Automated claims fulfillment system

• US 20020077867A1
• Filed: 02/22/2001
• Published: 06/20/2002
• Est. Priority Date: 12/14/2000
• Status: Abandoned Application

• Current Assignee: American Management Systems, Incorporated (CGI, Inc.)
• Original Assignee: American Management Systems, Incorporated (CGI, Inc.)
• Inventors: Richardson, Peter Edward, Harvie, John Charles, Gittins, Richard Simon
• Application Number:
  US09/789,730
• Publication Number:
  US 20020077867A1
• Time in Patent Office: Days
• US Class Current: 705/4
• CPC Class Codes: G06Q 30/02 Marketing; Price estimation or determination; Fundraising
• CPC Class Codes: G06Q 30/08 Auctions
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

A software-implemented, automated claims fulfillment system for fulfilling insurance claims. The claims fulfillment system aggregates claims fulfillment volume from multiple insurers for future periods, and reverse auctions the aggregated claims fulfillment volume to suppliers.

Claims

1. A process comprising:

aggregating claims fulfillment volume from multiple insurers for future periods; and

auctioning the aggregated claims fulfillment volume to suppliers.

2. A process as in claim 1, further comprising:

guaranteeing the auctioned aggregated claims fulfillment volume to the suppliers.

3. A process as in claim 1, further comprising:

load balancing actual claims fulfillment volume directed to suppliers winning the auctioned claims fulfillment volume.

4. A process as in claim 2, further comprising:

load balancing actual claims fulfillment volume directed to suppliers winning the auctioned claims fulfillment volume.

5. A process as in claim 1, further comprising:

presenting suppliers winning the auctioned claims fulfillment volume to a claimant submitting an actual claim; and

selecting a respective supplier of the presented suppliers by the claimant to fulfill the claim.

6. A process as in claim 1, wherein said auctioning comprises reverse auctioning the aggregated claims fulfillment volume to the suppliers.

7. A process as in claim 2, wherein said auctioning comprises reverse auctioning the aggregated claims fulfillment volume to the suppliers.

8. A process as in claim 3, wherein said auctioning comprises reverse auctioning the aggregated claims fulfillment volume to the suppliers.

9. A process as in claim 4, wherein said auctioning comprises reverse auctioning the aggregated claims fulfillment volume to the suppliers.

10. A process as in claim 5, wherein said auctioning comprises reverse auctioning the aggregated claims fulfillment volume to the suppliers.

11. An apparatus comprising:

an automated claims fulfillment system; and

computer communication channels connecting a plurality of insurers and a plurality of suppliers to the automated claims fulfillment system, the automated claims fulfillment system receiving an indication of claims fulfillment volume for future periods from the insurers through the computer communication channels, aggregating the claims fulfillment volume indicated by the insurers and auctioning the aggregated claims fulfillment volume to the suppliers through the computer communication channels.

12. An apparatus as in claim 11, wherein the automated claims fulfillment system provides guarantees of the auctioned aggregated claims fulfillment volume to the suppliers through the computer communication channels.

13. An apparatus as in claim 11, wherein the automated claims fulfillment system load balances actual claims fulfillment volume directed to suppliers winning the auctioned claims fulfillment volume.

14. An apparatus as in claim 12, wherein the automated claims fulfillment system load balances actual claims fulfillment volume directed to suppliers winning the auctioned claims fulfillment volume.

15. An apparatus as in claim 11, further comprising:

a claimant computer communication channel connecting a claimant submitting an actual claim to the automated claims fulfillment system, the automated claims fulfillment system presenting suppliers winning the auctioned claims fulfillment volume to the claimant through the claimant computer communication channel to allow the claimant to select a respective supplier of the presented suppliers through the claimant computer communication channel to fulfill the claim.

16. An apparatus as in claim 11, wherein the automated claims fulfillment system reverse auctions the claims fulfillment volume to the suppliers through the computer communication channels.

17. An apparatus as in claim 12, wherein the automated claims fulfillment system reverse auctions the claims fulfillment volume to the suppliers through the computer communication channels.

18. An apparatus as in claim 13, wherein the automated claims fulfillment system reverse auctions the claims fulfillment volume to the suppliers through the computer communication channels.

19. An apparatus as in claim 14, wherein the automated claims fulfillment system reverse auctions the claims fulfillment volume to the suppliers through the computer communication channels.

20. An apparatus as in claim 15, wherein the automated claims fulfillment system reverse auctions the claims fulfillment volume to the suppliers through the computer communication channels.

21. A computer-implemented process comprising:

automatically, by computer processing, aggregating claims fulfillment volume from multiple insurers for future periods; and

automatically, by computer processing, auctioning the aggregated claims fulfillment volume to suppliers.

22. A computer-implemented process as in claim 21, further comprising:

guaranteeing the auctioned aggregated claims fulfillment volume to the suppliers.

23. A computer-implemented process as in claim 21, further comprising:

automatically, by computer processing, load balancing actual claims fulfillment volume directed to suppliers winning the auctioned claims fulfillment volume.

24. A computer-implemented process as in claim 22, further comprising:

automatically, by computer processing, load balancing actual claims fulfillment volume directed to suppliers winning the auctioned claims fulfillment volume.

25. A computer-implemented process as in claim 21, further comprising:

automatically, by computer processing, presenting suppliers winning the auctioned claims fulfillment volume to claimants submitting actual claims; and

selecting, by computer processing, presented suppliers by the claimants to fulfill the claims.

26. A computer-implemented process as in claim 21, wherein said automatically auctioning comprises reverse auctioning the aggregated claims fulfillment volume to the suppliers.

27. A computer-implemented process as in claim 22, wherein said automatically auctioning comprises reverse auctioning the aggregated claims fulfillment volume to the suppliers.

28. A computer-implemented process as in claim 23, wherein said automatically auctioning comprises reverse auctioning the aggregated claims fulfillment volume to the suppliers.

29. A computer-implemented process as in claim 24, wherein said automatically auctioning comprises reverse auctioning the aggregated claims fulfillment volume to the suppliers.

30. A computer-implemented process as in claim 25, wherein said automatically auctioning comprises reverse auctioning the aggregated claims fulfillment volume to the suppliers.

31. An apparatus comprising:

means for aggregating claims fulfillment volume from multiple insurers for future periods; and

means for auctioning the aggregated claims fulfillment volume to suppliers.

32. An apparatus as in claim 31, further comprising:

means for presenting suppliers winning the auctioned claims fulfillment volume to a claimant submitting an actual claims; and

means for selecting by the claimant a respective supplier of the presented suppliers to fulfill the claim.

33. A process comprising:

aggregating claims fulfillment volume from a plurality of insurers;

estimating total claims fulfillment volume of the aggregated claims fulfillment volume to be guaranteed to suppliers;

auctioning the estimated total claims fulfillment volume to the suppliers; and

providing guarantees of the auctioned claims fulfillment volume to suppliers winning the reverse auctioned claims fulfillment volume.

34. A process as in claim 33, further comprising:

load balancing actual claims fulfillment volume directed to the winning suppliers.

35. A process as in claim 33, wherein said estimating estimates the total claims fulfillment volume in accordance with econometric and risk adjusted return models.

36. A process as in claim 33, further comprising:

presenting suppliers winning the auctioned claims fulfillment volume to a claimant submitting an actual claim; and

selecting a respective supplier of the presented suppliers by the claimant to fulfill the claim.

38. A process as in claim 37, further comprising:

load balancing actual claims fulfillment volume directed to the winning suppliers.

39. A process as in claim 37, wherein said estimating estimates the total claims fulfillment volume in accordance with econometric and risk adjusted return models.

40. A process as in claim 37, further comprising:

presenting suppliers winning the auctioned claims fulfillment volume to a claimant submitting an actual claim; and

selecting a respective supplier of the presented suppliers by the claimant to fulfill the claim.

37. A process comprising:

committing claims fulfillment volume for future periods by a plurality of insurers;

aggregating the committed claims fulfillment volume from the plurality of insurers;

estimating total claims fulfillment volume of the aggregated, committed claims fulfillment volume to be guaranteed to suppliers;

auctioning the estimated total claims fulfillment volume to the suppliers; and

providing guarantees of the auctioned claims fulfillment volume to suppliers winning the auctioned claims fulfillment volume.

41. A process comprising:

committing claims fulfillment volume for future periods by a plurality of insurers;

aggregating the committed claims fulfillment volume from the plurality of insurers;

estimating total claims fulfillment volume of the aggregated, committed claims fulfillment volume to be guaranteed to suppliers in accordance with econometric and risk adjusted return models;

reverse auctioning the estimated total claims fulfillment volume to the suppliers;

providing guarantees of the reverse auctioned claims fulfillment volume to suppliers winning the reverse auctioned claims fulfillment volume;

presenting the winning suppliers to claimants submitting actual claims;

selecting presented suppliers by the claimants to fulfill the claims; and

load balancing actual claims fulfillment volume directed to the winning suppliers.

42. A computer-implemented process comprising:

committing claims fulfillment volume for future periods by a plurality of insurers;

automatically, by a computer, aggregating the committed claims fulfillment volume from the plurality of insurers;

automatically, by a computer, estimating total claims fulfillment volume of the aggregated, committed claims fulfillment volume to be guaranteed to suppliers;

auctioning, by a computer, the estimated total claims fulfillment volume to the suppliers; and

providing guarantees of the auctioned claims fulfillment volume to suppliers winning the auctioned claims fulfillment volume.

43. A computer-implemented process comprising:

committing claims fulfillment volume for future periods by a plurality of insurers;

aggregating, by a computer, the committed claims fulfillment volume from the plurality of insurers;

estimating, by a computer, total claims fulfillment volume of the aggregated, committed claims fulfillment volume to be guaranteed to suppliers in accordance with econometric and risk adjusted return models;

reverse auctioning, by a computer, the estimated total claims fulfillment volume to the suppliers;

providing guarantees of the reverse auctioned claims fulfillment volume to suppliers winning the reverse auctioned claims fulfillment volume; and

load balancing, by a computer, actual claims fulfillment volume directed to the winning suppliers.

44. An apparatus comprising:

means for committing claims fulfillment volume for future periods by a plurality of insurers;

means for aggregating the committed claims fulfillment volume from the plurality of insurers;

means for estimating total claims fulfillment volume of the aggregated, committed claims fulfillment volume to be guaranteed to suppliers;

means for auctioning the estimated total claims fulfillment volume to the suppliers; and

means for providing guarantees of the auctioned claims fulfillment volume to suppliers winning the auctioned claims fulfillment volume.