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Insurance Abstract
A computer-based insurance claim processing system (500) provides
for the formation and segregated storage of associations (510) that
link various active insurance claims (506) to one another. In addition,
if desired, the associations can comprise additional information
regarding, for example, the nature or type of association and/or
other information as a user may wish to include to inform, control,
or otherwise characterize the association and/or the associated
claims.
Insurance Claims
1. A method for use with a computer-based insurance claim processing
system having a plurality of discrete active insurance claims stored
therein and having a user interface providing discrete access to
selected ones of the plurality of discrete active insurance claims,
the method comprising: providing an association that links at least
a first one of the plurality of discrete active insurance claims
to at least a second one of the plurality of discrete active insurance
claims with respect to at least one selected association criteria;
storing the association separate from storage of information as
corresponds to the discrete active insurance claims; using the association
when presenting the selected ones of the plurality of discrete active
insurance claims to a user via the user interface.
2. The method of claim 1 wherein the association criteria comprises
at least one of: a master/subordinate insurance claim relationship;
a shared casualty event; a primary/excess payment amount; claims
across multiple temporal reporting periods relating to a single
loss event; a shared insured entity.
3. The method of claim 1 wherein providing an association comprises:
providing an association creation opportunity to a user via the
user interface; receiving association creation information from
the user via the user interface; using the association creation
information to form the association.
4. The method of claim 1 wherein storing the association comprises
storing information regarding the association in a relational database
table.
5. The method of claim 1 wherein using the association when presenting
the selected ones of the plurality of discrete active insurance
claims to a user via the user interface comprises presenting information
regarding associated insurance claims in combination with a presently
presented insurance claim.
6. The method of claim 5 wherein presenting information regarding
associated insurance claims in combination with a presently presented
insurance claim further comprises providing a user-assertable link
that leads directly to information regarding one of the associated
insurance claims.
7. The method of claim 5 wherein presenting information regarding
associated insurance claims in combination with a presently presented
insurance claim further comprises displaying information from an
associated master insurance claim as if it formed part of a presently
displayed subordinate insurance claim.
8. The method of claim 1 further comprising: upon determining that
all insurance claims as correspond to a given association have been
deleted, automatically deleting the given association.
9. The method of claim 1 further comprising: receiving from a user
via the user interface supplemental content regarding a specific
active insurance claim; automatically adding the supplemental content
to another specific active insurance claim that is associated with
the specific active insurance claim by the association such that
the supplemental content is available to a user via the user interface
when accessing an associated insurance claim.
10. The method of claim 9 wherein automatically adding the supplemental
content to another specific active insurance claim comprises storing
the supplemental content in common with a discrete active insurance
claim as corresponds to the specific active insurance claim.
11. The method of claim 9 wherein automatically adding the supplemental
content to another specific active insurance claim comprises displaying
at least a portion of the supplemental content in common with discrete
active insurance claim information as corresponds to the specific
active insurance claim.
12. The method of claim 9 wherein the supplemental content comprises
an activity to be accomplished with respect to processing the specific
active insurance claim.
13. The method of claim 9 wherein the supplemental content comprises
a user note regarding the specific active insurance claim.
14. The method of claim 9 wherein the supplemental content comprises
a document.
15. The method of claim 1 wherein providing an association further
comprises providing a characterization regarding a type of association.
16. The method of claim 15 wherein using the association further
comprises presenting the characterization to a user via the user
interface.
17. The method of claim 15 wherein providing a characterization
regarding a type of association further comprises: presenting to
a user via the user interface an opportunity to enter the characterization;
receiving from the user an entered characterization; using the entered
characterization as the characterization.
18. The method of claim 17 wherein presenting to a user via the
user interface an opportunity to enter the characterization further
comprises presenting to the user a plurality of candidate characterizations.
19. The method of claim 1 further comprising: receiving from a
user via the user interface a search request as specifically relates
to the association; providing to the user in response to the search
request information regarding active insurance claims as correspond
to the association.
20. The method of claim 1 wherein the user interface comprises
a browser-based interface.
21. The method of claim 1 wherein: providing an association further
comprises providing additional information in conjunction with that
association; and storing the association further comprises storing
the additional information in conjunction with the association.
22. The method of claim 21 wherein providing additional information
in conjunction with that association further comprises collecting
the additional information from a user upon establishing the association.
23. The method of claim 21 wherein providing additional information
in conjunction with that association further comprises collecting
the additional information from a user with respect to an already
existing association.
24. The method of claim 21 further comprising automatically providing
at least a portion of the additional information to an external
component.
25. The method of claim 1 further comprising using information
contained in the association to influence, at least in part, a manner
by which a given discrete active insurance claim as is linked to
the association is to be processed.
26. The method of claim 1 further comprising using information
contained in the association as input to an automated rules-based
portion of the computer-based insurance claim processing system.
27. The method of claim 1 further comprising: using the association
to identify financial information for each discrete active insurance
claim as is linked to the association; using the financial information
to calculate an aggregate value.
28. The method of claim 1 wherein providing an association that
links at least a first one of the plurality of discrete active insurance
claims to at least a second one of the plurality of discrete active
insurance claims with respect to at least one selected association
criteria comprises automatically providing the association based,
at least in part, on at least one preselected association criteria.
29. An apparatus comprising a computer-based insurance claim processing
system comprising: a memory having discretely stored therein: a
plurality of discrete active insurance claims; at least one association
that links at least a first one of the plurality of discrete active
insurance claims to at least a second one of the plurality of discrete
active insurance claims with respect to at least one selected association
criteria; a user interface; a processor operably coupled to the
memory and to the user interface and being configured and arranged
to use the at least one association when presenting selected ones
of the plurality of discrete active insurance claims to a user via
the user interface.
30. The apparatus of claim 29 wherein the processor further comprises
means for: providing an association creation opportunity to a user
via the user interface; receiving association creation information
from the user via the user interface; using the association creation
information to form a new association that links at least one of
the plurality of discrete active insurance claims to at least one
other ones of the plurality of discrete active insurance claims;
storing the new association in the memory.
31. The apparatus of claim 29 wherein the processor further comprises
means for: receiving from a user via the user interface supplemental
content regarding a specific discrete active insurance claim; automatically
adding the supplemental content to another specific discrete active
insurance claim that is associated with the specific discrete active
insurance claim by the at least one association such that the supplemental
content is available to a user via the user interface when accessing
an associated insurance claim.
32. The apparatus of claim 29 wherein the at least one association
further comprises at least one of: a characterization regarding
a type of association; additional information as corresponds to
the association.
Insurance Description
TECHNICAL FIELD
[0001] This invention relates generally to insurance claims processing
and more particularly to computer-based insurance claim processing
systems.
BACKGROUND
[0002] When an insured party suffers an insured event (i.e., a
loss) the insuring party must typically process a corresponding
active insurance claim. This typically entails the creation of the
claim, assignment of the claim to one or more entities to effect
processing of the claim, a gathering of relevant facts, coverage
analysis, and the making of a claim payment to or on behalf of the
insured party, to name but a few of the more important defining
activities. It is typically in the interests of all concerned that
such processing occur in as rapid a manner as possible, thus rendering
the insured whole with as little delay as possible while also reducing
overhead requirements and corresponding expense for the insuring
party.
[0003] Computer-based insurance claim processing systems exist,
at least in part, to address such needs. Many of these systems serve
to provide centralized control and guidance with respect to initiating
insurance claims, assigning various claims processing tasks, and
effecting payments to the insured. At least some of these systems
go further and provide additional services and capabilities. For
example, it is known to leverage the capability of such a system
to aid in automatically facilitating best practices across a large
number of claims adjusters working tens of thousands of active claims.
[0004] Notwithstanding significant advances provided by computer-based
insurance claim processing systems, some issues yet remain. There
are times, for example, when a given insurance company might wish
to handle a number of claims as a group. Such a need can arise in
response to various circumstances. As one example, it may be helpful
to commonly treat all claims as stem from a common insured event
(such as damage to various parties owing to a single storm). As
a different example, it may be helpful to commonly treat all claims
as relate to a legal proceeding. As a third example, it may be helpful
to commonly treat multiple claims that are related by shared financial
transactions, as when a single large claim is split up into multiple
claims that are to be paid from separate accounts. As a fourth example,
it may be helpful to commonly treat multiple claims that arise from
the same event, but which apply to different financial reporting
periods.
[0005] There are also instances when the claims are not being formally
handled as a group but where some relationship among them is nevertheless
of interest. For example, one might link claims relating to similar
accidents at a similar employer, even if one claim has already been
settled and these claims are not necessarily the same "event"--they
are, however, similar enough that an adjuster would want to look
at the other claims as a valid point of reference.
[0006] Present attempts to address such a need essentially track
pre-computer-based insurance claim processing system solutions;
to establish such a group, the processing entity will annotate each
and every claim to be grouped in some manner to thereby both identify
and establish the group itself. This approach, however, presents
numerous problems. It tends to be labor intensive and prone to error.
Any given solution along these lines tends, ultimately, to be relatively
inflexible in form and practice. This, in turn, often tends to stymie
and/or inhibit use of the capability, thereby leaving the enterprise
in much the same situation as prevailed prior to incorporating such
an approach.
BRIEF DESCRIPTION OF THE DRAWINGS
[0007] The above needs are at least partially met through provision
of the insurance claim association method and apparatus described
in the following detailed description, particularly when studied
in conjunction with the drawings, wherein:
[0008] FIG. 1 comprises a flow diagram as configured in accordance
with various embodiments of the invention;
[0009] FIG. 2 comprises a flow diagram as configured in accordance
with various embodiments of the invention;
[0010] FIG. 3 comprises a flow diagram as configured in accordance
with various embodiments of the invention;
[0011] FIG. 4 comprises an illustrative user interface screen shot
as configured in accordance with various embodiments of the invention;
[0012] FIG. 5 comprises a block diagram as configured in accordance
with various embodiments of the invention; and
[0013] FIG. 6 comprises a data object schematic as configured in
accordance with various embodiments of the invention.
[0014] Skilled artisans will appreciate that elements in the figures
are illustrated for simplicity and clarity and have not necessarily
been drawn to scale. For example, the dimensions and/or relative
positioning of some of the elements in the figures may be exaggerated
relative to other elements to help to improve understanding of various
embodiments of the present invention. Also, common but well-understood
elements that are useful or necessary in a commercially feasible
embodiment are often not depicted in order to facilitate a less
obstructed view of these various embodiments of the present invention.
It will further be appreciated that certain actions and/or steps
may be described or depicted in a particular order of occurrence
while those skilled in the art will understand that such specificity
with respect to sequence is not actually required. It will also
be understood that the terms and expressions used herein have the
ordinary meaning as is accorded to such terms and expressions with
respect to their corresponding respective areas of inquiry and study
except where specific meanings have otherwise been set forth herein.
DETAILED DESCRIPTION
[0015] Generally speaking, these various embodiments are suitable
for deployment in conjunction with a computer-based insurance claim
processing system having a plurality of discrete active insurance
claims stored therein. Such a system will typically comprise a user
interface that provides discrete access to selected discrete active
insurance claims (for example, by providing information constituting
elements of the claim on a display). Pursuant to a general approach
in accordance with these teachings, one provides within that system
an association that links at least a first one of the discrete active
insurance claims to at least a second one of the discrete active
insurance claims with respect to at least one selected association
criteria. That association is stored separately, however, from information
as corresponds to the discrete active insurance claims themselves.
This association is then used when presenting selected ones of the
associated discrete active insurance claims to a user via the user
interface.
[0016] Depending upon the needs and/or wishes of a particular system
developer, providing such an association can comprise an automatic
event (using, for example, preselected association criteria as a
creation and/or specification trigger and/or guide) and/or a user-driven
event. As to the latter, an association creation opportunity can
be provided to a user (via, in a preferred approach, the system's
user interface) and association creation information received from
the user then used to form the association itself.
[0017] The association itself can comprise, for example, a defining
title and/or a characterization regarding a type of association.
The association can also comprise, if desired, additional information.
Such additional information, when available, can be employed in
a wide variety of ways.
[0018] Such an association will support a number of useful opportunities.
Examples include, but are certainly not limited to, using the association
information to influence a manner by which associated claims are
to be processed, using the association information as input to an
automated rules-based portion of the computer-based insurance claim
processing system, using the association information to identify
financial information for associated claims that can then be used,
for example, to calculate corresponding aggregate values representative
of the group of associated claims, and/or using the association
information to facilitate fraud detection and/or for settlement
guidance (for example, by referring to similar claims or past claims
with a same claimant).
[0019] So configured, active insurance claims are readily linked
by one or more associations. Such associations can be defined at
the time of creating a new active insurance claim or at some time
subsequent to the creation of such claims. Association creation
and management becomes relatively intuitive and simple to accomplish.
This, in turn, permits and fosters use of the capability, which
then aids in facilitating overall efficiency and effectiveness.
[0020] These and other benefits may become clearer upon making
a thorough review and study of the following detailed description.
Referring now to the drawings, and in particular to FIG. 1, these
teachings are generally intended for application in conjunction
with a computer-based insurance claim processing system having a
plurality of discrete active insurance claims stored therein and
further preferably having a user interface that facilitates providing
discrete access to selected ones of the plurality of discrete active
insurance claims. Such systems are general understood by those skilled
in the art and, for the sake of brevity, further description regarding
such systems will not be offered here except where otherwise pertinent
to the description of these embodiments.
[0021] A preferred process 100 facilitates provision 101 of an
association that links at least a first one of the plurality of
discrete active insurance claims to at least a second one of the
plurality of discrete active insurance claims with respect to at
least one selected association criteria. This association criteria
can and will vary considerably with the needs, requirements, and
desires of a given system administrator and/or user base. Examples
of association criteria include, but are certainly not limited to:
[0022] a master/subordinate insurance claim relationship;
[0023] a shared casualty event;
[0024] a primary/excess payment amount;
[0025] claims across multiple temporal reporting periods relating
to a single loss event; and
[0026] a shared insured entity;
[0027] to name but a few. If desired, the selected association
criteria can optionally be selected from amongst a plurality of
candidate association criteria 102 as may be provisioned with respect
to a given system. Also if desired, association criteria creation
capability can be provided to permit a given user or administrator
to dynamically define and/or specify new or modified association
criteria on the fly.
[0028] This step of providing an association can comprise an automated
process if desired. A particular association can be automatically
provided based, for example, upon at least one preselected association
criteria. To illustrate, a given system could be configured to automatically
associate all active insurance claims having a loss location within
a given geographic location (such as a given street, shared postal
code, a given sovereignty (such as but not limited to a municipality,
county, state or province, country, or the like), continent, or
the like).
[0029] This step of providing an association can also comprise
a user-driven process if desired. To illustrate, and referring momentarily
to FIG. 2, a given enabling process 200 can provide 201 an association
creation opportunity to a user via a given system user interface
(such as, for example, a browser-based user interface as will be
noted further herein). This process 200 can then support receiving
202 association creation information from the user via that user
interface and using 203 that association creation information to
form a corresponding association.
[0030] Returning again to FIG. 1, regardless of whether one creates
the association using an automated or user-driven process, the association
itself can be comprised of, at a minimum, links to the associated
active insurance claims. When the storage context comprises a relational
database, those links can comprise pointers to the table entries
for those discretely and separately stored active insurance claims.
In the alternative, or in addition to such an approach, the contents
of each individual active insurance claim can be modified to include
a similar pointer back to the association itself. As yet another
alternative, the linking information can be separately defined and
stored separate from both the claims and other association information.
[0031] The association can comprise other information as may be
useful or otherwise desired in a given setting. As one example,
the association can have a name (which name, when provided, will
preferably be at least somewhat descriptive with respect to the
nature of the basis of the association itself).
[0032] As another example, the association can be provided with
a characterization regarding a type of association as applies to
the association. For example, if associations are being used within
the system both for claims related by litigation and claims related
by geographic region, the association type could be used to indicate
which kind of association is being used to associate a given set
of claims. The association type, when accommodated, can be automatically
provided or again can be facilitated via user-based input. As to
the latter, a user can be presented (via, for example, the user
interface) with an opportunity to enter the characterization information
(by, for example, creating the characterization information and/or
by selecting a particular characterization type from a presented
list of available candidate types). Upon receiving an entered characterization
selection from a user, a compliant system can then use that entered
characterization as the characterization for the corresponding association.
[0033] If desired, a given association can also optionally comprise
other information. To illustrate, and referring momentarily to FIG.
3, an optional process 300, subsequent to providing 101 an association
as suggested above, can facilitate the provision 301 of additional
information as corresponds to the provided association. This can
comprise, for example, collecting the additional information from
a user upon (or subsequent to) establishment of the association
itself. The additional information can comprise any of a wide variety
of metric values and/or text entries as may aid a given system operator
with respect to efficient and effective insurance claims management.
This additional information can comprise particular information
regarding certain pertinent specifics pertaining to the association.
A non-exhaustive listing of illustrative examples might include:
[0034] specifics regarding a shared point of factual pertinence
such as, for example, information regarding a particular type of
asbestos as forms the basis of associating the insurance claims;
[0035] specifics regarding a shared legal context (such as a given
lawsuit, regulatory enforcement action, or the like);
[0036] a sequence number as corresponds to the association (counting,
for example, associations created within the system during some
temporal window of interest);
[0037] specifics regarding financial transactions (such as a financial
limit to be applied to payments made against claims within the association);
[0038] accounting or other categorization information to be used
when analyzing data related to the association (such as an accounting
code to be supplied to accounting systems for use in aggregating
payments made against claims within the association);
[0039] temporal information (such as dates of specific events relevant
to claims within the association).
[0040] Upon being so provided, such additional information is preferably
stored 302 in conjunction with the association information and therefore
comprises a part of the association as versus the individual discrete
active insurance claims that are linked to the association. This,
in turn, permits retrieval and/or usage of the additional information
in common and as appropriate during later usage of the association
itself as described below. Other possibilities also exist as will
be understood by those skilled in the art.
[0041] As but one illustrative example, this process 300 can optionally
facilitate the automatic provision 303 of at least a portion of
such additional information to an external component of choice.
For example, presuming an enterprise architecture that integrates
the computer-based insurance claims processing system with a downstream
financials system (such as an accounts payable system or a general
ledger system), certain additional information can be automatically
sent to the financials system to facilitate the appropriate functioning
of the latter. As a simple illustrative example, the additional
information can comprise a code number (relating, for example, the
association to a particular category of loss such as an asbestos
claim). This code number can be automatically provided to a downstream
financials system that associates that code number with payments
and/or other reports to thereby facilitate the ease by which subsequent
tracking can be effected.
[0042] As mentioned above, the user interface can comprise, in
a preferred approach, a browser-based interface. Such interfaces,
though constantly developing and expanding with respect to supported
capabilities and features, comprise a well-understood area of endeavor
and require no further elaboration here regarding their general
construct and nature. Referring momentarily to FIG. 4, however,
an illustrative example of a given browser-based interface 400 will
be provided to present a preferred approach to facilitating the
association creation mechanism described above.
[0043] In this illustrative example, the interface 400 provides
an association creation opportunity in conjunction with a specific
discrete active insurance claim (denoted here as "Claim (235-53-365870)").
In this example, the association creation opportunity permits a
user to enter or edit an association title 401. In this example
the title field 401 comprises a free text field having a limited
number of permissible characters. If desired, of course, other data
entry paradigms as are known in the art or hereafter-developed can
be employed instead. This illustrative embodiment also permits selection
of an association type 402 as described above. In this example,
the association type 402 is selected by a user from a list of candidate
permissible types (using a pop-up submenu of candidate choices (not
shown) to present such options in accordance with well-understood
prior art technique in this regard). If desired, this can comprise
a free text entry field or, as another alternative, a type creation
opportunity can be provided to the user (either as a selectable
option on the page shown or as a nested opportunity in the pop-up
submenu).
[0044] This embodiment further provides a "Description"
field 403 where a user can enter additional information regarding
the association as described above. In this embodiment this additional
information point of entry comprises a free text entry field. This
permits a user to enter essentially any anecdotal information of
interest and value. If desired, of course, preselected entry information
can be provided, either to supplement a free text entry capability
or in lieu thereof.
[0045] In this example, the association creation opportunity is
shown in conjunction with a display that relates, or stems from,
a specific discrete active insurance claim (i.e., "Claim 235-53-365870").
Associations serve, as described above, to associate and link one
discrete claim to another (or to others). This association creation
opportunity therefore also provides a claim association selection
opportunity 404. Only two associated claims (i.e., 235-53-365879
and 235-53-365889) are shown in this example for the sake of clarity
and simplicity, but it will be understood that essentially any number
of associated claims can be so accommodated. This portion of the
interface serves, in this illustrative embodiment, to allow a user
to add additional claims to the association or to remove currently
associated claims from the association. In this embodiment, the
user also has the opportunity to designate one or more active claims
as a "primary" or master claim to thereby reflect a master/subordinate
claim relationship as employed by some insurance companies when
managing their claims processing workload.
[0046] Note that this depiction shows how the association can be
created directly from the view of one of the active claims, thereby
illustrating the ease and convenience of creating and maintaining
associations in this way.
[0047] So configured, a user can readily effect the creation of
a useful and relevant association as per these teachings. Using
a browser-based interface provides further advantage in that such
interfaces are familiar to many users and thereby leverage the cumulative
experience and skill a given user may already possess with respect
to the navigation and usage of such an interface.
[0048] Referring again to FIG. 1, this process 100 then provides
for storing 103 the provided association separately from the storage
of information as corresponds to the discrete active insurance claims.
This separateness can be physical if desired (for example, through
the use of separate discrete memory platforms) but at least comprises
a logical partitioning (where, for example, the claim and association
information may share a common memory platform but are stored in
a logically segregated fashion). Pursuant to one approach such information
is stored in a relational database table in accordance with well-understood
prior art technique.
[0049] Created and stored, the association is then used 104 when
presenting information from and regarding discrete active insurance
claims to a user (preferably via the above-mentioned user interface).
This usage can and will vary with the needs of a given application
setting. Illustrative examples include, but are not limited to,
presenting information regarding one or more associated active insurance
claims in combination with a presently presented insurance claim
(for example, by displaying completion status, assigned appraisers,
proposed settlement payouts, and so forth) and/or by presenting
one or more user-assertable links that lead directly to information
regarding such associated insurance claims (for example, a simple
list of associated claims can be presented when viewing a given
specific claim, and by clicking on one of those listed associated
claims a user can be automatically taken to a detail page providing
in-depth content regarding that linked claim.
[0050] Other possibilities exist as well. For example, these teachings
are applicable in settings where a user provides supplemental content
regarding an active insurance claim that has been associated with
at least one other active insurance claim. To illustrate, and still
referring to FIG. 1, upon receiving 105 supplemental content regarding
a specific active insurance claim from a user (via, for example,
the user interface mentioned above), this process 100 can then further
provide for automatically adding 106 that supplemental content to
another specific active insurance claim that is associated with
the specific active insurance claim by the earlier formed association.
This, in turn, makes the supplemental content available to the user
when accessing that associated insurance claim.
[0051] The supplemental content can and will vary with the needs
and requirements of a given application setting. Illustrative examples
of supplemental content comprise, but are not limited to, specifications
regarding an activity to be accomplished with respect to processing
the corresponding active insurance claim, a user note regarding
the specific active insurance claim, a document or uncompleted form,
and so forth.
[0052] Such supplemental content can be automatically added in
this manner in various ways. For example, by one approach, the supplemental
content can be automatically stored in common with the associated
active insurance claim. So configured, upon recalling that associated
active insurance claim, the supplemental content as originally entered
with respect to the earlier mentioned specific active insurance
claim will be available for display at the same time. By another
approach, if desired, the supplemental information can be retained
in common with the original insurance claim but recalled for displaying
with other associated insurance claim information upon recalling
the latter for display. Those skilled in the art will likely recognize
or be otherwise able to devise other compliant mechanisms and approaches
as well.
[0053] As yet another illustrative example, supplemental information
from an associated master insurance claim can be automatically provided
for display when displaying information regarding an associated
subordinate insurance claim as though the former formed a part of
a presently displayed subordinate insurance claim.
[0054] By one optional approach, this process 100 can also comprise
receiving 107 from a user via the user interface a search request
as specifically relates to the association and the provision 108
of search request information regarding one or more active insurance
claims as correspond to the association (or associations) as comprises
a pertinent response to the search request. As yet another optional
approach, this process 100 can support using 109 such an association
in other ways when facilitating other system processes. For example,
the information contained in an association can be used to influence,
at least in part, a manner by which a given discrete active insurance
claim as is linked to the association is to be processed (for example,
an associated active insurance claim may be subject to a required
special authorization before payments are allowed when that active
insurance claim is associated with a particular identified loss
event).
[0055] As yet another example, information in an association can
be used as input to an automated rules-based portion of the computer-based
insurance claim processing system. And as yet a further example,
association information can be used to identify financial information
for each discrete active insurance claim as is linked to the association,
which financial information is then used to calculate one or more
aggregate values of interest (as may relate to, for example, total
reserves, total aggregate payments, and so forth for the associated
claims).
[0056] As described, these processes are particularly suitable
for use when supporting the processing active insurance claims.
The point of processing a given claim, of course, is to eventually
achieve closure of the claim as an active matter. If desired, and
again as an optional step, upon detecting 110 that all insurance
claims as correspond to a given association have been deleted (where
"deleted" refers generally to concluding, closing, removing,
or otherwise altering a claim's status from active to inactive status)
the given association itself is automatically deleted 111. This
avoids building up an inventory of associations that have outgrown
their specific applicability and value.
[0057] So configured, a large volume of discrete active insurance
claims as are inventoried and managed using a computer-based insurance
claim processing system can be usefully linked to one another via
an association process. The described associations comprise a highly
flexible approach and readily accommodate a wide variety of user
preferences and application paradigms. The creation, usage, and/or
termination of such associations can be highly automated and/or
rendered subject to specific user input and control. These associations
permit relatively simple links to be created between claims while
also readily accommodating a wealth of other kinds of association
information and characterizing data. The resultant associations,
which are readily integratable into many existing systems with little
or no change being required with respect to the underlying active
insurance claim data storage architecture, can be used to greatly
facilitate the ease by which a given user can be provided with access
to helpful and/or critical or controlling information as pertains,
ultimately, to correctly and quickly processing a given active insurance
claim.
[0058] Those skilled in the art will further appreciate that these
teachings facilitate permitting a given active insurance claim to
be a part of multiple associations or none at all. Users are able
to navigate, in a preferred approach, between associated claims
in a convenient and intuitive manner. Furthermore, in a preferred
approach as described, it will be appreciated that a system administrator,
user, or other interested party can readily add or extract information
of various kinds and in various ways as regards the claims themselves
and their linking associations.
[0059] Those skilled in the art will appreciate that the above-described
processes are readily enabled using any of a wide variety of available
and/or readily configured platforms, including partially or wholly
programmable platforms as are known in the art or dedicated purpose
platforms as may be desired for some applications. Referring now
to FIG. 5, an illustrative approach to such a platform will now
be provided. FIG. 5 generally depicts pertinent portions of an apparatus
500 comprising a computer-based insurance claim processing system.
This apparatus 500 includes generally a processor 501 (such as one
or more central or distributed processing platforms) that operably
couples to a user interface 502 (comprising, for example, a user
display 503 and a user input 504 such as a keyboard and cursor control
interface of choice (it will be understood by those skilled in the
art that a typical commercially viable offering will comprise a
large number of user interfaces to accommodate parallel usage by
a large number of users; only one such user interface is shown here
for purposes of clarity and simplicity)) and a memory 505.
[0060] The memory 505 can comprise a single storage platform or
can comprise a distributed memory. Such architectural choices are
well understood in the art and require no additional elaboration
here. In this embodiment, the memory 505 is partitioned, at least
logically, to comprise a plurality of discrete active insurance
claims 506 and a plurality of associations 510 that link various
claims to one another. To illustrate, as depicted, a first association
511 associates a first active insurance claim 507 to a second active
insurance claim 508 via corresponding links 513 and 514. Meantime,
another association (denoted here as being an Nth association 512
to underscore that any number of associations can be accommodated
by these teachings) serves to link the second active insurance claim
508 with other claims including an Nth active insurance claim 509.
Making reference to FIG. 6, these associations 600 can essentially
comprise, in a preferred approach, an association name (i.e., a
title), a characterization type (or types), links to associated
active insurance claims, and such additional information as may
suit the needs of a given application.
[0061] In such an apparatus 500, the processor 501 is preferably
programmed to use such associations as described above when presenting
selected active insurance claims to a user via the user interface
502. This can comprise, for example, providing an association creation
opportunity to a user via the user interface 502, receiving association
creation information from the user via the user interface 502, using
that association creation information to form a new (or modify an
existing) association that links at least one of the stored active
insurance claims to another such claim, and storing that new association
in the memory 505. This can also comprise, for example, receiving
from a user via the user interface 502 supplemental content regarding
a specific discrete active insurance claim, and automatically adding
that supplemental content to another discrete active insurance claim
that is associated with the first by a shared association such that
the supplemental content becomes available to a user when accessing
the another discrete active insurance claim.
[0062] So configured, and referring again to FIG. 5, such an apparatus
500 will readily support the segregated storage of associations
that serve to link various active insurance claims in various ways
to thereby serve various purposes as described above. Again, those
skilled in the art will recognize and understand that other platform
approaches may also be taken with similar benefits to be expected.
[0063] Those skilled in the art will recognize that a wide variety
of modifications, alterations, and combinations can be made with
respect to the above described embodiments without departing from
the spirit and scope of the invention, and that such modifications,
alterations, and combinations are to be viewed as being within the
ambit of the inventive concept.
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