DETAILED ACTION
The present application is being examined under the pre-AIA first to invent provisions.
This action is responsive to claims filed 03/05/2026 and Applicant’s request for reconsideration of application 12/313740 filed 03/05/2026.
Claims 18, 22, 26, and 30-35 have been examined with this office action.
Claim Interpretation
Production rules engine / parallel rules engine – the rules engines are described as tables of data (specification [0096-0097] [0122] [0279]) which is considered an abstract idea.
Claim Rejections - 35 USC § 101
35 U.S.C. 101 reads as follows:
Whoever invents or discovers any new and useful process, machine, manufacture, or composition of matter, or any new and useful improvement thereof, may obtain a patent therefor, subject to the conditions and requirements of this title.
Claims 18, 22, 26, and 30-35 are rejected under 35 U.S.C. 101 because the claimed invention is directed to an abstract idea of insurance claims processing (test any proposed changes to the automated loss verification (ALV) configurations or rules before they are incorporated into production [0279]) without significantly more.
Subject Matter Eligibility Standard
When considering subject matter eligibility under 35 U.S.C. 101, it must be determined whether the claim is directed to one of the four statutory categories of invention, i.e., process, machine, manufacture, or composition of matter. If the claim does fall within one of the statutory categories, it must then be determined whether the claim is directed to a judicial exception (i.e., law of nature, natural phenomenon, and abstract idea), and if so, it must additionally be determined whether the claim is a patent-eligible application of the exception. If an abstract idea is present in the claim, any element or combination of elements in the claim must be sufficient to ensure that the claim amounts to significantly more than the abstract idea itself. Examples of abstract ideas include fundamental economic practices; certain methods of organizing human activities; an idea itself; and mathematical relationships/formulas. Alice Corporation Pty. Ltd. v.CLS Bank International, et al., 573 U.S. _ (2014) as provided by the interim guidelines FR 12/16/2014 Vol. 79 No. 241.
Analysis
Step 1, the claimed invention must be to one of the four statutory categories. 35 U.S.C. 101 defines the four categories of invention that Congress deemed to be the appropriate subject matter of a patent: processes, machines, manufactures and compositions of matter. In this case independent claims 18 and all claims which depend from it are directed toward an apparatus, independent claim 26 and all claims which depend from it are directed toward a method, and independent claim 22 and all claims which depend from it are directed toward a computer readable medium storing instruction to perform functions/steps.
Step 2A Prong 1, Under Step 2 A, Prong 1 of the 2019 Revised § 101 Guidance, it is determined whether the claims are directed to a judicial exception such as a law of nature, a natural phenomenon, or an abstract idea (See Alice, 134 S. Ct. at 2355) by identify the specific limitation(s) in the claim that recites abstract idea(s); and then determine whether the identified limitation(s) falls within at least one of the groupings of abstract ideas enumerated in the 2019 PEG.
Specifically, claim 18 comprises inter alia the functions or steps of “A system comprising: at least one computer processor communicatively coupled to at least one non-transitory computer-readable medium comprising computer-executable instructions, the at least one non- transitory computer-readable medium further comprising a data source database comprising a plurality of corroborating data sources, wherein the computer-executable instructions are configured to, when executed by the at least one computer processor: (i.) execute a controlled programmatic testing environment and a programmatic production environment, wherein: (a.) the controlled programmatic testing environment and the programmatic production environment are in electronic communication with the data source database, (b.) the controlled programmatic testing environment comprises a parallel rules engine, and (c.) the programmatic production environment comprises a production rules engine separate from the parallel rules engine, the controlled programmatic testing environment being isolated from the programmatic production environment and the externally- received requests; (ii.) instantiate a first configuration within the controlled programmatic testing environment, wherein the controlled programmatic testing environment is configured to use the parallel rules engine and the first configuration to access corroborating data sources; (iii.) identify, within the controlled programmatic testing environment, an applicable total confidence level value from a data structure comprising a plurality of total confidence level values for each corroborating data source of a first set of corroborating data sources; (iv.) conduct, within the controlled programmatic testing environment, a plurality of verification iterations to evaluate the corroborating data sources that are included in the first set of corroborating data sources, wherein each verification iteration comprises: (a.) executing, within the controlled programmatic testing environment, sequential determinations of an accumulated verification value using a model with different configurations and/or corroborating data sources until the accumulated verification value is equal to or greater than a total confidence level value goal; and (b.) responsive to the accumulated verification value being equal to or greater than the total confidence level value goal, generating, within the controlled programmatic testing environment, a validated configuration corresponding to the configuration and corroborating data sources that resulted in the accumulated verification value being equal to or greater than the total confidence level value goal for incorporation into the programmatic production environment; (v.) assign, within the controlled programmatic testing environment, a hold-out sample label to a set of historical data stored within a database; (vi.) capture, within the controlled programmatic testing environment, a hold-out comparison data set associated with the set of historical data; (vii.) update, within the controlled programmatic testing environment, the model to generate an updated model based on the hold-out comparison data set; and (viii.) via the programmatic production environment, perform one or more operations to process claim data for a claimed loss event in real time upon receipt of an indication of the claimed loss event being submitted by a claimant using the production rules engine configured in accordance with the validated configuration”.
Claim 22 comprises inter alia the functions or steps of “A non-transitory computer-readable medium having program code that is stored thereon, the program code executable by one or more processing devices for performing operations comprising: (i.) executing, via the one or more processing devices, a controlled programmatic testing environment and a programmatic production environment, wherein: (a.) the controlled programmatic testing environment and the programmatic production environment are in electronic communication with a data source database that comprises a plurality of corroborating data sources, (b.) the controlled programmatic testing environment comprises a parallel rules engine, and (c.) the programmatic production environment comprises a production rules engine separate from the parallel rules engine, the controlled programmatic testing environment being isolated from the programmatic production environment and the externally-received requests; (ii.) instantiating a first configuration within the controlled programmatic testing environment, wherein the controlled programmatic testing environment is configured to use the parallel rules engine and the first configuration, and to access corroborating data sources; (iii.) identifying, within the controlled programmatic testing environment, an applicable total confidence level value from a data structure comprising a plurality of total confidence level values for each corroborating data source of a first set of corroborating data sources; (iv.) conducting, within the controlled programmatic testing environment, a plurality of verification iterations to evaluate the corroborating data sources that are included in the first set of corroborating data sources, wherein each verification iteration comprises: (a.) executing, within the controlled programmatic testing environment, sequential determinations of an accumulated verification value using a model with different configurations and/or corroborating data sources until the accumulated verification value is equal to or greater than a total confidence level value goal; and (b.) responsive to the accumulated verification value being equal to or greater than the total confidence level value goal generating, within the controlled programmatic testing environment, a validated configuration corresponding to the configuration and corroborating data sources that resulted in the accumulated verification value being equal to or greater than the total confidence level value goal for incorporation into the programmatic production environment; (v.) assigning, within the controlled programmatic testing environment, a hold-out sample label to a set of historical data stored within a database; (vi.) capturing, within the controlled programmatic testing environment, a hold-out comparison data set associated with the set of historical data; (vii.) updating, within the controlled programmatic testing environment, the model to generate an updated model based on the hold-out comparison data set; and (viii.) via the programmatic production environment, automatically performing perform one or more operations to process claim data for a claimed loss event in real time with the upon receipt of an indication of the claimed loss event being submitted by a claimant using the production rules engine configured in accordance with the validated configuration”.
Claim 26 comprises inter alia the functions or steps of “A method comprising: (i.) executing a controlled programmatic testing environment and a programmatic production environment, wherein: (a.) the controlled programmatic testing environment and the programmatic production environment are in electronic communication with a data source database that comprises a plurality of corroborating data sources, (b.) the controlled programmatic testing environment comprises a parallel rules engine, and (c.) the programmatic production environment comprises a production rules engine separate from the parallel rules engine, the controlled programmatic testing environment being isolated from the programmatic production environment and externally-received requests; (ii.) instantiating a first configuration within the controlled programmatic testing environment, wherein the controlled programmatic testing environment is configured to use the parallel rules engine and the first configuration, to access corroborating data sources; (iii.) identifying, within the controlled programmatic testing environment, an applicable total confidence level value from a data structure comprising a plurality of total confidence level values for each corroborating data source of a first set of corroborating data sources; (iv.) conducting, within the controlled programmatic testing environment, a plurality of verification iterations to evaluate the corroborating data sources that are included in the first set of corroborating data sources, wherein each verification iteration comprises: (a.) executing, within the controlled programmatic testing environment, sequential determinations of an accumulated verification value using a model with different configurations and/or corroborating data sources until the accumulated verification value is equal to or greater than a total confidence level value goal; and (b.) responsive to the accumulated verification value being equal to or greater than the total confidence level value goal, generating, within the controlled programmatic testing environment, a validated configuration corresponding to the configuration and corroborating data sources that resulted in the accumulated verification value being equal to or greater than the total confidence level value goal for incorporation into the programmatic production environment; (v.) assigning, within the controlled programmatic testing environment, a hold-out sample label to a set of historical data stored within a database; (vi.) capturing, within the controlled programmatic testing environment, a hold-out comparison data set associated with the set of historical data; (viii.) via the programmatic production environment, perform one or more operations to process claim data for a claimed loss event in real time upon receipt of an indication of the claimed loss event being submitted by a claimant using the production rules engine configured in accordance with the validated configuration”.
The cited limitations as drafted are systems and methods that, under their broadest reasonable interpretation, covers performance of a method of organizing human activity, but for the recitation of the generic computer components. Further, none of the limitations recite technological implementations details for any of the steps but, instead, only recite broad functional language being performed by the generic use of at least one processor. Insurance claims processing (test any proposed changes to the automated loss verification (ALV) configurations or rules before they are incorporated into production [0279]) is a fundamental economic practice long prevalent in commerce systems. If a claim limitation, under its broadest reasonable interpretation, covers a fundamental economic principle or practice but for the general linking to a technological environment, then it falls within the organizing human activity grouping of abstract ideas. Accordingly, the claim recites an abstract idea.
Step 2A Prong 2, Next, it is determined whether the claim is directed to the abstract concept itself or whether it is instead directed to some technological implementation or application of, or improvement to, this concept, i.e., integrated into a practical application. See, e.g., Alice, 573 U.S. at 223, discussing Diamond v. Diehr, 450 U.S. 175 (1981). The mere introduction of a computer or generic computer technology into the claims need not alter the analysis. See Alice, 573 U.S. at 223—24. “[T]he relevant question is whether the claims here do more than simply instruct the practitioner to implement the abstract idea on a generic computer.” Alice, 573 U.S. at 225.
In the present case, the judicial exception is not integrated into a practical application. The claim limitations are not indicative of integration into a practical application by claiming an improvement to the functioning of the computer or to any other technology or technical field. Further, the claim limitations are not indicative of integration into a practical application by applying or using the judicial exception in some other meaningful way.
In particular, the claims contain the following additional elements: a system; at least one computer processor; at least one non-transitory computer-readable medium; computer-executable instructions / program code; a data source database; a controlled programmatic testing environment; a programmatic production environment; a data structure; automatically triggering a reconfiguration of the programmatic production environment; one or more processing devices. However, the specification description of the additional elements a system ([Figure 1] [0043]); at least one computer processor ([Figure 2, element 24] [0044]); at least one non-transitory computer-readable medium ([0044-0045]); computer-executable instructions / program code ([0044-0045]); a data source database ([Figure 26, elements 110 and 112] [0279]); a controlled programmatic testing environment ([Figure 26] [0279-0280]); a programmatic production environment ([Figure 26] [0279-0280]); a data structure ([0079-0080]); automatically triggering a reconfiguration of the programmatic production environment (There is no support for this claim limit in the specification. For the purposes of compact prosecution this claim limit is interpreted as software programmed to updated rules engine values in the production environment based monitored data); one or more processing devices ([0047]) are at a high level of generality using exemplary language or as part of a generic technological environment and are functions any general purpose computer performs such that it amount no more than mere instruction to apply the exception to a particular technological environment. Further, none of the limitations recite technological implementations details for any of the steps but, instead, only recite broad functional language being performed by the generic use of at least one processor. Accordingly, these additional elements do not integrate the abstract idea into a practical application because it does not impose any meaning limits on practicing the abstract idea. Thus, the claim is directed toward an abstract idea.
Step 2B, the claim(s) does/do not include additional elements that are sufficient to amount to significantly more than the judicial exception because the additional elements when considered both individually and as an ordered combination do not amount to significantly more that the abstract idea(s). As discussed above with respect to integration of the abstract idea into a practical application, the additional element of using a processor to perform the abstract idea(s) amounts to no more than mere instructions to apply the exaction using a generic computer component. Mere instruction to apply an exertion using a generic computer component cannot provide an inventive concept. These generic computer components are claimed at a high level of generality to perform their basic functions which amount to no more than generally linking the use of the judicial exception to the particular technological environment of field of use (Specification as cited above for additional elements) and further see insignificant extra-solution activity MPEP § 2106.05 I. A. iii, 2106.05(b), 2106.05(b) III, 2106.05(g). Thus, the claims are not patent eligible.
As for dependent claims 30-35 these claims recite limitations that further define the same abstract idea using previously identified additional elements noted from the respective independent claims from which they depend. Therefore, the cited dependent claims are considered patent ineligible for the reasons given above.
Prior Art
The claims overcome the prior art of record such that none of the cited prior art reference’s disclosures can be applied to form the basis of a 35 USC § 102 rejection nor can they be combined to fairly suggest in combination, the basis of a 35 USC § 103 rejection when the limitations are read in the particular environment of the claims. Specifically, the abstract concepts involving “identify an applicable total confidence level value from a data structure comprising a plurality of total confidence level values for each corroborating data source of a first set of corroborating data sources; conduct a plurality of verification iterations to evaluate the corroborating data sources that are included in the first set of corroborating data sources, wherein each verification iteration comprises: executing sequential determinations of an accumulated verification value using a model with different configurations and/or corroborating data sources until the accumulated verification value is equal to or greater than a total confidence level value goal; and responsive to the accumulated verification value being equal to or greater than the total confidence level value goal, generating a validated configuration corresponding to the configuration and corroborating data sources that resulted in the accumulated verification value being equal to or greater than the total confidence level value goal for incorporation into the programmatic production environment”. Therefore, the claims may be allowable if amended to overcome the rejection(s) under 35 U.S.C. 112 and 35 U.S.C. 101, set forth in this Office action.
Response to Arguments
Applicant's arguments with regards to claims have been fully considered but they are not persuasive.
Examiner Response to Applicant’s Remarks Concerning Claim Rejections - 35 USC § 101: The Examiner respectfully disagrees with Applicant’s arguments. The examiner maintains that the abstract idea of insurance claims processing (test any proposed changes to the automated loss verification (ALV) configurations or rules before they are incorporated into production [0279]). Insurance claims processing (test any proposed changes to the automated loss verification (ALV) configurations or rules before they are incorporated into production [0279]) is a fundamental economic practice long prevalent in commerce systems. If a claim limitation, under its broadest reasonable interpretation, covers a fundamental economic principle or practice but for the general linking to a technological environment, then it falls within the organizing human activity grouping of abstract ideas. Accordingly, the claim recites an abstract idea. The undying technological environment, to include a specific computer system architecture, parallel rules engine, and deployment pipeline (not claimed), is merely a tool implementing a process that a human could perform involving how to test and validate rule-based configurations and models using corroborating data sources and hold-out samples in an isolated environment before deployment into a live production system. The isolated environment can be broadly interpreted as a pen and paper.
New dependent claims 30-35 recite limitations that further define the same abstract idea as their respective independent claims from which they depend. Therefore, the cited dependent claims are considered patent ineligible for the reasons given above. Again, arguments directed toward unclaimed validation and deployment pipeline are moot. Preventing execution of externally-received claims requests is an abstract and is a result of testing proposed changes to the ALV prior to placing into production use. As such, the examiner maintains the rejection.
Conclusion
For prior art made of record and not relied upon is considered pertinent to applicant's disclosure see Notice of References Cited items A-E submitted 03/07/2011 used as prior art in the office action submitted 03/07/2011.
Applicant's amendment necessitated the new ground(s) of rejection presented in this Office action. Accordingly, THIS ACTION IS MADE FINAL. See MPEP § 706.07(a). Applicant is reminded of the extension of time policy as set forth in 37 CFR 1.136(a).
A shortened statutory period for reply to this final action is set to expire THREE MONTHS from the mailing date of this action. In the event a first reply is filed within TWO MONTHS of the mailing date of this final action and the advisory action is not mailed until after the end of the THREE-MONTH shortened statutory period, then the shortened statutory period will expire on the date the advisory action is mailed, and any extension fee pursuant to 37 CFR 1.136(a) will be calculated from the mailing date of the advisory action. In no event, however, will the statutory period for reply expire later than SIX MONTHS from the date of this final action.
Any inquiry concerning this communication or earlier communications from the examiner should be directed to Gregory A Pollock whose telephone number is (571) 270-1465. The examiner can normally be reached M-F 8 AM - 4 PM.
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/Gregory A Pollock/Primary Examiner, Art Unit 3691
05/26/2026
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