Bruce Bealke - Valley Village CA, US Lawrence Shea - La Jolla CA, US
International Classification:
G06F017/60
US Classification:
705002000
Abstract:
Eliminating actual and potential bias from a malpractice claim evaluation process utilizes a double blind evaluation method, which includes the steps of retention by an entity having a direct or indirect interest in the claim of a neutral third party to obtain an independent evaluation of the claim, acquisition by the third party of facts relating to the claim which are sufficient to permit an independent objective evaluation of the claim, retention by the third party of a qualified independent expert to perform the claim evaluation, redaction from the sufficient facts of all facts which would permit the expert to identify any party involved or having an interest in the claim, submission by the third party of the sufficient facts after redaction to the expert in order to permit the expert to make an independent objective evaluation of the claim, preparation by the expert of a written independent objective evaluation of the claim, submission of the written claim evaluation by the expert to the third party, redaction from the written claim evaluation of any information which would permit identification the expert, and submission of the evaluation after redaction to the entity retaining the third party.
Bruce Bealke - Valley Village CA, US Lawrence Shea - La Jolla CA, US
International Classification:
G06F017/60
US Classification:
705080000, 705001000
Abstract:
The present invention relates to the satisfaction of an agreed to monetary settlement of a claim and provides claimants with the ability to electronically execute claims settlements, including releases, and for the issuance to the claimant, preferably electronically, of redeemable vouchers for at least a portion of the settlement amount and for the immediate transfer of funds for any remainder of the settlement amount to the claimant. In the presently preferred embodiment of the invention, a settlement processing entity is utilized to receive the proposed settlement terms and their acceptance, electronically receive the execution of any release by the claimant, and to initiate the electronic transfer of at least one voucher having a stated redemption value and, if required, settlement funds, the total of which exceeds the settlement amount, to the claimant after acceptance and electronic execution by the claimant of any release. In the preferred embodiment of the invention, the settlement processing entity pays a vendor obligated to redeem the voucher an amount less than the voucher's stated redemption value for the voucher. In further embodiment of the invention, the settlement processing entity receives a total monetary payment from the funding entity in satisfaction of the funding obligation which is less than the monetary settlement amount.
The present invention relates to the settlements of disputes and, in particular, offers insurance carriers, self-insured entities, and claimants the ability to formulate, review and electronically execute claims settlements, including releases, and for providing electronic funds transfer instructions for immediate release of settlement funds. In the preferred embodiment, in order to maintain confidentiality, an independent intermediary entity is utilized to receive the proposed settlement terms and their acceptance, electronically receive the execution of any release, and to coordinate electronic transfer of settlement funds after acceptance and electronic execution of any release, thereby reducing the time for completion of the entire transaction to less than two business days. In a further embodiment of the invention, the independent intermediary accumulates the settlement details and compiles a database of such information, which is accessible to claimants and insurers on a selective basis to assist in the evaluation of claims for settlement purposes, based on the settlement values of prior claims involving similar circumstances, and, preferably, is utilized by the insurance carriers, self-insured entities, and/or claimants prior to formulation of and/or acceptance of a claim settlement proposal to assist in evaluating the claim.