System for funding third-party-administered losses

A non-transitory computer-readable medium encoded with instructions for configuring at least one processor to:

• accept, based on formal rules, at least one insurance claim transaction received from at least one third party administrator;
• receive, from a third party administrator, in the issue file being adapted to be executed by an insurer's bank to make a payment to a claimant from an insurer-owned bank account;
• wherein each of the plurality of bank transactions includes a transaction amount, a transaction code related to an action to be taken with regard to the insurer-owned bank account, and bank information for permitting access and disposition of money held in the insurer-owned bank account for payment to the claimant;
• compare the plurality of bank transactions in the issue file to a plurality of transaction confirms corresponding a plurality of insurance claim transactions that have been accepted based on formal rules;
• wherein each of the plurality of transaction confirms includes a transaction amount, a transaction code related to an action to be taken with regard to the insurer-owned bank account, and bank information for permitting access and disposition of money held in the insurer-owned bank account for payment to the claimant;
• validate one or more of the plurality of bank transactions in the issue file if the transaction amount, transaction code, and bank information in a corresponding one of the plurality of transaction confirms match;
• pass the issue file received from the third party administrator to the insurer's bank so that the one or more of the plurality of bank transactions that have been validated are executed by the insurer's bank to make the payment to the claimant from the insurer-owned bank account;
• receive from the insurer's bank a paid file comprising a plurality of status reports corresponding to the plurality of bank transactions that have been validated;
• wherein each of the plurality of status reports includes a transaction amount, bank information, and a status code indicating the status of a corresponding one of the plurality of bank transactions;
• compare the plurality of bank transactions in the issue file to the plurality of status reports in the paid file received from the insurer's bank;
• and
• determine whether one or more of the plurality of bank transactions in the issue file is complete based on the status code in a corresponding one of the plurality of status reports in the paid file and whether the transaction amount and bank information in the corresponding one of the plurality of status reports in the paid file match.

A computer-implemented method for funding third-party-administered claim transactions comprising the steps of:

• receiving, from a third party administrator via a processor, a plurality of claim transactions;
• accepting, based on formal rules via the processor, one or more of the plurality of claim transaction;
• receiving, from the third party administrator via the processor, an issue file comprising a plurality of bank transactions, each of the plurality of bank transactions corresponding to one of the plurality of insurance claim transactions, each of the plurality of bank transactions in the issue file being adapted to be executed by an insurer's bank to make a payment to a claimant from an insurer-owned bank account;
• wherein each of the plurality of bank transactions includes a transaction amount, a transaction code related to an action to be taken with regard to the insurer-owned bank account, and bank information for permitting access and disposition of money held in the insurer-owned bank account for payment to the claimant;
• comparing, via the processor, the plurality of bank transactions in the issue file to a plurality of transaction confirms corresponding to some of the plurality of insurance claim transactions that have been accepted based on the formal rules;
• wherein each of the plurality of transaction confirms includes a transaction amount, a transaction code related to an action to be taken with regard to the insurer-owned bank account, and bank information for permitting access and disposition of money held in the insurer-owned bank account for payment to the claimant;
• validating, via the processor, one or more of the plurality of bank transactions in the issue file if the transaction amount, transaction code, and bank information in a corresponding one of the plurality of transaction confirms matches;
• passing, via the processor, issue file received from the third party administrator to the insurer's bank so that the one or more of the plurality of bank transactions that have been validated are executed by the insurer's bank to make the payment to the claimant from the insurer-owned bank account;
• receiving, from the insurer's bank via the processor, a paid file comprising a plurality of status reports corresponding to the plurality of bank transactions that have been validated;
• wherein each of the plurality of status reports includes a transaction amount, bank information, and a status code indicating the status of a corresponding one of the plurality of bank transactions;
• and
• verifying, via the processor, whether one or more of the plurality of bank transactions in the issue file is complete based on the status code in a corresponding one of the plurality of status reports in the paid file and whether the transaction amount and bank information in the corresponding one of the plurality of status reports in the paid file match.