Insurance claim association method and apparatus

• US 8,818,826 B2
• Filed: 04/24/2013
• Issued: 08/26/2014
• 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:
  US13/869,879
• Publication Number:
  US 20130238369A1
• Time in Patent Office: 489 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 use with a computer-based insurance claim processing system having a plurality of discrete active insurance claims stored therein, the method comprising:

receiving, via a user interface of the computer-based insurance claim processing system, a first association criteria from a user;

linking a first subset of the plurality of discrete active insurance claims, stored in a database of the computer-based insurance claim processing system, based on the first association criteria, wherein a first association is linked with the first subset of the plurality of discrete active insurance claims;

storing, in a memory, the first association criteria, wherein the memory is in a separate location from the storage of information that corresponds to the discrete active insurance claims;

storing, in the memory, first additional information relating to the first association criteria, wherein the first additional information characterizes a type of association corresponding to the first association criteria;

receiving, via the user interface of the computer-based insurance claim processing system, a second association criteria from the user;

linking a second subset of the plurality of discrete active insurance claims, stored in the database of the computer-based insurance claim processing system, based on the second association criteria, wherein a second association is linked with the second subset of the plurality of discrete active insurance claims;

storing, in the memory, the second association criteria;

storing, in the memory, second additional information relating to the second association criteria, wherein the second additional information characterizes a type of association corresponding to the second association criteria;

selecting, via the user interface, the first association or the second association; and

presenting to the user, via the user interface, the corresponding subset of discrete active insurance claims associated with the selected association.

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 wherein storing the first association criteria comprises storing information regarding the first association in a relational database table.

4. The method of claim 1 further comprises presenting information regarding associated insurance claims in combination with a presently presented insurance claim, 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.

5. The method of claim 1 further comprises presenting information regarding associated insurance claims in combination with a presently presented insurance claim, 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.

6. The method of claim 1 further comprising:

upon determining that all insurance claims as correspond to a given association have been deleted, automatically deleting the given association.

7. The method of claim 1 further comprising:

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

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 1 further comprising:

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

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,

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 1 further comprising:

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

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,

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 1 further comprising:

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

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,

wherein the supplemental content comprises an activity to be accomplished with respect to processing the specific active insurance claim.

11. The method of claim 1 further comprising:

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

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,

wherein the supplemental content comprises a user note regarding the specific active insurance claim.

12. The method of claim 1 further comprising:

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

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,

wherein the supplemental content comprises a document.

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

14. The method of claim 1 wherein providing an association further comprises providing a characterization regarding a type of association, and wherein using the first association further comprises presenting the characterization to a user via the user interface.

15. The method of claim 1 wherein providing an association further comprises providing a characterization regarding a type of association, wherein using the first association further comprises presenting the characterization to a user via the user interface, and 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; and

using the entered characterization as the characterization.

16. The method of claim 1 wherein providing an association further comprises providing a characterization regarding a type of association, wherein using the first association further comprises presenting the characterization to a user via the user interface, and 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; and

using the entered characterization as the characterization,

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 first association; and

providing to the user in response to the search request information regarding active insurance claims as correspond to the first 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 a first association further comprises providing additional information in conjunction with that association; and

storing the first association further comprises storing the additional information in conjunction with the first association.

20. The method of claim 1 further comprising:

providing a first association further comprises providing additional information in conjunction with that association; and

storing the first association further comprises storing the additional information in conjunction with the first association,

wherein providing additional information in conjunction with that association further comprises collecting the additional information from a user upon establishing the first association.

21. The method of claim 1 further comprising:

providing a first association further comprises providing additional information in conjunction with that association; and

storing the first association further comprises storing the additional information in conjunction with the first association,

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 1 further comprising:

providing additional information in conjunction with the first association criteria;

storing the first association criteria further comprises storing the additional information in conjunction with the first association; and

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 first association to influence, at least in part, a manner by which a given discrete active insurance claim as is linked to the first association is to be processed.

24. The method of claim 1 further comprising:

using information contained in the first 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 first association criteria to identify financial information for each discrete active insurance claim as is linked to the first association criteria; and

using the financial information to calculate an aggregate value.

26. The method of claim 1 wherein the additional information relating to the first 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.

27. 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 processor operably coupled to the memory and to the user interface, wherein the processor is configured to;

receive, via the user interface of the computer-based insurance claim processing system, a first association criteria from a user;

link a first subset of the plurality of discrete active insurance claims, stored in a database of the computer-based insurance claim processing system, based on the first association criteria, wherein a first association is linked with the first subset of the plurality of discrete active insurance claims;

store, in the memory, the first association criteria, wherein the memory is in a separate location from the storage of information that corresponds to the discrete active insurance claims;

store, in the memory, first additional information relating to the first association criteria, wherein the first additional information characterizes a type of association corresponding to the first association criteria;

receive, via the user interface of the computer-based insurance claim processing system, a second association criteria from the user;

link a second subset of the plurality of discrete active insurance claims, stored in the database of the computer-based insurance claim processing system, based on the second association criteria, wherein a second association is linked with the second subset of the plurality of discrete active insurance claims;

store, in the memory, the second association criteria;

store, in the memory, second additional information relating to the second association criteria, wherein the second additional information characterizes a type of association corresponding to the second association criteria;

select, via the user interface, the first association or the second association; and

present to the user, via the user interface, the corresponding subset of discrete active insurance claims associated with the selected association.

28. The apparatus of claim 27 wherein the processor is further configured to:

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

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

29. The apparatus of claim 27 wherein the first 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 27 wherein the additional information relating to the first 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.