Systems and methods for automated payment processing

• US 8,041,635 B1
• Filed: 02/20/2008
• Issued: 10/18/2011
• Est. Priority Date: 12/05/2007
• Status: Active Grant

• Current Assignee: United Services Automobile Association
• Original Assignee: United Services Automobile Association
• Inventors: Vareed, Zinda R., Garcia, Ana Maria, Diener, Pamela Glimm
• Primary Examiner(s): Dixon; Thomas
• Assistant Examiner(s): Fields; Benjamin S
• Application Number:
  US12/034,020
• Time in Patent Office: 1,336 Days
• Field of Search: 705/39
• US Class Current: 705/39
• CPC Class Codes: G06Q 20/10 specially adapted for electronic funds transfer [EFT] systems; specially adapted for home banking systems
• CPC Class Codes: G06Q 20/102 Bill distribution or payments
• CPC Class Codes: G06Q 20/4037 Remote solvency checks
• CPC Class Codes: G06Q 20/405 Establishing or using transaction specific rules
• CPC Class Codes: G06Q 40/02 Banking, e.g. interest calculation or account maintenance credit or loans G06Q40/03

Abstract

Apparatus and methods to process loss payments are described herein. In one example, an apparatus includes one or more data stores, a rules engine, an audit engine and a payment engine. In another example, the method may include receiving a notice of loss, deriving a payee, processing one or more rules using the information, determining whether an automatic payment can be made and transferring funds if the automatic payment can be made. In a further example, the method may include receiving a notice of loss, the loss having one or more exposures, processing one or more rules for each of the exposures in parallel, determining if an automatic payment can be made for each of the exposures and removing the automatic payment for an exposure if it can not be made while continuing processing payments for the remaining exposures.

Claims

1. An apparatus for providing automated payments having a computing device with a processor and memory for storing computing device executable instructions, the apparatus comprising:

a data store communicatively coupled to the computing device, wherein the data store maintains information related to a loss, wherein the loss is due to an automobile accident, and wherein the loss includes multiple exposures, each exposure representing a discrete portion of the loss that can be processed separately, where each exposure may independently expose an insurance company to liability, and wherein the data store includes at least one of the following;

an incident data store that maintains information related to specifics of the loss;

an insured data store that maintains information about an insured party involved in the loss; and

a policy data store that maintains policy specific information that may modify coverage amounts for the loss;

a rules engine communicatively coupled to the computing device, wherein the rules engine receives information from the data store to derive a context of the loss, and processes a rule related to the loss to derive a payment for an exposure of the multiple exposures of the loss based on the context;

an audit engine communicatively coupled to the computing device, wherein the audit engine provides an audit function to the rules engine including verifying an accuracy of the derived payment of the exposure; and

a payment engine communicatively coupled to the computing device, wherein the payment engine processes the derived payment subject to the audit engine verifying the accuracy of the derived payment, wherein the rules engine periodically determines whether information to derive the payment for the exposure of the multiple exposures of the loss is complete, and when the information to derive the payment for the exposure of the loss is complete, notifies the payment engine to process the derived payment for the exposure, and wherein the rules engine, audit engine, and payment engine operate to process the multiple exposures in parallel.

2. The apparatus of claim 1, further comprising:

a medical claims processor communicatively coupled to the computing device, wherein the medical claims processor provides an audit function related to first party medical losses to the rules engine.

3. The apparatus of claim 1, wherein the payment engine is configured to process the derived payment by issuing money transfer instructions intended to transfer funds to an account of a party related to the loss.

4. The apparatus of claim 1, wherein the rules engine is configured to prefetch information from the one or more data stores.

5. The apparatus of claim 4, wherein the rules engine is configured to retrieve zero-cost data.

6. The apparatus of claim 1, wherein the rules engine is configured to derive a context using the information, the context further used by the rules engine to derive information that is needed for further downstream processing.

7. A machine-readable medium for providing automated payments, comprising instructions, which when executed by a machine, cause the machine to execute the following software modules:

one or more data stores to maintain information related to a loss, wherein the loss is due to an automobile accident, and wherein the loss includes multiple exposures, each exposure representing a discrete portion of the loss that can be processed separately, where each exposure may independently expose an insurance company to liability, and wherein the one or more data stores include at least one of the following;

an incident data store to maintain information related to specifics of the loss;

an insured data store to maintain information about an insured party involved in the loss; and

a policy data store to maintain policy specific information that may modify coverage amounts for the loss;

a rules engine to receive information from the one or more data stores to derive a context of the loss, and to process one or more rules related to the loss to derive a payment for an exposure of the multiple exposures of the loss based on the context;

an audit engine to provide one or more audit functions to the rules engine including verifying an accuracy of the derived payment of the exposure; and

a payment engine to process the derived payment, wherein the rules engine periodically determines whether information to derive the payment for the exposure of the multiple exposures of the loss is complete, and when the information to derive the payment for the exposure of the loss is complete, notifies the payment engine to process the derived payment for the exposure, and wherein the rules engine, audit engine, and payment engine operate to process the multiple exposures in parallel.

8. The machine-readable medium of claim 7, further comprising:

a medical claims processor to provide one or more audit functions related to first party medical losses to the rules engine.

9. The machine-readable medium of claim 7, wherein the payment engine is configured to process the derived payment by issuing money transfer instructions intended to transfer funds to an account of a party related to the loss.

10. The machine-readable medium of claim 7, wherein the rules engine is configured to prefetch information from the one or more data stores.

11. The machine-readable medium of claim 10, wherein the rules engine is configured to retrieve zero-cost data.

12. The machine-readable medium of claim 7, wherein the rules engine is configured to derive a context using the information, the context further used by the rules engine to derive information that is needed for further downstream processing.

13. A system for providing automated payments, the system comprising:

a storage device having instructions contained therein which when executed cause the processor to execute the following software modules;

one or more data stores to maintain information related to a loss, wherein the loss is due to an automobile accident, and wherein the loss includes multiple exposures, each exposure representing a discrete portion of the loss that can be processed separately, where each exposure may independently expose an insurance company to liability, and wherein the one or more data stores include at least one of the following;

an incident data store to maintain information related to specifics of the loss;

an insured data store to maintain information about an insured party involved in the loss; and

a policy data store to maintain policy specific information that may modify coverage amounts for the loss;

a rules engine to receive information from the one or more data stores to derive a context of the loss, and to process one or more rules related to the loss to derive a payment for an exposure of the multiple exposures of the loss based on the context;

an audit engine to provide one or more audit functions to the rules engine including verifying an accuracy of the derived payment of the exposure; and

a payment engine to process the derived payment, wherein the rules engine periodically determines whether information to derive the payment for the exposure of the multiple exposures of the loss is complete, and when the information to derive the payment for the exposure of the loss is complete, notifies the payment engine to process the derived payment for the exposure, and wherein the rules engine, audit engine, and payment engine operate to process the multiple exposures in parallel.

14. The system of claim 13, further comprising:

a medical claims processor to provide one or more audit functions related to first party medical losses to the rules engine.

15. The system of claim 13, wherein the payment engine is configured to process the derived payment by issuing money transfer instructions intended to transfer funds to an account of a party related to the loss.

16. The system of claim 13, wherein the rules engine is configured to prefetch information from the one or more data stores.

17. The system of claim 16, wherein the rules engine is configured to retrieve zero-cost data.

18. The system of claim 13, wherein the rules engine is configured to derive a context using the information, the context further used by the rules engine to derive information that is needed for further downstream processing.