Patent Issued for Dynamic location tracking assignment and management of insurance claims (USPTO 11151658): Gigawarp Technologies LLC

2021 NOV 05 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- From Alexandria, Virginia, NewsRx journalists report that a patent by the inventors Cochran, Larry B (San Antonio, TX, US), Cronin, Michael T (San Antonio, TX, US), Scow, Anthony H (San Antonio, TX, US), filed on August 26, 2019, was published online on October 19, 2021.

The patent’s assignee for patent number 11151658 is Gigawarp Technologies LLC (San Antonio, Texas, United States).

News editors obtained the following quote from the background information supplied by the inventors:

“1. Field of the Invention

“The present invention relates to methods and systems of providing technology solutions to manage Property and Casualty (P&C) insurance claim triage, evaluation, assignment and resolution. The field of the invention includes, but is not limited to, property and casualty claims, traditional insurance companies, governmental insurers, self-insured entities and risk pooling organizations, as well as independent adjusting firms and third party claim estimating software/network providers. A preferred embodiment applies an intelligent dynamical real-time telematics-based algorithm to locate and track insurance adjusters and assign insurance claims to them based on a variety of factors including adjuster experience, license status, physical location, and capacity availability. An alternative embodiment relates to providing a market for the direct repair of automobile insurance claims. However, it should be evident to one skilled in the art how the innovations of the present invention, as exemplified by the described embodiments can be applied to other insurance fields.

“2. Description of Related Prior Art

“The insurance claim adjustment market in the United States is a highly competitive and complex business environment typically involving large amounts of money being exchanged in multiple transactions. According to some estimates, over 75 million claims were processed in the US market in 2015. This amounts to over 290,000 claims handled per typical business day. Furthermore, P&C insurance carriers commonly rely on an internal, and often highly inefficient, patchwork of proprietary home-built, vendor-customized, or off-the-shelf software products to manage the claims administration value chain, employing a large number of internal claims management professionals together with over 135,000 external businesses engaged in Third Party Administration and Insurance Claims Adjusting. In the current art, the receiving, reviewing, evaluating, and assigning of these claims is conducted individually in a very labor-intensive process involving human interaction during each processing stage. A 30-second reduction in the claims initiation and/or review process could reduce the costs of administering claims by as much as 1,200 full time workers per year in the claims industry. Handling and coordinating the claims process is a difficult task just to accomplish, much less accomplish efficiently.

“In the current state of the art, the insurance claims process starts with an event that causes a claim to be filed with an insurer. In many cases this can be an event that affects a single home such as damage caused by a fire or plumbing leaks. In some cases an area is hit by a storm or other catastrophic event that can cause multiple claims to be filed across the area. In other cases it is an automobile accident or an on-the-job injury resulting in a worker’s compensation claim. These events can result in thousands of claims from multiple insurance companies that need to be reviewed by a claims adjuster.

“Most insurance carriers and self-insured organizations (“claim managing firms” or “insurers”) use sophisticated software and information systems to help manage their claims. No matter the system used, they require humans to make the decisions to whom each claim is assigned, from the inception of the claim until final settlement or disposition. In many instances, multiple personnel or external vendors will be involved with the claim cycle process.

“Each claim assignment or routing decision, while routine in most cases, can be complicated owing to the dynamic nature of the human resources that are engaged to manage, investigate, or assist with the claim. People are mobile and constantly on the move. They have different skill sets and different licenses or credentials and experience for their specialization. People also have different thresholds of efficiency, whether it is how many claims they can handle in a day, or their operating levels of quality and speed of what they do, which presents decision challenges with respect to optimizing the workforce.

“Managing this dynamic data across the tens of thousands of people that handle claims in the U.S. every day is a major challenge and consumes time which affects customer service. For example, batches of claims are received by claim managing firms and are reviewed by managers. A dedicated manager can take up to 8 minutes to assign a claim to a single adjuster. For a major event involving 70,000 claims, this exercise can stall thousands of parallel activities within the critical path of the claims from being resolved, from dispatch to settlement and completion of repairs. The manager’s job is to assess and assign the claim to an adjuster. Ideally each claim is assigned in a manner to maximize the efficiency of the process. In practice, the time requirements result in inefficient assignment of claims.

“Each individual claim is reviewed by managers and assigned to individual adjusters on an individual or small group basis (5-10 claims). This operation takes considerable management resources to review, map and match an adjuster with the correct skills, licenses, and certifications for the claim. One firm can receive thousands of claims in a single day. When large numbers of claims are received they are generally not analyzed and tend to be distributed sometimes by zip code, and most often they are just matched with adjusters with no logic or regard to efficiently matching the claim with the correct adjuster.

“In the case of automobile damage claims, in the current state of the art, the choice of body shop to accomplish the repairs is done on an ad hoc basis. The insurance claim representative has a list of body shops and generally chooses the shop based on random factors. This results in many inefficacies. Some body shops may be overworked while others are under-utilized. Some body shops may be more economical while others overcharge. Some might have better outcomes with certain types of repairs. As it currently stands in the art, there is no method to effectively balance work, collect and evaluate costs and repair outcomes, and assign repairs in the most cost efficient manner.

“Therefore, there is a long-felt need in the art for an automated system to reliably, objectively, consistently, and efficiently route, assign and manage insurance claims, including automobile repair insurance claims, and taking into account not only adjuster skills, but also real-time physical location as well.”

As a supplement to the background information on this patent, NewsRx correspondents also obtained the inventors’ summary information for this patent: “The innovations of the present invention provide methods and systems to reliably, objectively, consistently, and efficiently assign and manage automobile insurance claims. One component of the disclosed system relates to a cloud-hosted, multi-tenant SaaS (software-as-a-service) application driven by a proprietary user interface and resource module that communicates with an algorithm engine to assess and decide what is the most efficient allocation of claims to the appropriate resources that would include insurance management, insurance claim adjusters, third party specialists such as automobile repair shops, contractors and other workers involved in the insurance claim cycle. For the vast majority of claim managing firms, each time a claim is received, it triggers a series of decisions that must be made and then processed to move the claim along a path from filing to inspection or investigation, to settlement or disposition.

“Preferred embodiments have the disruptive potential to reduce overall P&C industry claims-related expenses and indemnity losses by over $74 billion per annum in the U.S., representing an over 21% cost savings for the industry as a whole while contributing 0.4% to the U.S. Gross Domestic Product. Such cost savings are enabled by the operation of the proposed embodiments to reduce claims handling cycle time, adjuster cost, vehicle driving cost, claims loss severity, claims-related fraud, and erroneous assignment litigation costs.

“Preferred embodiments improve upon prior inventions by incorporating real-time dynamically updated geographic data into the claims assignment process. This results in many efficiencies as adjusters can be assigned claims close to them, minimizing travel time. Additionally, the dynamic nature of the geographic data means that claims are assigned to adjusters as they come in. Accordingly, an adjuster already in a neighborhood can have claims added and removed based on real-time geographic data and as claims are filed.

“After taking first notice of loss (“FNOL”), insurers must examine the loss report, determine what type of skill or expertise is required, where the best person or resource that fits that need is located relative to the location of the loss, and then physically assign the claim to that person or resource to begin the process. Through this process cycle, a single claim can bounce from one resource to the next until it ultimately reaches the right resource, all the while eating up precious time, expense and the patience of the claimant or policyholder. Oftentimes, this results in an ad hoc allocation of repairs with no accounting for efficiencies or prior outcomes.

“By using the present invention in place of human-based processes for assigning and routing claims, the Applicant has realized up to a 25% reduction in overall claim cycle time or 24 hours. Therefore, if the present invention can reduce the life cycle of claims by just 1 hour from the entire 69 million claims processed each year in the US, insurance companies could reduce labor-related claims processing costs by up to $2 billion per year. This is only if it reduces 1 hour from claim life cycle; in actual practice the present invention is likely to reduce it by much more.”

The claims supplied by the inventors are:

“1. An automated system for objectively assigning resources based on real-time, dynamically updated geographic location data to reduce cycle time comprising: a plurality of mobile devices each associated with an available resource; one or more processors; and a computer-readable storage device coupled to the one or more processors and having instructions stored thereon which, when executed by the one or more processors, cause the one or more processors to perform operations comprising: receiving claim data regarding a loss event, the claim data comprising a location of the loss event; receiving, in real-time from each of the mobile devices, geographic location data comprising a current location for each of the mobile devices; providing a first user interface comprising a map comprising the location of the loss event, the current location for each of the mobile devices, and a geographic region delineated by an editable shape around the current location of each mobile device: processing the claim data and geographic location data through a resource matching algorithm to assign a resource from the available resources associated with the mobile devices to the loss event, the location of the loss event within the geographic region of an assigned resource, the resource matching algorithm weighted according to a set of objective criteria, wherein the set of objective criteria comprises weighted values assigned to resource data, each of the claim data, and the geographic location data; and providing a second user-interface allowing a user to input a modification to the set of objective criteria, wherein the modification comprises one or more of the following: assigning resources based on a value assigned to a loss event proportionally weighted to a customer rating of each of the respective resources; assigning resources based on an optimal geographic distance; and assigning resources based on a severity or a priority for the loss event; and providing, to the mobile device associated with the assigned resource, the assignment of the resource to the loss event.

“2. The system of claim 1, wherein the operations comprise: providing, to the mobile device associated with the assigned resource, a location of the loss event and routing information to the location of the loss event.

“3. The system of claim 1, wherein the claim data comprises a longitude and latitude of the loss event, a loss type, a severity of the loss event, a structure value of the loss event, and a number of stories or floors of an affected building.

“4. The system of claim 1, wherein the resource data comprises: an availability of each of the resources, a pending workload for each of the resources, an efficiency rating for each of the resources, a skill rating for each of the resources, licensing information for each of the resources, certifications for each of the resources, and a customer service rating for each of the resources.

“5. The system of claim 1, wherein geographic location data comprises the longitude and the latitude location of each of the mobile devices, wherein each of the mobile devices comprises a Global Positioning System (GPS), and wherein the geographic location data is received from the GPS system for each of the mobile devices.

“6. The system of claim 1, wherein the set of objective criteria further comprises weighted values for a location of the loss event respective to the current location the mobile device, a time to get to a location of the loss event, claim type, qualifications need for the loss event, qualifications of the resource, a pending workload of the resource, and capacity of the resource, and wherein the qualifications of the resource comprise state licenses, availability, or military experience.

“7. The system of claim 1, wherein the set of objective criteria is configured to assign a closest resource with a minimum certifications and skill level appropriate for the loss event.

“8. The system of claim 1, wherein the resource is assigned until a final settlement or disposition of the loss event.

“9. The system of claim 1, wherein the assigned resource is an internal desk adjuster, an internal field adjuster, an external field adjuster, a vendor, or a specialist.

“10. The system of claim 1, wherein the resource matching algorithm assigns a plurality of the resources to the loss event.

“11. The system of claim 1, wherein the operations further comprise: determining a set of efficiency factors based on a plurality of assignments of received loss events to a respective resource selected from a pool of resources; and providing the set of efficiency factors to the user-interface.

“12. The system of claim 1, wherein the claim data is provided by an intake model, and wherein the assignment of the resource to the loss event is provided through a resource model, and wherein the intake model and resource model are independently hosted.

“13. The system of claim 1, wherein the operations further comprise: after providing the assignment of the resource: determining a time in repair (TIR) result for the loss event, and reporting the TER result for the loss event to an insurer.

“14. The system of claim 1, wherein the operations further comprise: determining a forecasting based on the claim data and the assigned resources, wherein the forecasting comprises at least one of the following: a total number of required resources to cover the loss event, revenue generation, an indemnity for a client associated with the loss event, and an expense for the client associated with the loss event.

“15. The system of claim 1, wherein the operations further comprise: determining a status of at least one license or certifications of at least one of the resources; and removing a resource from assignment consideration when the status is determined to be lapsed.

“16. A computer-implemented method for resource assignment, the method being executed by one or more processors and comprising: receiving claim data regarding a loss event, the claim data comprising a location of the loss event; receiving, in real-time from each of the mobile devices, geographic location data comprising a current location for each of the mobile devices; providing a first user interface comprising a map comprising the location of the loss event, the current location for each of the mobile devices, and a geographic region delineated by an editable shape around the current location of each mobile device; processing the claim data and geographic location data through a resource matching algorithm to assign a resource from the available resources associated with the mobile devices to the loss event, the location of the loss event within the geographic region of an assigned resource, the resource matching algorithm weighted according to a set of objective criteria, wherein the set of objective criteria comprises weighted values assigned to resource data, each of the claim data, and the geographic location data; and providing a second user-interface allowing a user to input a modification to the set of objective criteria, wherein the modification comprises one or more of the following: assigning resources based on a value assigned to a loss event proportionally weighted to a customer rating of each of the respective resources; assigning resources based on an optimal geographic distance; and assigning resources based on a severity or a priority for the loss event, and providing, to the mobile device associated with the assigned resource, the assignment of the resource to the loss event.

“17. One or more non-transitory computer-readable storage media coupled to one or more processors and having instructions stored thereon which, when executed by the one or more processors, cause the one or more processors to perform operations comprising: receiving claim data regarding a loss event, the claim data comprising a location of the loss event; receiving, in real-time from each of the mobile devices, geographic location data comprising a current location for each of the mobile devices; providing a first user interface comprising a map comprising the location of the loss event, the current location for each of the mobile devices, and a geographic region delineated by an editable shape around the current location of each mobile device; processing the claim data and geographic location data through a resource matching algorithm to assign a resource from the available resources associated with the mobile devices to the loss event, the location of the loss event within the geographic region of an assigned resource, the resource matching algorithm weighted according to a set of objective criteria, wherein the set of objective criteria comprises weighted values assigned to resource data, each of the claim data, and the geographic location data; and providing a second user-interface allowing a user to input a modification to the set of objective criteria, wherein the modification comprises one or more of the following: assigning resources based on a value assigned to a loss event proportionally weighted to a customer rating of each of the respective resources; assigning resources based on an optimal geographic distance; and assigning resources based on a severity or a priority for the loss event, and providing, to the mobile device associated with the assigned resource, the assignment of the resource to the loss event.”

For additional information on this patent, see: Cochran, Larry B. Dynamic location tracking assignment and management of insurance claims. U.S. Patent Number 11151658, filed August 26, 2019, and published online on October 19, 2021. Patent URL: http://patft.uspto.gov/netacgi/nph-Parser?Sect1=PTO1&Sect2=HITOFF&d=PALL&p=1&u=%2Fnetahtml%2FPTO%2Fsrchnum.htm&r=1&f=G&l=50&s1=11151658.PN.&OS=PN/11151658RS=PN/11151658

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