System and method for performing reinspection in insurance claim processing

INSURANCE COMPANY

F 6 CLIENT SENDS /70 - ASSIGNMENT - COMMUNICATIONS TO EZNET SERVER \ / \ AppRA|sER/ EZNET STORES EZNET STORES REPA'R SHOP ASSIGNMENT ‘N copy OF ASSIGN- REINSPECTION APPRAISER OR MENT IN REINSPEC TERMINAL SHOP MAN-BOX ~TORS MAILBOX / T (94 76 T2 78 74 . / REINSPECTOR APPRAISER OR EZNET STORES STATUS DOWNLOADS SHOP ACTIONS INFORMATION IN ~ ASSIGNMENT, TRIGGER STATUS REINSPECTORS = STATUS 8 AUDIT UPDATES SENT MAILBOX ' RESULT INFO. 1T'%RRE|N$PE¢- (WHICH FORM A 82 WORKFILE FOR ./80 EACH CLAIM) APPRAISER/SHOP EZNET STORES UPLOADS COMPLETED l 9&6 COMPLETED ASSIGMEN1-S m REINSPECTOFI EZNET CONTENTS AND PRIORITIZES WORKFILES /84 | - R P T I~:Z~ET PERFORMS s€£'t€T§°A‘t$Im_ ELECTRONIC AUDIT FILE To WORK ON _../-x_ I 1-86 "6 REINSPECTOR QAAR 86A REVIEWS THE COMPARE / Wm‘ // AUD" SPECTION PROFILE + RESULTS , 868, ';‘E)"'{|TSE|§)Eg$0R REINSPECTOR GENERATE A COMPLETES EXCEPTIONS /REINSPECTION AND H8./' DOCUMENTS ms866 CUSSION WITH / APPRAISER OR .0 '20”, REINSPECTOR REINSPECTOR S 90 LOCKS AND MANAGER 1 UPLOADS FILE ANALYZES REIN' QAGO 881 I2", SPECTOR PRODUC ELECTRONIC AUDIT . REINSPECTION -TIVITY 8 COM- DATA AND REIN‘ EZNET ROUTES RESULTS AVAILABLE PARES APPRAISAL , SPECTION DATA __ DATA TD QAGO FOR MANAGEMENT SOURCES FOR AVNLABLE FOR OR To CLIENTS ALL REINSPECTORS VIEWING AND APPUCATION ANALYSIS

TO INSURANCE "'—
COMPANY

THRESHOLDS ESTIMATE THRESHOLD = $ I00. 00 ,._, _/ 724

FIG. 8A

QUALITY ADVISOR APPRAISAL REVIEW
830 SAMPLE INSURANCE COMPANY
SAMPLE OFFICE
ZIC W. PAULINE ST.
DASDADAS, IL. soeos- 1718

(512) 2I2-l2I2 32 WRITTEN BYI ELIZABETH cum ADJUSTERZ NITA TRINH ,.__ CLAIM NUMBER153' UIB2-09I00 DATE OF LOSSZOB/Z7/I992 POUCY NUMBER: TEST EDI TRANSLATOR TYPE OF LOSSZCOLLISION REPAIR ccc's eom SHOP FACILITYI 444 MERCHANDISE MART CI-IICAGO,lL 60654-I234 PHZ(3I2I222*4636 owNER: ANTONI J. sum: DAYI(407)26?-'2328 4707 ST. LAWRENCE DR. FRIENDSWOOD, ‘IX 77546 EVENINGI

INSPECTIONS ccc's BODY SHOP

LOCATIONI 444 MERCHANDISE. MART
CHICAGO,IL 60654 PHI (407) 2l3'7842

INSPECTION TYPE:

VEHICLEI I987 CHEV FP2 8.5-OL"4 2D PRODIO8/I986
VINIUNK LICENSEISF EDI TX
ODOMETERI I942I2 DAYS TO REPAIRI7
DRIVEABLEZ YES POINT OF IMPACTI
5. RIGHT REAR
APPRAISALI LAST APPRAISEDZ $2,8IO.25 34
QTOTAL APPRAISEDZ $347I.I2 (838 840 842 844
1 36 APPRAISAL REVIEW RESUL§—(———-L‘
RULE DESCRIPTION RESULT EXCEPTION EXCEPTION CODE
RULE VARIANCE
'WORKFILE INFORMATION-
LAST APPRAISED EXCEEDS 80.9% 20.0% 60.9°/Q A
TOTAL APPRAISED ,
SUPPLEMENTS EXCEED 80.9% 40.0% 40.9% A
ORIGINAL ESTIMATE
TOTAL LOSS THRESHOLD Y ' " A

EXCEEDED

-ADMINSTRATIVE DATA AND vrrv 8 B or-:coos- .

VIN VALIDATION INVALID VALID _ A INSPECTED MATCHES ASSIGNED VIN N Y ‘

MILEAGE ENTERED Y Y ‘ — —PARTS RATIO OF ESTIMATES"

OEM 23.8°/0

AFTERMARKET 4 .7 °/0

SALVAGEI LKQ 9.5 °/o

REMANU FACTURED 0.0 0/0

-REPAIR VS. REPLACE

RCY PARTS SELECTED 0F DISPLAYED 0.0“/o 25.0°/0 -250°/0 A OEM PART DOLLARS °/o OF ESTIMATE 22.0°/o 70.0°/0 ‘ ‘ NUMBER OF MANUAL LINES ENTERED I4 5 9 A NUMBER OF PAINT LINES OVERRIDDEN 0 5 ‘ ‘ -ADDITIONAL PROFILE ELEMENTS‘

AFTERMARKET SELECT AUTO LIST AUTO SELECT ‘ A REFINISH CAPS USAGE Y Y " ' CLEAR COAT HOURS 2.5 3.0 ‘0-5 A TL THRESHOLD FOR STANDARD lO0°/0 40°/0 60°/0 A VEHICLES

TL THRESHOLD FOR OLDER VEHICLES 0"/0 I0°/o ‘l0°/0 8 TL CUTOFF YEAR FOR OLDER VEHICLES I966 I966 ‘ ' BODY SUPPLIES CHARGES Y Y ‘ " ‘CYCLE TIMES IN DAYS‘

LOSS T0 ASSIGNED 2 I0 ' ' ASSIGNED T0 APPRAISED 4 2 2 C APPRAISED TO START OF REPAIRS 2 I I C START OF REPAIRS T0 COMPLETION 2 Z ‘ ‘ ‘LABORI MATERIAL RATES‘

BODY $1.00 SI0.00 ‘ " PAINT $2.00 $9.00 " " MECHANICAL $3.00 S800 ‘ HRAME $4.00 $7.00 - STRUCTURAL S5.00 $6.00 ‘ ‘ DIAGNOSTIC $6.00 -$5.00 SI.OO A ELECTRICAL $7.00 S 4.00 83.00 A GLASS $8.00 $3.00 $5.00 A BODY SUPPLIES $9.00 S2.00 S7.00 A PAINT SUPPLIES SI0.00 SI.OO $9.00 A ‘PARTS RATE‘

SUBTOTALS PARTS MARKUPS 33.0°/0 330°/0

—TAXES