Candidate Function Claim Identification System

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Solution Overview

Problem

Existing systems face delays and inefficiencies in processing insurance claims related to comparative negligence issues, as they often require time-consuming language processing queries and manual reviews, leading to inefficient resource allocation and prolonged processing times.

Innovation Solution

A real-time claim identification system uses candidate functions associated with logical operators and predefined text strings to quickly determine if insurance claims involve comparative negligence, allowing for immediate assignment to specialized groups, reducing the need for batch processing and manual reviews.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Measurement precision

If traditional language processing queries and manual reviews are used to identify comparative negligence claims, then identification accuracy is improved, but processing time and resource consumption increase

Engineering Contradiction:

Improveidentification accuracyVSAvoidprocessing time

Core Design Contradiction:

Measurement precisionVSLoss of time

Solution Approach 1:

The patent segments the claim identification process into multiple stages: initial filtering using candidate functions with text strings, followed by more detailed analysis only for claims that pass the initial filter. This segmentation allows rapid processing of most claims while applying comprehensive analysis only where needed, thereby reducing overall processing time while maintaining identification accuracy.

Inventive Principle:

Principle #1Segmentation

Solution Approach 2:

The system performs preliminary actions by pre-defining candidate functions and associated text strings that are indicative of comparative negligence issues. These preliminary definitions enable the system to quickly screen claims without executing complex language processing queries on every claim, thus reducing processing time while preserving identification capability.

Inventive Principle:

Principle #10Preliminary action

2Reliability

If comprehensive language processing queries are executed on all claims, then identification completeness is improved, but computing resource consumption increases

Engineering Contradiction:

Improveidentification completenessVSAvoidcomputing resource consumption

Core Design Contradiction:

ReliabilityVSUse of energy by moving object

Solution Approach 1:

The patent applies partial action by using candidate functions with specific text strings to identify the majority of comparative negligence claims without executing comprehensive language processing queries on all claims. This partial approach consumes fewer computing resources while still achieving reliable identification of claims that require specialized handling.

Inventive Principle:

Principle #16Partial or excessive action

Solution Approach 2:

The candidate functions with text strings serve as intermediaries between the raw claim data and the comprehensive language processing system. These intermediaries filter and pre-process claims, identifying those that likely involve comparative negligence issues, thereby reducing the volume of claims that require resource-intensive comprehensive analysis.

Inventive Principle:

Principle #24Intermediary (Mediator)

3Measurement precision

If claims are manually reviewed to determine comparative negligence issues, then processing accuracy is improved, but productivity decreases

Engineering Contradiction:

Improveprocessing accuracyVSAvoidclaim processing throughput

Core Design Contradiction:

Measurement precisionVSProductivity

Solution Approach 1:

The system enables self-service by automatically identifying claims that involve comparative negligence issues using candidate functions and text string matching. This automated self-identification reduces the need for manual review while maintaining processing accuracy, thereby increasing overall claim processing throughput and productivity.

Inventive Principle:

Principle #25Self-service

Solution Approach 2:

The patent replaces the mechanical manual review process with an automated computational system that uses candidate functions and text string analysis. This substitution maintains processing accuracy through systematic rule-based identification while dramatically increasing productivity by eliminating manual labor bottlenecks.

Inventive Principle:

Principle #28Mechanics substitution (Replace mechanical system)

Data Source

PatentUS20240169283A1Claim analysis based on candidate functions

Publication Date: 2024.05.23 STATE FARM MUTAL AUTOMOBILE INSURANCE COMPANY

AI summary

Candidate function data can include data for multiple candidate functions that may indicate whether insurance claims are likely to involve certain issues, such as comparative negligence issues. A real-time claim identifier can use the candidate function data to determine, in near real-time, if claim data for a new insurance claim submitted to an insurance company satisfies at least one of the candidate functions. If the claim data satisfies at least one of the candidate functions, the insurance claim can be assigned to a corresponding destination in the insurance company, such as a department that processes comparative negligence claims, for further processing.