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1. WO2020109928 - CLAIM ANALYSIS SYSTEMS AND METHODS

Note: Text based on automatic Optical Character Recognition processes. Please use the PDF version for legal matters

[ EN ]

CLAIMS

1. A computer implemented method comprising:

receiving, from a submitter system, a claim review request, the claim review request comprising claim data in respect of a claim;

analysing the claim data to determine whether one or more defects exist in the claim; and

in response to determining that no defects exist in the claim data, communicating a claim release message to the submitter system, the claim release message causing a claim block maintained on the claim by the submitter system to be released.

2. The computer implemented method according to claim 1, wherein in response to determining that one or more defects do exist in the claim data, the method further comprises:

generating a defect notification comprising information in respect of the one or more defects identified in the claims and, in respect of each defect, a suggested review action; and

communicating the defect notification to the submitter or submitter system.

3. The computer implemented method according to claim 2, further comprising:

receiving, from the submitter system, a further claim review request in respect of the claim, the further claim review request comprising further claim data in respect of the claim, the further claim data comprising one or more of: additional claim data, amended claim data, comments; and

analysing at least the further claim data to determine whether any defects exist in the claim.

4. The computer implemented method according to claim 3, wherein in response to determining that no defects exist in the further claim data, the method further comprises:

communicating a claim release message to the submitter system, the claim release message causing a claim block maintained on the claim by the submitter system to be released.

5. The computer implemented method according to claim 3, wherein in response to determining that one or more defects do exist in the further claim data, the method further comprises:

determining that the one or more defects are all minor defects; in response to determining that all of the one or more defects are minor defects, determining that comments in respect of all of the one or more defects have been received from the submitter system; and

in response to determining that comments in respect of all of the one or more defects have been received from the submitter system, communicating a claim release message to the submitter system, the claim release message causing a claim block maintained on the claim by the submitter system to be released.

6. The computer implemented method according to claim 3, wherein in response to determining that one or more defects do exist in the further claim data, the method further comprises:

determining that comments in respect of one or more defects have not been received from the submitter system; and

in response to determining that comments in respect of one or more defects have not been received from the submitter system:

generating a further defect notification comprising information in respect of the one or more defects identified in

the claims and, in respect of each defect, a suggested review action; and

communicating the further defect notification to the submitter system.

7. The computer implemented method according to claim 3, wherein in response to determining that one or more defects do exist in the further claim data, the method further comprises:

determining that the one or more defects include major defects; in response to determining that the one or more defects include major defects, determining that comments in respect of all major defects have been received from the submitter system;

in response to determining that comments in respect of all major defects have been received from the submitter system:

generating an assessor input request; and

communicating the assessor input request to an assessor system.

8. The computer implemented method according to claim 7, further comprising:

receiving, from the assessor system, assessor input;

determining that the assessor input indicates that the claim should be allowed; and

in response to determining that the assessor input indicates that the claim should be allowed, communicating a claim release message to the submitter system, the claim release message causing a claim block maintained on the claim by the submitter system to be released.

9. The computer implemented method according to any one of claims 1 to 8, wherein analysing claim data to determine whether one or more defects exist in the claim comprises:

determining one or more rules that are potentially applicable to the claim data;

for each rule determined to be potentially applicable to the claim data:

applying the rule to the claim data to determine whether the rule is actually applicable;

if the rule is actually applicable, appending information associated with the rule to an analysis report; and returning the analysis report.

10. A claim review system comprising:

a processor,

a communication interface, and

a non-transitory computer-readable storage medium storing sequences of instructions, which when executed by the processor, cause the processor to implement the computer implemented method according to any of claims 1 - 9.

11. A non-transitory computer-readable storage medium storing sequences of instructions, which when executed by a computer processor, cause the processor to implement the computer implemented method according to any of claims 1 - 9.