Historical insurance transaction system and method

Abstract

The present invention relates to a system and method for conducting historical search transactions that relate directly or indirectly to insurance subrogation and adverse claims. The invention includes a method for the accurate resolution of insurance claims (including claims against self-insureds), and a method for determining the settlement rules applied by an insurer or self-insurer in settling automotive casualty claims.

Description

CROSS REFERENCE[0001]This application claims priority to U.S. Provisional Application No. 60 / 855,851 filed on Oct. 31, 2006, the entire contents of which are incorporated herein by reference, including any references cited therein.FIELD OF THE INVENTION[0002]The present invention relates to the insurance industry and industries that interact with those in the insurance industry. More particularly, the present invention relates to a system and method for conducting historical search transactions that relate directly or indirectly to insurance subrogation and adverse claims.SUMMARY OF THE INVENTION[0003]This invention provides methods for the accurate resolution of insurance claims (including claims against self-insureds).BACKGROUND OF THE INVENTION[0004]According to The Insurance Information Institute, in 1999, operating expenses of the average property and casualty insurer exceeded premiums by over 5%. This indicator has not materially changed in the years since. Inefficiencies and ...

AI Technical Summary

Problems solved by technology

Inefficiencies and unnecessary expenses in the collision repair and automotive parts industries are typically considered to be the main culprits behind this loss.

Historically, insurance companies have been unable to access real-time information on the purchasing practices of collision repair shops; unable to receive more aggressive pricing on parts; and unable to reduce the costs of conducting compliance inspections of repair shop transactions; and unable to confirm availability and quality of parts appearing on repair estimates.

Accordingly, insurance companies simply have not had the information and systems they need to control repair expenditures and claim costs.

Furthermore, without access to real-time information it has been difficult for the insurance companies to control the proliferation of abuse and fraud.

But without control over the repair estimating process and without timely and accurate information on the pricing, quality, and availability of parts before a repair begins, insurance companies lose their leverage.

However, the cost of auditing is substantial, ranging from about $85 to over $1,000 per audit.

However, the high cost of auditing restricts insurance companies from auditing more than about 30% of their claims.

An audit provides “after the fact” value, but it fails to attack the true issue—how the estimate was initially developed.

The inability of insurers to control estimate development and to prevent fraudulent transactions causes the property and casualty insurance industry to overpay on automotive repair claims by $7 billion a year.

The method employed is rarely successful and infrequently used.

A part supplier will sometimes respond to such a request, although infrequently and with limited ability to give a definitive answer to the request.

A request for information does not drive any revenue to the part supplier and in fact takes time away from the personnel that would otherwise be handling calls for orders.

This type of service has had very limited use because of the deficiencies outlined above.

Today's subrogation process results in increased claim cost, increased arbitration hearings, fewer settlements, fewer deductible refunds to insured motorists, and increased premiums to insureds.

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