System for maintaining an escrow account for reimbursing administrators of payments

Abstract

A loss ledger system to process third party fund requests on a daily basis, track historical requests, process validation on each request, maintain suspense/escrow and loss ledgers, and provide reconciliation assistance for accounting and claims processing departments. Additionally, the loss ledger system provides management reports, interfaces, security, audit and control and data conversion to facilitate minimizing escrowed resources, fraudulent activity and clerical errors.

1 - 10 . (canceled) 
     
     
         11 . A system for maintaining an escrow account associated with a third party administrator or TPA, the system comprising:
 (a) a capture tool that provides a company with an ability to:
 (i) receive, format and compile data files from the TPA; 
 (ii) receive, format and compile data files from a bank holding the escrow account; and 
 (iii) create relational databases interrelating records in the data files by the TPA, the escrow account and claim numbers; and 
   (b) a reconciliation tool that provides the company with an ability to:
 (i) analyze the databases created by the capture tool; and 
 (ii) identify claims that are outstanding against the escrow account in order to insure efficient funding of the escrow account. 
   
     
     
         12 . A system as recited in  claim 11 , further comprising an administration tool, the administration tool providing the company with an ability to coordinate the processing of the capture tool and reconciliation tool as well as generate a report summarizing the outstanding claims. 
     
     
         13 . A system as recited in  claim 12 , wherein the administration tool further provides the company with an ability to generate a report summarizing money reconciled by the reconciliation tool, pending transactions, recoveries, unmatchable funds, funds reconciled outside the system and losses paid to claimants. 
     
     
         14 . A system as recited in  claim 12 , wherein the administration tool further provides the company with an ability to generate a report substantially in real-time including a claim identifier, a policy number and a check payment detail such that the company can verify accuracy of a payment request. 
     
     
         15 . A system as recited in  claim 11 , wherein the reconciliation tool further provides the company with an ability to monitor progress of transactions to confirm funding of the escrow account. 
     
     
         16 . A system as recited in  claim 15 , wherein the reconciliation tool further provides the company with an ability to confirm that the transactions result in funds being sent to the escrow account of the bank. 
     
     
         17 . A system as recited in  claim 16 , wherein the company is part of a holding company system that has a plurality of such companies, each company having respective transactions associated therewith such that the system segregates data related to the plurality of the companies based upon policy data supplied by the TPA. 
     
     
         18 . A system for maintaining an escrow account associated with an insurance third party administrator (TPA), the system comprising:
 a holding company having a plurality of insurance carriers, each insurance carrier having respective transactions associated therewith, the transactions being related to a claim of a respective holder of an insurance policy issued by the insurance carrier,   wherein the holding company includes:   (a) a capture tool that provides the insurance carrier with an ability to:
 (i) receive, format and compile TPA data files from the TPA; 
 (ii) segregate data in the TPA data files related to the plurality of the insurance carriers based upon insurance policy data supplied in the TPA data files by the TPA; 
 (iii) receive, format and compile bank data files from a bank holding the escrow account; and 
 (iv) create relational databases interrelating records in the TPA and bank data files by the TPA, the escrow account and claim numbers; and 
   (b) a reconciliation tool that provides the insurance carriers with an ability to:
 (i) analyze the relational databases created by the capture tool; and 
 (ii) identify claims that are outstanding against the escrow account in order to insure efficient funding of the escrow account, wherein the outstanding claims are identified by a check number, amount, date, and insurance claim number. 
   
     
     
         19 . A system as recited in  claim 18 , wherein the reconciliation tool further provides the insurance carrier with an ability to monitor progress of transactions to confirm funding of the escrow account. 
     
     
         20 . A system as recited in  claim 19 , wherein the reconciliation tool further provides the insurance carrier with an ability to confirm that the transactions result in funds being sent to the escrow account of the bank. 
     
     
         21 . A system as recited in  claim 18 , further comprising an administration tool, the administration tool providing the insurance carrier with an ability to coordinate processing of the capture tool and reconciliation tool as well as generate a report summarizing the outstanding claims. 
     
     
         22 . A system as recited in  claim 21 , wherein the administration tool further provides the insurance carrier with an ability to generate a report summarizing money reconciled by the reconciliation tool, pending transactions, recoveries, unmatchable funds, funds reconciled outside the system, and losses paid to claimants. 
     
     
         23 . A system as recited in  claim 21 , wherein the administration tool further provides the insurance carrier with an ability to generate a report substantially in real-time including a claim identifier, a policy number and a check payment detail such that the insurance carrier can verify accuracy of a payment request. 
     
     
         24 . A system for maintaining an escrow account for an insurance carrier in a network in communication with a bank, a third party administrator (TPA), and the insurance carrier, the system comprising:
 (a) a capture tool computer connected to the network for providing the insurance carrier with an ability to:
 (i) receive funding requests from a TPA client computer of the TPA via the network, each fund request being an electronic record including a claim number, an amount, a check number and a check date; 
 (ii) format and compile TPA data files based on the funding requests; 
 (ii) receive, format and compile bank data files from a bank client computer of the bank holding the escrow account; 
 (iii) create relational databases interrelating records in the TPA and bank data files according to the TPA, the escrow account and claim numbers; and 
 (iv) approve the fund requests based upon the respective claim number, the amount, the check number, and the check date; and 
   (b) a reconciliation tool computer connected to the network for providing the insurance carrier with an ability to:
 (i) analyze the relational databases created by the capture tool computer; and 
 (ii) identify claims that are outstanding against the escrow account in order to insure efficient funding of the escrow account. 
   
     
     
         25 . A system as recited in  claim 24 , wherein the capture tool computer further provides the insurance carrier with an ability to monitor clearance of funds from the escrow account such that a second fund request for a same claim number, amount, check number or date is rejected 
     
     
         26 . A system as recited in  claim 25 , wherein monitoring includes daily tracking of a total of outstanding payments to be made from the escrow account so that a balance of the escrow account is minimized. 
     
     
         27 . A system as recited in  claim 24 , further comprising an administration tool computer connected to the network, the administration tool computer providing the insurance carrier with an ability to coordinate processing of the capture tool computer and reconciliation tool computer as well as generate a report summarizing the outstanding claims. 
     
     
         28 . A system as recited in  claim 27 , wherein the administration tool computer further provides the insurance carrier with an ability to: generate a report summarizing money reconciled by the reconciliation tool, pending transactions, recoveries, unmatchable funds, funds reconciled outside the system and losses paid to claimants; generate a report substantially in real-time including a claim identifier, a policy number and a check payment detail such that the insurance carrier can verify accuracy of a payment request; and monitor progress of transactions to confirm funding of the escrow account. 
     
     
         29 . A system as recited in  claim 27 , wherein the capture tool computer, reconciliation tool computer, and administration tool computer are embodied in a server. 
     
     
         30 . A system as recited in  claim 24 , wherein the reconciliation tool computer further provides the insurance carrier with an ability to confirm that the transactions result in funds being sent to the escrow account of the bank.