Computer system for processing of determinate and indeterminate data and associated user interfaces

Abstract

According to some embodiments, data may be received indicative of a plurality of insurance claims. A risk transfer opportunity platform processor may, based on the received data, identify an insurance claim as being associated with a potential risk transfer opportunity. For the identified insurance claim, the risk transfer opportunity platform processor may automatically arrange for a potential risk transfer user interface to be displayed to a claim handler and may receive, via the potential risk transfer user interface, recovery details from the claim handler, including an overall total damage value and a high and low risk transfer value. A summary report may then be automatically generated for a plurality of insurance claims based in part on the recovery details received from the claim handler, and an indication of the summary report may be transmitted.

What is claimed is: 
     
         1 . A computer system, comprising:
 a communication device to receive data indicative of a plurality of insurance claims submitted in connection with insurance policies, the received data including determinate data and indeterminate data;   a computer storage unit, in communication with the communication device, for receiving and storing said data indicative of the plurality of insurance claims;   a risk transfer opportunity platform processor in communication with the storage unit, wherein the processor is configured for:
 based on the received determinate and indeterminate data, automatically determining, employing a computerized predictive model trained on historical claim data including at least monetary information, demographic information, and claim notes, and prior risk transfer results, and further trained subsequently on current claim data and risk transfer results, whether, for a plurality of the insurance claims, there is another party potentially responsible for the insurance claim, the claims for which there is another party potentially responsible for the claim being identified as being associated with a potential risk transfer opportunity, wherein the historical claim data is scrubbed of erroneous values and subjected to data reduction to reduce variables associated with one another, categorizing of raw values to reduce granularity, and data transformations to improve interpretability, model fit or adherence to modeling assumptions prior to training the computerized predictive model; 
 responsive to the determination, proceeding to one of (a) or (b): 
 (a) for the insurance claims for which another party is determined to be potentially responsible:
 automatically arranging for a potential risk transfer user interface to be displayed to a claim handler, and 
 receiving, via the potential risk transfer user interface, recovery details from the claim handler, including an overall total damages value and a risk transfer value; 
 
 (b) for the insurance claims for which no other party is determined to be responsible, identifying the claims for normal insurance claim processing, without automatically arranging for a potential risk transfer user interface to be displayed to a claim handler. 
   
     
     
         2 . The system of  claim 1 , wherein the potential risk transfer interface includes fields for entry of data regarding at least a name of a potentially responsible party, a type of association with the claim of the potentially responsible party, and a liability percentage. 
     
     
         3 . The system of  claim 1 , wherein, for the insurance claims for which another party is determined to be potentially responsible, the system is further configured to automatically generate in the potential risk transfer user interface a pop-up window that displays a set of planned activities including a review of risk transfer activity having a due date, priority, and assigned claim handler, 
     
     
         4 . The system of  claim 1 , wherein the computerized predictive model is further configured to identify potential salvage recovery opportunities, and further comprising a property salvage recovery opportunity platform processor configured to automatically communicate potential salvage recovery opportunities identified by the computerized predictive model to salvage specialists and determine property salvage recovery amounts based on information received from salvage specialists via a graphical user interface. 
     
     
         5 . The system of  claim 1 , wherein, for the insurance claims for which another party is determined to be potentially responsible, the system is further configured for:
 automatically generating a summary report associated with a plurality of insurance claims based in part on the overall total damages value and risk transfer value received from the claim handler, and   transmitting an indication of the summary report.   
     
     
         6 . The system of  claim 1 , wherein the system is adapted to process insurance claims associated with any of: (i) automobile insurance, (ii) homeowners insurance, (iii) property insurance, (iv) general liability insurance, (v) commercial insurance, (vi) personal insurance, and (vii) workers' compensation insurance. 
     
     
         7 . The system of  claim 1 , wherein the risk transfer opportunity platform processor is further configured for:
 automatically transmitting an indication of a recovery amount to at least one of: (i) an email server, (ii) a workflow application, (iii) a report generator, (iv) a calendar application, and (v) a payment facilitation device.   
     
     
         8 . The system of  claim 1 , wherein the computerized predictive model comprises at least one of: (i) a neural network, (ii) a Bayesian network, (iii) a Hidden Markov model, (iv) an expert system, (v) a decision tree, (vii) a collection of decision trees, (viii) a support vector machine, and (ix) weighted factors. 
     
     
         9 . The system of  claim 1 , wherein the determining whether there is another party potentially responsible for the insurance claim is based at least in part on rules associated with transitions between subrogation statuses and a type of insurance associated with the insurance claim. 
     
     
         10 . The system of  claim 1 , wherein the information on which the computerized predictive model is trained further includes medical bill information. 
     
     
         11 . A computer-implemented method, comprising:
 receiving, by a communication device, data indicative of a plurality of insurance claims submitted in connection with insurance policies, the received data including determinate data and indeterminate data;   receiving from the communication device, and storing, by a computer storage unit, said data indicative of the plurality of insurance claims;   based on the received determinate and indeterminate data, automatically determining by a risk transfer opportunity platform processor employing a computerized predictive model trained on historical claim data including at least monetary information, demographic information, and claim notes, and prior risk transfer results, and further trained subsequently on current claim data and risk transfer results, whether, for a plurality of the insurance claims, there is another party potentially responsible for the insurance claim, and the claims for which there is another party potentially responsible for the claim being identified as being associated with a potential risk transfer opportunity;   wherein the historical claim data is scrubbed of erroneous values and subjected to data reduction to reduce variables associated with one another, categorizing of raw values to reduce granularity, and data transformations to improve interpretability, model fit or adherence to modeling assumptions prior to training the computerized predictive model;   responsive to the determination, proceeding to one of (a) or (b):   (a) for the insurance claims identified as being associated with a potential risk transfer opportunity, automatically arranging by the risk transfer opportunity platform processor for a potential risk transfer user interface to be displayed to a claim handler, and   receiving, via the potential risk transfer user interface by the recovery opportunity platform processor, recovery details from the claim handler, including an overall total damages value and a risk transfer value; and   (b) for the insurance claims for which no other party is determined to be responsible, identifying, by the risk transfer opportunity platform processor, the claims for normal insurance claim processing, without automatically arranging for a potential risk transfer user interface to be displayed to a claim handler.   
     
     
         12 . The computer-implemented method of  claim 11 , wherein the potential risk transfer interface includes fields for entry of data regarding at least a name of a potentially responsible party, a type of association with the claim of the potentially responsible party, and a liability percentage. 
     
     
         13 . The computer-implemented method of  claim 11 , further comprising, for the insurance claims identified as being associated with a potential risk transfer opportunity, automatically generating by the risk transfer opportunity processor in the potential risk transfer user interface a pop-up window that displays a set of planned activities including a review of risk transfer activity having a due date, priority, and assigned claim handler. 
     
     
         14 . The computer-implemented method of  claim 11 , further comprising:
 determining, by the risk transfer opportunity platform processor, employing the computerized predictive model, potential salvage recovery opportunities,   receiving, by a property salvage recovery opportunity platform processor, data indicative of the potential salvage recovery opportunities;   automatically communicating, by the property salvage recovery opportunity platform processor, potential salvage recovery opportunities identified by the computerized predictive model to salvage specialists; and   determining, by the property salvage recovery opportunity platform processor, property salvage recovery amounts based on information received from salvage specialists via a graphical user interface.   
     
     
         15 . The computer-implemented method of  claim 11 , further comprising, for the insurance claims identified as being associated with a potential risk transfer opportunity, automatically generating by the risk transfer opportunity platform processor a summary report associated with a plurality of insurance claims based in part on the overall total damages value and the risk transfer value received from the claim handler, and
 transmitting an indication of the summary report.   
     
     
         16 . The computer-implemented method of  claim 11 , wherein the method is adapted to process insurance claims associated with any of: (i) automobile insurance, (ii) homeowners insurance, (iii) property insurance, (iv) general liability insurance, (v) commercial insurance, (vi) personal insurance, and (vii) workers' compensation insurance. 
     
     
         17 . The computer-implemented method of  claim 11 , further comprising:
 automatically transmitting an indication of a recovery amount to at least one of: (i) an email server, (ii) a workflow application, (iii) a report generator, (iv) a calendar application, and (v) a payment facilitation device.   
     
     
         18 . The computer-implemented method of  claim 11 , wherein the computerized predictive model comprises at least one of: (i) a neural network, (ii) a Bayesian network, (iii) a Hidden Markov model, (iv) an expert system, (v) a decision tree, (vii) a collection of decision trees, (viii) a support vector machine, and (ix) weighted factors. 
     
     
         19 . The computer-implemented method of  claim 11 , wherein the determining whether there is another party potentially responsible for the insurance claim is based at least in part on rules associated with transitions between subrogation statuses and a type of insurance associated with the insurance claim. 
     
     
         20 . The computer-implemented method of  claim 11 , wherein the information on which the computerized predictive model is trained further includes medical bill information.