Computerized system and method for work management

What is claimed is:

1. A computer implemented method of managing work through a system comprising the steps of:

providing a processing means for processing data related to a work matter, including data stored in a storage means electronically interconnected therewith;

providing a plurality of intelligent terminals each having data storage and retrieval equipment, a display screen and at least one input device, wherein said intelligent terminals are electronically linked to and communicate with said processing means and are capable of accessing, displaying and storing data stored in said interconnected storage means;

providing at least one electronic scanner operably connected with a suitable instrumentality for operating on an output of said electronic scanner which instrumentality may include one of said intelligent terminals;

scanning a plurality of documents, with said electronic scanner, to create a plurality of electronic images, each said electronic image corresponding to a page of said plurality of documents;

inputting information through said intelligent terminal connected to said scanner to categorize said documents;

transmitting said electronic images to said processing means for storage on said data storage means;

creating, for each said document, a document summary file, including at least a portion of said characterization information and time, date and location information for said document and

writing said summary file information as at least one record to a database table located in said data storage means;

displaying a list, comprising at least a portion of said extracted information, corresponding to at least a portion of said records, at one of said intelligent terminals, as an indication of the presence of scanned documents;

selecting an image for display from said displayed list;

retrieving said image from its location on said main computer's data storage equipment;

displaying said retrieved image at one of said intelligent terminals;

linking said displayed image with a previously designated work matter;

automatically generating a comment describing said displayed image to an activity log stored in said storage means and linked to said work matter;

permanently associating said displayed image with said comment;

saving said comment, said image association and said work matter association on said main computer's data storage equipment;

providing a database table indicating a person associated with the processing of a work matter;

providing a staff member database table including a plurality of records each having information describing the attributes of a person associated with the processing of work matters;

comparing the person associated with the processing of a work matter with said plurality of records of said staff member database table; and

locating a record of said staff member database table corresponding to said person associated with said work matter.

2. A computer implemented method of managing work through a system, said system including a processing means for processing data related to a work matter, a storage means, and a plurality of intelligent terminals, wherein said storage means and said intelligent terminals are electronically linked with such processing means, comprising the steps of:

collecting and storing data in said storage means, which data may include information generated externally to said system, information resident in said system at an initial time, information developed in the course of work management activity, and staffing information related to said work matter;

scanning a plurality of documents with an electronic scanner having an output suitably linked with a processing instrumentality for processing and storage of an output signal from said scanner whereby a plurality of electronic images, corresponding to scanned portions of said plurality of documents, are created and stored, and wherein said scanned documents may include a portion of said information generated externally to said system, and further wherein characterization information in respect to said scanned documents may be linked to said electronic images through operation of said processing instrumentality;

causing said electronic images created by said scanner, including such characterization information as may have been linked to said images, to be stored in said data storage means, through operation of said processing instrumentality;

creating a document summary file for each document so stored in electronic image form, including at least a portion of said characterization information, time, date, and location information for that document, and writing that summary file information to a record in a database table in said data storage means;

routing a preselected portion of said summary file information to one of said intelligent terminals for display at said terminal and, at an operator's option, causing at least one of said electronic images associated with one of said documents included in said preselected portion of said summary file information to be displayed by said terminal for processing by said operator; and

recording all processing activities by said operator in an activity log associated with said work matter, whereby said activity log is electronically stored in said storage means and linked with said work matter at all times during which said work matter is being processed in said system.

3. The method according to claim 2 comprising the additional steps of:

causing at least one of said documents included in said preselected portion of said summary file information to be operated on by an optical character recognition device, whereby selected portions of said electronic images associated with that document are converted from image data to text data;

linking said converted text data with a designated work matter;

creating a matter summary file identifying at least said designated matter and said converted text data linked thereto, and storing said converted text data along with said summary file identification data for said designated work matter in said data storage means; and

causing at least one of said matter summary files to be displayed at one of said intelligent terminals for processing by an operator situated thereat, in accordance with a predetermined processing regime, and, at said operator's option, further causing detailed information stored in said storage means, and associated with said matter summary file, to be displayed at said intelligent terminal.

4. The method according to claim 3 comprising the additional steps of:

automatically sending data corresponding to said stored images to said optical character recognition device; reading data from preselected areas of said image and converting said data to text data; and writing said text data to a database table.

5. The method according to claim 2 comprising the additional steps of:

electronically connecting an input/output terminal at a remote location with said processing means, wherein said terminal includes a display screen;

remotely accessing said processing means from said terminal and selecting at least one image for display on said remote terminal;

causing said selected image to be transmitted to said remote terminal; and

displaying said image on said remote terminal display screen while maintaining access to said processing means.

6. The method according to claim 2 comprising the additional steps of:

providing a database table wherein a person associated with the processing of a work matter may be identified;

providing a staff member database table including a plurality of records each having information describing attributes of a person associated with the processing of work matters;

comparing identity information for said person associated with the processing of a work matter with records in said staff member database table;

locating a record in said staff member database table corresponding to said person associated with said work matter.

7. The method according to claim 6 comprising the additional step of automatically transmitting a selected electronic image to an electronic address listed in said staff member database table for said person associated with said work matter.

8. The method according to claim 2 comprising the additional steps of:

initially storing said scanned electronic images on magnetic storage media associated with said storage means;

transferring a first portion of said stored images from said magnetic media to optical disk storage means operatively linked to said processing means after a first preselected period of time based on required image access; and

transferring a second portion of said stored images from said magnetic media to said optical disk storage means after a second preselected period of time, said second period of time being of greater duration than said first period of time and being based on required image access.

9. The method according to claim 8 comprising the additional step of determining whether said transferred portion of said stored images is removed from said magnetic media in said first or second preselected period of time based on the type of work matter with which the image is associated.

10. The method accordingly to claim 2 comprising the additional steps of:

annotating a selected scanned electronic image via an input to said processing instrumentality;

saving said annotations on said storage means;

merging said annotation and said selected image; and displaying said merged annotated image at one of said intelligent terminals.

11. The method according to claim 2 comprising the additional step of:

providing a plurality of queues for displaying at least a portion of said summary file information for different preselected types of documents as identified, at least in part, by said document characterization information.

12. The method according to claim 2 comprising the additional steps of:

providing an image list to store and display an indication of every scanned electronic image associated with a particular work matter; and

providing an electronic reference library for storage and display of reference images used in making decisions with respect to work matters, wherein said reference images can be associated with particular activity log comments to substantiate a decision.

13. The method according to claim 2 comprising the additional steps of:

providing a means to handle payments through the system;

automatically generating a payment comment to said activity log when a payment is handled through the system; and

causing documentation associated with said payment to be scanned into the system and the resulting electronic images to be thereafter linked with said activity log payment comment.

14. The method according to claim 2 comprising the additional steps of:

providing a means for accepting incoming telephone calls;

automatically answering said telephone calls with a prerecorded message;

automatically prompting for information from a caller, wherein said information is to be input by the caller through a telephone keypad;

receiving information input by the caller through said telephone keypad; and providing information, based on said input keypad information, from said processing means to said caller in the form of voice communication.

15. The method according to claim 2 comprising the additional steps of:

selecting a party to whom a telephone call is to be made;

automatically dialing the selected party's number based on previously input information;

automatically generating an activity log comment regarding the call; and automatically recording the duration of the call, if the call is completed.

16. The method according to claim 2 comprising the additional steps of providing means to split, insert, re-order or copy said scanned electronic images.

17. A computer-implemented method for managing work through a system, said system including a processing means for processing data related to a work matter, a storage means interconnected with said processing means and a plurality of intelligent terminals electronically linked with said processing means, said method comprising the steps of:

scanning a plurality of documents with an electronic scanner having an output suitably linked with a processing instrumentality for processing and storage of an output signal from said scanner whereby a plurality of electronic images, corresponding to scanned portions of said plurality of documents, are created and stored, and wherein said scanned documents may include a portion of said data related to said work matter, and further wherein characterization information in respect to said scanned documents may be linked to said electronic images through operation of said processing instrumentality,

summarizing said data related to said work matter into a summary file,

electronically linking said data and said summary file,

storing said data and said summary file in said storage means subject to retrieval by an operator at one of said intelligent terminals for processing by said operator, and

recording the processing by said operator in an activity log associated with said work matter, whereby said activity long is electronically stored in said storage means and linked with said work matter at all times during which said work matter is being processed in said system.

18. The method according to claim 7 comprising the additional step of:

causing said electronic images created by said scanner, including such characterization information as may have been linked to said images, to be stored in said data storage means, through operation of said processing instrumentality.

19. The method according to claim 17 comprising the additional step of:

creating a document summary file for each document so stored in electronic image form, and writing that summary file information to a record in a database table in said data storage means.

20. The method according to claim 19, comprising the additional step of:

routing a preselected portion of said summary file information to one of said intelligent terminals for display at said terminal and, at an operator's option, causing at least one of said electronic images associated with one of said documents included in said preselected portion of said summary file information to be displayed by said terminal.

21. The method according to claim 20 comprising the additional step of:

causing at least one of said documents included in said preselected portion of said summary file information to be operated on by an optical character recognition device, whereby selected portions of said electronic images associated with that document are converted from image data to text data.

22. The method according to claim 21 comprising the additional step of:

linking said converted text data with a designated work matter.

23. A computer-implemented method of managing work through a system, said system including a processing means for processing data related to a work matter, a storage means interconnected with said processing means and a plurality of intelligent terminals electronically linked with said processing means, comprising the steps of:

scanning a plurality of documents with an electronic scanner having an output suitably linked with a processing instrumentality for processing and storage of an output signal from said scanner whereby a plurality of electronic images, corresponding to scanned portions of said plurality of documents, are created and stored, and wherein said scanned documents may include a portion of said data related to said work matter, and further wherein characterization information in respect to said scanned documents may be linked to said electronic images through operation of said processing instrumentality;

providing an electronic reference library for storage and display of reference images used in making decisions with respect to work matters, wherein said reference images are associated with particular activity log comments to substantiate a decision;

causing said elctronic images created by said scanner, including such characterization information as may have been linked to said images, to be stored in said dtat storage means, through operation of said processing instrumentality;

providing a plurality of system functions for processing work, wherein said work is derived from said electronic images; and

automatically moving a user between said plurality of functions based on document type and function.

24. A computer-automated system for managing work comprising:

a processing means for processing data relates to a work matter and a storage means electronically linked thereto, wherein data is collected and stored in storage means, which data may include information generated externally to said system, information resident in said system at an initial time, information developed in the course of work management activity, and staffing information related to said work matter;

a plurality of intelligent terminals interconnected with said processing means and said data storage means such that said terminals are able to access, display and store data stored n said data storage means;

an electronic scanner for scanning a plurality of documents, said scanner having an output suitably linked with a processing instrumentality for processing and storage of an output signal from said scanner, whereby a plurality of electronic images, corresponding to scanned portions of said plurality of documents, are created and stored, and wherein said scanned documents may include a portion of said information generated externally to said system, and further wherein characterization information in respect to said scanned documents may be linked to said electronic images through operation of said processing instrumentality;

document summary means for creating a document summary file respecting each document so stored in electronic image form, including at least a portion of said characterization information, time, date, and location information for that document, and for writing that summary file information to a record in a database table in said data storage means;

means for routing a preselected portion of said summary file information to one of said intelligent terminals for display at said terminal and, at an operator's option, for causing at least one of said electronic images associated with one of said documents included in said preselected portion of said summary file information to be displayed by said terminal for processing by said operator; and

means for recording processing activities by said operator in an activity log associated with said work matter, whereby said activity log is electronically stored in said storage means and linked with said work matter at all times during which said work matter is being processed in said system.

25. The system of claim 24 further comprising:

optical character recognition means disposed for operating on at least one of said documents included in said preselected portion of said summary file information, whereby, upon such operation, selected portions of said electronic images associated with that document are converted from image data to text data;

means for linking said converted text data with a designated work matter;

matter summary means for creating a matter summary file identifying at least said designated matter and said converted text data linked thereto, and storing said converted text data linked thereto, and storing said converted text data along with said summary file identification data for said designated work matter in said data storage means; and

means for causing at least one of said matter summary files to be displayed at one of said intelligent terminals for processing by an operator situated thereat, in accordance with a predetermined processing regime, and, at said operator's option, for causing detailed information stored in said storage means, and associated with said matter summary file, to be displayed at said intelligent terminal.

26. A work management system comprising:

processing means, including a data bank into which data is written and from which data is read, said data bank storing information regarding an initial transaction, work source information, office staff information, policy information, information regarding dates of importance, information regarding work processing activities, staff case lead information, and predetermined text data for preparing documents, the data bank including staff table means for storing, retrieving, displaying and modifying information about staff members who access the system, wherein said stored information includes one or more data items selected from the group consisting of: name, user ID, job title, supervisor, experience level, cost rate, diary rollover limit, scheduled vacation, payment authority, and staff functional and processing authority levels;

at least one terminal means for communicating with said processing means and operable by at least one operator to produce requests and to enter information and/or retrieve information for writing and/or reading from said data bank;

display means for displaying information that is entered and retrieved;

first merging means operatively interacting with said processing means for reading out from said data bank selected information regarding work processing activities and selected office staff information and merging said read out work processing activities information and said read out office staff information to compile an activity log listing key work activities and a staff member associated with those activities;

case summary means for automatically summarizing said initial transaction information;

routing means for routing transaction information to a staff member for processing in response to input through one of said terminal means; and

staff member electronic queue means for receiving said initial transaction summary and other electronic messages;

assignment means for assigning a case to a particular staff member for processing in response to input through one of said terminal means;

reassignment means for reassigning cases from a particular staff member to another staff member for processing;

diary means for automatically and manually setting, storing and displaying dates for various activities associated with the processing of a case including means for manually overriding automatically set diary dates;

activity log means for automatically recording information about transactions undertaken through the system in the processing of a case and for manually recording information and comments about other activities in the processing of a case including means for selectively displaying said recorded information and comments on said display means;

inquiry means for selectively retrieving and displaying transaction information in response to input of at least one case number through one of said terminal means;

system controller means for controlling an operator's movements within the system, wherein said system controller means verifies the availability of each requested function during a system session and verifies said operator's authority to access a system function prior to permitting such access; and

security means comprising security level means for selectively limiting access to certain predetermined functions of the system in accordance with a preset security level associated with each authorization code.

27. The system of claim 26, wherein said data bank is locatable in at least one remote location.

Description Submit all comments and votes

A. FIELD OF THE INVENTION

This invention relates to computer systems and methods, and more particularly to such systems and methods for work management and the like.

B. BACKGROUND OF THE INVENTION

The processing and tracking of work in process in most environments is virtually non-existent or intensely manual. By way of example, the processing and tracking of damage loss claims has been a time-consuming, mostly manual process requiring multitudes of paper records. As such, claim processing and tracking is expensive, complex and relatively unreliable in maintaining the collected information.

In a typical prior art claim processing system, a claims office receives an initial notice of a loss from an insured, a claimant, a customer or an agent. The loss notification is received by mail, telephone, or in-person. By way of example, when a notice of loss is received by mail in the claims office, it is sorted into the appropriate line of insurance business (e.g. workers' compensation, automobile, property/liability, fidelity/surety etc.) (See FIG. 1). Loss Notices are then delivered to one or more assistant managers and/or unit supervisors who review the notices and determine which claim "handler" actually will work on the claim(s). The supervisor also determines a diary date which is recorded on the original file to check on the status of the claim and the assigned handler's progress. The supervisor then sends a copy of the notice to that handler and calculates and notes the specific reserves to be set aside for the claim.

The original notice is given to a clerk for manual issuance of a claim number from a Register Book and for input into FOCS. (FOCS is a computer based claim recording system which relies on a mainframe computer located at a remote location to record the notice of loss. The FOCS system is used to record only actual claims and to issue certain payments. No claim adjustment support is provided to assist a claim handler in the progress of a claim to conclusion. The purpose of FOCS is essentially to assist in the maintenance of corporate financial records.) After the notice of loss information has been input into FOCS, a file is prepared and filed.

On a daily basis, clerks search all "open" files for claims with a diary date matching the day's date (See FIG. 2). All applicable files are removed and given to the appropriate claim handler or supervisor. After the necessary action is taken the files are refiled and any new diary dates noted.

When a claimant or insured calls to check on the status of a claim the handler, supervisor or clerk must again retrieve the file from wherever it is filed (See FIG. 3). The file is reviewed as necessary and then left for a clerk for refiling. At any time while the file is not properly filed, no correspondence received or other document can be placed in the file without undertaking a search for the file.

During the time the claim is "open", key events must be recorded in an Activity Log to provide an audit trail. (The Activity Log is one or more preprinted sheets of paper which are affixed to the inside of the claim file.) As these key activities occur, the claim handler is obligated to record them in the Activity Log. If the file is not located immediately, it becomes likely that the key event(s) will be recorded inaccurately or not at all.

When work on the claim has been completed, the handler requests that the file be closed. (See FIG. 4). A closure statement is input into the FOCS system to update the corporate record and the file is stamped closed and filed in a "closed" file bank. After a specific retention period all files are put in dead storage and then eventually destroyed.

As can be clearly seen, the prior art claim processing system, like most work processing systems, requires that the file be available for virtually every activity. Thus, when files are not found in their normal location, problems arise. Still further, recording of specific key events in the Activity Log and the maintenance of diary dates depends on human diligence. As such, many things which should be done or recorded never get completed in a timely manner, if at all.

C. OBJECTS OF THE INVENTION

Accordingly it is an object of the present invention to provide a system and method for alleviating the foregoing problems and improving upon the prior systems and methods.

It is another object of the present invention to reduce the time to respond to telephone inquiries about work in process.

It is a further object to automatically and securely maintain a record of the activities of all staff members in work processing.

It is yet another object to minimize the time to prepare and complete forms, letters, reports and checks in processing work.

It is a still further object to reduce or eliminate paper in the maintenance of records in processing work.

It is yet a further object to capture all physical documentation for the processing of work as electronic images which can be readily stored and retrieved.

It is another object to electronically associate substantiating documentation with all payment transactions undertaken through a computerized work management system.

It is yet another object to automatically track the time spent in particular matters which are undertaken through a computerized work management system.

It is a still further object to integrate the use of electronic imaging, voice processing and text data manipulation in a computerized work management system.

It is yet a further objective to enable multiple staff members to concurrently access image and text information in the processing of work in a computerized work management system.

D. SUMMARY OF THE INVENTION

In accordance with the present invention, there is provided a system and method for substantially automating work management. To illustrate the capabilities of this system and method, reference is made mainly to the processing of insurance claims. This reference should not be construed as a limitation on the application of this System to other work environments.

Throughout this specification, reference will be made primarily to two embodiments of the present invention ("first embodiment" and "second embodiment"). The first embodiment is a work management system which generally relies on manual input of documentary information and requires ready access to actual physical documentation. The second embodiment virtually eliminates the need for access to physical documentation by providing the capability to store and retrieve electronic images of documents. Where no distinction is made between embodiments the description should be construed to be applicable to all.

In the insurance claim adjustment environment, the present invention provides claim office supervisors and other staff members with the ability to maintain an accurate record of all activities undertaken in the processing of a claim and the further ability to quickly and easily access the complete claim file.

In accordance with a first embodiment of the present invention the processing of a claim begins with the receipt of a notice of loss ("Loss Notice") from an insured, a claimant, a customer or an agent. These Loss Notices are received by mail, telephone, in person or electronically. The information from these notices is keyed into a local computer where a separate electronic file or record is created for each "loss event and stored in a Loss Event database table."

In accordance with a second preferred embodiment of the present invention, work processing begins with the manual sorting of received mail. The sorted mail is first loosely indexed and then scanned into a local computer via a digital scanner. (The scanned documents are stored as electronic "images" which can be retrieved at will). The scanned mail is then electronically "routed" to office personnel identified by electronic addresses, or to one or more electronic queues. The various queues are reviewed by appropriate staff members who further electronically route the images to another staff member or, in rare cases, delete the image(s).

The actual processing of a claim begins with the receipt a notice of loss usually on a standardized form. In one preferred version of the second embodiment, after a standardized notice is scanned, it is sent to an Optical Character Recognition Device ("OCR") which reads the information in pre-defined zones on the form and places it in the appropriate fields in a Loss Claim database table.

In accordance with the present system and method, an operator accesses the local computer through a terminal, where he requests (usually through a displayed menu) a series of input screens called the Loss Processing Transaction ("LPTX"). These screens, which comprise the LPTX, each have a number of empty input fields preceded by descriptive prompts. In the first embodiment, the Loss Notice is manually input, through the LPTX screens, from the documentation or telephone call. In the second embodiment, if the Loss Notice cannot be processed by the OCR, the information is manually input into the Main CPU, in accordance with the descriptive prompt from the Loss Notice image which is displayed simultaneously with the various LPTX input screens.

A separate series of LPTX screens is typically available for each line of insurance business (e.g. workmen's compensation, automobile, property/liability, fidelity/surety, etc.). Thus, the particular LPTX screens which are displayed to the input operator are formatted according to the particular line of business which is the subject of the claim.

The LPTX is designed to capture information relevant to claim recording and to the loss adjustment process. All data relating to a claim which is collected, is stored in one or more locally supported database adapted to interface with a remotely located host computer ("Host") and its databases. The Host computer preferably maintains policy and other information, used in the loss adjustment process, that is also employed in the regular activities of the company.

If, for example, the claim is related to an automobile loss, a variety of relevant information is input from the Loss Notice and other sources (e.g. the insured's policy, police reports, interviews, etc.), including: information about the insured, information about the insured's policy, information regarding special procedures to be undertaken in the processing of the claim, a description of the accident, a description of any physical or property damage, information regarding any injured party, information about witnesses and/or passengers and any other relevant comments. All this information need not be immediately input into the claim file created with the LPTX. It may be added subsequently as more details are uncovered during the investigation of the loss.

Prior to inputting the Loss Notice information, the insured's policy information is verified by extracting such information from the local computer's databases or by interfacing with the Host and its databases, depending on where the policy information resides. This information "prefills" certain fields in the LPTX thereby further minimizing operator input.

In accordance with the first embodiment, once the information requested in the LPTX is input, and stored in a local database, the transaction is typically either "routed" by the input operator to a supervisor to access and review the file or directly "assigned" to a particular claim handler. When a claim is routed to a supervisor or assigned to a claim handler, a message is generated to the person's "mailbox" (discussed in detail below) briefly summarizing the claim transaction. If a claim is routed to a supervisor, he reviews the claim, then electronically assigns it to a particular staff member and sets aside reserves (based on his experience and calculations) to cover the expected cost of the claim. When the claim is assigned to a claim handler, an automatic numbering facility assigns the next available, appropriate number(s), from a numbering registry, to the claim(s). This facility eliminates the extra, manual step of ascertaining the next unused number(s) and recording it on the claim file and elsewhere.

When a claim is assigned, at least one due date ("diary" date) is typically set for the claim handler and/or the supervisor. The diary dates set for the handler are normally done automatically. In different versions of the present invention, diary dates for the supervisor can be set manually or automatically to encourage the supervisor to review the progress of the claim. Automatic dates are calculated and set by the System based on the type of claim and the handler's experience. Manual dates can be set to override or augment the automatic dates set by the system. Dates also may be set in the "Diary" by the claim handler or any other staff member with appropriate authority.

In the first embodiment, an electronic Activity Log is automatically created at the time of the first activity in the processing of the claim through the System. In the second embodiment, the Activity Log is automatically created when the new claim file is established along with a first entry defining the date the Loss Notice (image) was received into the system, when the image was attached for review and when the image was processed and by whom.

An Activity Log is essentially an overview of key activities associated with the loss adjustment process (e.g. payments, interviews, correspondence, images (in the second embodiment) etc.). Comments are electronically entered into the log to document these activities through normal keyboard entry or automatically generated when a specific system activity is undertaken. The date and the operator's initials are automatically entered into the Activity Log with the entry. Entries into the log are readily accessible for review by an operator and are displayed in reverse chronological order so that the most recent entries appear first.

In the second embodiment of the present invention, images and voice can be "linked" with individual Activity Log entries. The entries may include comments describing the image or voice message, but comments are not required. The linking of images to Activity Log entries provides the user with the ability to access pertinent documents from the Activity Log where they are identified and would logically be located.

Whenever certain functions within the system are accessed, and activities undertaken therefrom (e.g. Text processing or Payments), entries are automatically made to the Activity Log for that claim. The entries summarize the activity without conscious effort by the operator. Each entry consists of the date, the operator, the activity and the specifics associated with that activity (e.g. check issued for $500.00 to John Doe, etc.). In the second embodiment, for example, when a payment transaction is completed, the specifics of the payment are automatically written to the Activity Log and the associated substantiating documentation (images) is linked to the comment. The extra steps which would be required to locate the log, recall the specifics of the activity, and make a manual entry are eliminated. A handler's memory is not involved at all and the Activity Log will thus be accurate and up-to-date. Still further, the log serves as an audit trail because the Activity Log entries, once made, are secure and cannot be changed.

Individual claim files may be accessed directly by selecting a particular Diary entry. When the claim is accessed from the Diary in this manner, the Activity Log associated with the particular claim is displayed. This permits the handler or supervisor to find out the most recent activity undertaken or to see particular instructions which should be followed. If a Diary entry is not accessed or reset to another date, it will "rollover" to the succeeding day until it is accessed and rediaried. This prevents dates from being missed due to an unexpected absence or illness. If a Diary date rolls over too many times an "alert" message is generated to the handler's supervisor. The number of allowed "rollovers" is defined by a "Staff Table" through which specific parameters for staff member System usage are established.

The Diary also acts as a work load monitoring tool because the number of claims which should be "diaried" for any given day is limited. For example, if a supervisor/manager attempts to set a Diary date on a claim for a particular handler when the Diary listing for that handler already has the maximum number of claims to be reviewed for that day (as defined in the Staff Table for that handler), a message is displayed to the supervisor. (Despite the message, the supervisor can still assign the Diary date, if he desires). In this way, work can be more efficiently distributed throughout an office or a more realistic workload established for a particular handler.

Text processing is also preferably included within the system. This provides automatic/semi-automatic generation of forms and letters tailored to the particular office and the particular claim. In practice, the Text processing function is selected and a form or letter then chosen. Most of the preprepared forms and letters have blank fields embedded in them to make them specific to the appropriate claim. The System automatically attempts to fill in these blank fields from information previously entered and stored in the claim database. This saves time because the operator does not need to locate the basic claim information in a paper file or key it in. If all the necessary information to complete the document is not available from the claim file, the operator is prompted to provide it manually. When all the required fields in the document have been filled, the document's text data is sent to a printer. The documents are precoded to apprise the System and an output operator (an individual in charge of the printing of forms, letter and/or checks) of the proper paper on which the correspondence is to be printed and the number of copies to be generated. An Activity Log comment is also automatically generated to document the activity.

It is preferred that a Payment function be included in the System. There are typically four types of payments which can be made: (1) closing payments; (2) repetitive payments; (3) partial payments; and (4) reopen/close payments. Checks may be issued for any of the four types of payments upon selection by the claim handler. Many of the fields on the various payment screens are prefilled from information previously entered into the claim file (database). If insufficient information is available in the claim file to print a check, the operator is prompted to manually input the missing information in the appropriate fields.

If the requested amount of a check exceeds the specific monetary authority of the person authorizing the request, as defined in that user's corresponding Staff Table, the check request is automatically routed to a supervisor for approval. (In the second embodiment, any substantiating documentation (images) is also routed for review). Thus, all checks which are finally printed have been duly authorized.

There are two ways checks can be automatically issued. With the first method the check request is sent from the local computer to the Host computer where it is processed. The Host assigns a check number and sends a check printing command to a check printing queue for printing on a check printer located in the local office. With this method the local system is only involved in the front end of the transaction. The rest of the check transaction is handled by the Host computer. When the check transaction is completed, the check number is sent to the local system where it is recorded in the electronic claim file.

With the second method the check request is processed by the local computer which debits the local office's account in real time. (With the first method the corporate account is debited off-hours after all checks have been issued for a given day). The assignment of check numbers occurs locally and the check printing command is issued by the local computer. The Host is typically apprised of the check transactions via batch uploading from the local computer at various intervals.

As indicated above, all payments generate an entry to the Activity Log including: amount, requester, nature of benefit, payee name and check number (and in the second embodiment, substantiating documentation). This happens automatically without any effort on the part of an operator.

In one preferred embodiment of the present invention, an interactive Help system is available. The Help system is generally invoked from any screen, during any operation of the system, throughout the processing of a claim. It is activated by actuating one or more "function" keys at a terminal (i.e. separate keys which do not normally generate alphanumeric characters on the display screen). The Help function initially displays transaction and/or field specific codes which are used for filling in data fields within the various screens. Actuating still other function keys provides an explanation as to how to select and move between modules and operations within the system and accomplish various transactions or activities. The Help function is used to assist an operator in the proper input of information and the manipulation of screens and functions.

An "Info Search" feature, in a preferred embodiment of the invention, permits any operator to check on the status of a claim based on only minimal information, such as: the insured's last name, the claimant's last name, the insured's policy number or the claim number. (When a claim file is created this "minimal information" is automatically entered as a record into database tables for this purpose.) This feature is particularly valuable when an insured or a claimant telephones to check on the status of a claim. With the Info Search function, it is not necessary to physically retrieve a paper file which may or may not be complete. Rather, the operator who receives the telephone call simply accesses the Info Search function and inputs the appropriate name (full name, partial name or phonetic equivalent) and/or claim number to locate the electronic Info Search record containing the "minimal information." If the caller needs more detailed information, the complete claim file may be accessed, including its up-to-date Activity Log and, in the second embodiment, all images (documents) associated with the claim. From this an operator can quickly and easily provide the caller with a complete status report. Correspondingly, with a minimum of effort, the Activity Log may be updated to include any information imparted during the telephone call.

In the second embodiment of the present invention the Info Search function also serves as an image routing facility. It can be used to associate or "tag" images with particular claim files (images are "tagged" to individual claim files for evaluation purposes before they are permanently "linked" to the claim) or to route images to particular Mailboxes.

Directory Tables, which are included in a preferred embodiment of the present invention, function, in part, as an online telephone/address book. Any name, telephone number, address and tax code may be keyboard entered and stored in the Directory Tables. These entries are then accessible by name and can include attorneys, claimants, doctors, state agencies, etc. The Directory Tables are not claim specific and are shared by the entire office. These tables are also integrated with other System functions (e.g. Text Processing, Payments, LPTX, etc.) to prefill information into their respective data fields, as necessary.

The Staff Tables, mentioned previously, provide an online record for each member of the office staff. Each record includes the current title, diary limit, authority level and supervisor of the staff member as well as the maximum case load of that member. (In the second embodiment, the record also includes the member's telephone extension number, fax number and "Queue Access Authorities.") The Staff Tables are integrated with virtually every other System function. The information contained in the various Staff Table records is used to verify and prefill various data fields in other System functions. The authority level, diary limit and caseload limits (also queue access authorities in the second embodiment) of each staff member are set by supervisors with appropriate authority and entered into the Staff Tables. These records can be modified, deleted or added as necessary.

Statistics regarding claim assignments are stored and monitored to determine individual and office-wide performance through a caseload monitoring function. This function allows a supervisor to assess the general nature of an individual's work load and to examine a staff member's progress on groups of claims. This feature assists the supervisors in assigning claims to particular handlers and making more efficient use of the staff.

A windowing function also is provided in a preferred embodiment of the present invention. The windowing function permits an operator to work on more than one claim by opening a "window" into other claim files while others are being processed. (The operator can only enter data into one claim file at a time, but can switch back and forth between the various files.) This feature also allows the operator to access a second function, such as the Activity Log (while remaining within the same claim), and enter new information while in the middle of performing some other task (e.g. reviewing a diary). This feature may be used to access information from the Host computer without foregoing operations undertaken using the local computer. This is particularly useful when investigating the details of a policy where policy information is stored on the Host. In the second embodiment of the present invention the windowing feature permits the display of one or more images while other system screens are also displayed. This is an important feature in eliminating paper from an office.

Just as claims can be assigned to a particular handler, they can be reassigned as well. In a preferred embodiment of the present invention, the system is capable of reassigning one or all of an individual's claims to one or more handlers or supervisors. This is h