CHATBOT FOR REVIEWING INSURANCE CLAIMS COMPLAINTS
The following relates generally to AI-based review of insurance claims complaints. In some embodiments, one or more processors: (1) receive, via a chatbot, an insurance claim complaint; (2) categorize, via the chatbot, the insurance claim complaint by determining a category of the insurance claim complaint, the category comprising a tone category or a policy category; (3) build, via the chatbot, a complaint report including information of the insurance claim complaint and an indication of the category; and/or (5) send, via the chatbot, the complaint report to an insurance complaint administrator computing device.
1 . A computer-implemented method for using a chatbot (i) implemented by one or more processors, and (ii) including a generative pre-trained transformer (GPT), and/or long-short-term-memory (LSTM) to analyze complaints, comprising:
determining, via the one or more processors, a website with a complaint;
scraping, via the one or more processors, the complaint from the website;
receiving, using the chatbot, the complaint, wherein the chatbot includes the GPT, and/or the LSTM;
categorizing, using the chatbot, the complaint by determining a category of the complaint, the category comprising a tone category or a policy category;
building, using the chatbot, a complaint report including information of the complaint and an indication of the category; and
sending, using the chatbot, the complaint report to a complaint administrator computing device.
2 . The computer-implemented method of claim 1 , wherein:
the tone category comprises tone subcategories comprising: (i) rudeness of a claims adjuster; (ii) length of time it took a claims adjuster to respond to a customer; and/or (iii) difficulties with an application (app) and/or website; and
the policy category comprises policy subcategories comprising: (i) policy did not cover damage or loss; (ii) deductible was too high; and/or (iii) subsequent increase in policy premium.
3 . The computer-implemented method of claim 1 , wherein:
the receiving the complaint comprises receiving a plurality of complaints including the complaint; and
the complaint report includes a subreport of only tone category complaints, and/or a subreport of only policy category complaints.
4 . The computer-implemented method of claim 1 , wherein:
the receiving the complaint comprises receiving a plurality of complaints including the complaint; and
the complaint report comprises a table including indications of if the complaints are tone category complaints or policy category claims complaints.
5 . The computer-implemented method of claim 1 , wherein:
the receiving the complaint comprises receiving a plurality of complaints including the complaint, and wherein respective complaints of the plurality of complaints include dates and/or times of respective claims of the respective complaints; and
the method further comprises determining a trend in the respective claims based upon the dates and/or times.
6 . The computer-implemented method of claim 5 , wherein the trend comprises an increase or decrease in the respective claims:
in a particular geographic area; and/or
due to a cause of damage, the cause of damage including: hail damage, fire damage, frozen pipe damage, flood damage, and/or wind damage.
7 . The computer-implemented method of claim 1 , further comprising:
determining, using the chatbot, a type of policy associated with the complaint; and
receiving, using the chatbot, from the complaint administrator computing device, a selection of a type of policy;
wherein the building of the complaint report includes building the complaint report to include only complaints with the selected type of policy.
8 . The computer-implemented method of claim 1 , wherein the building of the complaint report includes building the complaint report to include an indication of if a customer of the complaint left a company of the claim.
9 . The computer-implemented method of claim 1 , further comprising training the chatbot with a historical dataset comprising: (i) historical claims complaints, and/or (ii) historical complaint reports.
10 . The computer-implemented method of claim 1 , wherein the information of the complaint includes:
an indication of a type of policy associated with the complaint;
a quotation from correspondence between a customer of the complaint and an employee of a company, wherein the employee of the company is a claims adjustor or an agent;
a summary of the complaint;
dates and/or times of one or more correspondences between the customer and the employee; and/or
imagery data corresponding to the complaint including imagery data of an item of a claim of the complaint.
11 . A computer system for using a chatbot (i) implemented by one or more processors, and (ii) including a generative pre-trained transformer (GPT), and/or long-short-term-memory (LSTM) to analyze complaints, the computer system comprising the one or more processors configured to:
determine a website with a complaint;
scrape the complaint from the website;
receive, using the chatbot, the complaint, wherein the chatbot includes the GPT, and/or the LSTM;
categorize, using the chatbot, the complaint by determining a category of the complaint, the category comprising a tone category or a policy category;
build, using the chatbot, a complaint report including information of the complaint and an indication of the category; and
send, using the chatbot, the complaint report to a complaint administrator computing device.
12 . The computer system of claim 11 , wherein:
the one or more processors are configured to receive the complaint by receiving a plurality of complaints including the complaint; and
the complaint report includes a subreport of only tone category complaints, and/or a subreport of only policy category complaints.
13 . The computer system of claim 11 , wherein the computer system further comprises a display device, and wherein the one or more processors are further configured to display the complaint report on the display device.
14 . The computer system of claim 11 , wherein the chatbot includes the GPT.
15 . The computer system of claim 11 , wherein the chatbot includes the LSTM.
16 . A computer system for using a chatbot (i) implemented by one or more processors, and (ii) including a generative pre-trained transformer (GPT), and/or long-short-term-memory (LSTM) to analyze complaints, the computer system comprising:
the one or more processors; and
one or more memories;
the one or more memories having stored thereon computer-executable instructions that, when executed by the one or more processors, cause the one or more processors to:
determine a website with a complaint;
scrape the complaint from the website;
receive, using a chatbot, the complaint, wherein the chatbot includes the GPT, and/or the LSTM;
categorize, using the chatbot, the complaint by determining a category of the complaint, the category comprising a tone category or a policy category;
build, using the chatbot, a complaint report including information of the complaint and an indication of the category; and
send, using the chatbot, the complaint report to a complaint administrator computing device.
17 . The computer system of claim 16 , wherein the one or more memories having stored thereon computer-executable instructions that, when executed by the one or more processors, cause the one or more processors to receive the complaint by receiving the complaint from a customer computing device.
18 . The computer system of claim 16 , wherein the one or more memories having stored thereon computer-executable instructions that, when executed by the one or more processors, cause the one or more processors to control a display device to display the complaint report.
19 . The computer system of claim 16 , wherein the chatbot includes the GPT.
20 . The computer system of claim 16 , wherein the chatbot includes the LSTM.