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Kafe 바로가기국가/구분 | United States(US) Patent 등록 |
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국제특허분류(IPC7판) |
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출원번호 | US-0434827 (2003-05-09) |
등록번호 | US-8126742 (2012-02-28) |
발명자 / 주소 |
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출원인 / 주소 |
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대리인 / 주소 |
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인용정보 | 피인용 횟수 : 7 인용 특허 : 269 |
An automated assignment system may operate with a computer to automatically assign insurable events to one or more organizational entities associated with an insurance organization. The automated assignment system may categorize the insurable event. In addition, the automated assignment system may i
An automated assignment system may operate with a computer to automatically assign insurable events to one or more organizational entities associated with an insurance organization. The automated assignment system may categorize the insurable event. In addition, the automated assignment system may identify at least one target organizational entity based on the categorization that is capable of handling the insurable event. Identification of the target organizational entity or entities may be a function of properties associated with the insurable event and the availability of the organizational entity or entities. Automatic assignment may also be a function of the current workload of the target organizational entity or entities.
1. A method for assigning at least a portion of an insured loss to an insurance claim processing organization comprising: receiving, with a computer processor in communication with a memory, insurance claim data for an insurance claim, the insurance claim data including insurance claim data variable
1. A method for assigning at least a portion of an insured loss to an insurance claim processing organization comprising: receiving, with a computer processor in communication with a memory, insurance claim data for an insurance claim, the insurance claim data including insurance claim data variables corresponding to the insurance claim;determining, with the computer processor, matches between the insurance claim data variables and a plurality of predetermined insurance claim business rules based upon expected insurance claim data types corresponding to each of the predetermined insurance claim business rules;segmenting, with the computer processor, the insurance claim data variables into a plurality of insurance claim data segments based upon the matches between the insurance claim data variables and the predetermined insurance claim business rules, a respective insurance claim data segment including an insurance claim pattern type, wherein the insurance claim pattern type includes at least one of a type of insurance claim pattern type and an insurance business condition pattern type, and the insurance claim pattern type including insurance claim characteristics;matching, with the computer processor, each of the insurance claim characteristics in the insurance claim pattern type to a respective insurance claim data variable in the respective insurance claim data segment, each of the insurance claim characteristics including an insurance claim attribute and a claim characteristic attribute;assigning, with the computer processor, a discrete value to the insurance claim attribute for each of the insurance claim characteristics, the assigned discrete value for a respective insurance claim characteristic based upon the matched insurance claim data variable and the claim characteristic attribute of the respective insurance claim characteristic, wherein the discrete value is descriptive of the matched insurance claim data variable;grouping, with the computer processor, the insurance claim characteristics of the insurance claim pattern type to form insurance claim patterns within the insurance claim pattern type;generating, with the computer processor, one or more insurance claim pattern outcomes for each of the one or more insurance claim patterns based upon the discrete value assigned to the insurance claim attribute of each of the one or more insurance claim characteristics;storing, in the memory, the one or more insurance claim pattern outcomes for each of the one or more insurance claim patterns;generating, with the computer processor, a first pattern result for the insurance claim pattern type based upon pattern analysis of a first selection of the one or more stored insurance claim pattern outcomes;generating, with the computer processor, a second pattern result for the insurance claim pattern type based upon pattern analysis of a second selection of the one or more stored insurance claim pattern outcomes;storing, in the memory, the first pattern result and the second pattern result in the memory as insurance claim pattern results; andassigning, with the computer processor, at least one target organizational entity to at least one portion of the insurance claim based upon a match between at least some of the insurance claim pattern results stored in the memory and an assignment template associated with the at least one target organization entity. 2. The method of claim 1, wherein assigning, with the computer processor, the at least one target organizational entity to the at least one portion of the insurance claim based upon the match between the at least some of the insurance claim pattern results stored in the memory and the assignment template associated with the at least one target organization entity comprises: matching, with the computer processor, selection criteria in the assignment template to the at least some of the insurance claim pattern results stored in the memory. 3. The method of claim 1, wherein assigning the at least one target organizational entity to the at least one portion of the insurance claim comprises: determining, with the computer processor, an assignability of the at least one targeted organizational entity to the at least one portion of the insurance claim to generate a target organizational entity availability indication;detecting, with the computer processor, generation of a target organizational entity availability indication to assign the at least one target organizational entity to the at least one portion of the insurance claim; andassigning, with the computer processor, the at least one target organizational entity to the at least one portion of the insurance claim based on the generated target organizational entity availability indication. 4. The method of claim 1, further comprising: detecting, with the computer processor, a failure to assign the at least one target organizational entity to the at least one portion of the insurance claim;in response to the detected failure to assign the at least one target organizational entity to the insurance claim, identifying, with the computer processor, at least one target exception organizational entity based on the at least some of the insurance claim pattern results stored in the memory and the insurance claim data;determining, with the computer processor, an assignability of the at least one target exception organizational entity to the at least one portion of the insurance claim; andassigning, with the computer processor, the at least one target exception organizational entity to the at least one portion of the insurance claim based on the determined assignability of the at least one target exception organizational entity. 5. The method of claim 4, the computer executable program code further comprising: detecting, with the computer processor, a failure to assign the at least one target exception organizational entity to the at least one portion of the insurance claim;identifying, with the computer processor, a default target organizational entity in response to the detected failure to assign the at least one target exception organizational entity to the at least one portion of the insurance claim; andassigning, with the computer processor, the at least one portion of the insurance claim to the default target organizational entity based on identification of the default target organizational entity. 6. The method of claim 1, further comprising: allocating, with the computer processor, a management tracking credit for the insurance claim to an area of an insurance organization based on the assignment of the at least one portion of insurance claim to the at least one target organizational entity; andwherein the management tracking credit acknowledges assignment of the at least one portion of the insurance claim within the insurance organization. 7. The method of claim 1, further comprising: aggregating, with the computer processor, based upon a logic based operation, at least some portion of the insurance claim pattern results stored in the memory to determine additional properties associated with the insurance claim, wherein the additional properties are stored as insurance claim pattern results in the memory. 8. The method of claim 1, wherein assigning, with the computer processor, the at least one target organizational entity to the at least one portion of the insurance claim based upon the match between the at least some of the insurance claim pattern results stored in the memory and the assignment template associated with the at least one target organization entity comprises: assigning, with the computer processor, an importance rank to each of the insurance claim pattern results based upon relative importance factors; andidentifying, with the computer processor, the at least one target organizational entity for the at least one portion of the insurance claim based upon the at least some of the insurance claim pattern results and the importance rank of at least some of the insurance claim pattern results. 9. The method of claim 8, wherein the relative importance factors include a financial impact of settlement of the insurance claim, an unwanted publicity factor associated with the insurance claim, and a customer satisfaction factor. 10. A tangible computer readable media comprising: computer program code stored on the tangible computer readable media, the computer program code executable on a computer processor, wherein the computer program code includes:an instruction to receive insurance claim data for an insurance claim, the insurance claim data including insurance claim data variables corresponding to the insurance claim;an instruction to determine matches between the insurance claim data variables and a plurality of predetermined insurance claim business rules based upon expected insurance claim data types corresponding to each of the predetermined insurance claim business rules;an instruction to segment the insurance claim data variables into a plurality of insurance claim data segments based upon the matches between the insurance claim data variables and the predetermined insurance claim business rules, a respective insurance claim data segment including an insurance claim pattern type, wherein the insurance claim pattern type includes at least one of a type of insurance claim pattern type and an insurance business condition pattern type, and the insurance claim pattern type including insurance claim characteristics;an instruction to match each of the insurance claim characteristics in the insurance claim pattern type to a respective insurance claim data variable in the respective insurance claim data segment, each of the insurance claim characteristics including an insurance claim attribute and a claim characteristic attribute;an instruction to assign a discrete value to the insurance claim attribute for each of the insurance claim characteristics, the assigned discrete value for a respective insurance claim characteristic based upon the matched insurance claim data variable and the claim characteristic attribute of the respective insurance claim characteristic, and wherein the discrete value is descriptive of the matched insurance claim data variable;an instruction to group the insurance claim characteristics of the insurance claim pattern type to form insurance claim patterns within the insurance claim pattern type;an instruction to generate one or more insurance claim pattern outcomes for each of the one or more insurance claim patterns based upon the discrete value assigned to the insurance claim attribute of each of the one or more insurance claim characteristics;an instruction to store the one or more insurance claim pattern outcomes for each of the one or more insurance claim patterns;an instruction to generate a first pattern result for the insurance claim pattern type based upon pattern analysis of a first selection of the one or more stored insurance claim pattern outcomes;an instruction to generate a second pattern result for the insurance claim pattern type based upon pattern analysis of a second selection of the one or more stored insurance claim pattern outcomes;an instruction to store the first pattern result and the second pattern result as insurance claim pattern results; andan instruction to assign at least one target organizational entity to at least one portion of the insurance claim based upon a match between at least some of the insurance claim pattern results and an assignment template associated with the at least one target organization entity. 11. The tangible computer readable media of claim 10, wherein the instruction to assign the at least one target organizational entity to the at least one portion of the insurance claim based upon the match between the at least some of the insurance claim pattern results and the assignment template associated with the at least one target organization entity comprises: an instruction to match selection criteria in the assignment template to the at least some of the insurance claim pattern results. 12. The tangible computer readable media of claim 10, where the instruction to assign the at least one target organizational entity to the at least one portion of the insurance claim further comprises: an instruction to determine an assignability of the at least one targeted organizational entity to the at least one portion of the insurance claim to generate a target organizational entity availability indication;an instruction to detect generation of a target organizational entity availability indication to assign the at least one target organizational entity to the at least one portion of the insurance claim; andan instruction to assign the at least one target organizational entity to the at least one portion of the insurance claim based on the generated target organizational entity availability indication. 13. The tangible computer readable media of claim 10, further comprising: an instruction to detect a failure to assign the at least one target organizational entity to the at least one portion of the insurance claim;an instruction to identify, in response to the detected failure to assign the at least one target organizational entity to the insurance claim at least one target exception organizational entity based on the at least some of the insurance claim pattern results and the insurance claim data;an instruction to determine an assignability of the at least one target exception organizational entity to the at least one portion of the insurance claim; andan instruction to assign the at least one target exception organizational entity to the at least one portion of the insurance claim based on the determined assignability of the at least one target exception organizational entity. 14. The tangible computer readable media of claim 13, the computer executable program code further comprising: an instruction to detect failure to assign the at least one target exception organizational entity to the at least one portion of the insurance claim;an instruction to identify a default target organizational entity in response to the detected failure to assign the at least one target exception organizational entity to the at least one portion of the insurance claim; andan instruction to assign the at least one portion of the insurance claim to the default target organizational entity based on identification of the default target organizational entity. 15. The tangible computer readable media of claim 12, further comprising: an instruction to allocate a management tracking credit for the insurance claim to an area of an insurance organization based on the assignment of the at least one portion of insurance claim to the at least one target organizational entity; andwherein the management tracking credit acknowledges assignment of the at least one portion of the insurance claim within the insurance organization. 16. The tangible computer readable media of claim 10, further comprising: an instruction to aggregate, with a logic based operation, at least some portion of the insurance claim pattern results to determine additional properties associated with the insurance claim, wherein the additional properties are stored as pattern results. 17. The tangible computer readable media of claim 10, wherein the instruction to assign the at least one target organizational entity to the at least one portion of the insurance claim based upon the match between the at least some of the insurance claim pattern results and the assignment template associated with the at least one target organization entity comprises: an instruction to assign an importance rank to each of the insurance claim pattern results based upon relative importance factors; andan instruction to identify the at least one target organizational entity for the at least one portion of the insurance claim based upon the at least some of the insurance claim pattern results and the importance rank of at least some of the insurance claim pattern results. 18. The computer readable tangible media of claim 17, wherein the relative importance factors include a financial impact of settlement of the insurance claim, an unwanted publicity factor associated with the insurance claim, and a customer satisfaction factor. 19. A system for automated assignment of at least part of an insurance claim comprising: a computer processor in communication with a memory, the computer processor configured to retrieve insurance claim data from the memory;the computer processor further configured to segment the insurance claim data based upon a plurality of predetermined insurance business rules;the computer processor further configured to associate a segment of the insurance claim data with an insurance claim pattern type, wherein the insurance claim pattern type includes a first insurance claim pattern and a second insurance claim pattern;the computer processor further configured to assign first discrete information to the first insurance claim pattern for pattern analysis based upon the segment of the insurance claim data associated with the insurance claim pattern type;the computer processor further configured to assign second discrete information to the second insurance claim pattern for pattern analysis based upon the segment of the insurance claim data associated with the insurance claim pattern type;the computer processor further configured to generate a first insurance claim pattern outcome for the first insurance claim pattern based upon a first combination of the first discrete information assigned to the first insurance claim pattern;the computer processor further configured to generate a second insurance claim pattern outcome for the first insurance claim pattern based upon a second combination the first discrete information assigned to the first insurance claim pattern;the computer processor further configured to generate a first insurance claim pattern outcome for the second insurance claim pattern based on a first combination of the second discrete information;the computer processor further configured to store the first insurance claim pattern outcome for the first insurance claim pattern, the second insurance claim pattern outcome for the first insurance claim pattern, and the first insurance claim pattern outcome for the second insurance claim pattern in the memory as stored insurance claim pattern outcomes associated with the insurance claim pattern type;the computer processor further configured to generate a first insurance claim pattern result for the insurance claim pattern type based upon a first logical combination of a first selection of the stored insurance claim pattern outcomes;the computer processor further configured to generate a second insurance claim pattern result for the insurance claim pattern type based upon a second logical combination of a second selection of the stored insurance claim pattern outcomes;the computer processor further configured to store the first insurance claim pattern result and the second insurance claim pattern result in association with the insurance claim pattern type in the memory; andthe computer processor further configured to assign at least a portion of the insurance claim associated with the segment of insurance claim data to one or more target organizational entities based upon at least one of the first insurance claim pattern result, the second insurance claim pattern result, and a combination thereof. 20. The system of claim 19, wherein the processor is further configured to assign the at least a portion of the insurance claim associated with the segment of insurance claim data the one or more target organizational entities based upon the at least one of the first insurance claim pattern result, the second insurance claim pattern result, and the combination thereof, comprises: the computer processor configured to match selection criteria in the assignment template to the at least some of the insurance claim pattern results stored in the memory. 21. The system of claim 19, further comprising: the computer processor further configured to determine an assignability of each of the one or more targeted organizational entities to the portion of the insurance claim; andin response to determination that one or more of the target organization entities is available, the computer processor is further configured to assign an available target organizational entity to the at least a portion of the insurance claim. 22. The system of claim 19, further comprising: in response to determination that all of the one or more target organization entities are unavailable for assignment to the portion of the insurance claim, the computer processor further configured to identify at least one target exception organizational entity based on at least one of the first insurance claim pattern result, the second insurance claim pattern result, and the insurance claim data, and a combination thereof;the computer processor further configured to determine an assignability of the at least one identified target exception organizational entity to the at least a portion of the insurance claim; andin response to determination that the at least one identified target exception organizational entity is available, the computer processor further configured to assign the at least a portion of the insurance claim to the identified at least one target exception organizational entity. 23. The system of claim 22, further comprising: in response to determination that the identified at least one target exception organizational entity is unavailable for assignment to the at least a portion of the insurance claim, the computer processor further configured to identify a default target organizational entity; andthe computer processor further configured to assign the at least a portion of the insurance claim to the default target organizational entity based on identification of the default target organizational entity. 24. The system of claim 19, further comprising: the computer processor further configured to allocate a management tracking credit for the at least a portion of the insurance claim to an area of an insurance organization based on the assignment of the at least a portion of the insurance claim to the one or more target organizational entities; andwherein the management tracking credit acknowledges assignment of the portion of the insurance claim within the insurance organization. 25. A tangible computer readable media comprising: computer program code stored on the tangible computer readable media, the computer program code executable on a computer processor, wherein the computer program code includes:an instruction to retrieve insurance claim data;an instruction to segment the insurance claim data based upon a plurality of predetermined insurance business rules;an instruction to associate a segment of the insurance claim data with an insurance claim pattern type, wherein the insurance claim pattern type includes a first insurance claim pattern and a second insurance claim pattern;an instruction to assign first discrete information to the first insurance claim pattern for pattern analysis based upon the segment of the insurance claim data associated with the insurance claim pattern type;an instruction to assign second discrete information to the second insurance claim pattern for pattern analysis based upon the segment of the insurance claim data associated with the insurance claim pattern type;an instruction to generate a first insurance claim pattern outcome for the first insurance claim pattern based upon a logic based analysis of a first combination of the first discrete information;an instruction to generate a second insurance claim pattern outcome for the first insurance claim pattern based upon a logic based analysis of a second combination of the first discrete information;an instruction to generate a first insurance claim pattern outcome for the second insurance claim pattern based upon a logic based analysis of a first combination of the second discrete information;an instruction to store the first insurance claim pattern outcome of the first insurance claim pattern, the second insurance claim pattern outcome of the first insurance claim pattern, and the first insurance claim pattern outcome of the second insurance claim pattern in the memory as stored insurance claim pattern outcomes associated with the insurance claim pattern type;an instruction to pattern analyze a first combination of the stored insurance claim pattern outcomes to generate a first insurance claim pattern result for the insurance claim pattern type;an instruction to pattern analyze a second combination of the stored insurance claim pattern outcomes to generate a second insurance claim pattern result for the pattern type;an instruction to store the first pattern result and the second pattern result in association with the pattern type; andan instruction to assign at least a portion of the insurance claim to at least one target organizational entity based upon a combination of the first insurance claim pattern result and the second insurance claim pattern result. 26. The tangible computer readable media of claim 25, wherein assigning the at least one target organizational entity based upon the combination of the first insurance claim pattern result and the second insurance claim pattern result further comprises: an instruction to identify the at least one target organizational entity based upon the combination of the first insurance claim pattern result and the second insurance claim pattern result. 27. The tangible computer readable media of the insurance claim of claim 25, further comprising: an instruction to determine an assignability of the at least one targeted organizational entity to the insurance claim to generate a target organizational entity availability indication;an instruction to detect generation of a target organizational entity availability indication to assign the at least one target organizational entity to the insurance claim; andan instruction to assign, in response to detection of the generation of the target organization entity availability indication, the at least one target organizational entity to the insurance claim based on the generated target organizational entity availability indication. 28. The tangible computer readable media of claim 27, further comprising: an instruction to detect a failure to assign the at least one target organizational entity to the insurance claim;an instruction to identify in response to detection of the failure to assign the at least one target organization entity to the insurance claim, at least one target exception organizational entity based on at least one of the first insurance claim pattern result, the second insurance claim pattern result, and the insurance claim data;an instruction to determine an assignability of the at least one target exception organizational entity to the insurance claim; andan instruction to assign the at least one target exception organizational entity to the at least a portion of the insurance claim based on the determined assignability of the at least one target exception organizational entity. 29. The tangible computer readable media of claim 25, further comprising: an instruction to detect a failure to assign the at least one target exception organizational entity to the insurance claim;an instruction to identify, in response to detection of the failure to assign the at least one target exception organizational entity to the insurance claim, identifying a default target organizational entity to the insurance claim; andan instruction to assign the insurance claim to the default target organizational entity based upon identification of the default target organizational entity. 30. The tangible computer readable media of claim 25, further comprising: an instruction to allocate a management tracking credit for the insurance claim to an area of an insurance organization based on the assignment of the at least a portion of the insurance claim to the at least one target organizational entity; andwherein the management tracking credit acknowledges assignment of the portion of the insurance claim within the insurance organization. 31. A system for assigning at least portions of an insurance claim to an organization comprising: a computer processor in communication with a memory, the processor configured to receive insurance claim data for the insurance claim, the insurance claim data including insurance claim data variables corresponding to the insurance claim;the computer processor further configured to determine matches between the insurance claim data variables and a plurality of predetermined insurance claim business rules based upon expected insurance claim data types corresponding to each of the predetermined insurance claim business rules;the computer processor further configured to segment the insurance claim data variables into a plurality of insurance claim data segments based upon the matches between the insurance claim data variables and the predetermined insurance claim business rules, a respective insurance claim data segment including an insurance claim pattern type, wherein the insurance claim pattern type includes at least one of a type of insurance claim pattern type and an insurance business condition pattern type, and the insurance claim pattern type including insurance claim characteristics;the computer processor further configured to match each of the insurance claim characteristics in the insurance claim pattern type to a respective insurance claim data variable in the respective insurance claim data segment, each of the insurance claim characteristics including an insurance claim attribute and a claim characteristic attribute;the computer processor further configured to assign a discrete value to the insurance claim attribute for each of the insurance claim characteristics, the assigned discrete value for a respective insurance claim characteristic based upon the matched insurance claim data variable and the claim characteristic attribute of the respective insurance claim characteristic, wherein the discrete value is descriptive of the matched insurance claim data variable;the computer processor further configured to group the insurance claim characteristics of the insurance claim pattern type to form insurance claim patterns within the insurance claim pattern type;the computer processor further configured to generate one or more insurance claim pattern outcomes for each of the one or more insurance claim patterns based upon the discrete value assigned to the insurance claim attribute of each of the one or more insurance claim characteristics;the computer processor further configured to store the one or more insurance claim pattern outcomes for each of the one or more insurance claim patterns;the computer processor further configured to generate a first pattern result for the insurance claim pattern type based upon pattern analysis of a first selection of the one or more stored insurance claim pattern outcomes;the computer processor further configured to generate a second pattern result the insurance claim pattern type based upon pattern analysis of a second selection of the one or more stored insurance claim pattern outcomes;the computer processor further configured to store the first pattern result and the second pattern results in the memory as insurance claim pattern results; andthe computer processor further configured to assign at least one target organizational entity to at least one portion of the insurance claim based upon a match between at least some of the insurance claim pattern results stored in the memory and an assignment template associated with the at least one target organization entity. 32. The system of 31, wherein the computer processor is further configured to assign the at least one target organizational entity to the at least one portion of the insurance claim based upon the match between the at least some of the insurance claim pattern results stored in the memory and the assignment template associated with the at least one target organization entity comprises: the computer processor further configured to match selection criteria in the assignment template to the at least some of the insurance claim pattern results stored in the memory. 33. The system of claim 31, further comprising: the computer processor further configured to determine an assignability of the at least one targeted organizational entity to the at least one portion of the insurance claim to generate a target organizational entity availability indication;the computer processor further configured to detect generation of a target organizational entity availability indication to assign the at least one target organizational entity to the at least one portion of the insurance claim; andthe computer processor further configured to assign the at least one target organizational entity to the at least one portion of the insurance claim based on the generated target organizational entity availability indication. 34. The system of claim 31, further comprising: the computer processor further configured to detect, with the processor, a failure to assign the at least one target organizational entity to the at least one portion of the insurance claim;the computer processor further configured to identify, in response to the detected failure to assign the at least one target organizational entity to the insurance claim, with the processor, at least one target exception organizational entity based on the at least some of the insurance claim pattern results stored in the memory and the insurance claim data;the computer processor further configured to determine an assignability of the at least one target exception organizational entity to the at least one portion of the insurance claim; andthe computer processor further configured to assign the at least one target exception organizational entity to the at least one portion of the insurance claim based on the determined assignability of the at least one target exception organizational entity. 35. The system of claim 34, further comprising: the computer processor further configured to detect failure to assign the at least one target exception organizational entity to the at least one portion of the insurance claim;the computer processor further configured to identify, with the processor, a default target organizational entity in response to the detected failure to assign the at least one target exception organizational entity to the at least one portion of the insurance claim; andthe computer processor further configured to assign the at least one portion of the insurance claim to the default target organizational entity based on identification of the default target organizational entity. 36. The system of claim 31, further comprising: the computer processor further configured to allocate a management tracking credit for the insurance claim to an area of an insurance organization based on the assignment of the at least one portion of insurance claim to the at least one target organizational entity; andwherein the management tracking credit acknowledges assignment of the at least one portion of the insurance claim within the insurance organization. 37. The system of claim 34, further comprising: the computer processor further configured to determine additional properties associated with the insurance claim based upon aggregation of at least some portion of the insurance claim pattern results stored in the memory. 38. The system of claim 31, the computer processor further configured to assign the at least one target organizational entity to the at least one portion of the insurance claim based upon the match between the at least some of the insurance claim pattern results stored in the memory and the assignment template associated with the at least one target organization entity comprises: the computer processor further configured to assign an importance rank to each of the insurance claim pattern results based upon relative importance factors; andthe computer processor further configured to identify the at least one target organizational entity for the at least one portion of the insurance claim based upon the at least some of the insurance claim pattern results stored in the memory and the importance rank of at least some of the insurance claim pattern results. 39. The system of claim 38, wherein the relative importance factors include a financial impact of settlement of the insurance claim, an unwanted publicity factor associated with the insurance claim, and a customer satisfaction factor.
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