System and method for automated processing of claims

摘要

A system and method are disclosed that provide for processing claims. The system and method include receiving a claim from a customer and determining if a customer average value associated with the customer is greater than or equal to a threshold value. The system and method also include processing the claim when the customer average value is less than the threshold value and determining if the claim meets one or more predetermined parameters when the customer average value is greater than or equal to the threshold value. In addition, the system and method include processing the claim when the claim meets the one or more predetermined parameters and forwarding the claim for further investigation when the claim fails to meet the one or more predetermined parameters and the customer average value is greater than or equal to the threshold value.