

8. One or more computer storage media storing computer readable instructions that, when executed, provide an internet-based vehicle insurance claim management application, the application comprising:

a first set of instructions defined by the computer readable instructions, wherein the first set of instructions translates data between the internet-based vehicle insurance claim management application and a first vehicle repair estimating system;

a second set of instructions defined by the computer readable instructions, wherein the second set of instructions translates data between the internet-based vehicle insurance claim management application and a second vehicle repair estimating system different from the first vehicle repair estimating system;

a third set of instructions defined by the computer readable instructions, the third set of instructions;

receives a first set of assignment data, that includes a first plurality of work requests submitted to a direct repair vehicle repair shop,

transfers the assignment data to a direct repair vehicle repair estimating system,

receives a first set of estimate data from the direct repair vehicle repair estimating system,

reviews the first set of estimate data for compliance with a set of contract-based conditions; and

a fourth set of instructions defined by the computer readable instructions, the fourth set of instructions;

receives a second set of assignment data that includes a second plurality of work requests submitted to a non-referral vehicle repair shop, wherein the non-referral vehicle repair shop is not included within a pre-approved shop network associated with an insurance company,

receives a second set of estimate data from the non-referral vehicle repair shop,

determines a rules-based intelligence score based on the second set of estimate data, and

determines an intervention level for the second set of estimate data based on the rules-based intelligence score, wherein the intervention level includes an automatic approval level, a desk adjuster level, and a field adjuster level,

wherein if the second set of estimate data and the rules-based intelligence score correlates to the intervention level being the automatic approval level, then the fourth set of instructions approves the second set of estimate data,

wherein if the second set of estimate data and the rules-based intelligence score correlates to the intervention level being the desk adjuster level, then the fourth set of instructions transfers the second set of estimate data to a desk adjuster for a desk review and the fourth set of instructions further receives one of an approved estimate data from the desk adjuster or a disapproved estimate data from the desk adjuster, and

wherein if the second set of estimate data and the rules-based intelligence score correlates to the intervention level being the field adjuster level, then the fourth set of instructions transfers the estimate data to a field adjuster for a field review and the fourth set of instructions further receives one of the approved estimate data from the field adjuster or the disapproved estimate data from the field adjuster.

9. The computer storage media of claim 8, wherein the determination of the rules-based intelligence score includes a line-by-line review of the estimate data.

10. The computer storage media of claim 8, wherein the determination of the rules-based intelligence score includes an aggregate review of the estimate data.

11. The computer storage media of claim 8, wherein the estimate data provided to the insurance company comprises a photograph of a vehicle.

12. The computer storage media of claim 8 further including a set of financial instructions defined by the computer readable instructions, the set of financial instructions storing and providing payment status information for the first and second plurality of vehicle work requests assigned to the direct repair vehicle repair shops and the non-referral repair shops.

13. The computer storage media of claim 8 further including a set of performance instructions defined by the computer readable instructions, the set of performance instructions storing and providing a performance metric for the direct repair vehicle repair shops as compared to other vehicle repair facilities working with the insurance company.

14. The computer storage media of claim 13, wherein the performance metric comprises a tier level and a ranking.

15. The computer storage media of claim 8, wherein the first and second set of instructions further provide a timeline indicating a plurality of milestone dates corresponding to a displayed vehicle work request.

16. The computer storage media of claim 8, wherein the first and second set of instructions further provide an interactive calendar through which the direct repair vehicle repair shops and the non-referral repair shops schedule repair of a vehicle corresponding to a displayed vehicle work request.

17. One or more computer storage media storing computer readable instructions that, when executed, provide a vehicle insurance claim management application, the application comprising:

a first set of instructions defined by the computer readable instructions, wherein the first set of instructions translates data between the vehicle insurance claim management application and a first vehicle repair estimating system;

a second set of instructions defined by the computer readable instructions, wherein the second set of instructions translates data between the vehicle insurance claim management application and a second vehicle repair estimating system different from the first vehicle repair estimating system;

a third set of instructions defined by the computer readable instructions, the third set of instructions;

receives a set of assignment data from an insurance company pertaining to a plurality of work requests submitted to a direct repair vehicle repair shop,

transfers the assignment data to a direct repair vehicle repair estimating system,

receives a set of estimate data from the direct repair vehicle repair estimating system,

reviews the estimate data for compliance with a set of contract-based conditions,

transfers the estimate data to an insurance company system to be reviewed for compliance with a set of estimate-based conditions,

receives a set of reinspection data,

reviews the reinspection data, and

updates the estimate data based on the reinspection data; and

a fourth set of instructions defined by the computer readable instructions, the fourth set of instructions;

receives a second set of assignment data that includes a second plurality of work requests submitted to a non-referral vehicle repair shop, wherein the non-referral vehicle repair shop is not included within a pre-approved shop network associated with an insurance company,

receives a second set of estimate data from the non-referral vehicle repair shop,

determines a rules-based intelligence score based on the second set of estimate data, and

determines an intervention level for the second set of estimate data based on the rules-based intelligence score, wherein the intervention level includes an automatic approval level, a desk adjuster level, and a field adjuster level.

18. The computer storage media of claim 17, wherein if the second set of estimate data and the rules-based intelligence score correlates to the intervention level being the automatic approval level, then the fourth set of instructions automatically approves the second set of estimate data.

19. The computer storage media of claim 17, wherein if the second set of estimate data and the rules-based intelligence score correlates to the intervention level being the desk adjuster level, then the fourth set of instructions transfers the second set of estimate data to a desk adjuster for a desk review and the fourth set of instructions further receives one of an approved estimate data from the desk adjuster or a disapproved estimate data from the desk adjuster.

20. The computer storage media of claim 17, wherein if the second set of estimate data and the rules-based intelligence score correlates to the intervention level being the field adjuster level, then the fourth set of instructions transfers the estimate data to a field adjuster for a field review and the fourth set of instructions further receives one of the approved estimate data from the field adjuster or the disapproved estimate data from the field adjuster.