Communication of insurance claim data

• US 8,751,270 B1
• Filed: 12/28/2012
• Issued: 06/10/2014
• Est. Priority Date: 10/13/2008
• Status: Active Grant

• Current Assignee: Allstate Insurance Company (Allstate Corporation)
• Original Assignee: Allstate Insurance Company (Allstate Corporation)
• Inventors: Hanson, Randall Martin, Ledder, James A., O'Halloran, Charles Ronald
• Primary Examiner(s): Le, Michelle L
• Application Number:
  US13/729,835
• Time in Patent Office: 529 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. An apparatus comprising:

a processor; and

a vehicle insurance claim management application configured to store computer-readable instructions that, when executed by the processor, perform the following method comprising;

receiving 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,

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

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

determining an intervention level for the 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 estimate data correlates to the intervention level being the automatic approval level, then the processor approves the estimate data,

wherein if the estimate data correlates to the intervention level being the desk adjuster level, then the processor transfers the estimate data to a desk adjuster for a desk review and the processor 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 correlates to the intervention level being the field adjuster level, then the processor transfers the estimate data to a field adjuster for a field review and the processor further receives one of the approved estimate data from the field adjuster or the disapproved estimate data from the field adjuster.

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

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

4. The apparatus of claim 1, wherein the vehicle insurance claim management application further comprises a set of financial instructions defined by the computer readable instructions, the set of financial instructions storing and providing payment status information for the plurality of work requests assigned to the non-referral vehicle repair shop.

5. The apparatus of claim 1, wherein the vehicle insurance claim management 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.

6. The apparatus of claim 5, wherein the performance metric comprises a tier level and a ranking.

7. The apparatus of claim 1, wherein the estimate data provided to the insurance company comprises a photograph of a vehicle.

8. The apparatus of claim 1, wherein the vehicle insurance claim management application further provides a timeline indicating a plurality of milestone dates corresponding to a displayed vehicle work request.

9. An apparatus comprising:

an insurance company data server;

a network configured to interconnect the insurance company data server, a web server, and a client server; and

a vehicle insurance claim management application configured to store computer-readable instructions executable by the insurance company data server, wherein the computer-readable instructions comprise the following;

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

transfers the first set of 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.

10. The apparatus of claim 9, wherein the determination of the rules-based intelligence score includes a line-by-line review of the second set of estimate data and an aggregate review of the second set of estimate data.

11. The apparatus of claim 9, wherein the vehicle insurance claim management application further includes a set of financial instructions defined by the computer readable instructions, the set of financial instructions storing and providing payment status information for the plurality of vehicle work requests assigned to the direct repair vehicle repair shops and the non-referral repair shops.

12. The apparatus of claim 9, wherein the vehicle insurance claim management application further includes 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.

13. The apparatus of claim 12, wherein the performance metric comprises a tier level and a ranking.

14. The apparatus of claim 9, wherein the vehicle insurance claim management application further provides a timeline indicating a plurality of milestone dates corresponding to a displayed vehicle work request.

15. The apparatus of claim 9, wherein the vehicle insurance claim management application further provides 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.

16. An apparatus comprising:

an insurance company data server;

a network configured to interconnect the insurance company data server, a web server, and a client server; and

a vehicle insurance claim management application configured to store computer-readable instructions executable by the insurance company data server, wherein the computer-readable instructions comprise the following;

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;

a second set of instructions defined by the computer readable instructions, the second 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 first set of 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 third set of instructions defined by the computer readable instructions, the third 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.

17. The apparatus of claim 16, wherein the determination of the rules-based intelligence score includes a line-by-line review of the second set of estimate data and an aggregate review of the second set of estimate data.

18. The apparatus of claim 16, 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 third set of instructions approves the second set of estimate data.

19. The apparatus of claim 16, 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 third set of instructions transfers the second set of estimate data to a desk adjuster for a desk review and the third 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 apparatus of claim 16, 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 third set of instructions transfers the estimate data to a field adjuster for a field review and the third set of instructions further receives one of the approved estimate data from the field adjuster or the disapproved estimate data from the field adjuster.