DETAILED ACTION
1. The present application, filed on or after March 16, 2013, is being examined under the first inventor to file provisions of the AIA . This Office action is in response to Applicant’s communication filed on December 22, 2025. Amendments to claims 1, 10, and 19 have been entered. Claims 1, 3, 5, 6, 8-10, 12, 14, 15, 17-19 and 21-25 are pending and have been examined. The reasons for the indication of allowable subject matter (over prior art) were already discussed in the Office action mailed on May 19, 2023 and hence not repeated here. The rejections and response to arguments are stated below.
Claim Rejections - 35 USC § 101
2. 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.
3. Claims 1, 3, 5, 6, 8-10, 12, 14, 15, 17-19 and 21-25 are rejected under 35 U.S.C. § 101 because the claimed invention is directed to an abstract idea without significantly more.
The claim(s) recite(s) a computer-implemented method for predicting fraud, which is considered a judicial exception because it falls under the category of “Certain Methods of organizing human activity” such as fundamental economic practice as well as commercial or legal interactions including agreements as discussed below. This judicial exception is not integrated into a practical application as discussed below. The claim(s) does/do not include additional elements that are sufficient to amount to significantly more than the judicial exception as discussed below.
Analysis
Step 1: In the instant case, exemplary claim 19 is directed to a process.
Step 2A – Prong One: The limitations of “A computer-implemented method for predicting fraud, the method being performed by one or more processors and comprising:
communicating, over one or more networks, with a computing device of a user to (i) receive each of location data and sensor data generated by an accelerometer, gyroscope, and/or inertial mass unit (“IMU”) of the computing device, the location data and sensor data being generated over a prior time period that covers when the claim event occurred; and (ii) implement permission-based monitoring of select user activities using a service application that is executed in a background state on the computing device of the user, before or during when the user makes a claim filing;
based on the sensor data, determining whether a location of the user at a moment when the claim event occurred is corroborated by the sensor data;
wherein communicating with the computing device of the user to implement permission-based monitoring includes:
initiating, over one or more networks, an interactive content generator to provide, via the service application, personalized interactive content for display on a display screen of the computing device to facilitate the user in a claim process following a claim event in which a property of the user is damaged, the interactive content generator generating a virtual, three-dimensional representation of the damaged property that the user interacts with to provide information that indicates a location and a severity of damage;
during the claim process, initiating, over the one or more networks, a live engagement monitor comprising a machine learning model to process, in real time and over the one or more networks, user interaction data corresponding to user interactions by the user with the personalized interactive content;
wherein, based on the user interaction data, the interactive content generator dynamically adapts a content flow of the personalized interactive content presented, via the service application, on the display screen of the computing device to provoke increased user engagement with the personalized interactive content by the user and maximize information provided by the user in connection with the claim process, wherein dynamically adapting the content flow comprises dynamically adapting an ordering of presented content in the content flow, and a design of the presented content;
receiving, during one or more application sessions where the user interacts with the personalized interactive content provided via the service application, image data indicating damage to a property of the user arising from the claim event;
processing the image data provided by the user to perform a corroborative process to determine whether the information provided by the user in connection with the claim event including the information provided by the user interacting with the three-dimensional virtual representation, corroborates with the damage as indicated by the image data;
receiving, over the one or more networks, location data from the computing device of the user, the location data indicating a dynamic location of the user while the user interacts with the personalized interactive content;
remotely monitoring (i) the dynamic location of the user, and (ii) the user interactions with the personalized interactive content;
executing a fraud pattern-matching model based on (i) whether the location
of the user at the moment of the claim event is corroborated by the sensor data, (ii) the corroborative process to determine whether the information provided by the user in connection with the claim event corroborates with the damage, (iii) the remotely monitored dynamic location of the user, and (iv) the remotely monitored user interactions with the personalized interactive content;
wherein execution of the fraud pattern-matching model generates a predictive fraud score for the user, the predictive fraud score being indicative of whether the claim filing by the user includes one or more fraudulent claims” as drafted, when considered collectively as an ordered combination without the italicized portions, is a process that, under the broadest reasonable interpretation, covers the category of “Certain Methods of organizing human activity” such as fundamental economic practice as well as commercial or legal interactions including agreements. The limitations “to provoke increased user engagement with the personalized interactive content and maximize information gathering in connection with the claim filing, wherein dynamically adapting the content flow comprises dynamically adapting an ordering of presented content in the content flow, and a design of the presented content,” is broadly interpreted to correspond to intended use of initiating a live engagement monitor.
Predicting fraud is a fundamental economic practice such as estimating and mitigating risk. Executing the fraud pattern-matching model and generating a predictive fraud score for the user, the predictive fraud score being indicative of whether a claim filing by the user includes one or more fraudulent claims is also fulfilling agreements for the insurance companies (See Specification paragraphs 2 and 22). That is, other than, one or more processors, one or more networks, a computing device (including a display screen) of a user including an accelerometer, gyroscope, and/or inertial mass unit (“IMU”), a service application, an interactive content generator, a live engagement monitor comprising a machine learning model, one or more networks, a personalized interactive content, a fraud pattern-matching model, and a corroborative process, nothing in the claim precludes the steps from being performed as a method of organizing human activity. If the claim limitations, under the broadest reasonable interpretation, covers methods of organizing human activity but for the recitation of generic computer components, then it falls within the “Certain methods of organizing human activity” grouping of abstract ideas. Accordingly, the claim recites an abstract idea.
Step 2A – Prong Two: The judicial exception is not integrated into a practical application. In particular, the claim only recites the additional elements of one or more processors, one or more networks, a computing device (including a display screen) of a user including an accelerometer, gyroscope, and/or inertial mass unit (“IMU”), a service application, an interactive content generator, a live engagement monitor comprising a machine learning model, one or more networks, a personalized interactive content, a fraud pattern-matching model, and a corroborative process to perform all the steps. A plain reading of Figures 1-2 and 13 and descriptions in at least associated paragraphs [0039] – [0041] and [00182] – [00186] reveals that a system comprising a network communication interface, computing device of a user including an accelerometer, gyroscope, and/or inertial mass unit (“IMU”), one or more processors and a memory storing instructions for the one or more processors, all suitably programmed is used execute the claimed steps. The communication interface, the computing device of a user (including a display screen) including an accelerometer, gyroscope, and/or inertial mass unit (“IMU”), the one or more networks and the memory are generic computer elements. The service application, an interactive content generator, the personalized interactive content, a live engagement monitor comprising a machine learning model, the corroborative process and the fraud pattern-matching model are broadly interpreted to include generic software suitably programmed to perform the corresponding functions. The one or more processors are broadly interpreted to include general-purpose processors suitably programmed to perform the associated functions. Hence, the additional elements in the claims are all generic components suitably programmed to perform their respective functions. The additional elements in all the steps are recited at a high-level of generality (i.e., as generic computer components performing generic computer functions) such that it amounts no more than mere instructions to apply the exception using generic computer components. Accordingly, these additional elements do not integrate the abstract idea into a practical application because they do not impose any meaningful limits on practicing the abstract idea. Hence, claim 19 is directed to an abstract idea.
Step 2B: The claim does not include additional elements that are sufficient to amount to significantly more than the judicial exception. As discussed above with respect to integration of the abstract idea into a practical application, using the additional elements (identified above) to perform the claimed steps amounts to no more than mere instructions to apply the exception using generic computer components. The additional elements of the instant underlying process, when taken in combination, together do not offer substantially more than the sum of the functions of the elements when each is taken alone. Mere instructions to apply an exception using a generic computer component cannot provide an inventive concept. Hence, independent claim 19 is not patent eligible. Independent claims 1 and 10 are also not patent eligible based on similar reasoning and rationale.
Dependent claims 3, 5, 6, 8, 9, 12, 14, 15, 17, 18 and 21-25, when analyzed as a whole are held to be patent ineligible under 35 U.S.C. 101 because the additional recited limitations only refine the abstract idea further.
For instance, in claims 3, and 12, the steps “wherein the user interactions indicate that the user viewed policy information prior to the claim event, and wherein the executed instructions cause the computing system to further generate the predictive fraud score based at least in part on the user viewing the policy information” under the broadest reasonable interpretation, are further refinements of methods of organizing human activity because these steps describe the intermediate steps of the underlying process.
In claim 21, the steps “further comprising generating the predictive fraud score based at least in part on the user viewing the policy information” under the broadest reasonable interpretation, are further refinements of methods of organizing human activity because these steps describe the intermediate steps of the underlying process.
In claims 5-6, 14-15 and 22-23, the steps “wherein the executed instructions further cause the computing system to: compile historical claim data in a database, the historical claim data indicating occurrences of fraudulent claim filings and contextual information corresponding to claimant behavior prior to the fraudulent claim filings”, “wherein the executed instructions further cause the computing system to: based on the historical claim data, generate the fraud pattern-matching model that links the claimant behavior prior to the fraudulent claim filings” under the broadest reasonable interpretation, are further refinements of methods of organizing human activity because these steps describe the intermediate steps of the underlying process. The additional element of a database is broadly interpreted to include a generic database suitably programmed to store the associated data. The additional element of the database, performs a traditional function recited at a high-level of generality such that it amounts no more than mere instructions to apply the exception using generic computer components.
In claims 8-9, 17-18 and 24-25, the steps “wherein the executed instructions further cause the computing system to: generate a graphical user interface for a policy provider of the user, the graphical user interface presenting the predictive fraud score of the user”, “wherein the graphical user interface further presents a claim view providing contextual information for the predictive fraud score for the policy provider” under the broadest reasonable interpretation, are further refinements of methods of organizing human activity because these steps describe the intermediate steps of the underlying process. The additional element of a graphical user interface recited in these claims are broadly interpreted to correspond to generic software suitably programmed to perform the associated function. The additional element of the graphical user interface, performs a traditional function recited at a high-level of generality such that it amounts no more than mere instructions to apply the exception using generic computer components.
In all the dependent claims, the judicial exception is not integrated into a practical application because the limitations are recited at a high-level of generality such that it amounts no more than mere instructions to apply the exception using generic computer components. Also, the claims do not affect an improvement to another technology or technical field; the claims do not amount to an improvement to the functioning of a computer system itself; the claims do not affect a transformation or reduction of a particular article to a different state or thing; and the claims do not move beyond a general link of the use of an abstract idea to a particular technological environment. In addition, the dependent claims do not include additional elements that are sufficient to amount to significantly more than the judicial exception. The additional elements of the instant underlying process, when taken in combination, together do not offer substantially more than the sum of the functions of the elements when each is taken alone. The claims as a whole, do not amount to significantly more than the abstract idea itself. For these reasons, the dependent claims also are not patent eligible.
Response to Arguments
4. In response to Applicant’s arguments on pages 12-15 of the Applicant’s remarks that the claims are patent-eligible under 35 USC 101 when considered under the MPEP 2106, the Examiner respectfully disagrees.
The claims recite a computer-implemented method for predicting fraud, which is considered a judicial exception because it falls under the category of “Certain Methods of organizing human activity” such as fundamental economic practice as well as commercial or legal interactions including agreements as discussed in the rejection. Predicting fraud is a fundamental economic practice such as estimating and mitigating risk. Executing the fraud pattern-matching model and generating a predictive fraud score for the user, the predictive fraud score being indicative of whether a claim filing by the user includes one or more fraudulent claims is also fulfilling agreements for the insurance companies. Hence, the claims recite an abstract idea.
Response to Applicants’ arguments regarding Step 2A – Prong two:
According to MPEP 2106, limitations that are indicative of integration into a practical application include:
Improvements to the functioning of a computer, or to any other technology or technical field - see MPEP 2106.05(a)
Applying or using a judicial exception to effect a particular treatment or prophylaxis for a disease or medical condition
Applying the judicial exception with, or by use of, a particular machine - see MPEP 2106.05(b)
Effecting a transformation or reduction of a particular article to a different state or thing - see MPEP 2106.05(c)
Applying or using the judicial exception in some other meaningful way beyond generally linking the use of the judicial exception to a particular technological environment, such that the claim as a whole is more than a drafting effort designed to monopolize the exception - see MPEP 2106.05(e).
In the instant case, the judicial exception is not integrated into a practical application, because none of the above criteria is met. The additional elements in the claims are one or more processors, one or more networks, a computing device (including a display screen) of a user including an accelerometer, gyroscope, and/or inertial mass unit (“IMU”), a service application, an interactive content generator, a live engagement monitor comprising a machine learning model, one or more networks, a personalized interactive content, a fraud pattern-matching model, and a corroborative process to perform all the steps. A plain reading of Figures 1-2 and 13 and descriptions in at least associated paragraphs [0039] – [0041] and [00182] – [00186] reveals that a system comprising a network communication interface, computing device of a user including an accelerometer, gyroscope, and/or inertial mass unit (“IMU”), one or more processors and a memory storing instructions for the one or more processors, all suitably programmed is used execute the claimed steps. The communication interface, the computing device of a user (including a display screen) including an accelerometer, gyroscope, and/or inertial mass unit (“IMU”), the one or more networks and the memory are suitably programmed generic computer elements. The service application, an interactive content generator, the personalized interactive content, a live engagement monitor comprising a machine learning model, the corroborative process and the fraud pattern-matching model are broadly interpreted to include generic software suitably programmed to perform the corresponding functions. The one or more processors are broadly interpreted to include general-purpose processors suitably programmed to perform the associated functions. Hence, the additional elements in the claims are all generic components suitably programmed to perform their respective functions. The additional elements in all the steps are recited at a high-level of generality (i.e., as generic computer components performing generic computer functions) such that it amounts no more than mere instructions to apply the exception using generic computer components. Accordingly, these additional elements do not integrate the abstract idea into a practical application because they do not impose any meaningful limits on practicing the abstract idea. Hence, the claims are directed to an abstract idea.
The Examiner does not see the parallel or similarity between the Applicant’s claims and those in ENFISH, LLC V. MICROSOFT CORP., 822 F.3d 1327, 1336 (Fed. Cir. 2016), MCRO, INC. v. BANDAI NAMCO GAMES AMERICA INC., 837 F.3d 1299, 1314 (Fed. Cir. 2016), COSMOKEY SOLUTIONS GMBH & CO. KG V. DUO SECURITY LLC (Federal Circuit, 2021). And CORE WIRELESS LICENSING S.A.R.L. V. LG ELECTRONICS, INC., 880 F.3d 1356 (Fed. Cir. 2018), Therefore, the Applicant’s arguments are not persuasive. Similarly, the Examiner does not see the parallel or similarity between the Applicant’s claims and those in TrendSpider LLC (PTAB 2024). Also, these PTAB decisions are non-precedential and specific to the facts of the case being litigated. As such, these decisions are not binding on the examination process. Hence, Applicant’s arguments are not persuasive.
The additional elements mentioned on pages 13-14 of the remarks such as
“an interactive content generator generating a virtual, three- dimensional representation of the damaged property that the user interacts with to provide information that indicates a location and a severity of damage”
“a live engagement monitor comprising a machine learning model to process, in real time and over the one or more networks, user interaction data corresponding to user interactions by the user with the personalized interactive content”
"processing the image data provided by the user to perform a corroborative process to determine whether the information provided by the user in connection with the claim event, including the information provided by the user interacting with the three-dimensional virtual representation, corroborates with the damage as indicated by the image data”
“remotely monitoring (i) the dynamic location of the user, and (ii) the user interactions with the personalized interactive content by the user on the computing device”
"executing a fraud pattern-matching model based on (i) whether the location of the user at the moment of the claim event is corroborated by the sensor data, (ii) the corroborative process to determine whether the information provided by the user in connection with the claim event corroborates with the damage, (iii) the remotely monitored dynamic location of the user, and (iv) the remotely monitored user interactions with the personalized interactive content”
only further refine the abstract idea of predicting fraud, using suitably programmed generic computer components in their ordinary capacity. The additional elements in the claim (identified in the rejection) are generic computer components used, as tools in their ordinary capacity, to apply the abstract idea. It does not involve any improvements to another technology, technical field, or improvements to the functioning of the computer itself.
Applicant’s arguments regarding Step 2B have already been addressed in the rejection and hence not repeated here. The Examiner does not see the parallel or similarity between the Applicant’s claims and those in BASCOM. Therefore, the Applicants’ arguments are not persuasive.
One of the guidelines used to analyze the claims to see if the additional elements are well-known, routine and conventional is the USPTO guidelines in the Berkheimer Memo in MPEP 2106.04(d).
The Berkheimer Memo in USPTO guidelines in MPEP 2106.04(d) states:
Appropriate forms of support that an additional element (or combination of additional elements) is well-understood, routine, conventional activity include one or more of the following:
1. A citation to an express statement in the specification or to a statement made by an applicant during prosecution that demonstrates the well-understood, routine, conventional nature of the additional element(s).
2. A citation to one or more of the court decisions discussed in MPEP § 2106.05(d)(II) as noting the well-understood, routine, conventional nature of the additional element(s).
3. A citation to a publication that demonstrates the well-understood, routine, conventional nature of the additional element(s).
4. A statement that the examiner is taking official notice of the well-understood, routine, conventional nature of the additional element(s).
The additional elements in the claims are one or more processors, one or more networks, a computing device (including a display screen) of a user including an accelerometer, gyroscope, and/or inertial mass unit (“IMU”), a service application, an interactive content generator, a live engagement monitor comprising a machine learning model, one or more networks, a personalized interactive content, a fraud pattern-matching model, and a corroborative process to perform all the steps. A plain reading of Figures 1-2 and 13 and descriptions in at least associated paragraphs [0039] – [0041] and [00182] – [00186] reveals that a system comprising a network communication interface, computing device of a user including an accelerometer, gyroscope, and/or inertial mass unit (“IMU”), one or more processors and a memory storing instructions for the one or more processors, all suitably programmed is used execute the claimed steps. The communication interface, the computing device of a user (including a display screen) including an accelerometer, gyroscope, and/or inertial mass unit (“IMU”), the one or more networks and the memory are suitably programmed generic computer elements. The service application, an interactive content generator, the personalized interactive content, a live engagement monitor comprising a machine learning model, the corroborative process and the fraud pattern-matching model are broadly interpreted to include generic software suitably programmed to perform the corresponding functions. The one or more processors are broadly interpreted to include general-purpose processors suitably programmed to perform the associated functions. Hence, the additional elements in the claims are all generic components suitably programmed to perform their respective functions. The fact that general purpose computers, suitably programmed, may be used to perform the claimed method and the fact that the claims at issue do not require any nonconventional computer, network, or other components, or even a “non-conventional and non-generic arrangement of known, conventional pieces” but merely call for performance of the claimed functions “on a set of generic computer components, satisfies the Berkheimer Memo in the USPTO guidelines in MPEP 2106.04(d) requirement that the additional elements are conventional elements (as outlined in criterion 1 of the guidelines). The additional elements of the instant underlying process, when taken in combination, together do not offer substantially more than the sum of the functions of the elements when each is taken alone. Hence, Applicant’s arguments are not persuasive.
For these reasons and those discussed in the rejection, the rejections under 35 USC § 101 are maintained.
Conclusion
5. The prior art made of record and not relied upon is considered pertinent to applicant's disclosure:
(a) Fields; Brian Mark et al. (US Pub. 2024/0281891 A1) discloses using artificial intelligence (AI) and/or machine learning (ML) to recommend a change in insurance coverage. In some embodiments, one or more processors: receive customer information of an insurance customer; determine that an insurance change recommendation trigger has occurred by routing the customer information into an insurance recommendation machine learning and/or artificial intelligence algorithm; and in response to determining the insurance change recommendation trigger, send a recommendation for an insurance policy change for the insurance customer.
6. 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 Narayanswamy Subramanian whose telephone number is (571) 272-6751. The examiner can normally be reached Monday-Friday from 9:00 AM to 5:00 PM. If attempts to reach the examiner by telephone are unsuccessful, the examiner's supervisor, Abhishek Vyas can be reached at (571) 270-1836. The fax number for Formal or Official faxes and Draft to the Patent Office is (571) 273-8300.
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/Narayanswamy Subramanian/
Primary Examiner
Art Unit 3691
January 28, 2026