Insurance claims processing

US9299108B2 · kind B2 · utility

Assignee

• Tata Consultancy Services Limited · IN

Inventors

• Frank Diana · Somerville, US
• Kevin Mulcahy · Flemington, US
• Gary Menkin · Palatka, US
• Ajay Bhargava · Round Rock, US
• Ruchi Gupta · Pune, IN
• Tumpa Bhattacharyya · Sherghati, IN

Key dates

• Filing date: Feb 22, 2013
• Grant date: Mar 29, 2016
• Expiry date: Feb 22, 2033

Classification

• Technology area (CPC G): Physics
• CPC primary: G06Q10/10
• WIPO field: IT methods for management
• WIPO sector: Electrical engineering

Abstract

Systems and methods for insurance claims processing in an insurance industry are described. The method comprises combining extracted claims data from one or more data sources to obtain a consolidated claims record and removing noise from text data of the consolidated claims record to obtain a claim dataset. The claims data comprises a plurality of claims. Further, ascertaining one or more suspicion indicators in the plurality of claims based on an analytical technique. Further, assigning a score to each of the plurality of claims based on at least one scoring rule. The score is an indicative of a level of suspicion of a claim. Furthermore, detecting at least one of insurance claims fraud and subrogation potential claims based on the score assigned to each of the plurality of claims.