Abstract: A system and method for automated claims data auditing. The system may include a memory device configured to store a plurality of audit questions associated with audit question metadata, to store a plurality tasks associated with task metadata, to store a plurality workflows associated with workflow metadata and to store a plurality surveys associated with survey metadata. The system may include a processor configured to generate an audit template based on at least a subset of the plurality of surveys and the plurality of tasks. The processor may further be configured to generate a copy of the audit template for use in a project. The system may include a receiver configured to receive assignment instructions associated with the project, wherein the assignment instructions assign resources to the project.

Abstract: A system and method for workers' compensated risk analysis. The method comprising transmitting standard workers' compensation questions to a user device, receiving a response to the set of standard workers' compensation, selecting a set of supplemental questions based on the received responses to the set of standard workers' compensation questions and transmitted the set of supplemental questions to the user device, receiving a response to the set of supplemental questions and generating a risk score for workers' compensation insurance based on at least the responses to the standard questions and the supplemental questions.

Abstract: A method and system for converting XML files to and from files in a data format based on hierarchies in real-time. A method for converting from XML to the data format based on hierarchies includes: applying a stylesheet to at least one XML file thereby generating at least one data record in an intermediate format and including information included in the at least one XML file; and, translating the at least one record in the intermediate format to the data format based on hierarchies. A method for converting from a data format based on hierarchies to XML includes: translating at least one record including information stored in the file format based on hierarchies to an intermediate format; and, applying a stylesheet to the at least one record in the intermediate format thereby generating at least one XML file being indicative of the information and suitable for transmission.

Abstract: A system and method are disclosed herein for maintaining an inventory of assets located at an insured property covered under an insurance policy based on data received from IP-addressable devices located at the property. The system includes an inventory database for storing inventory information about assets located at an insured property, a communication interface for receiving registration and operational data associated with an IP-addressable device, and a business logic computer. The business logic computer creates a data structure for storing inventory information about assets located at the insured property in the inventory database for each insured property. The business logic computer determines, for the insured property, the inventory information about the insured property's assets based on registration and operational data received from its IP-addressable devices located at the property.

Abstract: A system and method are disclosed herein to determine an insurance premium discount based on telematics data. The system includes a computer memory and a processor in communication with the computer memory. The computer memory stores data indicative telematics data received from a sensor within a vehicle, including at least one of geo-position information of the vehicle and vehicle kinematics data. The processor is configured to identify safety events and associated safety event locations based on the telematics data. The processor is further configured to display to the driver indications of the safety events on a map display along with indications of safety events associated with other drivers.

Abstract: Systems, methods, apparatus, computer program code and means for rating and pricing insurance policies are provided. In some embodiments, an automated insurance processing platform rates and prices insurance policies by including a territory factor in the calculation of a premium for the policy. Pursuant to some embodiments, the territory factor is calculated by receiving historical loss data, geographical data, and demographic data, analyzing the historical loss data, the geographical data, and the demographic data to identify data having similar claim behaviors. The historical loss data is analyzed to identify at least a frequency and severity of historical loss by coverage type.

Abstract: Systems and methods are disclosed herein for processing data in connection with insurance information submissions. The system may be configured to receive entity data relating to an entity for which insurance coverage is sought, and query an interface of a third-party platform based on the entity data. The system may then be configured to receive third-party platform interface data from the third-party platform, analyze the data to determine a web site address for a web page on the third-party platform relating to the entity, and retrieve third-party platform web site data from the web page on the third-party platform indicative of content related to the entity. The system may be configured to pre-fill insurance forms relating to the entity based on the third-party platform data.

Abstract: A system and method are provided for determining a composition of a service provider network for providing services according to a workers' compensation insurance plan. The system and method acquires claim information, which describes workers' compensation claims and medical service providers, and determines a metric value for each of the medical service providers, adjusts the metric values, assigns scores based on the adjusted metric values, determines an average of the assigned scores, and generates results data based on the assigned scores. The results data indicates, for each of the medical service providers, whether the medical service provider should be included in the service provider network. The service provider metrics include a metric that relates to an amount paid per claim and a percentage of claims that involved lost time.

Abstract: According to some embodiments, first and second schedule patterns are determined. For example, a graphical user interface might be used to indicate the times, days, and/or weeks when information is to be transferred. A first transfer of information may be scheduled between remote devices in accordance with the first schedule pattern, and a second transfer may be scheduled in accordance with the second schedule pattern. Moreover, a third transfer of information between remote devices may be automatically scheduled in accordance with both the first and second schedule patterns.

Abstract: A computer-implemented method for determining payroll related insurance premiums includes receiving at a server computer first payroll data relating to a first employer in a first data format from a first source and second payroll data in a second data format from a second source. At least one of the first source and the second source includes an employer payroll computer system at an employer location. The received data is read and extracted by a utility program at the employer location. The method further includes conditioning the received payroll data into uniform format payroll data; filtering by at least one of the utility program and the server computer the payroll data to remove non-premium related data; applying by inclusion and exclusion rules from a rules engine to determine payroll data items to consider in calculating a payroll-based insurance premium; and calculating payroll-based insurance premiums.

Abstract: This invention relates generally to a computer system and method for integrating insurance policy underwriting. In one aspect it integrates the older legacy insurance policy generating systems to on line systems where users access the system through browsers. The computer system to perform the process of underwriting, rating, quoting, binding, and booking an insurance policy includes browsers, data bases, processors and a dispatcher that parses the information to select an insurance process. Suitable software programs review messages received from users to determine if certain messages are less than a prescribed limit. If a message is greater than the limit, then the message is parsed into a header information and one or more data fields whereby the header information is provided to a legacy processor and to policy generation software for further creation of policy related information and documentation.

Abstract: A method for identifying select ones of insurance records which possess a favorable subrogation potential. The method includes receiving data indicative of a plurality of claims; automatically calculating a base score to identify select ones of the claims which demonstrate at least a given probability of expected subrogation recovery dependently upon the received data; automatically identifying risk factors for each of the select claims; and, automatically scoring each of the select claims dependently upon the base scores and identified risk factors to provide a value indicative of an expected subrogation recovery.

Abstract: Disclosed is a novel insurance product that provides additional reinsurance coverage to mitigate risks associated with catastrophic events which adversely affect property and casualty insurance rates. The reinsurance product contains one or more tiers of protection which allows a purchaser to vary the coverage related to one or more catastrophic events, such as an earthquake, a hurricane, or a flood.

Abstract: A system for administering a variable annuity account includes a processor and a memory in communication with the processor. The processor is adapted to: access from a memory storage device data indicative of actual performance over a time period of a fund within the variable annuity account; access from a memory storage device data indicative of benchmark performance of the fund; compare the actual performance data to the benchmark performance data, and store the result of the comparison in the memory; based on the results of the step of comparing, determine whether to refund to the account an amount; if the amount is to be refunded, access data indicative of the refund amount; access data indicative of the asset value of the account; determine an updated asset value based on the asset value and the amount to be refunded; store the determined updated asset value in a memory storage location; and provide an output signal including data indicative of the change in the asset value of the account.

Abstract: Pursuant to some embodiments, insurance systems, methods and devices are provided which include a data storage device for storing, updating and providing access to loss risk score data. In some embodiments, a request for information associated with a user's location identified by user location data may be received over a communications network. A computer processing system may then be operated to generate a safety score associated with said use location data, the safety score being based on a plurality of loss risk factors associated with the user location data. A response, including the safety score, may then be transmitted to the user over the communications network.

Abstract: A Personal Health Application (PHA) management system stores templates that are used to generate customized PHA documents. The PHA management system receives a request for a PHA document, where the request includes information that describes a new insurance policy or modification of a policy that an insurance consumer is requesting, that indicates the state or other area in which the insurance consumer lives, that indicates the reason that the consumer is requesting the new policy or modification, and/or other information. The PHA management system generates a PHA document based on a stored template and the information included in the request, and the generated PHA document may be provided to the insurance consumer.

Abstract: The computer method for managing performance of a customer service representative comprising: establishing a target performance grade, collecting a set of quantitative data generated as a result of customer contact; collecting a set of qualitative data input characterizing service representative performance; generating a performance grade based on the sets of quantitative and qualitative data; and determining if the target performance grade has been met; and if the performance grade has been met, paying the service representative based upon said successful performance grade and if the performance grade has not been met, then paying displaying a the performance grade.

Abstract: Systems and methods for providing dividends to customers are disclosed. The system includes a database for storing data and a business logic processor for determining a dividend to provide to a customer. The stored data includes eligibility criteria for membership in one of a plurality of group dividend plans, data about customers assigned to the plans, and premium payments associated with the customers. The business logic processor receives eligibility data related to a customer's eligibility for assignment to a group dividend plan. The business logic processor uses the received data to identify a dividend group plan that a customer is eligible to join and assigns the customer to the identified plan. Finally, the business logic processor calculates a dividend to provide to the customer based on the assigned plan.

Abstract: Systems and methods are disclosed herein for collecting and processing auto insurance claim-related data. Initial data is collected from a customer or a third party appraiser via a user interface. The initial data is used to retrieve relevant compliance guideline and policy information, which is used to modify and/or populate fields in the user interface. Collected and/or retrieved information is then stored and/or used to adjust an insurance claim workflow process.

Abstract: An advanced underwriting and risk evaluation system leverages data from utility based metering devices and other IP addressable devices, and machines to provide real time operational and usage data. The data is used by an insurance entity to modify and adjust insurance coverages and premiums in the case of certain usage exceptions and conditions in view of an underlying policy coverage.