# US 8,751,270 B1 · Communication of insurance claim data > Agents: this data is available as JSON from the patentgrep API and MCP server — see https://patentgrep.com/llms.txt - Number: US 8,751,270 B1 - Document ID: US8751270B1 - Status: Granted - Kind: B1 - Application number: 13/729,835 - Filed: 2012-12-28 - Granted: 2014-06-10 - Earliest claimed: 2008-10-13 - Assignees: Allstate Insurance Company - Applicants: Allstate Insurance Company - Inventors: Randall Martin Hanson; James A. Ledder; Charles Ronald O'Halloran - Web page: https://patentgrep.com/patent/US8751270B1 ## CPC - G06Q 40/08: Insurance - G06Q 10/10: Office automation; Time management - G06Q 10/20: Administration of product repair or maintenance - G06Q 30/0283: Price estimation or determination - G06Q 10/06: Resources, workflows, human or project management; Enterprise or organisation planning; Enterprise or organisation modelling - G06Q: INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR ## 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 ### Claim 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. ### Claim 2 (depends on 1) The apparatus of claim 1, wherein the determination of the rules-based intelligence score includes a line-by-line review of the estimate data. ### Claim 3 (depends on 1) The apparatus of claim 1, wherein the determination of the rules-based intelligence score includes an aggregate review of the estimate data. ### Claim 4 (depends on 1) 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. ### Claim 5 (depends on 1) 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. ### Claim 6 (depends on 5) The apparatus of claim 5, wherein the performance metric comprises a tier level and a ranking. ### Claim 7 (depends on 1) The apparatus of claim 1, wherein the estimate data provided to the insurance company comprises a photograph of a vehicle. ### Claim 8 (depends on 1) 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. ### Claim 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. ### Claim 10 (depends on 9) 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. ### Claim 11 (depends on 9) 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. ### Claim 12 (depends on 9) 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. ### Claim 13 (depends on 12) The apparatus of claim 12, wherein the performance metric comprises a tier level and a ranking. ### Claim 14 (depends on 9) 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. ### Claim 15 (depends on 9) 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. ### Claim 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. ### Claim 17 (depends on 16) 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. ### Claim 18 (depends on 16) 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. ### Claim 19 (depends on 16) 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. ### Claim 20 (depends on 16) 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.