System and method for processing insurance claims
View Patent ↗Systems consistent with the present invention automatically process data associated with insurance claims to identify insurance claims with subrogation potential. Text from an insurance claim file may be automatically analyzed to extract data that can be quantified to determine whether the claim may have subrogation potential.
1. A computer system for processing an insurance claim, comprising:
a processor; and
a memory storing computer instructions which, when executed by the processor, cause the system to perform a method for processing an insurance claim, the method comprising:
receiving, by a text analyzer, text corresponding to the insurance claim,
automatically separating, by the text analyzer, the text into groups of words, and
analyzing, by the text analyzer, using a specialized insurance dictionary, the groups of words to extract data elements; and
assigning, by a rules engine, a value to each of the data elements, the value reflecting each data element's relevance to claim subrogation potential, and
evaluating, by the rules engine, the values assigned to the data elements to determine whether the insurance claim has subrogation potential.
2. The system of claim 1 , further comprising a separate processor that runs the rules engine.
3. The system of claim 1 , wherein the values are based on historical data about subrogation of insurance claims.
4. The system of claim 1 , wherein the values are based on industry practice regarding subrogation of insurance claims.
5. A system for processing an insurance claim based on different types of documents related to the insurance claim, comprising:
a processor; and
a memory storing computer instructions which, when executed by the processor, cause the system to perform a method for processing an insurance claim, the method comprising:
receiving, by a text analyzer, at least two different types of documents corresponding to the insurance claim, and
automatically processing, by the text analyzer, the text of each document according to its document type, using a specialized insurance dictionary, to extract data elements; and
assigning, by a rules engine, a value to each of the data elements, the value reflecting each data element's relevance to claim subrogation potential, and
evaluating, by the rules engine, the values assigned to the data elements to determine whether the insurance claim has subrogation potential.
6. The system of claim 5 , wherein the document types include at least two of: sentence textual group document, non-sentence textual group document, graphic document, comma separated value document, and tab-delimited text document.
7. The system of claim 5 , wherein one of the documents is a sentence textual group document, and wherein the text analyzer processes the text of the sentence textual group document according to the grammatical roles of words in the sentence textual group document.
8. The system of claim 5 , wherein one of the documents is a non-sentence textual group document, and wherein the text analyzer processes the text of the non-sentence textual group document according to field headings and data in the non-sentence textual group document.