Automated Claim Mediation System Using Confidential Offer Rules
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Solution Overview
Problem
Current methods for settling insurance claims between claimants and insurance companies are costly, time-consuming, and inefficient, often requiring mediation, arbitration, or litigation.
Innovation Solution
An automated system using a software package as a mediator, based on a predetermined rule set, that calculates a settlement amount by considering open and confidential offers from both parties, allowing for iterative revisions and alternative dispute resolution methods.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Productivity
If automated software mediation is implemented, then cost and time efficiency improve, but system complexity increases
Solution Approach 1:
The patent introduces an automated mediation system that acts as an intermediary between claimants and insurers. This software-based mediator uses predetermined rules and algorithms to calculate settlement amounts, replacing or reducing the need for human mediators and thereby improving efficiency while managing complexity through automation.
Solution Approach 2:
The system enables self-service mediation where the software automatically processes claims data, applies settlement rules, and generates settlement amounts without requiring extensive human intervention. Both parties can submit their positions and receive automated mediation outcomes, reducing operational complexity through standardized automated processes.
2Ease of operation
If confidential offers are used, then negotiation effectiveness improves, but information transparency decreases
Solution Approach 1:
The automated mediation system serves as a confidential intermediary that receives and processes offers from both parties without revealing them to each other. The system maintains information security by acting as a trusted third party that can evaluate all inputs objectively while preserving the confidentiality that enables effective negotiation.
Solution Approach 2:
The patent replaces traditional transparent negotiation mechanics with an automated computational system that processes confidential information. Instead of direct party-to-party communication, the system uses algorithmic processing to evaluate confidential offers and generate settlement recommendations, maintaining transparency in the process while preserving confidentiality in the inputs.
Data Source
AI summary
An improved claim mediation process includes an automated feature permitting a software package to act as the mediator based upon a predetermined rule set. Open offers are made by both sides, but kept secret from the opposing party are criteria by which the offer can be adjusted and still be acceptable to that party. The system takes into account the open offers and the confidential adjustment criteria and, if possible according to the predetermined rule set, calculates and displays a settlement amount.