Computerized system and method for work management

Abstract

A computerized system and method for managing work in process is provided. Case specific information, including information from an initial transaction is electronically entered into a database and automatically linked with a work source index which includes basic client information. Input information residing in externally generated documents is scanned into the system as images for subsequent display or conversion to textual data. As work is performed on the case, the system tracks its progress and provides a variety of support functions. An electronic activity log function maintains a record of key activities involved in the processing of work items.

Claims

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

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 helpful, for example, when a handler or supervisor is ill for an extended period of time or leaves the office permanently. The reassignment is done electronically so that the reassigned claims are passed to the new handler intact. The notice of reassignment is sent to the new handler's or supervisor's Mailbox.

As indicated above, when a claim is routed electronically from one person to another, a summary of the claim, in message form, is sent to a person's Mailbox. The Mailbox, of the present invention, is analogous to an electronic in and out box. When a supervisor assigns or reassigns a claim to a handler a message appears on the handler's Mailbox screen indicating that he has an assignment. Assignments are viewed through the handler's Assignment Mailbox, but the complete file (including images in the second embodiment) may be accessed to determine the actual steps to be taken.

The Mailbox screen also indicates to a supervisor whether any alerts have been generated (e.g. authority level exceeded for check issuance, etc.). This enables a supervisor to pinpoint certain office problems automatically.

A number of print queue managers are also provided to allow an output operator to monitor the flow of reports, forms, letters and checks (and images in the second embodiment) to be printed. This is helpful when a number of lengthy or specialized print jobs have created a backlog at the time that a top priority print job is sent to the printer. The print queue managers enable an output operator to shift the print jobs in the print queue to accommodate those with higher priority. The print queue managers also display any special printing information, such as number of copies, type of paper, etc.

A specialized feature, which is part of a preferred embodiment of the present invention is referred to generally as "Local Data." The Local Data feature includes a screen or set of screens which have been generically formatted to accommodate database fields of numeric, date and alphanumeric data. (A set of these screens is available for input and display for each claim). The particular display configuration of the screen or screens is selectable by the individual claims office. The purpose of the Local Data feature is to permit each claims office to design its own display screens to accommodate specialized information which the office desires to maintain. This information primarily is of the type needed to complete specific state agency filing requirements, but it may be used simply for statistical purposes or customer needs. The data input through the customized screens created with the Local Data function is intended to be kept locally in the claims office and not communicated to the Host.

The Local Data function provides each office with the same number of generic numeric, date and alphanumeric fields (each of which is also of a predetermined length) to arrange into customized screens. Once these fields have been arranged into a particular display format for use in a local office, they can only be modified by an operator with the proper level of authority. Any number of these fields can be employed and there is no requirement that all/any of them be used. Since the fields are generic, they can be used in any format to store any information desired by the local claims office as long as the information conforms to the field designations. The Local Data function is integrated with Text processing such that customized forms and letter can be generated which rely on the information input through a Local Data screen or field. Since the information input through Local Data is maintained on a local database it is also available for extraction through an Ad Hoc Reporting function.

In a preferred embodiment of the present invention an Ad Hoc Reporting function is provided. This function relies on a standard database query to extract information from any System database. The Reporting function may be employed to extract any combination of data required and to output the data in a user designed format. For example, this function can be used to determine all office payments for any given time period.

In the second embodiment of the present invention a number of additional features facilitate the use of electronic images instead of paper. Several image queues are provided which permit review of a plurality of images to determine routing and/or action to be undertaken. For example, there is a Medical Payments Queue for reviewing and processing medical bills as well a number of mail queues for reviewing loosely sorted mail which has been received. Mailboxes also act as queues for lining up mail or other work. In accordance with this embodiment of the present invention, images may be associated with the work which has been routed to a mailbox or other queue.

The ability to "mark-up" an image with free-form input is also provided in the second embodiment. An electronic tablet and stylus are preferably used to input hand markings onto an image. If the user desires, the "marked-up" image can be saved and associated with any claim being processed through the System. However, the original image always remains in the System unchanged.

The second embodiment can also directly and automatically send and receive faxes through a "Fax Gateway." Faxes, composed in Text processing and/or images which have been scanned into the system, can be sent out as faxes through the Fax Gateway. The number to which the fax is to be sent is either pulled from the Directory Tables or manually input. In either case, the sending of a fax automatically generates a comment to the Activity Log of the particular claim with which it is associated. Faxes which are received via the Fax Gateway are saved as images and immediately sent to a predetermined mail queue for review. A received fax is not reduced to hard copy unless manually requested at a later time.

Documents, which are generated through the system to request information from third parties, are preferably set up with alphanumeric identifiers in predetermined locations on the documents. These documents, when returned with the requested information, are scanned into the system and routed to the OCR where the identifiers are read. This permits automatic classification and/or identification of the received information allowing it to be routed to a specific electronic address without going through a mail queue.

The second embodiment is also designed to process voice communications. All telephone communication whether outgoing or incoming can be recorded and linked with particular claim records. (This feature may be omitted from the System to minimize data storage requirements). Outgoing calls, like faxes, automatically generate a comment to the Activity Log associated with the claim being processed. Incoming calls may be recorded or, through a Voice Front-End Processor ("VFEP"), can give the caller claim information residing on the system, in voice form, without human intervention.

A Central Library is also preferably provided with the second embodiment. The Central Library functions as a repository for commonly referenced information such as policy forms, endorsements, large account instructions ("LACONS") and general letters in image form. This information would have existed in a variety of locations, in paper form, in prior art offices.

The main purpose of the Central Library is to provide reference materials which can be attached to the Activity Log to provide documentation to substantiate work processing decisions. This makes the record supporting a claim superior to all prior such records since everything can now be found quickly and easily in one place. The library is also updatable to allow for the inclusion of newly revised policies and the like.

A Document Manager function, which can be used to manipulate images, is preferably provided in the second embodiment. This function permits a user to split a document into multiple documents, insert a document into another document, rearrange a document, delete an "in-process" document and copy a document.

As can be clearly seen, the present invention yields substantial improvements over prior systems. Other features and advantages of the invention are set forth in the following description and drawings.

E. DESCRIPTION OF THE DRAWINGS

In the drawings:

FIG. 1 is a flow chart depicting the manual steps undertaken when a notice of loss is received in a prior art claims office;

FIG. 2 is a flow chart depicting the manual steps associated with the use of claim diary in a prior art claims office;

FIG. 3 is a flow chart depicting the manual steps associated with the receipt of a claim status inquiry in a prior art claims office;

FIG. 4 is a flow chart depicting the manual steps associated with the "closing" of a claim file in a prior art claims office;

FIG. 5 is a schematic diagram of a work management system constructed in accordance with a first preferred embodiment of the present invention;

FIG. 6 is a schematic diagram of a work management system constructed in accordance with the second embodiment of the present invention;

FIG. 7 is an explanatory diagram depicting the construction of an Action Diagram;

FIG. 8 is an Action Diagram illustrating the computer program and operative steps of the System Controller;

FIG. 9 is a block diagram depicting the interrelationship of the System functions of the first embodiment of the present invention;

FIG. 10 is a block diagram depicting the flow of mail into an office employing the second embodiment of the present invention;

FIG. 11 is a block diagram depicting the flow of mail through the MSCN function in accordance with the second embodiment of the present invention;

FIG. 12 is a block diagram depicting the physical display of an image from a mail queue in accordance with the second embodiment of the present invention;

FIG. 13 is a block diagram depicting the flow of mail through the SCAN function in accordance with the second embodiment of the present invention;

FIG. 14 is a block diagram depicting the flow of mail through the General Mail Queue in accordance with the second embodiment of the present invention;

FIG. 15 is a block diagram depicting the flow of mail through the OCR in accordance with the second embodiment of the present invention;

FIG. 16 is a block diagram depicting a first flow of Loss Notices through the System in accordance with the second embodiment of the present invention;

FIG. 17 is a block diagram depicting a second flow of Loss Notices through the System in accordance with the second embodiment of the present invention;

FIG. 18 is a block diagram depicting the flow of medical bills through the System in accordance with the second embodiment of the present invention;

FIG. 19 is a block diagram depicting the flow of reference documents through the System in accordance with the second embodiment of the present invention;

FIG. 20 is a block diagram depicting the flow of mail to an Incoming Mailbox in accordance with the second embodiment of the present invention;

FIG. 21 is a block diagram depicting the physical display an image from the Image List in accordance with the second embodiment of the present invention;

FIG. 22 is a block diagram depicting the linking of a document to the Activity Log in accordance with the second embodiment of the present invention;

FIG. 23 is a block diagram depicting the flow associated with the receipt of a fax by the System in accordance with the second embodiment of the present invention;

FIG. 24 is a block diagram depicting the flow associated with the sending of a fax through the System in accordance with the second embodiment of the present invention;

FIG. 25 is a block diagram depicting the annotation of an image in accordance with the second embodiment of the present invention;

FIG. 26 is a block diagram depicting the operation of the Voice Mail portion of the System in accordance with the second embodiment of the present invention;

FIG. 27 is a block diagram depicting the operation of the Agency Inquiry portion of the system in accordance with the second embodiment of the present invention;

FIG. 28 is a block diagram depicting a first approach to image review by an Outside Claim Representative in accordance with the second embodiment of the present invention;

FIG. 29 is a block diagram depicting the Anticipatory Remote Caching approach to image review in accordance with the second embodiment of the present invention;

FIG. 30 is a block diagram depicting a flow diagram depicting the flow of information between database tables in accordance with the present invention;

FIG. 31 is a flow diagram highlighting the database tables associated only with the second embodiment depicting the flow of information between the tables unique to the second embodiment and other database tables associated with the first and second embodiments;

FIG. 32 is a flow diagram depicting the flow of information between the Event Queue Table and other database tables in accordance with the present invention;

FIG. 33 is a flow diagram depicting the flow of information between the Staff Member Table and other database tables in accordance with the present invention;

FIG. 34 is a flow diagram depicting the flow of information between various database tables in accordance with the present invention;

FIG. 35 is a flow diagram depicting the flow of information between the Text Processing database tables;

FIG. 36 is a flow diagram depicting the flow of information between database tables associated with the purge and recall functions of the System of the present invention;

FIG. 37 is a flow diagram depicting the flow of information between the database tables of the Purge database of the present invention; and

FIG. 38a-38e together comprise a block diagram depicting an overview of the System in accordance with the second embodiment of the present invention.

F. GENERAL DESCRIPTION

FIG. 5 illustrates schematically a first preferred embodiment of a portion 20 of the system of the invention. The system portion 20 includes local data processing equipment at a first station 32, Host data processing equipment at a second station 30 and two separate sets of display input/output equipment at two other stations 34 and 36. (Although only two display input/output stations 34 and 36 are shown in FIG. 5, it should be understood that it is preferred to use more stations than two.)

In the first preferred embodiment of the invention the Host data processing station 30 is located at a remote location. The local data processing station 32, output printing equipment 48 and 52 , and the display input/output equipment 50 are all located in the claims office. (Some display input/output equipment 50 may be located at remote stations 34. Communication between the local data processing station 32 and this remote display input/output equipment 50 occurs via the modem 60.)

The data processing equipment located at the claims office includes a computer CPU 38. The computer is preferably a moderately high-speed, high-capacity computer such as a Wang VS, however, the computer can be any general purpose digital computer having sufficient speed and capacity for processing data in the system.

Also located at the claims office is a plurality of input/output devices 50, each comprising a keyboard and a display screen which are used for programming purposes as well as data input and review. The output printing equipment 48 is used to print out checks, forms, reports and various types of correspondence.

A modem 60 is used for sending and receiving data over telephone lines 64 to a modem 66 provided at the Host computer 62.

When a Loss Notice is received in a claims office, an operator inputs the information received in that notice through the keyboard 68. The information is then transmitted over intraoffice lines 56 to the local computer 38 which stores the information on a disk at a disk drive 42. Information regarding the claims file which is created is routed through the intraoffice lines 56 to the electronic "Mailbox" of a supervisor for review.

Typically, the supervisor reviews the newly created file on his display screen 70 and through his keyboard 68 assigns a claim handler to it and sets aside reserves. The supervisor then routes the claim (in the form of a claim summary message) to the designated handler's Mailbox through the intraoffice lines 56.

As the claim handler processes the claim he normally accesses various functions in the system including the Diary, the Activity Log, the Payment transaction, etc. Each function is accessed through a keyboard 68 and consists of one or more preformatted input screens which are displayed on a display screen 70. The functions are preprogrammed and run on the local computer 38. The information input in response to prompts in the functions' preformatted screens is stored in the local computer 38.

When a form, letter or check needs to be prepared, the appropriate function is accessed through a keyboard 68, the preformatted screens associated with the function are displayed on a display screen 70 and any necessary information input through a keyboard. The output to be printed is routed through intraoffice lines 56 to a local printer 48 or 52 where it goes into a print queue. (Print queue managers are available to control the printing priority). Upon exiting the print queue, the output is printed by the local printer 48 or 52, reviewed and sent out.

As mentioned above, the Host computer 62 interfaces with the local computer 38. In practice, the Host computer 62 communicates with the local computer 78 through its modem 66, the phone lines 64 and the local modem 60. In response to a request from the Host computer 62, the local computer 38 copies certain information stored in the local database and uploads it to the Host computer 62 and vice versa. This information then resides in both the Host computer 62 and the local computer 38. It is not removed from the local computer's storage facility 42 or 46.

FIG. 6 is a schematic illustration of a second preferred embodiment of the hardware of the present invention. A minicomputer (CPU) 210, such as a Wang VS 7160 with about 40 megabytes ("MB") of random access memory ("RAM") is the primary processing unit ("Main CPU") of the System. Associated with the Main CPU 210 are a plurality of storage devices 214, 216 and 218 for reading and writing data and for maintaining and providing access to the databases and other software which comprise additional portions of the present invention.

An automated backup system 222 is used to support the backup operations required by the enormous capacity magnetic drives which are preferably used for daily activities. The hardware of the backup system preferably employs industry standard 8 mm cartridge tape. This tape can hold approximately 2.3 gigabytes ("GB") of information. The software is called Wang Unattended Backup Utility ("WUBU").

The backup procedure is preferably done daily and weekly during off-peak hours in response to pre-selected time triggers. The daily backup procedure copies anything changed in any database table during the previous 24 hour period as well as any new images scanned into the System. The weekly backup preferably copies all the database tables and all images residing on magnetic disks.

An image transfer controller 224 controls the physical storage and retrieval of images from an optical disk storage device 218. It manages the traffic of the flow of image data from optical disks to the Main CPU 210. The optical disk storage device 218 is preferably an optical disk jukebox. The jukebox typically has two or more drives for reading the optical disks and storage racks for storing a plurality of disks. When information is requested from a disk the location of the disk is determined. If the disk is located in one of the two drives it is simply read. However, if the disk resides in the storage racks, drive must be cleared by removing one disk and replacing it with the appropriate disk from the storage racks. This procedure is done automatically, but results in a dramatic increase in response time.

One or more digital scanners 226 are employed with the second embodiment of the present invention. The scanners 226 are image capture devices which, by way of example, could be Wang SC300 or SC4000 scanners. Each scanner 226 is linked to a personal computer 228 ("PC") which not only controls the physical scanner functions, but also the transfer of compressed images to magnetic or optical disk. The PC 228, which includes a storage and retrieval device as well as a display device, is also used to screen images (via the display device) after they have been scanned to insure their good quality. The software which operates through the PC to control the scanner(s) is Wang WIIS Emulation Work Station software. The software recognizes and controls the operation of the scanner, the compression of the image and the transfer of the image to the Main CPU 210.

A Voice Front-End Processor 230 ("VFEP") is also linked to the Main CPU 210. The VFEP 230 is a voice and telephone control processor that provides an interface between a telephone system 232 and the Main CPU 210. It is preferably used in conjunction with software by Wang called Speech and Telephony Environment for Programmers ("STEP") which integrates voice and telephone functions with user applications and voice mail which is itself integrated into the System. STEP has routines which act as an interface between the VFEP 230 and the Main CPU 210. For example, when an outgoing telephone call is made through the System, the Main CPU 210 issues a command to initiate the call, the STEP software then passes that command to the VFEP 230 and the call is made. Thus, STEP acts as the interpreter between the Main CPU 210 and the VFEP 230. The VFEP 230 can support a plurality of telephone lines and is used for recording statements taken over the phone, supporting automated telephone inquiries and handling internal/external voice mail.

A Fax Gateway 234 is provided to permit the sending and receiving of faxes through the system. The Fax Gateway provides a connection between CPU applications and external facsimile machines 236. Faxes are received as images and can be routed to any electronic address like any other image, text data, checks, etc.

If an incoming fax is a System generated or other preset form, the image can be routed to an Optical Character Recognition Device 238 ("OCR"). The OCR 238 converts images to ASCII data based on its recognition of multiple text fonts. The OCR 238 can read information from any image in the system which is in a preset form, not just faxes.

The Main CPU 210 is also connected to one or more printer devices 240 which are capable of printing out reproductions of the electronic images.

A plurality of workstations 242 and 244, functioning as smart terminals, are linked with the Main CPU 210. The workstations 242 and 244 are Personal Computers ("PC's") preferably with 16 or 19 inch high resolution monitors (monitors of this type provide enhanced viewing of images). These workstations 242 and 244 are the primary means of text input into the system and image review. Each workstations 242 or 244 preferably includes a large capacity hard drive 260 or 262, a keyboard 264 or 266 and a free-form input device 268 or 270 (e.g. a mouse or a tablet and stylus). Each workstation 242 or 244 is associated with one or more electronic addresses to which work can be routed. Each also forms the basis for operator interaction with the system.

A Host computer 246 also communicates with the Main CPU 210. It functions in the same way as described with respect to the first embodiment.

Outside claim representatives are able to communicate with the Main CPU 210 via modem 248. This facilitates the sending and receiving of faxes or other electronic communication. Typically, each outside claim rep has a remote smart terminal system which includes a scanner 250, a printer 252, special free-form annotation software 254, a fax card 258 and a terminal 256 with disk storage and retrieval capability and a free-form input device 272.

Other valuable features of the invention will be discussed in the more detailed description which follows.

G. DETAILED DESCRIPTION

As indicated in the previous section, reference is made to the processing of insurance claims to illustrate the features and capabilities of the system and method of the present invention. It should be understood that this is a description of only a few preferred embodiments and other embodiments may be accordingly prepared by one of skill in the art.

Similarly, the present description makes reference primarily to preferred work flows through the System of the present invention. However, an almost infinite number of work flows is possible based on the System's ability to move between virtually any of its functions upon manually input directions.

1. System Security

In order to prevent the theft of data, the unauthorized issuance of checks, system vandalism, etc., a security system is provided to limit access to the system of the present invention. Preferably, an off-the-shelf security system called MENUTECH.RTM. is integrated into the "front end" of the System. MENUTEC.RTM. controls Log On procedures via User IDs. It is also able to control user access to the System functions via further integration.

Each employee in an office is assigned to a particular security level based on his responsibilities. The security level is used to limit the system functions and transactions which can be accessed or performed by the employee. This is done by comparing the user's security level with the level of the function being called.

Initially, each employee is given a User ID (usually his initials) and a password which limit his system access to his assigned security level. When an employee wishes to use the system, he must first Log On using his User ID. If the User ID is entered correctly, the system validates it and then displays a password screen. The operator inputs his password through this screen and the system passes the password to MENUTECH.RTM. which verifies it through an encrypted security file. If the password is validated, a Main Menu screen for the operator's appropriate security level is displayed. If an incorrect password or User ID is entered, a message appears and the operator is prompted to reenter the incorrect term. Generally, after three unsuccessful attempts, an error message is displayed and the operator is locked out of the system. (An alert is also simultaneously generated to a supervisor.) If the password entered has expired (most passwords remain active for 30 days) a Password Expiration screen (not shown) is displayed. This screen permits an operator to select a new password and then access the system. It is not necessary to wait until a password expires. Rather, passwords can be changed at any time through a Password Change screen (not shown).

2. System Driver

The System Driver is a program module that manages and controls every System session. It does this by controlling the timing and execution of all system functions. The System Driver is based on a model transaction which is the blueprint for every online transaction.

FIG. 8 is an Action Diagram of an overview of a successful System session. (As shown in FIG. 7, an Action Diagram is analogous to a sideways flow chart. The nested brackets depict various functional steps occurring under the umbrella of other functional steps. Double lines indicate a loop, while single lines with multiple bracket ends indicate a choice of functions. Wording between two pairs of asterisks is merely explanatory in nature.) As indicated at 102, entry into the system must be achieved prior to the takeover of all operations by the System Driver 100. After the System Driver has assumed control it first verifies that the requested transaction is available for use within the System 104 (primary and default menus are not subject to this verification since, if the system is available these menus must be available as well. The code to invoke the Default Primary Menu is given automatically after successful logon and just prior to takeover by the System Driver 100). Once the System Driver 100 verifies the availability of the requested function it must insure that the operator has the proper authority to invoke the requested function 108. This is done by comparing the function's required authority level with the System Security (Menutech) authority level. If the operator has the appropriate authority, the function is "run."

Two types of functions may be invoked, either a menu function 110 or an application function 112. If a menu function is selected, the System Driver 100 first checks for messages (i.e. System error messages or new entries to the Assignment or Referral Mailboxes) and then displays the appropriate message 114. Next, the selected menu is displayed 116. A number of options are available from within a menu including: Help, Local Copy, Logoff and a variety of application functions 118. Help and Local Copy do not cause any change in the System location, Logoff 120 exits the System entirely, while the selection of an application returns the System Driver to the Function Control position 104.

If an application function is initially selected 112 the record(s) to be acted upon must be selected 122. This involves either the entry of a new claim number or the selection of "Data Carry" when leaving a previous function. (The selection of Data Carry carries the same claim record(s) and all its information to the next function.) If Data Carry is not used, the System Driver first checks for any messages and displays appropriate screen indicators 124. It then provides a screen or screens which permit the selection of a claim number 126.

Once a claim number has been chosen the System Driver again checks for messages 128 before undertaking any business transaction 130. (A business transaction is the part of a function which changes or creates a specific record or set of records.) Any business transaction can be interrupted 132 to "window" to another function of a different type. The original transaction is restored 132 when the operator windows back out of the other function.

Just prior to completing the business transaction the operator can place a four letter code in a `Next Trans` field to specify the next function to be undertaken 134. When the business transaction is then ended, the function is exited and the System Controller returns to the Function Control position 104 to evaluate the next requested function. (The following is a partial list of available functions: Loss Processing Transaction, Activity Log, Diary, Directory Tables, Info Search, Payments, Reassignments, Secondary Menu and Text Processing. All the available functions are shown in block form in FIG. 8).

3. The First Embodiment

a. Menu Screens

The menu screens serve as a table of contents enabling an operator to select a desired system function or transaction. Following a successful logon, the System displays a Default Primary Menu tailored to the operator's specific needs and security level. (See, e.g., Tables I and II, for screens designed for a claim handler and a supervisor). The appropriate Primary Menu screen for a particular operator is determined by a Default Menu Number which is entered in the operator's Staff Table.

A Secondary Menu, shown in Table III is also available. This Secondary Menu displays less frequently used functions and transactions. Using the Primary Menu or the Secondary Menu, an operator can access virtually any available system function.

System functions are accessed from the Primary or Secondary Menus by actuating the "PF" or "Function" key corresponding to the desired function (e.g. a PF1 or F1 key is pressed to access the Claim Status Change function from the Secondary Menu, the PF5 or F5 key is pressed from a Main Menu to access the Directory Tables function, etc.).

                  TABLE I
    ______________________________________
    CLAIM HANDLER MENU
    ______________________________________
     ##STR1##
    1)    Activity Log    9)    LP Element Change
    2)    Claim Status Changes
                          10)   Mailbox Menu
    3)    Diary Function  11)   Nature of Payments
    4)    Diary Listing   12)   Payments
    5)    Directory Tables
                          13)   TEXT forms
    6)    Info Search           Selection/Completion
    7)    LPT Inquiry     14)   Wang OFFICE
    8)    LP Control Change
                          15)   CAS Secondary Menu
    32)   Logoff
    ______________________________________

                  TABLE II
    ______________________________________
    SUPERVISOR MENU
    ______________________________________
     ##STR2##
    1)   Activity Log      10)   Mailbox Menu
    2)   Claim Status Changes
                           11)   Nature of Payments
    3)   Diary Function    12)   Payments
    4)   Diary Listing     13)   Reassignments
    5)   Directory Tables  14)   Wang OFFICE
    6)   Info Search       15)   CAS Secondary Menu
    7)   Investigative Instructions
    8)   LP Control Change
    9)   LP Element Change
    32)  Logoff
    ______________________________________

                  TABLE III
    ______________________________________
    CAS SECONDARY MENU
    ______________________________________
     ##STR3##
    1)  Claim Status Changes
                          12)   Payment Corrections
    2)  Diary Function    13)   Reassignments
    3)  Diary Listing     14)   Staff Table
    4)  HTC Sent          15)   Subsequent Print Trans
    5)  Investigate Instrs.
                          17)   Text Forms
                                Selection/Completion
    6)  Local OHC         18)   TEXT Print Queue
    7)  Loss Processing Trans
                          19)   Word Processing
    8)  LP Control Change 21)   3270 Emulation
    9)  LP Element Change 22)   DPSA Security Functions
    10) LPT Inquiry       23)   Forms Maintenance
    11) LPT Subsequentys  24)   Text Processing
    16) Return to Previous Menu
    32) Logoff
    ______________________________________

                                      TABLE IV
    __________________________________________________________________________
    LOSS PROCESSING TRANSACTION  LPTX
    __________________________________________________________________________
     ##STR4##
    AGENT CODE:
                  ##STR5##
    LOSS DATE:
                  ##STR6##
    REPT DATE:
                  ##STR7##
     ##STR8##          1 AUTOMOBILE
                       2 PROPERTY/LIABILITY
                       3 WORKERS'COMPENSATION
                       4 FIDELITY/SURETY
    TELEPHONE FIRST REPORT: *
                       LOCAL PREFILL: X
    ENTER) POLICY INFO 6) POLICY INDEX 18) HELP 23) LC 32) CANCEL
    __________________________________________________________________________

                                      TABLE V
    __________________________________________________________________________
    POLICY INFORMATION
    __________________________________________________________________________
    POL NUM:
              ##STR9##
    AGT CODE:
              ##STR10##
    INSURED:
              ##STR11##
    STREET:
              ##STR12##
    CITY:
              ##STR13##
    BUS PH:
              ##STR14##
    POL EFF:
              ##STR15##
    FORMS/ENDT:
    SPECIFY FORMS/ENDT AFF COV:
    EXCESS IND:CERT NUM:LARS IND:LARS LOC CODE:
    SERV EXPEDITER CODE:
    ENTER)
         VEH-DRIVER
                 3)
                   SPECIAL PROCEDURES
                                 18)
                                   HELP
    27)  ERASE LPT
                 1)
                   CLAIM SET-UP  19)
                                   SELF REFER
    23)  LC      30)
                   LOCAL DATA
    __________________________________________________________________________

                  TABLE VI
    ______________________________________
    SPECIAL PROCEDURES
    ______________________________________
    PERRY, FREDERICK 02 PH 123123
     ##STR16##
     ##STR17##
     ##STR18##
     ##STR19##
     ##STR20##
     ##STR21##
     ##STR22##
    ENTER) ADD 4) PREVIOUS PAGE 18) HELP
    23) LC 16) RETURN 3) NEXT PAGE
    ______________________________________

                                      TABLE VII
    __________________________________________________________________________
    VEHICLE - DRIVER COVERAGE INFORMATION
    __________________________________________________________________________
    CUSTOMER TESTER           02 PH 123123
    VEH NUM:
           YR:           MAKE:       MODEL:
    VIN:                 PLATE:      ST:
    COV/DED
           BI: PD:            MED PAY:       NON COLL:
           COLL:
               UM:                   NO FAULT:
           T/L:
               RR:                   FULL GLASS:
               LIAB DED AMT:         DED COV:
    SPECIFY IF OTHER COV/LIMITS:
    MI: LOSS PAYEE:
    SPECIFY IF OTHER INSUR ON VEHICLE:
    ENTER `X` IF DRIVER SAME AS INSD:
    DRIVER:                          TITLE:
    STREET:
    CITY:      ST:       ZIP:        PHONE:
    LIC NUM:   ST:
    AGE:       DOB:      SEX: MS:    REL TO
    INSD:
    ENTER) DESC OF ACC 19) SELF REFER 18) HELP 16) RETURN
    __________________________________________________________________________

                                      TABLE VIII
    __________________________________________________________________________
    DESCRIPTION OF ACCIDENT                LPTX
    __________________________________________________________________________
    CUSTOMER TEST                      02 PH 123123
    DESCRIBE ACCIDENT:
    LOC OF ACCIDENT:
    CITY:                            ST:   ZIP:
    ENTER "X" IF SUBROGATION POSSIBILITIES:
    INVEST AUTHORITY:
    VIOLATIONS/CITATIONS:            VIOLATION CODE:
    REPT TO:                     REPT TO:
    COVERAGE REQ:  RSK ALRT: QUESTNBLE COV IND: SVRTY IND:
    6)
      ADD CLMT     14)
                     WITNESS
                           19)
                             SELF REFER
                                     18)
                                       HELP
                                           16)
                                             RETURN
    15)
      COMMENTS-CONTACT     28)
                             RESP PARTY
                                     23)
                                       LC  27)
                                             ERASE LPT
    __________________________________________________________________________

                                      TABLE IX
    __________________________________________________________________________
    CLAIMANT INFORMATION
    __________________________________________________________________________
    CUSTOMER TEST        02 PH 123123
    CLAIMANT - ENTER X IF SAME AS INSURED:
    (IF NOT ENTER DATA BELOW)
    NAME:              P/C:
                          TITLE:
    STREET:
    CITY:        ST:      ZIP:
    BUS PH:               RES PH:
          AGE:   SEX:     MS:       NUM DEP:
          OCC CODE:
                 STATUS:  INCOME RANGE:
                                    TIN:
    11)
      PHYS DAMAGE
                13)
                  INJURY   18)
                             HELP
                                 16)
                                   RETURN
    12)
      PROP DAMAGE
                30)
                  LOCAL DATA     23)
                                   LC
    __________________________________________________________________________

                                      TABLE X
    __________________________________________________________________________
    PHYSICAL DAMAGE INFORMATION
    __________________________________________________________________________
    CUSTOMER TEST                02 PH 123123
    OWNER NAME: CUSTOMER TEST
    DESCRIBE DAMAGE TO INSD VEH:
    USED W/PERM? (Y/N):  PURPOSE OF USE:
    REPAIR EST:    ENTER "X" IF SALVAGE POSSIBILITIES:
    WHERE/WHEN VEH CAN BE SEEN:
    ATTY (N/R): NAME:
    CLM DESC CODE:    CLM DESC:
    LOSS TYPE: CLM SYM:  COV ID:  TOTAL LOSS IND:
    EST INC LOSS:  EST INC ALLOC EXP:  VERIFIER:
    PTA:    JIA:     CLAIMS MADE DATE:
    1)
      CLAIM SET-UP
               13)
                 INJURY    18)
                             HELP
    6)
      ADD CLMT 31)
                 STAT CODING
                           23)
                             LC
    16)
      RETURN   11)
                 PHYS DAMAGE
                           30)
                             LOCAL DATA
    __________________________________________________________________________

                                      TABLE XI
    __________________________________________________________________________
    AUTO THIRD PARTY PROPERTY DAMAGE
    __________________________________________________________________________
    CUSOTMER TEST                  02 PH 123123
    OWNER: CUSTOMER TEST
    PROPERTY DAMAGE
    DESC OF PROP:
    DESC OF DAMAGE:
    REPAIR EST:  ENTER "X" IF SALVAGE POSSIBILITIES:
    WHERE DAMAGE CAN BE SEEN:
    ATTY (N/R):
               NAME:
    IF DRIVER OTHER THAN OWNER - DRIVER NAME:
    OTHER PROP INSD BY:
    ENTER "X" IF DED AMT APPLIES:
    CLM DESC CODE:
                  CLM DESC:
    LOSS TYPE:     CLM SYM: COV ID:
                                  TOTAL LOSS IND:
    EST INC LOSS:  EST INC ALLOC EXP:
                                   VERIFIER:
    PTA:      JIA:                CLAIMS MADE DATE:
    1) CLAIM SET-UP
               18) HELP
                       30) LOCAL DATA
                                   16) RETURN
    6) ADD CLMT
               13) INJURY
                       31) STAT CODING
                                   23) LC
    __________________________________________________________________________

                                      TABLE XII
    __________________________________________________________________________
    INJURED PARTY INFORMATION
    __________________________________________________________________________
    CUSTOMER TEST                             02 PH
    123123
    NAME: CUSTOMER TEST
    DESC OF INJURY:
    TYPE INJURY CODE:
                 DIS BEG DATE: DIS END DATE:
    ENTER "X" IF DED AMT APPLIES:
                              SEAT BELT USE:
    ATTY (N/R):
             NAME:
    CLM DESC CODE: DLM DESC:
    LOSS TYPE: CLM SYM:  COV ID:       COLL SOURCE IND:
    EST INC LOSS:   EST INC ALLOC EXP:     VERIFIER:
    PTA:  JIA:                        CLAIMS MADE DATE:
     1) CLAIM SET-UP
               12) PROP DAMAGE
                          23) LC        18) HELP
    11) PHYS DAMAGE
               31) STAT CODING
                          22) SERVICE PROVIDER
     6) ADD CLMT
               16) RETURN 13) INJURY    30) LOCAL DATA
    PACKAGE: DUPLICATE PAYMERNT PROBLEM
    __________________________________________________________________________

                                      TABLE XIII
    __________________________________________________________________________
    CLAIM SET-UP SCREEN
    __________________________________________________________________________
    SMITH, JOHN                         02 PH 123123
                   TELEPHONE FIRST REPORT:
    LOSS       CLM                     EST INC
    TYPE       SYM      CLMT NAME      LOSS
    CR         AF       CLAIMANT #1    300
    CR         AP       CLAIMANT #2    450
    CP         AC       CUSTOMER TEST  150
     1) ROUTE-PROCESS       10) POLICY INFO
     2) SELECT KEY CLM
                 6) ADD CLAIM
                            19) SELF REFER
                                       18) HELP
                 7) DESC OF ACC
                            25) MODIFY LOSS
                                       23) LC
     17) MORE FUNCTIONS
                 9) MODIFY CLMT
                            29) VEH-DRIVER
                                       27) ERASE LPT
    __________________________________________________________________________

                                      TABLE XIV
    __________________________________________________________________________
    ROUTE-PROCESS SCREEN   LPTX
    __________________________________________________________________________
    INSURED, INC.                   02 WEC 123123
     ##STR23##
                   ##STR24##
                             ##STR25##
     ##STR26##
     ##STR27##
                   ##STR28##
                             ##STR29##
    ENTER) ROUTE
               2) PROCESS
                       18) HELP
                              23) LC
                                   16) RETURN
    __________________________________________________________________________

                  TABLE XV
    ______________________________________
    CCLM
    ADD COMPANION CLAIM TRANSACTION
    ______________________________________
                   ENTER CLAIM NUMBER:
    ENTER) CLAIM LIST
                     18) HELP   32) CANCEL
    ______________________________________

                                      TABLE XVI
    __________________________________________________________________________
    CLAIMANT INFORMATION
    __________________________________________________________________________
    BUMSTEAD, DAGWOOD                02 PH 000999
    CLAIMANT - ENTER X IF SAME AS INSURED:
                              (IF NOT ENTER DATA BELOW)
    NAME:                    P/C:    TITLE:
    STREET:
    CITY:        ST:         ZIP:
    BUS PH:                  RES. PH:
    AGE:              SEX:   MS:     NUM DEP:
    OCC CODE:    STATUS:
                        INCOME RANGE:
                                     TIN:
    11) PHYS DAMAGE
                 13) INJURY  18) HELP
                                     16) RETURN
    12) PROP DAMAGE
                 30) LOCAL DATA
                             23) LC
    __________________________________________________________________________

                  TABLE XVII
    ______________________________________
    LP - CONTROL CHANGES
    MENU
    ______________________________________
             ##STR30##
    1) CLAIM NUMBER/RECORD REPORT CHANGE
    2) POLICY NUMBER CHANGE
    3) DELETE LINKAGE
    4) CHANGE LINKAGE
    5) CLAIMANT NAME CHANGE
    18) HELP    23) LC       32)
    CANCEL
    ______________________________________

                                      TABLE XVIII
    __________________________________________________________________________
    LP - CONTROL CHANGES
    __________________________________________________________________________
    CLAIM NUMBER
    INSURED: JOHNSON, RICHARD
                             P/C: P  TITLE: MR
           CLAIMANT: JONES, PETER
                             P/C: P  TITLE: MR
           POLICY NUMBER: 02PH 120000
           CLAIM NUMBER: 023 AP 00103
            ##STR31##
     ##STR32##
                    ##STR33##
                         ##STR34##
                               ##STR35##
                                  ##STR36##
    ENTER) CHANGE CLAIM
                   23) LC
                       18) HELP
                             32) CANCEL
    __________________________________________________________________________

                  TABLE XIX
    ______________________________________
    LOSS INQUIRY
    ______________________________________
    CLAIM NUMBER: 023 AC 13131
    ENTER) VIEW INFORMATION
                         16) RETURN
    ______________________________________

                                      TABLE XX
    __________________________________________________________________________
    AUTO LOSS ASSIGNMENT/INQUIRY SUMMARY SCREEN
    __________________________________________________________________________
    INSURED:
           DARBY ENTERPRISES
           300 COMPOSER AVENUE    BUS PH:
           WEST HARTFORD CT 06102 RES PH:
    POL NUM: 37 DP 100111
                     AGENCY:
    CLM DESC:                     WITNESS: N
    LOSS DATE: 08/01/88
                     TIME OF LOSS: 06
                                  PREPORTED DATE:
    TELEPHONE FIRST REPORT:
    CLAIM NUMBER
               CLAIMANT EST INC LOSS
                                  HAND/SUPV
    023 AC 13131
               DARBY ENTERPRISES
                            2,000 RRD/CGM
                            300 COMPOSER AVENUE
               WEST HARTFORD CT 06102
                                  BUS PH:
                                  RES PH:
    023 AN 13132
               JOHN DALEO         BUS PH:
               258 CONCORD DR.    RES PH:
               POTTSTOWN, PA 19464
    ENTER)
         SLDT CLAIM
                    7) SLCT CLAIMANT
                                12) ADD DIARY ENTRY
    16)  RETURN     4) PREV CLAIM
                                10) POLICY INFO
    14)  ACTIVITY  17) NT        5) NEXT CLAIM
    11)  DESC OF ACC
                   29) VEH-DRIVER
                                23) LC
    __________________________________________________________________________

                                      TABLE XXI
    __________________________________________________________________________
    PHICIAL DAMAGE INFORMATION
    __________________________________________________________________________
    BURMINGHAM, TED              12 MKZ 030889
    OWNER NAME: BURMINGHAM, TED
    NUMBER: *                    OFFICE: *
    DESCRIBE DAMAGE TO INSD VEH:
    USED W/PERM? (Y/N):     PURPOSE OF USE:
    REPAIR EST:     ENTER "X" IF SALVAGE POSSIBILITIES:
    WHERE/WHEN VEH CAN BE SEEN:
    ATTY (N/R):  NAME:
    CLM DESC CODE: CLM DESC:
    LOSS TYPE:    COV ID:
                         TOTAL LOSS IND:
    EST INC LOSS:  EST INC ALLOC ESP:
                                 VERIFIER:
    CLAIMS MADE DATE:
    1) CLAIM SET-UP
              11) PHYS DAMAGE
                         18) HELP
                               16) RETURN
    6) ADD CLMT
              13) INJURY 23) LC
                               30) LOCAL DATA
    __________________________________________________________________________

                                      TABLE XXIII
    __________________________________________________________________________
    STAFF DIRECTORY
    __________________________________________________________________________
    LAST NAME      FIRST NAME
                             INITIALS
                                     JDC
    ANDERSON       SUSAN     SAA     GA
    ANDREWS        ANNE      AOA     ASR
    ASHTON         PAULA     PXA     SA
    BALD           LISA      LLS     ICR
    BARNES         DWAYNE    DJB     SA
    BARR           DAVID     DKB     OCR
    BARR           ROBIN     RSB     CA
    BARR 2ND       ROBIN     RB1     OCR
    BEARSE         ELIZABETH EJB     OSU
    BECKER-JONES   PAM       PBJ     OCR
    BECKLES-MITCHELL
                   BRENDA    BAM     IND
    BELISLE        JOANNE    JAB     CP
    BELL           ANNE      ALB     CA
    BENSON         RON       RAB     999
    ENTER) INQUIRE
               6) ADD
                     9) MODIFY
                           16) RETURN
                                   8) DELETE
    5) NEXT/LAST
               7) FIND
                    18) HELP
                           23) LC
    __________________________________________________________________________

                                      TABLE XXIII
    __________________________________________________________________________
    VALID JDC - AMC COMBINATIONS
    __________________________________________________________________________
    JOB         ADJUSTMENT
                          JOB
    DESCRIPTION CODE
                METHOD CODE
                          DESCRIPTION
    GA          1         GENERAL ADJUSTER
    HSR         1         HEALTH SERVICES REP
    OCR         1         OUTSIDE CLAIM REP
    OCS         1         OUTSIDE CLAIM SPECIALIST
    OSR         1         OUTSIDE SENIOR CLAIM DEP
    RCR         1         RESIDENT CLAIM REP
    CP          2         CLAIM PROCESSOR
    ICR         3         INSIDE CLAIM REP
    ICS         3         INSIDE CLAIM SPECIALIST
    ISR         3         INSIDE SENIOR CLAIM REP
    TCR         3         TELEPHONE CLAIM REP
    CA          4         CLAIM ASSISTANT
    OSU         4         OFFICE SERVICES UNIT
    SA          4         SYSTEM ADMINISTRATOR
    6) ADD STAFF MEMBER
                  18) HELP
                        23) LC
    5) NEXT/LAST        32) CANCEL
    __________________________________________________________________________