Claims adjuster allocation
A central claims adjuster control unit associated with an entity may oversee the assignment of claims cases to claims adjusters. The control unit may designate that a threshold number of cases may be assigned to certain claims adjusters. When new claims cases arrive, the control unit may monitor the workload of each of the claims adjusters and the threshold value assigned to any of the claims adjusters before assigning the case to one of the adjusters. If no adjuster is available, the control unit may store the case(s) in a memory until one of the adjusters becomes available. An additional feature of the control unit includes a user interface for modifying information about claims adjusters, including whether or not a threshold value is associated with them, the value of any associated threshold, and the reassignment of cases from one adjuster to another.
1 . A method comprising:
determining, by a processor of a central adjuster control unit, based on one or more factors associated with a zone, a region where a catastrophic event may occur, wherein the determining comprises real-time monitoring of sensor data associated with the region before the catastrophic event occurs;
estimating, by the processor, a number of potential claims in the region should the catastrophic event occur, wherein the estimating comprises compiling and evaluating the sensor data on at least one of wind speed, rainfall, fire speed, water speed, water depth, or earthquake magnitude, wherein the sensor data is measured by one or more physical sensors;
determining, by the processor, a plurality of claims adjusters for handling the number of potential claims in the region should the catastrophic event occur;
storing, by the processor, an identity of each of the plurality of claims adjusters in a memory of the central adjuster control unit;
receiving, by the processor, a plurality of insurance-related claims through a communication network associated with the central adjuster control unit; and
automatically assigning, by the processor, based on one or more assignment rules, a portion of the plurality of insurance-related claims to each of the plurality of claims adjusters, wherein at least one of the one or more assignment rules indicates a threshold number of insurance-related claims available for assignment to each of a portion of the plurality of claims adjusters;
responsive to each of the plurality of claims adjusters being assigned the portion of the plurality of insurance-related claims up to the threshold number of insurance-related claims automatically assigning, by the processor, a remainder of the plurality of insurance-related claims to a capacity entity, wherein the capacity entity comprises a designated memory location within the central adjuster control unit that stores information related to the identity of insurance-related claims awaiting adjuster assignment;
continuously monitoring, by the processor, workloads of the plurality of claims adjusters to detect when a claims adjuster has capacity below the threshold number; and
responsive to a claims adjuster of the plurality of claims adjusters being subsequently determined to have less than the threshold number of insurance-related claims, automatically re-assigning, by the processor, one or more of the insurance-related claims from the capacity entity to the claims adjuster up to the threshold number of insurance-related claims, wherein the automatic re-assigning occurs without manual intervention upon detection of capacity below the threshold number.
2 . The method of claim 1 , wherein the estimating the number of potential claims in the region should the catastrophic event occur is further based on at least one of historical data or the number of customer insurance policies in the region.
3 . The method of claim 1 , further comprising:
automatically assigning, by the processor, the portion of the plurality of insurance-related claims to each of the plurality of claims adjusters based on a role of one or more of the plurality of claims adjusters, wherein at least one of the assigned insurance-related claims does not count towards the threshold number of insurance-related claims available for assignment based on the role of the one or more of the plurality of claims adjusters, wherein the role comprises one of a claim owner role or a claim handler role, and wherein insurance-related claims assigned in the claim handler role do not count toward the threshold number.
4 . The method of claim 1 , further comprising:
reassigning, by the processor, one or more of the plurality of insurance-related claims from
one or more of the plurality of claims adjusters to one or more different entities.
5 . The method of claim 1 , wherein the assigning the plurality of insurance-related claims is on a first-in, first-out (FIFO) basis.
6 . A non-transitory computer-readable storage medium having computer-executable program instructions stored thereon that when executed by a processor of a central adjuster control unit, cause the processor to perform steps comprising:
determining, by the processor, based on one or more factors associated with a zone, a region where a catastrophic event may occur, wherein the determining comprises real-time monitoring of sensor data associated with the region before the catastrophic event occurs;
estimating, by the processor, a number of potential claims in the region should the catastrophic event occur, wherein the estimating comprises compiling and evaluating the sensor data on at least one of wind speed, rainfall, fire speed, water speed, water depth, or earthquake magnitude, wherein the sensor data is measured by one or more physical sensors;
determining, by the processor, a plurality of claims adjusters for handling the number of potential claims in the region should the catastrophic event occur;
storing, by the processor, an identity of each of the plurality of claims adjusters in a memory of the central adjuster control unit;
receiving, by the processor, a plurality of insurance-related claims through a communication network associated with the central adjuster control unit;
continuously monitoring, by the processor, workloads of the plurality of claims adjusters to detect when a claims adjuster has capacity below the threshold number; and
automatically assigning, by the processor, based on one or more assignment rules, a portion of the plurality of insurance-related claims to each of the plurality of claims adjusters, wherein at least one of the one or more assignment rules indicates a threshold number of insurance-related claims available for assignment to each of a portion of the plurality of claims adjusters;
responsive to each of the plurality of claims adjusters being assigned the portion of the plurality of insurance-related claims up to the threshold number of insurance-related claims automatically assigning a remainder of the plurality of insurance-related claims to a capacity entity, wherein the capacity entity comprises a designated memory location within the central adjuster control unit that stores information related to the identity of insurance-related claims awaiting adjuster assignment; and
responsive to a claims adjuster of the plurality of claims adjusters being subsequently determined to have less than the threshold number of insurance-related claims, automatically re-assigning one or more of the insurance-related claims from the capacity entity to the claim adjuster up to the threshold number of insurance-related claims, wherein the automatic re-assigning occurs without manual intervention upon detection of capacity below the threshold number.
7 . The computer-readable storage medium of claim 6 , wherein the estimating the number of potential claims in the region should the catastrophic event occur is further based on at least one of historical data or the number of customer insurance policies in the region.
8 . The computer-readable storage medium of claim 6 , wherein the computer-executable program instructions further cause the processor to perform steps comprising:
automatically assigning, by the processor, the portion of the plurality of insurance-related claims to each of the plurality of claims adjusters based on a role of one or more of the plurality of claims adjusters, wherein at least one of the assigned insurance-related claims does not count towards the threshold number of insurance-related claims available for assignment based on the role of the one or more of the plurality of claims adjusters, wherein the role comprises one of a claim owner role or a claim handler role, and wherein insurance-related claims assigned in the claim handler role do not count toward the threshold number.
9 . The computer-readable storage medium of claim 6 , wherein the computer-executable program instructions further cause the processor to perform steps comprising:
reassigning, by the processor, one or more of the plurality of insurance-related claims from one or more of the plurality of claims adjusters to one or more different entities.
10 . The computer-readable storage medium of claim 6 , wherein the assigning the plurality of insurance-related claims is on a first-in, first-out (FIFO) basis.
11 . An apparatus comprising:
a processor of a central adjuster control unit; and
a memory configured to store computer-readable instructions that, when executed by the processor, cause the processor to perform steps comprising:
determining, by the processor, based on one or more factors associated with a zone, a region where a catastrophic event may occur, wherein the determining comprises real-time monitoring of sensor data associated with the region before the catastrophic event occurs;
estimating, by the processor, a number of potential claims in the region should the catastrophic event occur, wherein the estimating comprises compiling and evaluating the sensor data on at least one of wind speed, rainfall, fire speed, water speed, water depth, or earthquake magnitude, wherein the sensor data is measured by one or more physical sensors;
determining, by the processor, a plurality of claims adjusters for handling the number of potential claims in the region should the catastrophic event occur;
storing, by the processor, an identify identity of each of the plurality of claims adjusters in the memory;
receiving, by the processor, a plurality of insurance-related claims through a communication network associated with the central adjuster control unit; and
automatically assigning, by the processor, based on one or more assignment rules, a portion of the plurality of insurance-related claims to each of the plurality of claims adjusters, wherein at least one of the one or more assignment rules indicates a threshold number of insurance-related claims available for assignment to each of a portion of the plurality of claims adjusters;
responsive to each of the plurality of claims adjusters being assigned the portion of the plurality of insurance-related claims up to the threshold number of insurance-related claims, automatically assigning a remainder of the plurality of insurance-related claims to a capacity entity, wherein the capacity entity comprises a designated memory location within the central adjuster control unit that stores information related to the identity of insurance-related claims awaiting adjuster assignment;
continuously monitoring, by the processor, workloads of the plurality of claims adjusters to detect when a claims adjuster has capacity below the threshold number; and
responsive to a claims adjuster of the plurality of claims adjusters being subsequently determined to have less than the threshold number of insurance-related claims, automatically re-assigning one or more of the insurance-related claims from the
capacity entity to the claims adjuster up to the threshold number of insurance-related claims, wherein the automatic re-assigning occurs without manual intervention upon detection of capacity below the threshold number.
12 . The apparatus of claim 11 , wherein the estimating the number of potential claims in the region should the catastrophic event occur is further based on at least one of historical data or the number of customer insurance policies in the region.
13 . The apparatus of claim 11 , wherein the computer-readable instructions, when executed by the processor, further cause the processor to perform steps comprising:
automatically assigning, by the processor, the portion of the plurality of insurance-related claims to each of the plurality of claims adjusters based on a role of one or more of the plurality of claims adjusters, wherein at least one of the assigned insurance-related claims does not count towards the threshold number of insurance-related claims available for assignment based on the role of the one or more of the plurality of claims adjusters, wherein the role comprises one of a claim owner role or a claim handler role, and wherein insurance-related claims assigned in the claim handler role do not count toward the threshold number.
14 . The apparatus of claim 11 , wherein the computer-readable instructions, when executed by the processor, further cause the processor to perform steps comprising:
reassigning, by the processor, one or more of the plurality of insurance-related claims from one or more of the plurality of claims adjusters to one or more different entities.
15 . The apparatus of claim 11 , wherein the assigning the plurality of insurance-related claims is on a first-in, first-out (FIFO) basis.