Patent ID: 8046281

Claim:
A system to process an insurance claim comprising at least one subsystem that: includes a memory and one or more processors in a number of computing apparatuses, wherein the one or more processors execute program instructions stored in the memory such that the at least one subsystem: collects information about losses to be covered by and data relevant to processing of the insurance claim; classifies said information into a plurality of skill profiles including a work skill level profile; determines a skill level required to handle the claim; searches a data store having records of claim handlers, skill profiles associated with such claim handlers and at least one parameter from among the following group of parameters: skill levels associated with said claim handlers, availability of said claim handlers, and workload of said claim handlers; provides a recommendation to assign the insurance claim to an available claim handler with the requisite skill level; provides the option to accept or override the recommendation; and assigns a claim handler to process the insurance claim in real time wherein a customer service representative provides a customer with identification and contact information of the claim handler during an initial interaction, wherein the subsystem that provides the recommendation to assign the insurance claim comprises at least one subsystem that: determines a number of service requests currently assigned to the claim handler; determines a number of hours that the claim handler spent on processing other claims; determines a future availability of hours for the claim handler to process new claims; calculates a total probability of assigning the claim by: determining probable claims that could have been assigned to each claim handler at a given point in time by subtracting hours needed for service requests currently assigned from the number of hours that the claim handler spent on processing other claims to calculate a difference, and dividing the difference by a productivity factor; determining a number of claims that each claim handler could potentially handle based on available hours at the given point in time by dividing the future availability of hours for the claim handler to process new claims by the productivity factor; and calculating the total probability of handling the claim by adding the probable claims that could have been assigned to each claim handler at the given point in time to the number of claims that each claim handler could potentially handle based on available hours at the given point in time; and recommends the claim handler with the highest total probability number.