US 8,751,270 B1Granted

Communication of insurance claim data

AssigneeAllstate Insurance Company

InventorsRandall Martin Hanson, James A. Ledder, Charles Ronald O'Halloran

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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.

Claims20

Dependent claims

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.

7 more elements

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.

17 more elements

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.

13 more elements

Dependencies are inferred from the claim text.

Facts

Application: 13/729,835Filed 28 Dec 2012 · continuation
Priority: 13 Oct 2008
Granted: 10 Jun 2014
Term ends: Not estimatedThe source records don’t support an estimate.

Classification6 codes

G06Q 40/08
Finance; Insurance; Tax strategies; Processing of corporate or income taxes: insurance
G06Q 10/10
Administration; Management: office automation; Time management
G06Q 10/20
Administration; Management: administration of product repair or maintenance
G06Q 30/0283
Marketing; Price estimation or determination; Fundraising: price estimation or determination

Family

Application12/250,325Parent of this continuation-in-part · filed 13 Oct 2008
Application13/150,969Parent of this continuation · filed 1 Jun 2011
Application13/601,019Parent of this continuation · filed 31 Aug 2012
US 8,265,963 B1Parent of this continuation
US 8,311,856 B1Parent of this continuation-in-part
Application13/150,969Parent of this continuation-in-part
US 8,527,305 B1Related patent
US 8,751,270 B1This patent

From the US filing history. Foreign family members aren’t listed.

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