Patent Issued for Communication of insurance claim data (USPTO 11861725): Allstate Insurance Company

2024 JAN 22 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Allstate Insurance Company (Northbrook, Illinois, United States) has been issued patent number 11861725, according to news reporting originating out of Alexandria, Virginia, by NewsRx editors.

The patent’s inventors are Hanson, Randall M. (Grayslake, IL, US), Ledder, James A. (Prairie Grove, IL, US), O’halloran, Charles Ronald (Downers Grove, IL, US).

This patent was filed on February 28, 2022 and was published online on January 2, 2024.

From the background information supplied by the inventors, news correspondents obtained the following quote: “Mob Vehicle repair shops and insurance companies can gain efficiencies and improve quality of service by interoperating electronically to exchange data and documents such as repair requests, estimates, photos, authorizations, invoices, and payments. Some claim-handling systems used by insurance companies can support such interoperability with repair shop systems, known as estimating systems.

“An insurer claim-handling system is typically designed to work with a specific brand of estimating system, thus requiring vehicle repair shops to use that brand to interoperate with the insurance company. Different insurance companies may specify or require the use of different estimating systems, which means that vehicle repair shops wanting to interoperate with or perform repairs for two or more insurance companies may have to purchase and maintain two or more estimating systems. The costs of purchasing, using, training, maintaining, and supporting multiple systems are inefficient for any vehicle repair shop and can be prohibitive to smaller vehicle repair shops that would otherwise want to work with multiple insurance companies.”

Supplementing the background information on this patent, NewsRx reporters also obtained the inventors’ summary information for this patent: “The following presents a simplified summary of the invention in order to provide a basic understanding of some aspects of the invention. This summary is not an extensive overview of the invention. It is not intended to identify key or critical elements of the invention or to delineate the scope of the invention. The following summary merely presents some concepts of the invention in a simplified form as a prelude to the more detailed description provided below.

“To overcome limitations in the prior art described above, and to overcome other limitations that will be apparent upon reading and understanding the present specification, the present invention is directed to methods and systems for providing a vehicle insurance claim management application (VICMA) that will improve communication and streamline collaboration between the vehicle repair shop and an insurance company in three general task groups: assignment management (comprising work requests, estimates/photos, and reinspections), financial management, and performance measurement. The invention also provides interoperability with different types of estimating systems.

“Additionally, the present invention is 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.

“A first aspect of the invention provides one or more computer storage media storing computer readable instructions that, when executed, provide a vehicle insurance claim management application (VICMA). The VICMA comprises an adapter module and a non-referral module. The adapter module may be defined by the computer readable instructions. Additionally, the adapter module may translate data between the application and a vehicle repair estimating system. The non-referral module may also be defined by the computer readable instructions. The non-referral module may receive a set of assignment data from an insurance company pertaining to a plurality of work requests submitted to a non-referral vehicle repair shop. The non-referral vehicle repair shop may not be included within a pre-approved shop network associated with the insurance company. Additionally, the non-referral module may receive a set of estimate data from the non-referral vehicle repair shop and determine whether the non-referral repair shop is in a staffed market or a non-staffed market. Further, the non-referral module may determine a rules-based intelligence score based on the estimate data, wherein the rules-based intelligence score is defined as low-range, mid-range, or high-range. The non-referral module may also determine an intervention level for the estimate based on the rules-based intelligence score and whether the non-referral repair shop is in the staffed market or the non-staffed market. The intervention level may include an automatic approval level, a desk adjuster level, and a field adjuster level. Furthermore, if the estimate data has a low-range rules-based intelligence score, the intervention level is the automatic approval level and the non-referral module may approve the estimate data. Additionally, if the estimate data has a mid-range rules-based intelligence score, the intervention level is the desk adjuster level and the non-referral module may transfer the estimate data to a desk adjuster for a desk review and the non-referral module may further receive one of an approved estimate data from the desk adjuster or a disapproved estimate data from the desk adjuster. Also, if the estimate data has a high-range rules-based intelligence score and the non-referral repair shop is in a staffed market, the intervention level is the field adjuster level and the non-referral module may transfer the estimate data to a field adjuster for a field review and the non-referral module may further receive one of the approved estimate data from the field adjuster or the disapproved estimate data from the field adjuster. In addition, when the estimate is not approved, the non-referral module may allow the adjuster to create a “review” or “change” request which may be electronically sent to the non-referral repair shop. The non-referral repair shop may respond electronically to the review request.

“A second aspect of the invention further includes the above described aspect of the VICMA with a financial module that stores, captures, and/or provides payment status information for the vehicle repair claims assigned to the non-referral vehicle repair shop.”

The claims supplied by the inventors are:

“1. An insurance claim system for improved interoperability between an insurance company data server and a vehicle repair shop system of a non-referral vehicle repair shop to efficiently communicate data between an insurer and a non-referral vehicle repair shop, the insurance claim system comprising: the insurance company data server at an insurance company, the insurance company data server comprising at least one first computer processor and a user interface and coupled to a network; and a vehicle insurance claim management application communicatively coupled to the insurance company data server and the vehicle repair shop system of the non-referral vehicle repair shop, the vehicle insurance claim management application configured to execute a specific sequence of steps with the insurance company data server and the vehicle repair shop system to cause the insurance claim system to: receive a work request and assignment data relating to a vehicle from the insurance company data server, translate and change the assignment data into a format accepted by the vehicle repair shop system, wherein the translating includes encrypting the assignment data, provide a real-time update between the vehicle insurance claim management application and the vehicle repair shop system with at least one of the work request or assignment data changes, transmit and communicate the assignment data to the vehicle repair shop system, determine, if the non-referral vehicle repair shop is in a staffed market or a non-staffed market, the staffed market associated with a market in which field adjusters are available and the non-staffed market associated with a market in which no field adjusters are available, determine a time period in which a vehicle repair estimate must be received from the vehicle repair shop system, determine, if the vehicle repair estimate was received before expiration of the time period, responsive, at least in part to, not receiving the vehicle repair estimate before the expiration of the time period and determining the non-referral vehicle repair shop is in the staffed market, assign a field estimate assignment to a field adjuster in the staffed market, and responsive, at least in part, to not receiving the vehicle repair estimate before the expiration of the time period and determining the non-referral vehicle repair shop is in the non-staffed market, contact the non-referral vehicle repair shop.

“2. The insurance claim system of claim 1, wherein the non-referral vehicle repair shop is contacted by the insurance claim system transmitting a reminder to the vehicle repair shop system.

“3. The insurance claim system of claim 1, wherein the vehicle insurance claim management application is further configured to execute a specific sequence of steps with the insurance company data server to cause the insurance claim system to: receive the vehicle repair estimate with estimate data from the vehicle repair shop system of the non-referral vehicle repair shop within the time period; and responsive, at least in part to, receiving the vehicle repair estimate within the time period: translate and change the estimate data into a format accepted by the vehicle insurance claim management application, wherein the translating includes encrypting the estimate data, calculate a rules-based intelligence score based on an analysis and audit of the estimate data, wherein the rules-based intelligence score is related to an identification of anomalies in the estimate data and includes a statistically-based analysis of historical estimate data, determine a 3-tier intervention level for the estimate data based on the rules-based intelligence score by comparing the rules-based intelligence score to one of a low-range, mid-range, or high-range threshold, wherein the 3-tier intervention level is one of a plurality of intervention levels, and wherein the low-range, mid-range, and high-range threshold is determined and adjusted by the vehicle insurance claim management application, and further wherein the low-range, mid-range, and high-range threshold is configurable, provide real-time updates between the vehicle insurance claim management application and the vehicle repair shop system when any information changes, and transmit and communicate, over Internet, to the vehicle insurance claim management application, the real-time updates of any information changes.

“4. The insurance claim system of claim 1, wherein the vehicle insurance claim management application is further configured to execute a specific sequence of steps with the insurance company data server to further cause the insurance claim system to store and provide payment status information for a plurality of work requests assigned to the non-referral vehicle repair shop.

“5. The insurance claim system of claim 1, wherein the vehicle insurance claim management application is further configured to execute a specific sequence of steps with the insurance company data server to further cause the insurance claim system to store and provide 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 insurance claim system of claim 1, wherein the insurance company data server is coupled to a web server through which users interact with the vehicle insurance claim management application and the insurance claim system.

“7. The insurance claim system of claim 6, wherein the web server includes a claim processing system used to store the assignment data for further processing.

“8. The insurance claim system of claim 1, wherein the vehicle insurance claim management application is further configured to execute a specific sequence of steps with the insurance company data server to further cause the insurance claim system to provide a timeline indicating a plurality of milestone dates corresponding to a displayed vehicle work request.

“9. An insurance claim system for improved interoperability between an insurance company data server and a vehicle repair shop system to efficiently communicate data between an insurer and a non-referral vehicle repair shop, the insurance claim system comprising: the insurance company data server at an insurance company comprising at least one first computer processor and a user interface and coupled to a network; and a vehicle insurance claim management application communicatively coupled to the insurance company data server, a first vehicle repair shop system of a direct repair vehicle repair shop, and a second vehicle repair shop system of the non-referral vehicle repair shop, the vehicle insurance claim management application configured to execute a specific sequence of steps with the insurance company data server, the first vehicle repair shop system, and the second vehicle repair shop system to cause the insurance claim system to: receive a first work request including first assignment data relating to a first vehicle from the insurance company data server; translate and change the first assignment data into a format accepted by the vehicle insurance claim management application; provide a real-time update between the vehicle insurance claim management application and the vehicle repair shop system with at least one of the work request or assignment data changes, transfer the translated first assignment data to the first vehicle repair shop system; receive a first vehicle repair estimate with a first estimate data corresponding to the first vehicle from the first vehicle repair shop system; translate and change the first estimate data into a format accepted by the vehicle insurance claim management application; review the translated first estimate data for compliance with contract-based conditions; receive a second work request and second assignment data relating to a second vehicle from the insurance company data server; translate and change the second assignment data into a format accepted by the vehicle insurance claim management application; transfer the translated second assignment data to the second vehicle repair shop system; determine, if the non-referral vehicle repair shop is in a staffed market or a non-staffed market, the staffed market associated with a market in which field adjusters are available and the non-staffed market associated with a market in which no field adjusters are available; determine a time period in which a second vehicle repair estimate with second estimate data corresponding to the second vehicle must be received; determine, if the second vehicle repair estimate was received before an expiration of the time period; responsive, at least in part to, not receiving the second vehicle repair estimate before the expiration of the time period and determining the non-referral vehicle repair shop is in the staffed market, assign a field estimate assignment to a field adjuster in the staffed market and transmit and communicate to the vehicle repair shop system in real-time, through the vehicle insurance claim management application, an updated assignment data corresponding to the assigned field estimate assignment; and responsive, at least in part, to not receiving the second vehicle repair estimate before the expiration of the time period and determining the non-referral vehicle repair shop is in the non-staffed market, contact the non-referral vehicle repair shop.”

There are additional claims. Please visit full patent to read further.

For the URL and additional information on this patent, see: Hanson, Randall M. Communication of insurance claim data. U.S. Patent Number 11861725, filed February 28, 2022, and published online on January 2, 2024. Patent URL (for desktop use only): https://ppubs.uspto.gov/pubwebapp/external.html?q=(11861725)&db=USPAT&type=ids

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