Insurance claim capitation and predictive payment modeling

• US 10,176,532 B1
• Filed: 04/24/2017
• Issued: 01/08/2019
• Est. Priority Date: 09/20/2012
• Status: Active Grant

• Current Assignee: Allstate Insurance Company (Allstate Corporation)
• Original Assignee: Allstate Insurance Company (Allstate Corporation)
• Inventors: Hanson, Randall, Johnson, Robert H., Stricker, Kurt M., Marlow, Clint J.
• Primary Examiner(s): Hamilton, Lalita M
• Application Number:
  US15/494,958
• Time in Patent Office: 624 Days
• CPC Class Codes: G01S 19/13 Receivers
• CPC Class Codes: G06Q 10/20 Administration of product repair or maintenance
• CPC Class Codes: G06Q 30/0283 Price estimation or determination
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G07C 5/008 communicating information to a remotely located station transmission systems for measured values G08C

Abstract

A claim-based capitation model is proposed for handling vehicle repair insurance claims. Rather than determining a detailed estimate of the expected actual cost of repair, the estimate may be determined using a simpler model. For example, the insurance company and a repair facility may agree to following a predictive payment model in which the insurance company pays a fixed predicted capitated amount of money for each repair claim, regardless of the amount of repair work that will be needed. Alternatively, the insurance company may pre-pay a fixed capitated amount for a predicted number of future insurance claims.

Claims

1. A system comprising:

a processor;

a non-transitory computer-readable medium storing instructions that, when executed by the processor, cause the system to;

store first data comprising a model that associates a first one or more loss attributes with a plurality of multipliers and that associates a second one or more loss attributes with a plurality of costs;

receive, from a first computing device of a vehicle, second data, generated by the first computing device of the vehicle, wherein the second data is generated based on acceleration data generated by an accelerometer of the first computing device;

select, based on the second data, at least a first loss attribute from the first one or more loss attributes and at least a second loss attribute from the second one or more loss attributes;

determine a capitated cost of repair of the vehicle based on the first loss attribute and the second loss attribute; and

transmit, to a repair facility, a notification regarding payment based on the determined capitated cost of repair.

2. The system of claim 1, wherein determining the capitated cost of repair of the vehicle comprises determining the capitated cost of repair without inspecting actual damage to the vehicle.

3. The system of claim 1, wherein the instructions that, when executed by the processor, further cause the system to:

receive, via a communication network, third data from the repair facility indicating an actual cost of repair; and

revise the model based on the third data.

4. The system of claim 1, wherein the first one or more loss attributes or second one or more loss attributes comprises a place of occurrence of an incident involving the vehicle.

5. The system of claim 1, wherein the first one or more loss attributes or second one or more loss attributes comprises a date of occurrence of an incident involving the vehicle.

6. The system of claim 1, wherein the payment comprises the capitated cost of repair.

7. The system of claim 1, wherein the first computing device further comprises a global positioning sensor configured to sense a location of the vehicle and the first computing device is configured to generate the second data further based on the location of the vehicle.

8. The system of claim 1, wherein the first computing device further comprises a sensor configured to sense a speed of the vehicle and the first computing device is configured to generate the second data further based on the speed of the vehicle.

9. The system of claim 1 further comprising the first computing device.

10. A computing device comprising:

a processor;

a non-transitory computer-readable medium storing instructions that, when executed by the processor, cause the computing device to;

store first data comprising a model that associates a first one or more loss attributes with a plurality of multipliers and that associates a second one or more loss attributes with a plurality of costs;

receive, from a second computing device associated with a vehicle, second data that comprises vehicle sensor data, wherein the second computing device comprises a global positioning sensor configured to sense a location of the vehicle and the second computing device is configured to generate the vehicle sensor data based on the location of the vehicle;

select, based on the second data, at least a first loss attribute from the first one or more loss attributes and at least a second loss attribute from the second one or more loss attributes;

determine a capitated cost of repair of the vehicle based on the first loss attribute and the second loss attribute; and

transmit, to a repair facility, a notification regarding payment based on the determined capitated cost of repair.

11. The computing device of claim 10, wherein the instructions that, when executed by the processor, cause the computing device to:

initiate, at the repair facility, repair of the vehicle for the capitated cost of repair.

12. The computing device of claim 10, wherein the second computing device further comprises an accelerometer configured to sense an acceleration of the vehicle, and wherein the second computing device is further configured to generate the vehicle sensor data based on the acceleration of the vehicle.

13. The computing device of claim 10, wherein a determination of the capitated cost of repair of the vehicle comprises determining the capitated cost of repair without inspecting actual damage to the vehicle.

14. The computing device of claim 10, wherein the instructions that, when executed by the processor, cause the computing device to:

receive, via a communication network, third data from the repair facility indicating an actual cost of repair; and

revise the model based on the third data.

15. The computing device of claim 10, wherein the first one or more loss attributes or second one or more loss attributes comprises a place of occurrence of an incident involving the vehicle.

16. The computing device of claim 10, wherein the first one or more loss attributes or second one or more loss attributes comprises a date of occurrence of an incident involving the vehicle.

17. The computing device of claim 10, wherein the second computing device further comprises a sensor configured to sense a speed of the vehicle, and wherein the second computing device is configured to generate the vehicle sensor data further based on the speed of the vehicle.

18. A system comprising:

a computing device associated with a vehicle and an apparatus,

wherein the computing device comprises one or more processors, and memory storing machine readable instructions that, when executed by the one or more processors of the computing device cause the computing device to;

generate location data corresponding to the vehicle via a global positioning sensor;

generate speed data corresponding to the vehicle;

generate acceleration data corresponding to the vehicle; and

transmit vehicle data comprising the location data, the speed data, and the acceleration data to the apparatus;

wherein the apparatus comprises;

one or more processors, and memory storing machine readable instructions that, when executed by the one or more processors, cause the apparatus to;

store first data comprising a model that associates a first one or more loss attributes with a plurality of multipliers and that associates a second one or more loss attributes with a plurality of costs;

receive, the vehicle data from the computing device;

select, based on the vehicle data, at least a first loss attribute from the first one or more loss attributes and at least a second loss attribute from the second one or more loss attributes; and

determine a capitated cost of repair of the vehicle based on one or more of the plurality of multipliers associated with the first loss attribute, and further based on one or more of the plurality of costs associated with the second loss attribute.

19. The system of claim 18, wherein the first one or more loss attributes or second one or more loss attributes comprises a place of occurrence of an incident involving the vehicle.

20. The system of claim 18, wherein the first one or more loss attributes or second one or more loss attributes comprises a date of occurrence of an incident involving the vehicle.