Note : Les descriptions sont présentées dans la langue officielle dans laquelle elles ont été soumises.
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AUTOMATED REIMBURSEMENT INTERACTIONS
REFERENCE TO RELATED APPLICATIONS
The present application claims priority from U.S. Patent Application Serial
No.
13/900,919 to Ketzef, filed May 23, 2013, entitled AUTOMATED REIMBURSEMENT
INTERACTIONS, which is a continuation-in-part of U.S. Patent Application
Serial No.
12/949,367 (published as US 2012/0130750) to Ketzef, filed November 18, 2010,
entitled
AUTOMATED INSURER INSURED INTERACTIONS. The disclosures of the
aforementioned applications are hereby incorporated by reference.
FIELD OF THE INVENTION
The present invention relates to systems and methodologies for automated
reimbursement interactions.
BACKGROUND OF THE INVENTION
The following publications are believed to represent the current state of the
art:
MPP Power Text2Insure Text Messaging Travel Insurance Service, MPP Global
Solutions, dated September 24, 2010;
U.S. Patent Nos. 4,491,725; 4,858,121; 5,235,507; 5,359,509; 6,208,973;
6,343,310; 6,609,200; 6,823,075; 6,941,363; 7,028,012; 7,039,603; 7,236,950;
7,287,071;
7,380,707; 7,434,729; 7,584,125; 7,590,557; 7,698,182; 7,792,686 and
8,066,192;
U.S. Published Patent Application Nos.: 2002/0035529; 2003/0088441;
2003/0187695; 2004/0083123; 2004/0148204; 2005/0015280; 2005/0086075;
2005/0122953; 2005/0228700; 2006/0106650; 2007/0005402; 2007/0129972;
2007/0168234; 2007/0174082; 2008/0228641; 2010/0185534; 2011/0145007 and
2012/023929;
European Published Patent Application Nos.: EP 2168025 and EP 1360632; and
all references cited therein.
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SUMMARY OF THE INVENTION
The present invention seeks to provide improved systems and methodologies for
automated reimbursement interactions.
There is thus provided in accordance with a preferred embodiment of the
present
invention a computerized immediate settlement insurance claim payment system
including
insurance policy issuing functionality for issuing, by an insurer, an
insurance policy to an
insured, and associating the policy with a payment-enabled mobile communicator
to be
carried by the insured and, upon the occurrence of an insured event, to be
employed by the
insured to cover at least part of the cost of the insured event, the insurance
policy including
a charge back provision allowing the insurer to charge back payments made to
the insured
via an identified credit card account of the insured, at least near real time
automatic
insurance claim verification functionality which is operative to automatically
verify the
right of the insured to obtain payment from the insurer by automatically
verifying at least
one of the value of the payment, the type of recipient entitled to receive
such payment and
the location of the recipient as identified by the mobile communicator,
insurance claim
documentation requesting functionality operative to request, at the initiative
of the insurer,
documentation relating to the insured event and chargeback functionality
operative to
charge back, at the initiative of the insurer, at least part of the payment
via the identified
credit card account of the insured.
Preferably, the payment-enabled mobile communicator enables at least some
medical information regarding the insured to be communicated to a medical
service
provider. Additionally, the payment-enabled mobile communicator stores the at
least some
medical information regarding the insured to be communicated to a medical
service
provider. Alternatively, the payment-enabled mobile communicator communicates
the at
least some medical information regarding the insured from an external database
to the
medical service provider.
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In accordance with a preferred embodiment of the present invention the payment-
enabled mobile communicator provides at least one of recommendations and
travel
directions to an insured to assist in contacting a medical service provider.
Preferably, the chargeback functionality is operative, in the absence of
receipt of
the documentation, to charge back the payment via the identified credit card
account of the
insured. In accordance with a preferred embodiment of the present invention
the
chargeback functionality is operative, upon receipt of the documentation, to
charge back at
least part of the payment via the identified credit card account of the
insured.
Preferably, the insured authorizes a mobile communication service provider to
provide country of origin information relating to the payment-enable mobile
communicator
to the insurer.
In accordance with a preferred embodiment of the present invention the payment-
enabled mobile communicator includes at least two of the following
functionalities:
insurance policy issuance functionality, payment location verification
functionality,
medical treatment documentation communication functionality, medical
information
communication functionality, medical service provider recommendation
functionality,
medical service provider travel directions functionality, claim eligibility
ascertaining
functionality, payment level eligibility functionality and claim adjudication
functionality.
More preferably, the payment-enabled mobile communicator includes at least
five of the
following functionalities: insurance policy issuance functionality, payment
location
verification functionality, medical treatment documentation communication
functionality,
medical information communication functionality, medical service provider
recommendation functionality, medical service provider travel directions
functionality,
claim eligibility ascertaining functionality, payment level eligibility
functionality and claim
adjudication functionality.
There is also provided in accordance with another preferred embodiment of the
present invention a computerized reimbursement system including at least one
reimbursement-enabled mobile communicator having computerized memory
functionality,
computerized communications functionality and wireless payment functionality
and at
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least one reimbursement-enabled computer server having computerized memory
functionality and computerized communications functionality, at least one of
the at least
one reimbursement-enabled mobile communicator and the at least one
reimbursement-
enabled computer server storing reimbursement policy parameters which are
selectable by
a reimbursing party using the system, the reimbursement policy parameters
including at
least payee location and transaction amount, at least one of the at least one
mobile
communicator and the at least one computer server being operative to
automatically
complete payment transactions which are compliant with the reimbursement
policy
parameters and to automatically reject payment transactions which are not
compliant with
the reimbursement policy parameters.
Preferably, the at least one computer server is operative to seek repayment of
at
least a portion of a payment already made which fails to satisfy certain
criteria. In
accordance with a preferred embodiment of the present invention the at least
one
reimbursement-enabled mobile communicator is utilized by an employee of the
reimbursing party and the repayment includes deducting the at least a portion
of a payment
from wages of the employee.
Preferably, the criteria include providing documentation relating to the
payment
transaction.
In accordance with a preferred embodiment of the present invention the policy
parameters include at least one single transaction maximum payment amount.
Additionally
or alternatively, the policy parameters include at least one trip duration
maximum payment
amount.
Preferably, a mobile communication service provider is authorized to provide
country of origin information relating to the payment-enable mobile
communicator to the
computerized reimbursement system.
In accordance with a preferred embodiment of the present invention the payment-
enabled mobile communicator includes at least two of the following
functionalities:
payment location verification functionality, payment documentation
communication
functionality, product/service provider recommendation functionality,
product/service
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provider travel directions functionality, reimbursement eligibility
ascertaining
functionality, reimbursement amount eligibility functionality and
reimbursement
adjudication functionality. More preferably, the payment-enabled mobile
communicator
includes at least four of the following functionalities: payment location
verification
functionality, payment documentation communication functionality,
product/service
provider recommendation functionality, product/service provider travel
directions
functionality, reimbursement eligibility ascertaining functionality,
reimbursement amount
eligibility functionality and reimbursement adjudication functionality.
Most preferably, the payment-enabled mobile communicator includes all of the
following functionalities: payment location verification functionality,
payment
documentation communication functionality, product/service provider
recommendation
functionality, product/service provider travel directions functionality,
reimbursement
eligibility ascertaining functionality, reimbursement amount eligibility
functionality and
reimbursement adjudication functionality.
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BRIEF DESCRIPTION OF THE DRAWINGS
The present invention will be understood and appreciated more fully from the
following detailed description, taken in conjunction with the drawings in
which:
Figs. 1A, 1B, 1C, 1D, 1E, 1F and 1G are simplified pictorial illustrations of
steps in
an insurer-insured interaction employing the system and methodology of a
preferred
embodiment of the present invention;
Figs. 2A, 2B, 2C, 2D, 2E and 2F are simplified pictorial illustrations of
steps in an
insurer-insured interaction employing the system and methodology of another
preferred
embodiment of the present invention;
Fig. 3A is a simplified flow chart illustrating one example of the operation
of the
system of Figs. 1A-2F;
Fig. 3B is a simplified flow chart illustrating another example of the
operation;
Figs. 4A, 4B, 4C, 4D, 4E, 4F and 4G are simplified pictorial illustrations of
steps in
an insurer-insured interaction employing the system and methodology of another
preferred
embodiment of the present invention;
Fig. 5 is a simplified flow chart illustrating one example of the operation of
the
system of Figs. 4A-4G;
Figs. 6A, 6B, 6C, 6D, 6E, 6F, 6G, 6H and 61 are simplified pictorial
illustrations of
steps in employee reimbursement interactions employing the system and
methodology of
another preferred embodiment of the present invention; and
Fig. 7 is a simplified flow chart illustrating one example of the operation of
the
system illustrated in Figs. 6A-6I.
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DETAILED DESCRIPTION OF PREFERRED EMBODIMENTS
The embodiments described hereinbelow include various computer implemented
functions, some of which may be executed by a server or other computer system
and some
of which may be executed by a mobile communicator. The present invention
preferably
includes software implemented modules stored on a tangible medium, such as a
readable
disk or other storage device, for performing the various functions described
hereinbelow.
Additionally or alternatively, the functions described hereinbelow may include
computer
instructions implemented in hardware.
Reference is now made to Figs. 1A, 1B, 1C, 1D, 1E, 1F and 1G, which are
simplified pictorial illustrations of steps in an insurer-insured interaction
employing the
system and methodology of a preferred embodiment of the present invention. The
system
of Figs. lA - 1G is a computerized immediate settlement insurance claim
payment system
comprising insurance policy issuing functionality for issuing, by an insurer,
an insurance
policy to an insured, and associating the policy with an insurance card to be
carried by the
insured. Upon the occurrence of an insured event, the insurance card is to be
presented by
the insured in association with a card reader to cover at least part of the
cost of the
insurance event. The insurance policy includes a charge back provision
allowing the
insurer to charge back payments made to the insured via an identified credit
card of the
insured.
The immediate settlement insurance claim payment system also comprises
automatic insurance claim verification functionality which, responsive to
presentation of
the insurance card, is operative to automatically verify the right of the
insured to receive
payment from the insurer by automatically verifying at least one of the value
of the
payment, the type of recipient entitled to receive such payment as identified
by the card
reader and the location of the recipient as identified by the card reader.
The immediate settlement insurance claim payment system also comprises
insurance claim documentation requesting functionality operative to request
from the
insured, at the initiative of the insurer, following paying of the payment,
documentation
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relating to the insured event, and chargeback functionality operative to
charge back, at the
initiative of the insurer, in the absence of receipt of the documentation, at
least part of the
payment via the identified credit card of the insured.
As shown in Fig. 1A, prior to traveling, such as on January 1, 2011, a
potential
purchaser of travel insurance contacts an insurer which utilizes a self-
executing insurance
claim payment system 100, to purchase travel insurance to be associated with
an insurance
card 102 using a credit card 104. It is appreciated that insurance card 102
may be
distributed free of charge by travel agencies, publishers of travel
information, or by any
other entity. As seen in Fig. 1A, contact with the insurer may be via
telephone or via an
automated telephone-operated system.
Upon establishing contact with the insurer, the potential purchaser of travel
insurance is prompted for an insurance card identification number and for
personal credit
card information to pay for the travel insurance. It is appreciated that a
potential purchaser
of travel insurance may not be in possession of an insurance card when
contacting the
insurer, and may be provided with an insurance card after purchasing the
travel insurance.
Additionally, the potential purchaser of travel insurance is prompted for
information pertaining to his future travels, such as dates of travel and
destination. Upon
providing the requested information, the information is stored in system 100
which
provides confirmation of purchase of travel insurance to the purchaser.
It is a particular feature of the present invention that an insurance card
102, once
associated with an insurance contract, preferably serves as a debit card to
which
reimbursements of expenses incurred by the insured under the coverage provided
by the
insurance contract are transferred, under the terms of the insurance contract.
Turning now to Fig. 1B, it is shown that on the planned date of departure of
January 5, the insured arrives at a port of departure such as an airport. Once
inside the port
of departure, the insured preferably passes through a portal 110 which
automatically
detects the insured's insurance card 102, such as by an RFID mechanism which
is part of
portal 110, which mechanism detects an RFID chip embedded in insurance card
102, and
thereby ascertains the insured's presence at the port of departure.
Alternatively, the
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insured's presence at the port of departure may be ascertained by determining
the location
of the insured's cell phone using standard cell phone locating techniques.
Upon ascertaining the insured's presence at the port of departure, a
communication system (not shown) which is part of portal 110 notifies self-
executing
insurance claim payment system 100 of the insured's imminent departure, which
causes
system 100 to automatically activate the insured's travel insurance.
Alternatively, upon
ascertaining the insured' s presence at the port of departure, the insurer may
contact the
insured before activating the insured's travel insurance to verify the
insured's present
medical condition or travel plans. In the absence of mechanisms operative to
automatically
ascertain the insured's presence at the port of departure, the insured may
contact the insurer
to report his imminent departure, and to request activation of the insurance.
Turning now to Fig. 1C, it is shown that while abroad, on a later date such as
on
January 10, the insured injures his leg. The insured is taken to a hospital
120 by an
ambulance 122 and provides access to his medical history to the hospital
staff. Preferably,
the insured's medical history is encoded on insurance card 102 at the time of
purchase of
the travel insurance.
As shown in Fig. 1C, the insured receives appropriate medical treatment, and
contacts the insurer to report details of the injury and of the medical
facility where
treatment is being received, and to request advance funding of the estimated
cost of the
treatment. In response, the insured is prompted to provide personal credit
card details for
guarantee.
It is a particular feature of the present invention that self-executing
insurance
claim payment system 100 includes fraud detection functionality which is
automatically
operative to detect, with a high degree of certainty, fraudulent claims
reported to the
insurer. This detection may be achieved, for example, by voice analysis
techniques or by
statistical analysis.
It is another particular feature of the present invention that for claims
which
system 100 determines, with a high degree of certainty, to be legitimate,
system 100 is
operative to automatically provide advance funding of expected medical
expenses incurred
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by the insured under the coverage provided by the insurance, based on the
reporting by the
insured of the medical expense incurred. Preferably, advance funding is
automatically
transferred by system 100 to the insured's insurance card 102. Alternatively,
the advance
funding may be provided to the insured, for example, by crediting the
insured's credit\debit
card, bank account, or any other personal banking or crediting system.
It is yet another particular feature of the present invention that the system
100
requires that credit card details of the insured be provided to serve as a
guarantee to be
invoked by the system 100 to reimburse the insurer in a case where the insured
has
received from the insurer compensation for fraudulent or unjustified insurance
claims,
despite activation of the fraud detection functionality.
It is appreciated that system 100 comprises a knowledge base which facilitates
calculation of expected medical expenses, which knowledge base includes
accumulated
statistics of cost of treatment of a wide range of medical treatments provided
in any of a
wide range of locales and medical institutions around the world.
Returning now to Fig. 1C, upon determining with a high degree of certainty
that
the insured's claim is legitimate, and upon obtaining a guarantee in the form
of the
insured's personal credit card details, advance funding is preferably provided
to the insured
via the insured's insurance card 102. As seen in Fig. 1C, the insured's
insurance card 102
is credited with $500, which is the expected cost of the insured's medical
expense as
estimated by system 100.
Upon checking out of the hospital 120, the insured is charged $435 for the
medical treatment he received at the hospital 120, which the insured pays
using insurance
card 102. It is appreciated that the actual charge of $435 is less than the
$500 credited to
insurance card 102.
Alternatively, as shown in Fig. 1D, the insured defers contacting the insurer
until
after completing the medical treatment and after paying $435 to the hospital
120. Payment
may be achieved, for example, by charging the insured's credit card 104. After
checking
out of the hospital 120, the insured contacts the insurer to report the injury
and to request
reimbursement for the cost of the treatment. In response, the insured is
prompted to
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provide personal credit card details for guarantee. Upon determining with a
high degree of
certainty that the insured's claim is not fraudulent or unjustified, and upon
obtaining a
guarantee in the form of the insured's personal credit card 104 details,
reimbursement is
preferably provided to the insured via the insured's insurance card 102,
personal credit
card 104, personal debit card, or to the insured's bank account. As seen in
Fig. 1D,
subsequent to the reimbursement, the insured withdraws the reimbursed sum of
$435 via
an ATM machine 130.
Turning now to Fig. 1E, it is shown that upon returning from abroad, such as
on
February 1, the insured provides documentation 140 to the insurer regarding
medical
treatment provided and any related costs incurred during the insured's trip
abroad. Upon
receiving documentation 140 of the treatment and its cost of $435 from the
insured, self-
executing insurance claim payment system 100 collects any difference between
sums
previously forwarded to the insured and the actual justified cost of the
treatment as
determined by the insurer, from the insured's insurance card 102. In the
scenario of Fig. 1C
this difference is $65, which is the difference between the $500 originally
forwarded to the
insured and the $435 which the insured actually paid for the treatment.
Alternatively, as shown in Fig. 1F, should the insured fail to provide such
documentation within a reasonable amount of time, such as by March 1, self-
executing
insurance claim payment system 100 sends the insured a reminder to provide the
documentation, warning him that failure to do so will result in the insurer
invoking the
guarantee provided in the form of credit card 104, as described hereinabove
with regard to
Figs. 1C & 1D.
As shown in Fig. 1G, should the insured fail to provide relevant documentation
by
April 1, despite the warning sent by the insurer, self-executing insurance
claim payment
system 100 invokes the guarantee provided in the form of credit card 104, and
charges the
insured's credit card 104 for the total amount of $435 previously provided to
the insured.
Reference is now made to Figs. 2A, 2B, 2C, 2D, 2E and 2F, which are simplified
pictorial illustrations of steps in an insurer-insured interaction employing
the system and
methodology of another preferred embodiment of the present invention. As shown
in Fig.
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2A, on January 1, 2011, a potential purchaser of automobile insurance contacts
an insurer
which utilizes a self-executing insurance claim payment system 200, to
purchase
automobile insurance to be associated with an insurance card 202 using a
credit card 204.
It is appreciated that insurance card 202 may be distributed free of charge by
automobile
dealers, or by any other entity. As seen in Fig. 2A, contact with the insurer
may be via
telephone or via an automated telephone-operated system.
Upon establishing contact with the insurer, the potential purchaser of
automobile
insurance is prompted for an insurance card identification number and for
personal credit
card information. It is appreciated that a potential purchaser of automobile
insurance may
not be in possession of an insurance card when contacting the insurer, and may
be provided
with an insurance card after purchasing the automobile insurance.
Additionally, the potential purchaser of automobile insurance is prompted for
information pertaining to the automobile 210 to be insured, such as make and
model and
identification of designated drivers. Upon providing the requested
information, the
information is stored in system 200 which provides confirmation of purchase of
automobile insurance to the purchaser and activates the automobile insurance.
Turning now to Fig. 2B, it is shown that on a later date such as on January
10, the
insured automobile 210 is involved in an automobile accident. The automobile
210 is
towed to a garage 220 where it is repaired. As shown in Fig. 2B, the insured
contacts the
insurer to report details of the accident and of the garage where repairs are
being made to
the automobile 210, and to request advance funding of the estimated cost of
the repairs. In
response, the insured is prompted to provide personal credit card details for
guarantee.
It is a particular feature of the present invention that self-executing
insurance
claim payment system 200 includes fraud detection functionality which is
automatically
operative to detect, with a high degree of certainty, fraudulent claims
reported to the
insurer. This detection may be achieved, for example by voice analysis
techniques or by
statistical analysis.
It is another particular feature of the present invention that for claims
which
system 200 determines, with a high degree of certainty, to be legitimate,
system 200 is
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operative to automatically provide advance funding of expected expenses
incurred by the
insured under the coverage provided by the insurance, based on the reporting
by the
insured of the expense incurred. Preferably, advance funding is automatically
transferred
by system 200 to the insured's insurance card 202. Alternatively, the advance
funding may
be provided to the insured, for example, by crediting the insured's
credit\debit card, bank
account, or any other personal banking or crediting system.
It is yet another particular feature of the present invention that the system
200
requires that credit card details of the insured be provided to serve as a
guarantee to be
invoked by the system 200 to reimburse the insurer in a case where the insured
has
received from the insurer compensation for fraudulent or unjustified insurance
claims,
despite activation of the fraud detection functionality.
It is appreciated that system 200 comprises a knowledge base which facilitates
calculation of expected automobile repair expenses, which knowledge base
includes
accumulated statistics of cost of a wide range of automobile repairs provided
in any of a
wide range of locales.
Returning now to Fig. 2B, upon determining with a high degree of certainty
that
the insured's claim is legitimate, and upon obtaining a guarantee in the form
of the
insured's personal credit card details, advance funding is preferably provided
to the insured
via the insured's insurance card 202. As seen in Fig. 2B, the insured's
insurance card 202
is credited with $1000, which is the expected cost of the insured's automobile
repairs as
estimated by system 200.
Upon checking out of the garage 220, the insured is charged $875 for the
repairs
done at the garage 220, which the insured pays using insurance card 202. It is
appreciated
that the actual charge of $875 is less than the $1000 credited to insurance
card 202.
Alternatively, as shown in Fig. 2C, the insured defers contacting the insurer
until
after repairs to the automobile 210 are completed and after paying $875 to the
garage 220.
Payment may be achieved, for example, by charging the insured's credit card
204. After
checking out of the garage 220, the insured contacts the insurer to report the
accident and
to request reimbursement for the cost of the repairs. In response, the insured
is prompted to
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provide personal credit card details for guarantee. Upon determining with a
high degree of
certainty that the insured's claim is not fraudulent or unjustified, and upon
obtaining a
guarantee in the form of the insured's personal credit card 204 details,
reimbursement is
preferably provided to the insured via the insured's insurance card 202,
personal credit
card 204, personal debit card, or to the insured's bank account. As seen in
Fig. 2C,
subsequent to the reimbursement, the insured withdraws the reimbursed sum of
$875 via
an ATM machine 230.
Turning now to Fig. 2D, it is shown that at a later date, such as on February
1, the
insured provides documentation 240 to the insurer regarding automobile repairs
provided
and any related costs. Upon receiving documentation 240 of the repairs and its
cost of $875
from the insured, self-executing insurance claim payment system 200 collects
any
difference between sums previously forwarded to the insured and the actual
justified cost
of the repairs as determined by the insurer, from the insured's insurance card
202. In the
scenario of Fig. 2B, this difference is $125, which is the difference between
the $1000
originally forwarded to the insured and the $875 which the insured actually
paid for the
repairs.
Alternatively, as shown in Fig. 2E, should the insured fail to provide such
documentation within a reasonable amount of time, such as by March 1, self-
executing
insurance claim payment system 200 sends the insured a reminder to provide the
documentation, warning him that failure to do so will result in the insurer
invoking the
guarantee provided in the form of credit card 204, as described hereinabove
with regard to
Figs. 2B & 2C.
As shown in Fig. 2F, should the insured fail to provide relevant documentation
by
April 1, despite the warning sent by the insurer, self-executing insurance
claim payment
system 200 invokes the guarantee provided in the form of credit card 204, and
charges the
insured's credit card 204 for the total amount of $875 previously provided to
the insured.
Reference is now made to Fig. 3A, which is a simplified flow chart
illustrating
one example of the operation of the system of Figs. 1A-2F. As shown in Fig.
3A, a
potential purchaser of insurance purchases insurance from an insurer, which
insurance is
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then activated by the insurer. After the occurrence of an insured event which
is covered by
the insurance, the insured contacts the insurer, provides details of the
insured event and
provides personal credit card details for guarantee. All of the foregoing is
preferably
achieved via data communication between a potential purchaser's computer, most
preferably his mobile communicator, and a server of the insurer, without real
time human
intervention on the part of the insurer. An insured event may be any event
whose resolution
thereof which is covered under the terms of the purchased insurance.
The system, upon ascertaining with a high degree of certainty that the
insured's
claim is not fraudulent, forwards the estimated cost of resolving the insured
event to the
insured. The insured uses the forwarded funds to pay a service provider for
services
received to resolve the insured event. Upon providing, by the insured,
documentation and
details of the cost of services provided to the insured, the insurer utilizes
the
documentation to ascertain that the insured's claim is legitimate and not
fraudulent. The
insurer then collects the difference between the sum previously forwarded to
the insured's
insurance card and the actual cost of service as paid by the insured, from the
insured
insurance card. If the insured does not provide relevant documentation within
a reasonable
timeframe, or if the documentation is not sufficient to prove the legitimacy
of the insured's
claim, the insurer invokes the guarantee and charges the insured's credit card
for the
amount previously forwarded.
Reference is now made to Fig. 3B, which is a simplified flow chart
illustrating
another example of the operation of the system of Figs. 1A-2F. As shown in
Fig. 3B, a
potential purchaser of insurance purchases insurance from an insurer, which
insurance is
then activated by the insurer. After the occurrence of an insured event which
is covered by
the insurance, the insured pays a service provider for services received in
conjunction with
the insured event. The insured then contacts insurer and provides to the
insurer details of
the insured event and personal credit card details for guarantee. The system,
upon
ascertaining with a high degree of certainty that the insured's claim is not
fraudulent,
forwards to the insured reimbursement of sums paid by the insured to the
service provider,
and requests the insured to provide documentation of the services provided and
costs
thereof to the insurer. If the insured does not provide relevant documentation
within a
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reasonable timeframe, or if the documentation is not sufficient to prove the
legitimacy of
the insured's claim, the insurer invokes the guarantee and charges the
insured's credit card
for the amount previously reimbursed.
Reference is now made to Figs. 4A, 4B, 4C, 4D, 4E, 4F and 4G, which are
simplified pictorial illustrations of steps in an insurer-insured interaction
employing the
system and methodology of another preferred embodiment of the present
invention. The
system of Figs. 4A - 4G is a computerized immediate settlement insurance claim
payment
system comprising insurance policy issuing functionality for issuing, by an
insurer, an
insurance policy to an insured, and associating the policy with a mobile
communicator to
be carried by the insured. Upon the occurrence of an insured event, the mobile
communicator is to be used by the insured to communicate information
associated with at
least one of and preferably all of: the insured, the insurance policy and the
insurance event.
This communication may be with a services provider, such as a medical services
provider,
or the insurer and is preferably with both. The communicator may also be
employed to
facilitate communication between the services provider and the insurer.
The communicator may additionally be used to store or access remotely stored
information relating to the insured, such as, for example, the insured's
medical history, the
insured's insurance history and other information provided by the insured or
accessible
from remote databases.
The insurance policy preferably includes a charge back provision allowing the
insurer to charge back payments made to the insured via an identified credit
card account
of the insured.
The immediate settlement insurance claim payment system also comprises
automatic insurance claim verification functionality which, responsive to the
above
communications, is operative to automatically verify the right of the insured
or the service
provider to receive payment from the insurer by automatically verifying at
least one of the
identity of the insured, the entitlement of the insured to services to be paid
by the insurer
based, inter alia, on the personal information of the insured which is stored
on the
communicator or accessible using the communicator, the value of the payment to
be made
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by the insurer, the location of the service provider and other information
relating to the
service provider.
The immediate settlement insurance claim payment system preferably also
comprises insurance claim documentation requesting functionality operative to
request
from the insured, at the initiative of the insurer, prior to, concurrently
with or following the
payment, documentation relating to the insured event, and chargeback
functionality
operative to charge back, at the initiative of the insurer, in the absence of
receipt of the
documentation, at least part of the payment via the identified credit card
account of the
insured.
As shown in Fig. 4A, prior to traveling, such as on Jan. 1, 2011, a potential
purchaser of travel insurance contacts an insurer, preferably by employing a
payment-
enabled mobile communicator 400 and utilizing a self-executing insurance claim
payment
system 402 to purchase a travel insurance policy. Self-executing insurance
claim payment
system 402 preferably includes a server operative to execute computer
instructions and
may be implemented in hardware and/or by executing software instructions
stored on a
tangible medium. As described further hereinbelow, system 402 preferably also
includes
data communication functionality to enable communication with payment-enabled
mobile
communicator 400 and with other devices associated with system 402.
The travel insurance policy may be paid for by using the payment-enabled
mobile
communicator 400 in a conventional manner using the purchaser's credit card
account. It is
appreciated that the contact with the insurer may be via the payment-enabled
mobile
communicator 400, as shown in Fig. 4A, via a data application or by voice vis-
a-vis a
human operator or an automated telephone-operated system. Alternatively, the
entire
policy purchase transaction may be conducted using the internet either via the
payment-
enabled mobile communicator 400 or another computer.
Upon establishing contact with the insurer, the potential purchaser of travel
insurance is prompted to provide his credit card account information to pay
for the travel
insurance. This may be done seamlessly when using a payment-enabled mobile
communicator 400.
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In the case of medical insurance, the potential purchaser is preferably
prompted to
upload his medical history. This medical history may be uploaded manually by
the
potential purchaser but more preferably is downloaded directly either to the
payment-
enabled mobile communicator 400 or to an insurer's secure server 406 from a
repository
408 which maintains this information, in response to entry of an appropriate
password or
passwords. It is appreciated that the personal information regarding the
insured is stored,
whether on the mobile communicator 400 or on the insurer's secure server 406,
using
appropriate password safeguards, which may be multi-level password safeguards
depending on the sensitivity of the information.
Additionally, the potential purchaser of travel insurance may be prompted for
information pertaining to his future travels, such as dates of travel and
destination. Upon
providing the requested information, the information is stored in system 402,
which
provides confirmation of purchase of travel insurance to the purchaser.
It is a particular feature of the present invention that the mobile
communicator
400, once associated with an insurance contract, preferably serves as a debit
card to which
reimbursements of expenses incurred by the insured under the coverage provided
by the
insurance contract are transferred, under the terms of the insurance contract.
Turning now to Fig. 4B, it is shown that on the planned date of departure of
January 5, the insured arrives at a port of departure, such as an airport.
Once inside the port
of departure, the insured's mobile communicator 400 indicates its location
using standard
cell phone locating techniques and thereby confirms the insured's presence at
the port of
departure.
Upon ascertaining the insured's presence at the port of departure, a
communication system 422 notifies self-executing insurance claim payment
system 402 of
the insured's imminent departure, which causes system 402 to automatically
activate the
insured's travel insurance. Alternatively, upon ascertaining the insured's
presence at the
port of departure, the insurer may contact the insured, preferably using the
insured's
mobile communicator 400, before activating the insured's travel insurance to
verify the
insured's present medical condition or travel plans. In the absence of
mechanisms
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operative to automatically ascertain the insured' s presence at the port of
departure, the
insured may contact the insurer, preferably using the insured' s mobile
communicator 400,
to report his imminent departure, and to request activation of the insurance.
As a further
alternative, activation may take place automatically at a date and time
selected by the
insured.
Turning now to Fig. 4C, it is seen that while abroad, on a later date such as
on
January 10, the insured injures his leg. The insured is taken to a hospital by
an ambulance
and provides access to his medical history to either or both the ambulance
staff and the
hospital staff, preferably using the insured's mobile communicator 400 either
to download
the medical history stored in mobile communicator 400 or to access it from
server 406. It is
appreciated that the insured' s mobile communicator 400 may have embedded
therein PIN-
activatable security codes which may be used to access information regarding
the insured,
such as his medical history and his insurance claim history. Multiple,
different PIN codes
may be employed for multiple different levels of security. A PIN-code override
functionality may be provided via system 402 for emergency use when the
insured is
unconscious or otherwise unable to enter his PIN code.
Preferably, the insured' s personal information including his medical and
insurance
history is divided into a plurality of different categories, each having its
own different level
of security, such as:
a. Basic personal information, such as name, address, contact telephone
numbers, languages spoken, photograph, height, weight and known drug
allergies;
b. Allergies, history of illnesses and treatments, emergency contact
details; and
c. Genetic characteristics and family history.
It is also appreciated that information, such as medical histories of multiple
insured
persons, such as members of a family travelling together, may be stored or
accessible using
a single mobile communicator 400. Furthermore, the insured information may be
stored on
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or accessible using multiple mobile communicators 400, which may be carried by
a single
insured or by members of his family. It is appreciated that the system 402 may
provide, via
the insured's mobile communicator 400, contact details and directions to the
insured as to
preferred service providers and may additionally automatically make an
appointment for
treatment of the insured by a preferred service provider in the vicinity of
the insured.
As shown in Fig. 4C, the insured receives appropriate medical treatment from a
service provider, and either he or the service provider contacts the insurer,
preferably using
the insured's mobile communicator 400, to report details of the injury and of
the medical
facility where treatment is being received, and to request funding of the
estimated or actual
cost of the treatment. It is appreciated that this contact may be in the
context of two-way
data communication and need not involve an actual voice communication
involving either
or both the insured or a human representative of the insurer. In the context
of this two-way
data communication, the location of the insured may be ascertained manually by
the
insurer prompting the insured, or a third party, to enter the insured's
location and/or
automatically, utilizing GPS functionality of the insured's mobile
communicator 402 or by
cellular telephone location functionality of a cellular provider providing
communication
with the mobile communicator 402.
The insured may be prompted to provide personal credit card account details
for a
guarantee if the funding is found to be unjustified.
It is a particular feature of the present invention that self-executing
insurance claim
payment system 402 includes fraud detection functionality which is
automatically
operative to detect, with a high degree of certainty, fraudulent claims
reported to the
insurer. This detection may be achieved, for example, by voice analysis
techniques, by
statistical analysis or by cross checks employing, inter alia, the insured's
medical history
and insurance claim history which may be stored on the insured's mobile
communicator or
accessed thereby.
It is another particular feature of the present invention that for claims
which system
402 determines, with a high degree of certainty, to be legitimate, system 402
is operative to
automatically provide advance or real time funding of expected or actual
medical expenses
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incurred by the insured under the coverage provided by the insurance policy,
based on the
reporting by the insured or the service provider of the medical expense
incurred.
Preferably, advance funding is automatically transferred by system 402 to
credit card or
debit card payment functionality of the insured's mobile communicator 400.
Alternatively,
the funding may be provided to the insured, for example, by crediting the
insured's or the
service provider's credit\debit card account, bank account, or any other
personal banking
or crediting system.
It is yet another particular feature of the present invention that the system
402
requires that credit card account details of the insured be provided to serve
as a guarantee
to be invoked by the system 402 to reimburse the insurer in a case where the
insured has
received from the insurer compensation for fraudulent or unjustified insurance
claims,
notwithstanding activation of the fraud detection functionality.
It is appreciated that system 402 comprises a knowledge base which facilitates
calculation of expected medical expenses, which knowledge base includes
accumulated
statistics of cost of treatment of a wide range of medical treatments provided
in any of a
wide range of locales and medical institutions around the world.
Returning now to Fig. 4C, it is seen that upon determining, with a
sufficiently high
degree of certainty, that the insured's claim is legitimate, funding is
preferably provided to
the insured via the credit card or debit card payment functionality of
insured's mobile
communicator 400. As seen in Fig. 4C, the credit card or debit card payment
functionality
of insured's mobile communicator 400 is credited with $500, which is the
expected cost of
the insured's medical expense as estimated by system 402.
Upon checking out of the hospital, the insured is charged $435 for the actual
cost of
the medical treatment he received at the hospital, which the insured pays
using the credit
card or debit card payment functionality of insured's mobile communicator 400.
It is
appreciated that the actual charge of $435 is less than the $500 credited to
credit card or
debit card payment functionality of insured's mobile communicator 400.
Alternatively, as shown in Fig. 4D, the insured defers contacting the insurer
until
after completing the medical treatment and after paying $435 to the hospital.
Payment may
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be achieved, for example, by charging the credit card or debit card payment
functionality
of insured's mobile communicator 400. After checking out of the hospital, the
insured
contacts the insurer, preferably via the insured's mobile communicator 400, to
report the
injury and to request reimbursement for the cost of the treatment. It is
appreciated that this
contact may be in the context of two-way data communication and need not
involve an
actual voice communication involving either or both the insured or a human
representative
of the insurer. Upon determining with a high degree of certainty that the
insured's claim is
not fraudulent or unjustified, and optionally upon obtaining a guarantee in
the form of the
insured's personal credit card account details, reimbursement is preferably
provided to the
insured via the credit card or debit card payment functionality of insured's
mobile
communicator 400, the insured's personal credit card, personal debit card, or
to the
insured's bank account.
Turning now to Fig. 4E, it is shown that upon returning from abroad, such as
on
February 1, the insured may provide documentation 450 to the insurer regarding
medical
treatment provided and any related costs incurred during the insured's trip
abroad. This is
preferably done using a camera or scanning functionality of the insured's
mobile
communicator 400. Upon receiving documentation 450 of the treatment and its
cost of
$435 from the insured, self-executing insurance claim payment system 402
collects any
difference between sums previously forwarded to the insured and the actual
justified cost
of the treatment as determined by the insurer, from the credit card or debit
card payment
functionality of insured's mobile communicator 400. In the scenario of Fig. 4C
this
difference is $65, which is the difference between the $500 originally
forwarded to the
insured and the $435 which the insured actually paid for the treatment.
Alternatively, as shown in Fig. 4F, should the insured fail to provide
requested
documentation within a reasonable amount of time, such as by March 1, self-
executing
insurance claim payment system 402 sends the insured a reminder, preferably to
the
insured's mobile communicator 400, to provide the documentation, warning him
that
failure to do so will result in the insurer invoking the credit card account
guarantee
provided by the insured, as described hereinabove with regard to Figs. 4C &
4D.
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As shown in Fig. 4G, should the insured fail to provide relevant documentation
by
April 1, despite the warning sent by the insurer, self-executing insurance
claim payment
system 402 invokes the guarantee provided and charges the insured's credit
card account
for the total amount previously provided to the insured. In Fig. 4G, this
amount is shown as
$435, which was actually paid in the scenario of Fig. 4D.
It is appreciated that all of the foregoing may be achieved without there
taking
place any human voice telephone conversation involving either the insured or a
representative of the insurer. It is further appreciated that at any suitable
stage, either the
insured or the insurer may elect to initiate a personal human to human
telephone
interaction, preferably using the insured's mobile communicator 400.
It is additionally appreciated that mobile communicators which have been
specifically programmed with applications to carry out the foregoing
functionalities may
be provided to insured persons, who can use them instead of or in addition to
their own
mobile communicators for some or all of the above-described functions.
Additionally, the system 402 may provide automatic warnings to the insured or
to
other appropriate parties regarding overuse of certain medicines or the use of
dangerous
combinations of medicines, as well as reminders to update or refresh
prescriptions.
It is appreciated that the system and methodology described hereinabove with
reference to Figs. 2A - 2F may also be modified to employ a mobile
communicator in the
manner generally described hereinabove with reference to Figs. 4A - 4G.
Reference is now made to Fig. 5, which is a simplified flow chart illustrating
one
example of the operation of the system of Figs. 4A - 4G. As shown in Fig. 5, a
potential
purchaser of insurance purchases insurance from an insurer, which insurance is
then
activated by the insurer. All of the foregoing is preferably achieved via data
communication between a potential purchaser's computer, most preferably his
mobile
communicator, and a server of the insurer, without real time human
intervention on the part
of the insurer.
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As discussed hereinabove with reference to Fig. 4A, to purchase the insurance
the
purchaser typically provides some or all of the following:
Personal information, such as name, address, age or date of birth and
passport number;
Personal medical information, such as medications and allergies to
medications;
Credit card account information to charge the cost of the insurance and
any disbursements/reimbursements related to the insurance policy;
Travel information, such as dates of travel and destinations;
Permission to access medical history; and
Permission for the mobile communication service provider to provide
country of origin information to the insurer.
As discussed hereinabove with reference to Fig. 4B, the purchased insurance
policy
is typically activated either automatically when the insured reaches a
departure port or at a
predetermined date and time.
After the occurrence of an insured event which is covered by the insurance,
the
insured contacts the insurer, typically utilizing the insured's mobile
communicator 400,
and provides details of the insured event and provides personal credit card
account details
for guarantee. All of the foregoing is preferably achieved via data
communication between
a potential purchaser's computer, most preferably his mobile communicator, and
a server
of the insurer, without real time human intervention on the part of the
insurer. An insured
event may be any event which the resolution thereof is covered under the terms
of the
purchased insurance.
The system, upon ascertaining with a sufficiently high degree of certainty
that the
insured's claim is not fraudulent, forwards the estimated or actual incurred
cost of
resolving the insured event to the insured, preferably using the insured's
mobile
communicator 400. The insured uses the forwarded funds to pay a service
provider for
services received to resolve the insured event. Upon the insured providing
documentation
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and details of the cost of services provided to the insured, the insurer
utilizes the
documentation to ascertain that the insured's claim is legitimate and not
fraudulent. The
insurer then collects the difference between the sum previously forwarded to
the insured's
credit card account and the actual cost of service as paid by the insured,
from the insured's
credit card account. If the insured does not provide relevant documentation
within a
reasonable timeframe, or if the documentation is not sufficient to prove the
legitimacy of
the insured's claim, the insurer invokes the guarantee and charges the
insured's credit card
account for the amount previously forwarded.
Reference is now made to Figs. 6A, 6B, 6C, 6D, 6E, 6F, 6G, 6H and 61, which
are
simplified pictorial illustrations of steps in reimbursement interactions
employing the
system and methodology of another preferred embodiment of the present
invention. The
system of Figs. 6A - 61 is a computerized reimbursement system comprising
reimbursement authorization functionality for issuing or activating, by a
reimbursing party,
such as an employer, a reimbursement-enabled mobile communicator to be carried
by a
person authorized to receive reimbursement, such as an employee about to leave
on a
business trip. The computerized reimbursement system preferably includes a
charge back
provision allowing the reimbursing party to charge back the authorized user
for the cost of
unauthorized payments made using the reimbursement-enabled mobile
communicator.
The system also comprises automatic reimbursement verification functionality
which is operative to automatically verify the right of the authorized user or
other payee to
receive payment from the reimbursing party by automatically verifying at least
one of the
location of the payee, the entitlement of the authorized user to purchase
products or
services based, inter alia, on parameters of a reimbursement policy of the
reimbursing
party, which are stored on the reimbursement-enabled mobile communicator or
accessible
using the reimbursement-enabled mobile communicator, and the value of the
payment to
be made.
The system preferably also comprises reimbursement documentation requesting
functionality operative to request from the authorized user, at the initiative
of the
reimbursing party, prior to or following payment, documentation relating to a
payment,
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and chargeback functionality operative to charge back to the authorized user,
at the
initiative of the reimbursing party, in the absence of receipt of acceptable
documentation or
under other appropriate circumstances, at least part of the payment.
As shown in Fig. 6A, prior to traveling on a business trip, such as on Jan. 1,
2011,
an employer representative may provide a reimbursement-enabled mobile
communicator
600 to an authorized user, such as an employee about to go on a business trip.
Alternatively, the employer representative may enable a mobile communicator of
the authorized user to be enabled for reimbursement by the computerized
reimbursement
system, such as by downloading a suitable application to the mobile
communicator of the
authorized user. In this alternative embodiment, the application preferably
requests that the
user grant permission for the mobile communication service provider to provide
country of
origin information to the computerized reimbursement system. Additionally or
alternatively, country of origin information is provided to the computerized
reimbursement
system by product and service providers processing transactions utilizing
reimbursement-
enabled mobile communicator 600.
Additionally, reimbursement-enabled mobile communicator 600 may also include
functionality to recommend preferred product and service providers and to
provide travel
directions thereto.
As seen in Fig. 6A, the reimbursing party, such as the employer, typically
informs
the authorized user, typically the employee, of the reimbursement policy
associated with
the reimbursement-enabled mobile communicator 600.
Turning now to Fig. 6B, it is shown that in the course of a business trip in
Japan,
the employee uses reimbursement-enabled mobile communicator 600 to pay a
restaurant
bill for $50, which does not exceed the restaurant expense maximum
reimbursable amount
of $50. The transaction is preferably completed in a conventional manner via
the cellular
network and the internet with the employer's bank 602 and a server 604 on
which the
computerized reimbursement system resides.
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Fig. 6C shows a similar authorized transaction for payment of a hotel bill of
$350,
which does not exceed the hotel expense maximum reimbursable amount of $400.
Fig. 6D shows an unauthorized transaction, wherein the amount charged is less
than
a global maximum reimbursable amount, such as $500, but the type of
transaction is not
generally available. In this example, the payment nevertheless is made by the
system,
which is unable to ascertain that the transaction is unauthorized.
Fig. 6E shows another type of unauthorized transaction, wherein the amount of
the
payment exceeds a single transaction expense type maximum reimbursable amount
for the
type of purchase, such as a $200 limit on computer supplies, but is within a
single
transaction global maximum reimbursable amount, such as $500. In this example,
the
payment is made by the system.
Fig. 6F illustrates yet another type of unauthorized transaction, wherein the
amount
is greater than the single transaction global maximum reimbursable amount,
such as $500,
and the type of purchase is recognized as an unauthorized purchase. In this
example, the
payment is not made by the system.
Fig. 6G illustrates yet another type of unauthorized transaction, wherein the
amount
charged is less than the expense type maximum reimbursable amount, but the
charge is
made in a location that is not an authorized location. In this example, the
payment is not
made by the system.
Fig. 6H illustrates a reimbursement review functionality of the computerized
reimbursement system which may be operative, at the initiative of the
reimbursing party, to
provide to the reimbursing party an output, based on the reimbursement policy
parameters,
indicating questionable processed transactions that need to be reviewed, as
seen in Fig. 6H.
Thus, for example, for the transactions illustrated in Figs. 6B and 6C, in
which the type of
transaction is authorized and the amount of the transaction does not exceed
the single
transaction expense type maximum reimbursable amount, no review is
recommended,
while for the transactions illustrated in Fig. 6D, in which the type of
transaction is not
generally available, and Fig. 6E, in which the amount of the transaction
exceeds the single
transaction expense type maximum reimbursable amount but does not exceed the
single
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transaction global maximum reimbursable amount, the computerized reimbursement
system may be operative to recommend review.
Upon review of the processed transactions, the reimbursing party may employ
the
computerized reimbursement system to charge back to the authorized user at
least a portion
of the payment. It is appreciated that when the authorized user is an employee
of the
reimbursing party, the charge back may be implemented by automatically
deducting the at
least a portion of the payment from the employee's wages, as seen in Fig. 61.
Thus, in the illustrated example shown in Fig. 61, the reimbursing party
employs the
computerized reimbursement system to charge back to the authorized user the
entire
amount of the unauthorized transaction illustrated in Fig. 6D, which charge
back is
implemented by automatically deducting the payment from the employee's wages.
Reference is now made to Fig. 7, which is a simplified flowchart of the
operation of
the system of Figs. 6A - 61.
As seen in Fig. 7, a reimbursing party, such as an employer, activates a
reimbursement-enabled mobile communicator by loading reimbursement policy
parameters into the reimbursement-enabled mobile communicator. It is
appreciated that
reimbursement policy parameters may include, for example, a geographic
location or
locations, a type of reimbursable expense, a single transaction expense type
maximum
reimbursable amount, a single transaction global maximum reimbursable amount,
a trip
duration expense type maximum reimbursable amount and a trip duration global
maximum
reimbursable amount. It is appreciated that reimbursement policy parameters
may include
one or more of time dependent parameters, such as start date and duration of a
specific
business trip, location dependent parameters, employee dependent parameters
and global
parameters, or any combination thereof.
The reimbursing party, such as an employer, provides a reimbursement-enabled
mobile communicator to an authorized user, such as an employee about to leave
on a
business trip.
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The authorized user may then use the reimbursement-enabled mobile
communicator to pay for products and/or services.
As seen in Fig. 7, when the reimbursement-enabled mobile communicator is
presented to pay for products and/or services, the computerized reimbursement
system is
preferably operative, utilizing information received regarding the location,
the type and the
amount of the charge, to ascertain if the transaction is within the
reimbursement policy
parameters. Based on the information received regarding the transaction and
the
reimbursement policy parameters, the computerized reimbursement system is
preferably
operative to either process or not process the payment.
For example, as seen in Figs. 6B and 6C, where the type of transaction is
authorized
and the amount of the transaction does not exceed the single transaction
expense type
maximum reimbursable amount, the system will generally process the payment.
For example, as seen in Fig. 6D, where the type of transaction is not
generally
available and the amount of the transaction does not exceed the single
transaction global
maximum reimbursable amount, the system will generally process the payment.
In another example, seen in Fig. 6E, where the type of transaction is
authorized and
the amount of the transaction exceeds the single transaction maximum expense
type
reimbursable amount but does not exceed the single transaction global maximum
reimbursable amount, the system will generally process the payment.
In another example, seen in Fig. 6F, where the type of transaction is
recognized as
not authorized and/or the amount of the transaction exceeds the single
transaction global
maximum reimbursable amount, the system will generally not process the
payment.
In another example, seen in Fig. 6G, where the location is not authorized,
even if
the type of transaction is authorized and the amount of the transaction does
not exceed the
single transaction expense type maximum reimbursable amount, the system will
generally
not process the payment.
As seen further in Fig. 7, the computerized reimbursement system is preferably
operative to request documentation relating to a payment from the authorized
user, prior to
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or following payment. It is appreciated that the computerized reimbursement
system is
further operative, in the absence of receipt of acceptable documentation or
under other
appropriate circumstances, such as using the reimbursement-enabled mobile
communicator
for an unauthorized payment, to charge back to the authorized user at least a
portion of the
payment.
It is appreciated that in the case where the authorized user is an employee,
the
charge back may be implemented by automatically deducting the at least a
portion of the
payment from the employee's wages, as seen further in Fig. 61.
It is also appreciated that the computerized reimbursement system may be
operative
to provide to the reimbursing party an output, based on the reimbursement
policy
parameters, indicating questionable processed transactions that need to be
reviewed, as
seen in Fig. 6H. Thus, for example, for the transactions illustrated in Figs.
6B and 6C, in
which the type of transaction is authorized and the amount of the transaction
does not
exceed the single transaction expense type maximum reimbursable amount, no
review is
recommended, while for the transactions illustrated in Fig. 6D, in which the
type of
transaction is not generally available, and Fig. 6E, in which the amount of
the transaction
exceeds the single transaction expense type maximum reimbursable amount but
does not
exceed the single transaction global maximum reimbursable amount, the
computerized
reimbursement system may be operative to recommend review.
As seen further in Fig. 7, upon review of the processed transactions, the
reimbursing party may employ the computerized reimbursement system to charge
back to
the authorized user at least a portion of the payment. Alternatively, the
reimbursing party
may decide to accept the transaction. It is appreciated that when the
authorized user is an
employee of the reimbursing party, the charge back may be implemented by
automatically
deducting the at least a portion of the payment from the employee's wages, as
seen in Fig.
61.
Thus, for example, for the transaction illustrated in Fig. 6D, in which the
system
generally will process the payment, upon review, the reimbursing party may
realize that
the payment was for an unauthorized type of use and employ the computerized
CA 02913315 2015-11-23
WO 2014/188435 PCT/1L2014/050462
reimbursement system to charge the authorized user for the entire amount of
the payment.
It is appreciated that in the case where the authorized user is an employee of
the
reimbursing party, the charge back may be implemented by automatically
deducting the at
least a portion of the payment from the employee's wages.
Similarly, for the transaction illustrated in Fig. 6E, in which the system
generally
will process the payment, upon review, the reimbursing party may realize that
the payment
was for an amount greater that the maximum authorized amount and employ the
computerized reimbursement system to charge the authorized user for the amount
of the
payment greater than the maximum authorized amount. Alternatively, as seen in
Fig. 7,
upon review, the reimbursing party may decide to accept the payment and not
charge the
authorized user for the amount of the payment greater than the maximum
authorized
amount.
It will be appreciated by persons skilled in the art that the present
invention is not
limited by what has been particularly shown and described hereinabove. Rather
the scope
of the present invention includes both combinations and subcombinations of the
various
features described hereinabove as well as modifications thereof which would
occur to
persons skilled in the art upon reading the foregoing description and which
are not in the
prior art.
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