COMPUTER NETWORK FOR GENERATING PROPOSED INSURANCE CLAIM SETTLEMENTS AND SUBMITTING THEM TO INSURANCE CARRIERS

• US 20110246244A1
• Filed: 04/01/2011
• Published: 10/06/2011
• Est. Priority Date: 04/06/2010
• Status: Abandoned Application

• Current Assignee: Farmers Insurance Group of Companies
• Original Assignee: Farmers Insurance Group of Companies
• Inventors: O'Rourke, Christopher J.
• Application Number:
  US13/078,169
• Publication Number:
  US 20110246244A1
• Time in Patent Office: Days
• 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 network for generating a proposed insurance claim settlement and submitting it to an insurance carrier, including: (a) a computer system that receives insurance injury information from an operator; (b) a computer system that receives accident information from the operator; (c) a computerized injury evaluation system that then computes: (i) a proposed claim settlement based upon the injury information and the accident information, and (ii) a likelihood of claim settlement based upon the identity of a selected insurance carrier; (d) a computer system that presents the proposed claim settlement and the likelihood of claim settlement to the operator; and (e) a computer system that sends the proposed claim settlement from the computerized injury evaluation system to the selected insurance carrier after receiving an approval from the operator.

Claims

1. A computer network for generating a proposed insurance claim settlement and submitting the proposed insurance claim settlement to an insurance carrier, comprising:

(a) a computer system that receives injury information from an operator through a web-based interface;

(b) a computer system that receives accident information from the operator through a web-based interface;

(c) a computerized injury evaluation system that receives injury information and the accident information and then computes;

(i) a proposed claim settlement amount based upon the injury information and the accident information, and

(ii) (ii) a likelihood of claim settlement for the proposed amount based upon the identity of a selected insurance carrier;

(d) a computer system that presents the proposed claim settlement amount and the likelihood of claim settlement statement to the operator through a web-based interface; and

(e) a computer system that sends a demand for the proposed claim settlement amount from the computerized injury evaluation system to the selected insurance carrier after receiving an approval from the operator.

2. The network of claim 1, wherein the computerized injury evaluation system comprises:

a computer sub-system that determines a proposed financial amount that corresponds to lost earnings;

a computer sub-system that determines a proposed financial amount that corresponds to payment of medical bills; and

a computer sub-system that determines a proposed financial amount that corresponds to pain and suffering damages.

3. The network of claim 2, wherein the computerized injury evaluation system adds together the three financial amounts in claim 2 and presents the total as the proposed claim settlement.

4. The network of claim 1, wherein the person injured in the accident is the operator.

5. The network of claim 1, wherein the similarity of the accident to other accidents is determined by comparing the received accident information to accident information pre-stored in a database.

6. The network of claim 5, wherein the accident information pre-stored in the database is information corresponding to a plurality of different accidents that occurred in the local vicinity of the accident submitted by the operator.

7. The network of claim 5, wherein the accident'"'"'information pre-stored in the database is information corresponding to data compiled by focus groups in the local vicinity of the accident submitted by the operator.

8. The network of claim 1, further comprising:

(f) a computer system that sends either;

(i) a check and a release;

or

(ii) a counter offer,

from the selected insurance carrier to the operator after the selected insurance carrier has reviewed the proposed insurance claim settlement, and after receiving an approval from the selected insurance carrier.

9. The network of claim 1, wherein the computer system that sends the proposed claim settlement from the computerized injury evaluation system to the selected insurance carrier permits the operator to first select the applicable insurance carrier among a plurality of insurance carriers using a web-based interface.

10. The network of claim 1, wherein the likelihood of settlement statement comprises a statement of the percentage of time that the selected insurance carrier has accepted a proposed claim settlement generated by the computer network in the past.

11. The network of claim 1, wherein the computer network simultaneously receives insurance coverage and accident information from a plurality of different operators and computes individual proposed claim settlements and likelihood of claim settlement statements for each of the plurality of different operators.

12. The network of claim 11, wherein the computerized injury evaluation system comprises:

a module for receiving the insurance injury information;

a module for receiving the accident information;

a database for storing both accident information and injury information from a plurality of different accidents; and

an analytical system module that compares the received accident and injury information to accident and insurance information in the database to determine the proposed claim settlement amount.

13. The network of claim 12, wherein the computer injury evaluation system further comprises:

A validation system that flags at least one of;

(i) medical expenses, or

(ii) lost earnings

received from the operator when the information is outside of pre-determined range boundaries.

14. The network of claim 1, wherein the computer system that receives accident information from the operator comprises a system for the operator to submit claim proofs to the selected insurance carrier.

15. The network of claim 14, wherein the claim proofs are at least one of medical bills and wage statements.

16. The network of claim 11, wherein each of the plurality of operators are located at different remote locations, each of the plurality of different insurance carriers are located at different remote locations, and the computerized injury evaluation system is located at a single central location.

17. A method for generating a proposed insurance claim settlement and submitting the proposed insurance claim settlement to an insurance carrier, comprising:

(a) a remote operator sending injury information through a web-based interface to a central computerized injury evaluation system;

(b) the remote operator sending accident information through a web-based interface to the central computerized injury evaluation system;

(c) the remote operator selecting an insurance carrier through the web-based interface;

(d) the central computerized injury evaluation system computing;

(i) a proposed claim settlement amount based upon the insurance injury information and the accident information, and

(ii) a likelihood of claim settlement based upon the identity of the selected insurance carrier;

(e) the central computerized injury evaluation system presenting the proposed claim settlement amount and the likelihood of claim settlement to the operator; and

(f) the remote operator authorizing the central computerized injury evaluation system to submit the proposed claim settlement amount to the selected insurance carrier.

18. The method of claim 17, wherein the central computerized injury evaluation system:

(i) records a financial amount that corresponds to lost earnings;

(ii) records a financial amount that corresponds to payment of medical bills; and

(iii) determines a proposed financial amount that corresponds to pain and suffering damages.

19. The method of claim 18, wherein the proposed financial amount that corresponds to pain and suffering damages is determined as a financial range.

20. The method of claim 18, wherein the central computerized injury evaluation system adds together the three financial amounts in claim 18 and presents the total as the proposed claim settlement amount.

21. The method of claim 17, wherein the central computerized injury evaluation system computes the proposed pain and suffering amount by comparing:

(i) the age of the person injured in the accident to the ages of persons injured in other accidents; and

(ii) the similarity of the impact of the accident to other accidents.

22. The method of claim 21, wherein the central computerized injury evaluation system compares the similarity of the accident to other accidents by comparing the received accident information to accident information pre-stored in a database corresponding to a plurality of different accidents that occurred in the local vicinity of the accident submitted by the operator.

23. The method of claim 22, further comprising:

focus groups in the local vicinity of the operator submitting the accident information that is pre-stored in the database.

24. The method of claim 17, further comprising:

(g) the selected insurance carrier reviewing the proposed insurance claim settlement amount submitted by the remote operator; and

(h) the selected insurance carrier instructing the central computerized injury evaluation system to send the remote operator either;

(i) a check and a release;

or

(ii) a counter offer.

25. The method of claim 17, wherein the computer network simultaneously receives insurance coverage and accident information from a plurality of different operators and computes individual proposed claim settlements and likelihood of claim settlement statements for each of the plurality of different operators.