Intelligent methods of inspection for property and casualty insurance claims

• US 10,387,961 B1
• Filed: 03/08/2013
• Issued: 08/20/2019
• Est. Priority Date: 03/08/2013
• Status: Active Grant

• Current Assignee: United Services Automobile Association
• Original Assignee: United Services Automobile Association
• Inventors: Burgess, Cleburne, Amstutz, John H., Limas, Shanna, Lopez, Ramon M.
• Primary Examiner(s): Kanervo, Virpi H
• Application Number:
  US13/791,132
• Time in Patent Office: 2,356 Days
• Field of Search: 705 33, 705 36 R, 705 38
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

Methods and systems for facilitating loss reporting and resolution are described. In some embodiments, a method includes identifying a bounded geographical area affected by a weather event potentially causing property losses to customers of an insurer. The weather event may have an intensity profile in the bounded geographical area. The method further includes generating a customer density profile in the bounded geographical area and predicting resource utilization based on the customer density profile and the weather event intensity profile in the bounded geographical area.

Claims

1. A method comprising:

receiving, via a weather data acquisition module, weather data relating to a weather event potentially causing property losses to customers of an insurer;

in response to receiving the weather data;

activating or deactivating data feeds based on a propensity of the weather event to cause the property losses, and

taking images of one or more insured properties which may incur the property losses prior to the weather event and after the weather event;

identifying, by a processor associated with a computer system, a bounded geographical area affected by the weather event, the weather event having a weather event intensity profile and a weather event duration profile in the bounded geographical area;

generating, by the processor associated with the computer system, a customer density profile in the bounded geographical area, wherein the customer density profile is indicative of locations one or more insured properties in the bounded geographical area;

creating, by the processor associated with the computer system, subsections within the bounded geographical area based on an overlay of the weather event intensity profile, the weather event duration profile, and the customer density profile indicating the one or more insured properties on a map of the bounded geographical area;

assigning a severity code to each of the subsections indicating an estimated level of severity of the property losses based on the images, sensor data from sensors, the weather event intensity profile, the weather event duration profile and the customer density profile, wherein the sensors include the data feeds;

displaying, on a display device associated with an onsite adjustor, a map of the customer density profile and indications of the estimated level of severity of the property losses of each of the insured properties in the customer density profile;

in response to receiving a selection of one or more insured properties for select customers, launching loss reports of the selected one or more insured properties for the select customers on the display device;

automatically opening the loss reports of the selected one or more insured properties for the select customers prior to receiving customer-generated loss reports from the select customers, wherein the automatically opened loss reports are based at least in part on the sensor data from the sensors, loss reports received from other customers and a proximity of the other customers to the select customers;

predicting, using an adaptive model trained from historical weather event profiles and associated loss data, resource utilization for each of the subsections based on the assigned severity code in each of the subsections; and

allocating resources to each of the subsections according to the predicted resource utilization.

2. The method of claim 1, further comprising:

recommending a level and a type of the resources for each of the subsections based on the predicted resource utilization.

3. The method of claim 1, wherein predicting the resource utilization for each of the subsections comprises:

estimating customer needs in each of the subsections based on the customer density level profile and the weather event intensity profile.

4. The method of claim 1, further comprising:

receiving the customer-generated loss reports from one or more of the customers, wherein predicting the resource utilization for each of the subsections is further based on the received customer-generated loss reports.

5. The method of claim 1, further comprising:

acquiring the weather data prior to occurrence of the weather event, wherein the weather event intensity profile is generated from the weather data acquired prior to the occurrence of the weather event.

6. The method of claim 1, wherein automatically opening the loss reports is further based on the weather intensity profiles in locations of the one or more insured properties of the select customers.

7. The method of claim 1, further comprising:

after the weather event, verifying that reported property losses were caused by the weather event using the images taken prior to the weather event.

8. The method of claim 1, further comprising:

receiving the customer-generated loss report for an insured property of one of the customers; and

determining that the customer-generated loss report is fraudulent based on a location of the insured property and the weather intensity profile.

9. The method of claim 1, further comprising:

notifying customers of potential property losses based on locations of the one or more insured properties of the customers in relation to the weather event intensity profile.

10. The method of claim 1, wherein the resources include at least one of the following:

insurance adjustors, hotel rooms, roofing contractors, building materials, and insurer'"'"'s employees.

11. The method of claim 1, wherein the resources include insurance adjustors, and wherein the method further comprises:

assigning subsections or portions of subsections to the insurance adjustors for inspection, wherein inspection includes inspecting insured properties in the subsections or the portion of the subsections according to the predicted resource utilization.

12. The method of claim 1, further comprising:

scheduling the resources to proactively assist potentially affected customers with resolving property losses.

13. The method of claim 12, wherein the resources are preferred providers of the insurer.

14. A system for facilitating claims reporting and resolution comprising:

a database comprising;

weather event data associated with a weather event capable of causing property losses to customers of an insurance provider in a bounded geographical area, and

location data of one or more insured properties of the customers of the insurance provider in the bounded geographical area;

a memory comprising software modules; and

a processor in communication with the memory, the processor operable to execute the software modules, the software modules comprising;

a weather acquisition module configured to;

collect the weather event data,

activate or deactivate data feeds based on a propensity of the weather event to cause the property losses,

generate a weather event intensity profile indicating severity of the weather event in the bounded geographical area and a weather event duration profile indicating a duration of the weather event in the bounded geographical area, and

in response to collecting the weather event data, take images of the one or more insured properties which may incur the property losses prior to the weather event and after the weather event;

a customer density profiler configured to;

generate a customer density profile indicating locations of the one or more insured properties of the customers in the bounded geographical area;

a subsectioning module configured to;

create subsections within the bounded geographical area based on an overlay of the weather event duration profile, the weather event intensity profile and the customer density profile indicating the one or more insured properties on a map of the bounded geographical area;

a resource prediction module configured to;

assign a severity code to each of the subsections indicating an estimated level of severity of the property losses based on the images, sensor data from sensors, the weather event duration profile, the weather event intensity profile, and the customer density profile, wherein the sensors include the data feeds, and

predict, using an adaptive model trained from historical weather event profiles and associated loss data, resource utilization for each of the subsections based on the assigned severity code in each of the subsections; and

a resource allocator configured to;

display, on a display device associated with an onsite adjustor, a map of the customer density profile and indications of the estimated level of severity of the property losses of each of the insured properties in the customer density profile;

in response to selecting of one or more insured properties for select customers, launch loss reports of the selected one or more insured properties for the select customers on the display device;

automatically open the loss reports of the selected one or more insured properties for the select customers prior to receiving customer-generated loss reports from the select customers, wherein the automatically opened loss reports are based at least in part on the sensor data from the sensors, loss reports received from other customers, and a proximity of the other customers to the select customers; and

allocate resources to each of the subsections according to the predicted resource utilization.

15. A non-transitory computer-readable medium having computer-readable instructions for programming a computer, the instructions comprising instructions which, when executed by a processor, perform a following method:

receiving weather data relating to a weather event potentially causing property losses to customers of an insurer;

in response to receiving the weather data;

activating or deactivating data feeds based on a propensity of the weather event to cause the property losses, and

taking images of one or more insured properties which may incur the property losses prior to the weather event and after the weather event;

identifying a bounded geographical area affected by the weather event, the weather event having an intensity profile and a weather event duration profile in the bounded geographical area;

generating a customer density profile in the bounded geographical area, wherein the customer density profile is indicative of locations one or more insured properties in the bounded geographical area;

creating subsections within the bounded geographical area based on an overlay of the weather event intensity profile, the weather event duration profile and the customer density profile indicating the one or more insured properties on a map of the bounded geographical area;

assigning a severity code to each of the subsections indicating an estimated level of severity of the property losses based on the images, sensor data from sensors, the weather event intensity profile, the weather event duration profile, and the customer density profile, wherein the sensors include the data feeds;

displaying, on a display device associated with an onsite adjustor, a map of the customer density profile and indications of the estimated level of severity of the property losses of each of the insured properties in the customer density profile;

in response to receiving a selection of one or more insured properties for select customers, launching loss reports of the selected one or more insured properties for the select customers on the display device;

automatically opening the loss reports of the selected one or more insured properties for the select customers prior to receiving customer-generated loss reports from the select customers, wherein the automatically opened loss reports are based at least in part on the sensor data from the sensors, loss reports received from other customers, and a proximity of the other customers to the select customers;

predicting, using an adaptive model trained from historical weather event profiles and associated loss data, resource utilization for each of the subsections based on the assigned severity code in each of the subsections; and

allocating resources to each of the subsections according to the predicted resource utilization.

16. The non-transitory computer-readable medium of claim 15, wherein the method further comprises:

recommending a level and a type of the resources for each of the subsections based on the predicted resource utilization.

17. The non-transitory computer-readable medium of claim 15, wherein predicting the resource utilization for each of the subsections comprises:

estimating customer needs in each of the subsections based on the customer density profile and the weather event intensity profile.

18. The non-transitory computer-readable medium of claim 15, wherein the method further comprises:

receiving the customer-generated loss reports from one or more of the customers, wherein predicting the resource utilization for each of the subsections is further based on the received customer-generated loss reports.

19. The non-transitory computer-readable medium of claim 15, wherein the method further comprises:

acquiring the weather data prior to occurrence of the weather event, wherein the weather event intensity profile is generated from the weather data acquired prior to the occurrence of the weather event.

20. The non-transitory computer-readable medium of claim 15, wherein automatically opening the loss reports is further based on the weather intensity profiles in locations of the one or more insured properties of the select customers.