Systems and methods for facilitating the reporting of an injury claim to an insurance company

Abstract

In accordance with one or more embodiments, an apparatus for facilitating insurance claims provides for receiving a medical report from a treating physician, the medical report indicating an evaluation of an injury of an injured worker; determining whether a report of a claim for the injury has previously been received from a medical liaison; and authorizing, prior to a report of the claim by either an employer of the injured worker or the injured worker when a report of the claim has previously been received from the medical liaison, a progression of an investigation of the claim by a claim professional based on the medical report.

What is claimed is: 
     
         1 . An apparatus for processing a workers compensation insurance claim comprising:
 a processing device; and   a memory device in communication with the processing device, the memory device storing instructions that when executed by the processing device result in:
 receiving a medical report from a treating physician, the medical report indicating an evaluation of an injury of an injured worker; 
 determining whether a report of a claim for the injury has previously been received from a medical liaison; and 
 authorizing, prior to a report of the claim by either an employer of the injured worker or the injured worker when a report of the claim has previously been received from the medical liaison, a progression of an investigation of the claim by a claim professional based on the medical report. 
   
     
     
         2 . An apparatus for processing a workers compensation insurance claim comprising:
 a processing device; and   a memory device in communication with the processing device, the memory device storing instructions that when executed by the processing device result in:
 receiving, from a first entity distinct from an employer and an injured worker, an initial report of a workers compensation claim for an injury of the injured worker; 
 receiving, from the first entity, a description of an in-person evaluation of the injured worker; 
 receiving, from a physician distinct from the first entity, a medical report of the injury; and 
 authorizing a finalization of an investigation by a claim professional of the workers compensation claim based on the initial report and the description received from the first entity and the receiving of the medical report. 
   
     
     
         3 . An apparatus for expediting a reporting of workers compensation claims comprising:
 a processing device; and   a memory device in communication with the processing device, the memory device storing instructions that when executed by the processing device result in:
 receiving, in a claim reporting system residing on a computing device and operable to facilitate the reporting of workers compensation insurance claims for an injured worker, information related to a report of a workers compensation claim, the information being provided by an insurance medical liaison,
 the information being indicative of an evaluation, by the medical liaison, of at least one of the work-related injury and the injured worker; 
 
 establishing a record in the claim reporting system for the workers compensation claim based at least in part on the information received from the insurance medical liaison; and
 wherein the record is established faster than without the medical liaison being present. 
 
   
     
     
         4 . An apparatus for facilitating management of a property/casualty insurance claim comprising:
 a processing device; and   a memory device in communication with the processing device, the memory device storing instructions that when executed by the processing device result in:
 receiving, in a claim reporting system residing on a computing device and operable to facilitate the reporting of property/casualty insurance claims for an injured person, information related to a report of an injury claim, the information being provided by an insurance medical liaison located at a location at which the injured person has been evaluated,
 the information being indicative of an evaluation, by the insurance medical liaison, of at least one of the injury and the injured person; and 
 
 establishing a record in the claim reporting system for the injury claim based at least in part on the information received from the insurance medical liaison. 
   
     
     
         5 . The apparatus of  claim 4 , wherein the injured person is one of a first party claimant and a third party claimant. 
     
     
         6 . The apparatus of  claim 4 , wherein the injured person is an injured worker and the injury claim is a workers compensation claim. 
     
     
         7 . The apparatus of  claim 4 , wherein the information indicative of the evaluation comprises at least one observation, made by the insurance medical liaison, about at least one of a part of the injured worker's body claimed to be injured, a demeanor, a mental state, and an anxiety level of the injured worker while at the location. 
     
     
         8 . The apparatus of  claim 4 , wherein the information indicative of the evaluation comprises at least one answer provided by the injured worker during an interview of the injured worker conducted by the insurance medical liaison at the location. 
     
     
         9 . The apparatus of  claim 4 , wherein the information indicative of the evaluation comprises an indication of at least one recommendation provided to the injured worker by a treating medical professional prior to the injured worker leaving the location. 
     
     
         10 . The apparatus of  claim 9 , wherein the at least one recommendation comprises a recommendation for at least one of a treatment regiment, a physician referral, a medication, a therapist referral, a therapy, a prescription, work restrictions, and work release. 
     
     
         11 . The apparatus of  claim 4 , wherein the instructions when executed by the processing device further result in:
 receiving from the insurance medical liaison a description of a conversation initiated by the insurance medical liaison with an employer of the injured worker while the injured worker is at the location.   
     
     
         12 . The apparatus of  claim 4 , wherein the instructions when executed by the processing device further result in:
 determining whether a claim for the work-related injury has previously been reported by at least one of an employer of the injured worker and the injured worker.   
     
     
         13 . The apparatus of  claim 4 , wherein the location is at least one of a medical facility, a work site, a retail facility, and a vehicle. 
     
     
         14 . The apparatus of  claim 4 , wherein the insurance medical liaison comprises at least one of a live nurse and a claim representative. 
     
     
         15 . The apparatus of  claim 4 , wherein the insurance medical liaison comprises a virtual representation of a person. 
     
     
         16 . The apparatus of  claim 4 , wherein the insurance medical liaison comprises software stored on a device located at the location. 
     
     
         17 . The apparatus of  claim 16 , wherein the software is operable to receive information from at least one sensor located at the location, the sensor operable to determine at least one portion of the information. 
     
     
         18 . A non-transitory computer-readable medium storing instructions that when executed by a processing device result in:
 receiving, in a claim reporting system residing on a computing device and operable to facilitate the reporting of property/casualty insurance claims for an injured person, information related to a report of an injury claim, the information being provided by an insurance medical liaison located at a location at which the injured person has been evaluated,   the information being indicative of an evaluation, by the insurance medical liaison, of at least one of the injury and the injured person; and   establishing a record in the claim reporting system for the injury claim based at least in part on the information received from the insurance medical liaison.