Category: SOFT SETTLE

Insurance Claim Settlements by means of Artificial Intelligence

SoftSettle Support

Artificial Intelligence or AI has inspired several global businesses in various industries  to develop and implement their required technologies. AI revolutionizes our traditional day-to-day tasks.

One of the domains that can benefit from AI is insurance Claim Settlements. Artificial Intelligence guarantees a fair and fast settlement which would have taken days had traditional approach been accepted for claim settlement. Adopting Artificial Intelligence brings advantages for both companies and their customers. It can simplify claims processing for adjusters and make settlement quicker and more transparent for clients. It can help bringing this most responsible and difficult segmented task of the industry to a new level and attract even more clients.

It is true that we can never underestimate the importance of Artificial Intelligence in other tasks of total Insurance. This technology can greatly improve the insurance industry, simplify routine processes and take care of mundane tasks. We can only anticipate the positive changes AI will trigger in the near future.

it can be said that technology is now being increasingly utilized to make the insurance claims simpler, faster and more cost effective. The outdated processes are slowly being changed for the better, in view of the advancement of artificial intelligence and machine learning, among other forms of technology. Not only will this adoption of technology improve the insurance processes, but will eventually lead to a much better and smoother customer experience.

Soft Settle adopting Artificial Intelligence as the technological stimulant for Insurance Claim Settlement has facilitated automatic process of requests and interactions between the Insurance Company or its adjuster and the client. As such chatbots, related fields and other mode of interactions are being integrated in the workflow can simplify the conversation and make communication more effective and stress-free. Such an approach facilitates reduction of amount of time and thus let the disputants negotiates with respective interests getting reconciled to reach a decision.

As of now, Claim Settlement Process is a manual and laborious affair that requires the involvement of several people in the form of witnesses with a lot of paperwork and communication methods. The devices of communications can be advanced using the optimizing algorithms which ultimately capable of eliminating the process which are prone to not only time consuming and costly but is also prone to errors and inconsistencies. The integration of artificial intelligence and machine learning in Soft Settle Platform to accelerate the process of negotiations to the effect of claim settlement claims settlement adjudication is already helping increase the efficiency of case managers and enabling them to take more informed decisions.

 

 

The inevitable implementation of technology stimulated Application in resolving E-Commerce Disputes

Adv. Meerza Zaheer, Chief Consultant, Senate Legis

Electronic commerce is the process by which businesses and consumers buy and sell goods and services through an electronic medium.

We have been witnessing the online presence of majority of companies in the present market since early 1990. Since you have recognized the ability to conduct business through the internet, you might have also accepted the online shopping starts from food and clothes to entertainment, furniture and whatever essential products for human life under the sky.

Electronic commerce brings both comforts and discomforts to its users. You may be enjoying the comforts widely include on the spot sales and purchase, competitive costs, convenience, saving of time, etc. On the other hand, the discomforts include frauds and cyber-crimes committed against e-commerce users. At times there are disagreements and dissatisfactions as well among buyers and purchasers that cannot be resolved using traditional litigation methods.

But the countries like India is lagging behind in applying the ADR or ODR mechanisms and technology driven solutions to find settlements against such cropping commercial conflicts or e-commerce disputes. It is quite unfortunate that India is still strange to the resolution of e-commerce disputes by means of ODR.

ODR  more evidently capable of helping  e-commerce disputes resolutions in India and like countries. I feel some of the areas where we must pay special attention include technology related dispute resolution, film, media and entertainment industry dispute resolution in India, cross border e-commerce dispute resolution in India, etc. E-courts and ODR can be effectively used for all the above mentioned purposes.

E-commerce players in India have many techno legal obligations to follow and cyber law due diligence in India is one such obligation. Not only legal requirements for undertaking e-commerce in India are stringent but even Internet intermediaries liability in India must be taken seriously by companies engaged in online transactions and businesses.

As the cyber presence of the commercial transactions is cropping up without any breaks use of e-courts paving way for e-commerce disputes resolution has become a necessity in all senses. The first and second segment of the project under the banner of Gateway to Equity & Justice (www.odrsupport.com) and (www.softsettle.com)  providing ODR policies and frame work,  facilitating E-commerce players from getting assaulted by some laws which may cause them held liable for cases like Intellectual Property infringement and other violations, introduced e-Court as a virtual resolution center or settlement support center.

Soft Settle negotiations capable of undoing the hassles used to crop up in physical negotiations to settle insurance claim.

SoftSettle Support

The initial settlement offer that comes from the insurance company can come at any time after you’ve filed your claim. Some claimants have to wait weeks to receive the offer, and some receive it rather quickly. Unfortunately, there is no set time in which the initial offer must be made.

The initial offer you receive from the insurance adjuster will almost always be a “lowball” offer. They may defend their low offer by claiming that you were partially at fault for the accident that caused your injuries in the case of physical injury, or that the injuries you suffered weren’t severe enough to warrant a greater amount. They may also question the amount of pain and suffering you experienced. They will aggressively defend their position of a low offer because this will often intimidate people into simply accepting the low offer. Do not ever accept the initial offer unless it is a fair offer.

When you receive the initial settlement offer in writing, examine the reasons the insurance adjuster has given for the low settlement amount. Each of these points will become a part of your counteroffer letter, and you should respond to each and every one. Your counteroffer letter will reassert your original position described in your demand letter, as well as respond to each of their low-offer reasons in turn. Keep your emotions out of the letter and stick to facts, such as the extreme pain and suffering you have had to endure and the frustration and hassle of attending medical treatments. Be professional, courteous, and confident, and never attack the claims adjuster personally in your counteroffer letter.

The above developments are there never to be overlooked and those using the platform Soft Settle, also experience the same process prior to the negotiation. But you can convert the offer into a fairer one with the negotiations using the platform under the supervision and facilitation of SS-Equity (ICS).

You may automatically react to the initial low offer from the part of the adjuster of the insurance company. You will counter the offer and ultimately this would turn into a prolonged counter offer battle where you may hire an attorney to bring everything to tedious court litigation.

Soft Settle does facilitate both insured and insurer to come in terms with each other and it would take the interests of the parties rather than their positions getting reconciled so as to make them come together in the potential zone of agreement to reach a solution acceptable to both. This has to be treated as win-win proposition or beyond.

Above everything the expensive litigation could be avoided and the elements of scientific mediation are being evaluated to bring the most cost effective, appropriate and harmonious settlement between or among the parties.

Finding algorithms to create a fairer legal system

SoftSettle Support

Disputes are virtual certainty in any society. A great percentage of these disputes revolve around money- how much is owed to whom. A vast legal system has been built around resolving monetary disputes, whether it involves a dispute over money owed or a cause of action for damages arising from a commercial or physical injury to a party. Even in the litigious society, most disputes do settle without resort to the courts.

Many disputes settle late in the game, often on the courthouse steps and usually only in an effort to avoid an uncertain outcome in litigation. Of course, by that time, all litigants have spent a significant amount of money in prosecuting or defending the lawsuit. While the courthouse settlement is a meaningful and preferable alternative to a trial, such settlement would be less costly and probably more fair if it had occurred much earlier in the process.

One of the settlement dynamics that impedes the early resolution of many disputes is that the parties find it very difficult to move very far or very fast in their negotiations. Impediments to prompt settlement include posturing, a fear of appearing weak or uncertain, an unrealistic vision or understanding of the other side’s position, or fear of vulnerability. In most cases, the negotiation starts at extreme positions and passes through a number of incremental, snail-like movement before a final settlement number is reached. Removing these impediments can help the parties achieve agreement much more quickly.

Mediators can play a vital role in advancing settlement. The mediator can frequently speed the process by finding out from each party, on a confidential basis, what are that party’s “trigger points’—what does that party expect to get out of the dispute. In addition, the mediator can learn, or at least discern, a party’s “bottom line”. During this information gathering, the mediator may discover that the “bottom lines” are not that far apart. If the parties are far apart at first, skillful wrangling by the mediator can frequently bring the parties within reach of each other. At that point, the parties are much closer together than they would have been had they set out on the traditional negotiation path.

One significant benefit of the mediator is that each party’s conversations and disclosures are maintained in confidence until agreement is close at hand. All of the fears normally associated with face-to-face negotiations dissolve. There is no need for a party to avoid making a big move towards the middle, which carries the risk in personal negotiations of appearing uninformed, weak or desperate. Neither party holds back information or bargaining proposals because the filter of the mediator is always there. Moreover either party can retrench and retract a previous settlement position while preserving the settlement opportunity.

While a mediator is a very valuable asset, not every party to a dispute wants to use a mediator. Most disputes are settled through person-to-person discussions, and most frequently through attorneys. Face-to-face settlement conferences can require significant commitment of time and monetary resources by the parties and their attorneys. Negotiations through mail, or even e-mail, can be slow and ripe for posturing. Both approaches eliminate the safe harbor of confidentiality that allows the participants to freely examine, offer and counteroffer without fear of reprisal or without risk of killing the negotiations.

In recent years, internet based systems have arisen that guide parties through a settlement process. In many of these online settlement systems, each party is entitled to make a limited number of offers/counter offers, usually three, in alternating fashion. These offers, counter offers, bids may be reflected to be the interests and software would work upon them is meant and built for Soft Settle platform rather than “split the difference” or “choosing the midpoints” so as to reach the settlement. Hence SoftSettle Support developed a different level of concept so as to pronounce Robotic Verdict.

A detriment of these prior systems is that they force the settlement amount to be at the midpoint between offers. This approach limits the flexibility of the settlement system and obligates the participants to “settle the blind” at an unknown amount. Moreover, these prior systems only offer one approach to settlement, again limiting the flexibility of the system to meet differing expectations of the participants. There remains a need for an automated dispute settlement system that retains the security of confidentiality while providing flexible approaches to meet the desires of the participants.

What is desired, therefore, is a system for performing dispute resolution that enables parties to present their issues to a customized decision maker and receive a determination in short amount of time at a reasonable price. Providing such a dispute resolution that operates over the internet with automated negotiation in the forefront could be the ideal turn in the revolution of dispute resolution inspired by technology.

Finding Algorithms to create a fairer legal system

Online Dispute Resolution, an ideal way-out in finding Consumer Dispute Resolution

SoftSettle Support

ODR or Online Dispute Resolution is a pioneering method to resolve grievances, issues or disputes, especially now when both consumers and business started to use virtual space for concluding contracts and performing various transactions.

Legal action may not be the most suitable remedy for disputes especially so when such disputes are the outcome of e-commerce transactions or dealings on the Internet. The Internet exposes us to a variety of fields and in turn disputes too seem to be inevitable. It is best to resolve these grievances, issues or disputes arising as a result of the Internet in that very same environment, that is, the Internet.

As for the ordinary locally based offline consumer disputes too the traditional court intervention does not benefit the consumers as well as traders to find a settlement in a cost effective and fast manner. The crawling attitude of the court behavior to find a settlement will definitely lead the clients to find a better alternative to this effect.

ODR supplements existing ADR methods based on the assumption that certain disputes (more specifically e-disputes) can also be resolved quickly and adequately via the Internet. ODR can be defined as the deployment of applications and computer networks for resolving disputes with ADR methods. Both e-disputes and brick and mortar disputes can be resolved using ODR.

SoftSettle Support has come up with innovative digitilized concepts that can eliminate the limitations of the traditional legal devices to find a resolution to the effect of consumer issues whether it is offline or online.

SoftSettle Support has developed a concept where dispute resolution techniques range from methods where parties have full control of the procedure, to methods where a third party is in control of both the process and the outcome. These primary methods of resolving disputes may be complemented with Information and Communication Technology (ICT). When the process is conducted mainly online it is referred to as ODR, i.e. to carry out most of the dispute resolution procedure online, including the initial filing, framing up the issues, electronic negotiation, the neutral appointment, evidentiary processes, oral hearings if needed, online discussions, and even the rendering of binding settlements. Thus, SoftSettle has developed an ODR system  which  is a different medium to resolve disputes, from beginning to end, respecting due process principles.

Traditional Court system does not provide an effective solution to the effect of Consumer Dispute Resolution.

SoftSettle Support

Alternative Dispute Resolution (ADR) describes a range of methods (such as mediation and arbitration) designed to avoid the need to go to court to enforce legal rights. Usually these methods are a cheaper and quicker route for resolving a dispute.

SoftSettle Support has stepped up further with a new innovative resolution tools to make the consumer dispute resolution more cheaper and flexible. SoftSettle Support has come up with new techniques that can support the varying nature of online and offline marketplaces in a dynamic fashion. Further the described techniques provide a comprehensive ODR system that may be tailored to, and integrated within, an online and offline market place. The technology built by SoftSettle Support allow automated or manually assisted processes to address the grievances of the customers.

All the designs developed are enough to reduce the time and enhance the flexibility so as to generate the efficiency which are more and enough for limiting the extent of reputation of both buyers and sellers.

The techniques integrated in the software may provide new technology, online and offline user interface processes which allow the ODR system described herein to automatically tailor a dispute resolution experience for users or user types with given sets of issues. As a result ODR system can better route disputes in an automated or manual fashion separately or in an combined fashion.

Techniques are described for handling disputes online. The technology addresses needs arising through the recent growth of global online and offline marketplace and online and offline selling.

Soft Settle deals with E-Commerce Disputes

SoftSettle Support

The proliferation of electronic commerce using the Internet as a common communication medium has established a need for an effective dispute resolution mechanism when exchanges in electronic commerce are unsatisfactory to one or more the parties involved. The Internet is a convenient medium by which consumers and businesses can purchase a variety of goods and services. Since buyers and sellers meet online, convenience of selecting, ordering and payment is offset by the possibility of the transaction not occurring as planned and the difficulty in resolving any issues post-order. Issues could include corrupt traders or merchants, a failure to deliver the goods or services promised, a lack of quality in the goods or services which are delivered or other ways in which one of the two parties feels that the transaction did not occur as expected. The difficulty of resolving an issue once it occurs is compounded by the fact the parties are in different locations and therefore cannot show one another visually what may be the issue, or cannot discuss face to face other alternatives that they may lead to mutual satisfaction. All these factors also contribute to a general lack of trust between parties. Hence the lack of adequate system lead to leave the parties highly dissatisfied with the electronic commerce experience with a common outcome of not participating as much or at all due to the risks or due to an incidence of real or perceived dispute.

What can SS-EQUITY (E-Com Dispute Resolution) do to resolve e-commerce disputes?

Finding the traditional dispute resolution processes like court litigation and traditional ADR do not provide an effective solution and so far not effective in dealing with cross-border or cross-state or often times cross-locality transactions that may occur in electronic commerce and further traditional ADR are generally slow and very procedural comparatively.

As such SS-EQUITY (E-Commerce) groomed up with an ODR system applies the techniques beyond the traditional dispute resolution mechanisms, such as automated complaint handling, automated direct negotiation between the parties, automated agreement processes, facilitating case handling, facilitated mediation, specialized mediation processes and specific marketplace processes could able to meet the challenges posed by the present trend of e-commerce disputes. Techniques are described for handling disputes online. The

techniques particularly relate to low-volume as well as  high-volume dispute handling, and integration with an online marketplace or general online selling. The techniques can handle even a very high volume of concurrent disputes cost effectively, and provide for the central management of a large and geographically distributed group of dispute resolution specialists that assist

with online dispute resolution. The techniques address needs arising through the recent growth of global online market places and online selling.

Commitments

Soft Settle facilitates the parties with the techniques aiming at faster settlement with transparency in the solutions. Further SS-Equity (ECDR) incorporated in the platform Soft Settle promotes effortless experiences in resolving e-commerce disputes.

Features

  • A method is technically integrated to enable a complainant to automatically design a dispute resolution process from a plurality of component process.
  • Technical integration of a method to receive characterization information
  • Technical integration of a method to enable access to deliberation information associated with a second dispute to facilitate resolution of first dispute.
  • Assisting a review of a plurality of component processes that respectively utilized to facilitate the resolution of a dispute.
  • Independent review feedback is incorporated
  • The settlement process can be synchronous or asynchronous as according to the convenience of the parties.
  • Repeated e-Negotiation till a resolution is found
  • An escalated mode with a neutral assisting the disputants in finding a solution (software built) where the neutral’s decision in respect of disputes would be final.
  • As an appeal parties can again approach an appellate tribunal in a different platform Mediator Affair integrated in www.odrsupport.com.
  • An automatic Agreement would be generated on settlement in all situations referred above after the parties approving the Agreement Framework.

 

 

 

Electronic Dispute Resolution of E-Commerce Disputes through Internet

SoftSettle Support

Today, consumers order billions of dollars of merchandise, manufactures, and parts, orchestrate the transnational assembly of products, and move vast amounts of capital from one financial institution to another using electronic means including the internet.

The Internet transformed the way the industrialized world does business over the Internet only with organizations having a physical location in their state. Businesses doing business transactions confront the same problems. The result is uncertainty. Uncertainty breeds apprehension. Apprehension castes a chilling pale over the Internet preventing the opportunities for speed of light, inexpensive commerce from business only using a brick and mortar store, or else use the phone, mail, or the internet without the desired certainty as to jurisdiction and choice of law. However, if you have ever been in a lawsuit, as opposed to private Undercurrent law, this is uncertain and large, expensive; time- consuming fights may develop. It is desired to avoid having to deal with these issues by providing disputes in the same manner as the original transaction was conducted, i.e., on-line using client computers connected together over the Internet.

SoftSettle Support has come forward with an invention to run in internet that can take challenge to defeat the tribulations of expensive, time consuming litigations apart from confusion over choosing the laws of the countries.

It is further recognized herein that the desired dispute arising out of an e-commerce transaction, or who generally engage in transactions over the Internet. The desired system would also provide an inexpensive and convenient on-line forum to resolve business over the Internet with the correspondingly similar ease and time-saving convenience as entering into those on-line transactions in the first place. It would be advantageous to get disagreements considered and adjudicated as quickly as possible and from the convenience of the parties’ own computers. It is desired that the parties should be able to do so before an independent, impartial tribunal without having to resolve expensive and time-consuming issues of where the method of electronically adjudicating a method including selecting an electronic dispute, and electronically processing the adjudicating of the dispute to resolution. It may be agreed upon in advance of finalizing an e-commerce transaction giving rise to a dispute resolution by electronic agreement. The level selecting step may include a mutual agreement by parties involved in the dispute before or after the transaction is finalized.

A system, software and dispute are further provided, the dispute adjudication level from multiple levels providing various extents of procedural options involved in the adjudicating of the dispute in accordance with the selected level including electronic filing of each of a complaint, an answer to the complaint, and final argument submissions by parties involved in the dispute resolution web page accessible by parties involved in the dispute resolution web page.

The platform Soft Settle facilitates resolution with the issues being considered to be provided with the neutral adjudication in basic and escalated mode as the appeal or second attempt being integrated in www.softsettle.com  and if not satisfied by the clients further extension of the adjudication to be referred to another appellate tribunal with a different platform Mediator Affair integrated in www.odrsupport.com powered by SoftSettle Support.

You need not accept a raw deal, but you have to make your case and negotiate a better settlement

SoftSettle Support

Before you get annoyed about a claim payment or denial, review your insurance policy to see if you are covered for the damage in dispute and what the money limits for your coverage. Once you realized how much you deserve out of the policy you have availed, it will help your strengthen your argument if you are in the right.

You can seek clarifications to insurers when you are blurred over the settlement was lower than expected. If policy sounds ambiguous, you have to make it clear the particular section in question. Once you are clear on your insurer’s position, prepare document that can help prove your case. If your insurance company thinks it will cost certain amount to compensate the loss you have suffered but you think it will be more, get a written estimate from an independent contractor.

If you need to dispute a denial or low settlement offer, start by writing a letter to your claims adjuster. Briefly explain your point of view, including any evidence you have prepared that supports your side, and request that the adjuster review the claim.

Even if you’re seething inside, remain polite. Don’t threaten to hire an attorney. If you take an adversarial tone right off the bat, your insurer might decide to let its lawyers do the talking. If your case is week, a law suit may damage your expectations.

Appraisal is a common process used in disagreements between insured and insurers over property damage. Two appraisers will be in charge if  a dispute arises as both sides pick each appraiser to represent them. If there is a deadlock they can resort to the dispute resolution process mooted by SoftSettle Support using the platform of MEDIATOR AFFAIR integrated in the portal www.odrsupport.com
Further an online mediation can be called for, where a Mediator can be nominated by both parties from among the panel of professionals provided by the ODR providers. SoftSettle Support channelizes online mediation using the platform MEDIATOR AFFAIR integrated in www.odrsupport.com. Typically faster mode of Mediation is guaranteed through this portal and application respectively and the negotiation for clear verdict in the form of  claim settlement  which is software stimulated, integrated in the portal www.softsettle.com and the mobile application SOFT SETTLE

 

Approach in resolving Insurance Disputes

SoftSettle Support

As careful as we are, there is the possibility of being involved in an accident while you’re driving.   Or having damage occur to your home due to circumstances you can’t control.   While carrying car insurance and home insurance minimizes the financial risks and responsibilities of the aftermath of an accident, there is a possibility that you and your insurance company could disagree about the benefits you’re entitled to in the event that you have to file a claim.

What can you do in the case of a dispute with your insurance company?   The best scenario is that you and your insurance provider can come to an agreement that works for both of you, but in the case that it isn’t possible to resolve the disagreement between both parties, there are other options available to you.

SoftSettle Support shapes online platforms for insurance claim settlement.

There is, of course, a range of options available to disputing parties who do not wish to proceed to formal litigation (litigation Is typically costly, time consuming. Uncertain and ultimately unsatisfying regardless of the outcome.) A number of processes, of varying degrees of formality, are available to assist the parties to resolve their dispute themselves, or in some cases, to impose a settlement regime on the parties. These resolution processes can be divided into two broad categories.

First are consensual processes such as conciliation and mediation, where the parties to the dispute typically meet with an independent third party to explore settlement options. The third party is not supposed to impose any unilateral decision but to assist and persuade the parties to generate and refine their own settlement options.

Second are adjudicative processes such as arbitration, appraisal, early  neutral evaluation or mini trial. The parties are given the opportunity to make submissions to an independent umpire. Each parties’ submissions are weighed by the umpire and a decision is made. This third party must them review that material before formulating an appropriate settlement regime.

SoftSettle Support facilitates an environment for both insurers and insured as insurer will gain more credibility to canvass more clients as he is not inclined to constantly battling with customers in court and insured will get sigh of relief so far as insurer used to be conciliatory and attractive to their existing and prospective customers

SoftSettle Support provides a portal or application to insurer and insured where they can submit their disputes to get it resolved by means of online mediation and online arbitration presided by experienced neutral and arbitrators. These advantages are being built and integrated in the virtual court powered by SoftSettle Support in www.odrsupport.com. Apart from regular disputes used to occur in the negotiation (resolution) process to reach an accepted claim settlement is being integrated in www.softsettle.com. These opportunities allows the insured more time in mediation sessions to articulate his or her position. The insurer would also get an opportunity to reconcile to go with a win-win strategy rather than preserving an attitude of obstinacy in the process of litigation.

Hence SoftSettle Support strikes the conscious of the parties  as the conciliatory nature of processes like online mediation ensures that the parties are given every chance to preserve their existing relationships. Consensual processes encourage the parties to work together to generate settlement options.

Hope these suggestions might be some of the analytical answers to the questions posed by the scenario described in the top paragraphs.