Patent Application Titled “Method Of Providing Personal Engagement In Recovery And Return To Work For Individuals On Disability Insurance” Published Online (USPTO 20220036470): Patent Application

2022 FEB 17 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- According to news reporting originating from Washington, D.C., by NewsRx journalists, a patent application by the inventors Incze, Elizabeth G. (Cumberland Foreside, ME, US); Leach, Paul W. (Miami, FL, US); Nelson, Keith L. (Parkland, FL, US); Phidd, Michael G. (Rockville, MD, US); Williams, Michael J. (Freeport, ME, US), filed on December 16, 2020, was made available online on February 3, 2022.

No assignee for this patent application has been made.

Reporters obtained the following quote from the background information supplied by the inventors: “The disability insurance business is not nimble, and has not substantially changed since the early 1960’s. Traditional benefits require a period of total disability, followed by benefits for two years if you are unable to perform the material duties of your own occupation no matter what your capabilities are for performing some level of productive work. As such, the industry needs to take into account significant improvements in healthcare, proven solutions for accommodating people with disabilities, and flexible workplace schedules including telework.”

In addition to obtaining background information on this patent application, NewsRx editors also obtained the inventors’ summary information for this patent application: “One embodiment provides a system for processing a subscriber reported disability claim from a subscriber of a disability insurance carrier. The reported claim, data including subscriber reported medical conditions data. The system includes an interface configured for receiving the medical conditions data and converting said medical conditions data to first elements of first metadata. The system further includes at least one database configured to receive and store: (i) the first metadata; and (ii) a plurality of second metadata, each of the plurality of second metadata containing second elements representing assigned medical conditions that each of a plurality of claim managers are assigned for handling. The system further includes at least one server for electronically: accessing the first and second metadata; identifying, based on a comparison, at least one second metadata wherein all of the first elements are at least a subset of the second elements, thereby identifying one or more claim managers, of the plurality of claim managers, for handling each of the reported medical conditions; and based on a weighting analysis, assigning responsibility to one of the one or more claim managers for handling the disability claim on behalf of the disability insurance carrier. The server includes a processor and a memory. The processor is configured to execute computer-executable instructions stored in the memory to perform operations of: receiving notification of the medical conditions data being received at the interface; acquiring the first elements of the first metadata of the medical conditions data and the second elements of the second metadata from the database; comparing the first elements of the first metadata of the medical conditions data with the second elements of the second metadata to obtain a list of the one or more claim, managers capable of being assigned responsibility of the disability claim; filtering the list of the one or more claim managers capable of being assigned responsibility of the disability claim by determining which claim managers have capabilities most suitable to process the disability claim; selecting at least one individual claim manager to assign the disability claim from the filtered list of the one or more claim managers capable of being assigned responsibility of the disability claim; and assigning the at least, one individual claim manager as being responsible for the insurance claim by updating the first metadata stored in the database to reflect that the at least one individual claim manager is responsible for the disability claim.

“Another embodiment provides a user interface for configuring a team of claim managers suitable for processing disability claims for a disability insurance carrier. The user interface includes a team configuration interface configured to add one or more claim managers to the team of claim managers or remove the one or more claim managers from the team of claim managers. The user interface also includes a claim manager capability assignment interface configured to specify capabilities of a selected claim manager from the team of claim managers. The user interface also includes a claim assignment data interface configured to specify an amount and type of insurance claims assigned to the selected claim manager from the team of claim managers and the user interface also includes a benefit authority interface configured to specify limitations on a monetary amount in benefits the selected claim manager can approve.

“Yet another embodiment includes a method for processing a disability claim at a disability insurance carrier. The method includes: receiving medical condition data related to the disability claim; converting the medical condition data to first elements of first metadata and storing the first elements of the first metadata in a database; receiving notification of the medical conditions data being received at the interface; acquiring the first elements of the first metadata of the medical conditions data and second elements of second metadata representing previously stored assigned medical conditions that each of a plurality of claim managers are assigned for handling from the database; comparing the first elements of the first metadata of the medical condition data with the second elements of the second metadata to obtain a list of the one or more claim managers capable of being assigned responsibility of the disability claim; filtering the list of the one or more claim managers capable of being assigned responsibility of the disability claim by determining which claim managers have capabilities most suitable to process the disability claim; selecting at least one individual claim manager to assign the disability claim from the filtered list of the one or more claim managers capable of being assigned responsibility of the disability claim; and assigning the at least one individual claim manager as being responsible for the insurance claim by updating the first metadata stored in the database to reflect that the at least one individual claim manager is responsible for the disability claim.”

The claims supplied by the inventors are:

“1. A graphical user interface executed by at least one server for configuring a team of claim managers suitable for processing disability claims for a disability insurance carrier, the user interface comprising: a team configuration interface configured to allow a user to add one or more claim managers to the team of claim managers or remove the one or more claim managers from the team of claim managers; a claim manager capability assignment interface configured to allow a user to specify capabilities of a selected claim manager from the team of claim managers; a claim assignment data interface configured to allow a user to specify an amount and type of insurance claims assigned to the selected claim manager from the team of claim managers; and a benefit authority interface configured to allow a user to specify limitations on a monetary amount in benefits the selected claim manager can approve.

“2. The graphical user interface of claim 1, wherein the team configuration interface, the claim manager capability assignment interface, the claim assignment data interface and the benefit authority interface are only accessible to a supervisory claim manager responsible for managing the team of claim managers.

“3. The graphical user interface of claim 1, wherein the team configuration interface comprises an add button and a remove button, the add button configures the user interface to add, the one or more claim managers to the team of claim managers and the remove button configures the user interface to remove the one or more claim managers from, the team of claim managers.

“4. The graphical user interface of claim 1, wherein the team configuration if displays a number of insurance claims assigned to each claim manager in the team of claim managers.

“5. The graphical user interface of claim 1, wherein the claim manager capability assignment interface comprises a capability type drop down box that specifies a specific capability and a value drop down box that specifies a value of the specific capability.

“6. The graphical user interface of claim 5, wherein the claim manager capability assignment interface comprises an add capability button and a remove selected button, wherein the add capability button configures the claim manager capability assignment interface to add the specific capability selected in the drop down box and the value of the specific capability in the value drop down box as one of the capabilities of the selected claim manager.

“7. The graphical user interface of claim 1, wherein the claim assignment data interface comprises a max claims allowed data entry box and a save max allowed button, wherein a maximum, number of claims the selected claim manager is allowed to be assigned is specified in the max claim allowed data entry box and saved as an attribute of the selected claim manager when the save max allowed button is actuated.

“8. The graphical user interface of claim 1, wherein the claim assignment data interface comprises an unavailable days box that specifies dates the selected claim manager is unavailable to be assigned an insurance claim.

“9. The graphical user interface of claim 1, wherein the benefit authority interface includes a data entry box for entry of the monetary amount and an update capability limits button, and wherein when the updating capability limits button is actuated, the monetary amount entered into the data entry box is stored as a limitation for the monetary amount in benefits the selected claim manager can approve.

“10. The graphical user interface of claim 1, further comprising an assignment process management interface configured to allow a user to specify compare field criteria to be used to develop one or more claim manager assignment rules to be used to assign a specific disability claim to a specific claim manager.

“11. The graphical user interface of claim 10, wherein the assignment process management interface is further configured to allow a user to change the order in which a plurality of the claim manager assignment rules will be processed in order to assign the specific disability claim to the specific claim manager.

“12. The graphical user interface of claim 1, further comprising: an action handler interface configured to allow a user to specify a trigger event for the automatic performance of a claim management actions

“13. A graphical user interface executed by at least one server for automatically selecting individual claim managers to process disability claims, the user interface comprising: an assignment process management interface configured to display one or more claim manager assignment rules to be processed for automatically selecting an individual claim manager to be assigned a specific disability claim; the assignment process management interface further configured to allow a user to specify a compare field criteria to be used to develop an additional claim manager assignment rule, and the assignment process management interface further configured to allow a user to add the additional claim manager assignment rule to the displayed claim manager assignment rules.

“14. The graphical user interface of claim 13, wherein the assignment process management interface is further configured to specify the order in which the displayed claim manager assignment rules will be processed.

“15. The graphical user interface of claim 13, wherein the assignment process management interface is further configured to allow a user to change the order in which the displayed claim manager assignment rules will be processed.

“16. The graphical user interface of claim 13, wherein the assignment process management interface comprises a menu with a plurality of selectable compare field criteria to be used to develop the additional claim manager assignment rule.

“17. The graphical user interface of claim 16, wherein the assignment process management interface is further configured to allow a user to a add or remove selectable compare field criteria.

“18. The graphical user interface of claim 16, wherein at least one of the selectable compare field criteria is based on the availability of claim managers.

“19. The graphical user interface of claim 13, further comprising: a team configuration interface configured to allow a user to add or remove one, or more claim managers to a team of claim managers; and a claim manager capability assignment interface configured to allow a user to specify capabilities of a selected claim manager from the team of claim managers.

“20. The graphical user interface of claim 13, further comprising: a claim assignment data interface configured to allow a user to specify an amount and type of insurance claims assigned to the selected claim manager from a team of claim managers; and a benefit authority interface configured to allow a user to specify limitations on a monetary amount in benefits the selected claim manager can approve.”

For more information, see this patent application: Incze, Elizabeth G.; Leach, Paul W.; Nelson, Keith L.; Phidd, Michael G.; Williams, Michael J. Method Of Providing Personal Engagement In Recovery And Return To Work For Individuals On Disability Insurance. Filed December 16, 2020 and posted February 3, 2022. Patent URL: https://appft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&Sect2=HITOFF&d=PG01&p=1&u=%2Fnetahtml%2FPTO%2Fsrchnum.html&r=1&f=G&l=50&s1=%2220220036470%22.PGNR.&OS=DN/20220036470&RS=DN/20220036470

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