Method, apparatus, and products for managing insurance

• US 20020128877A1
• Filed: 03/12/2001
• Published: 09/12/2002
• Est. Priority Date: 03/12/2001
• Status: Abandoned Application

• Current Assignee: Donald N. Levit
• Original Assignee: Donald N. Levit
• Inventors: Levit, Donald N.
• Application Number:
  US09/804,412
• Publication Number:
  US 20020128877A1
• Time in Patent Office: Days
• US Class Current: 705/4
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

The present invention relates to managing insurance programs. In another aspect, the present invention relates to managing insurance programs that provide an opportunity for a policy owner to be eligible for increasing benefits the greater the total amount of premiums paid by the policy owner. In even another aspect, the present invention relates to providing health insurance in which ownership of a portion of the premiums of a policy owner vests in the policy owner.

Claims

1. A method of managing health insurance benefits for policy owners, the method comprising:

(a) accepting payment of a premium amount from the policy owner; and

(b) allocating the premium amount between an individual investment account, at least partially owned by the policy owner, and a general reserve fund.

2. The method of claim 1, wherein a claim is received from the policy owner for payment of medical expenses caused by a medical event.

3. The method of claim 2, wherein processing the claim for payment comprises determining amounts to be paid including use of a medical multiple factor.

4. The method of claim 3, wherein the claim is paid from the individual investment account and the general reserve account based on the processed claim.

5. The method of claim 3, wherein the medical multiple factor is determined by:

estimating totals for a plurality of policy owners of annual premium receipts, annual claims liability, and annual investment income,

wherein the investment income is a sum of income of both a pool of individual investment accounts and the general reserve fund;

estimating an average total amount of the general reserve fund including premium deposits without any withdrawals for a future year;

determining a total amount that can be withdrawn from the general reserve fund for payment of claims during the future year that maintains a reserve to pay at least a portion of operating expenses and unforseen claims expenses during the future year; and

determining a number to use as the medical multiple factor, which when multiplied by an estimated average balance of the individual investment accounts of policy holders likely to file claims in the future year, equals the total amount that can be withdrawn from the general reserve account and the pool of individual investment accounts.

6. The method of claim 3, wherein the medical multiple factor is redetermined by:

obtaining actual performance information for the total of the plurality of policy owners of annual premium receipts, annual claims liability, and annual investment income;

determining estimates of future annual premium receipts, annual claims liability, and annual investment income wherein the estimates factor in the actual performance information; and

redetermining an amount to use as the medical multiple factor which when multiplied by the estimated average balance of the individual investment accounts of policy holders likely to file claims in the future year, results in preserving a reserve of funds from which to pay claims and operating expenses in the future year.

7. The method of claim 6, wherein the estimates of total annual premium receipts, annual claims liability, and annual investment income are determined by:

obtaining data for the plurality of policy owners, the data comprising a policy owner census, waiting period status, payment history, and claims history;

determining a probable total number and size of premiums to be paid by existing and future policy owners for the future year based in part on premiums paid in a previous year;

determining an estimated total number and cost of medical claims to be submitted by existing and future policy owners for the future year based in part on claims filed in the previous year;

determining the estimate of annual investment income from types of investments and investment income from the previous year; and

determining the estimates of total annual premium receipts, annual claims liability, and annual investment income.

8. The method of claim 3, wherein processing the claim comprises:

determining whether the policy owner has satisfied a waiting period prior to being eligible for use of the general reserve fund for payment of a portion of a processed claim, to the extent provided by the medical multiple; and

if the waiting period has been satisfied, applying the medical multiple factor to the claim to calculate an amount of money available to withdraw from the individual investment account of the policy owner and from the general reserve fund for payment of the claim.

9. A method of managing health insurance benefits for policy owners, the method comprising:

(a) paying a health benefit from the individual investment account and the general reserve account based on the processed claim.

10. A computer system for managing health insurance benefits, comprising a processor provided with instructions, the instructions which when executed instruct the processor to:

a) record a choice by a policy owner of a premium amount to be paid by the policy owner for health insurance;

(b) enter a payment of the premium amount from the policy owner in a ledger;

(c) allocate the premium amount of the policy owner between an individual investment account and a general reserve fund and recording ownership by the policy owner of a portion of the premium amount allocated to the individual investment account of the policy owner;

(d) post a claim from the policy owner for medical expenses caused by a medical event;

(e) process the claim for payment, wherein processing the claim comprises determining whether the policy owner has satisfied a waiting period prior to being eligible for use of the general reserve fund for payment of a portion of a processed claim, to the extent provided by a medical multiple factor; and

(f) print a check authorizing payment of the claim to the policy owner based on the processed claim.

11. The apparatus of claim 10, wherein the instructions comprise steps for determining the medical multiple factor by:

estimating totals for a plurality of policy owners of annual premium receipts, annual claims liability, and annual investment income, wherein investment income is a sum of income of both a pool of the individual investment accounts and the general reserve fund; and

estimating an amount to use as the medical multiple factor which when multiplied by a balance of the individual investment accounts of policy holders likely to file claims in a future year, results in preserving a reserve of funds from which to pay claims and operating expenses.

12. The apparatus of claim 11 wherein the instructions comprise steps for redetermining the medical multiple factor by:

obtaining actual performance information for the total of the plurality of policy owners of annual premium receipts, annual claims liability, and annual investment income;

determining estimates of future annual premium receipts, annual claims liability, and annual investment income wherein the estimates factor in the actual performance information; and

redetermining an amount to use as the medical multiple factor which when multiplied by the balance of the individual investment accounts of policy holders likely to file claims in the future year, results in preserving a reserve of funds from which to pay claims and operating expenses in the future year.

14. The computer-readable media of claim 13, wherein the instructions comprise steps for determining the medical multiple factor by:

estimating totals for a plurality of policy owners of annual premium receipts, annual claims liability, and annual investment income, wherein investment income is a sum of income of both a pool of the individual investment accounts and the general reserve fund; and

estimating an amount to use as the medical multiple factor which when multiplied by a balance of the individual investment accounts of policy holders likely to file claims in a future year, results in preserving a reserve of funds from which to pay claims and operating expenses.

15. The computer-readable media of claim 14, wherein the instructions comprise steps for redetermining the medical multiple factor by:

obtaining actual performance information for the total of the plurality of policy owners of annual premium receipts, annual claims liability, and annual investment income;

determining estimates of future annual premium receipts, annual claims liability, and annual investment income wherein the estimates factor in the actual performance information; and

redetermining an amount to use as the medical multiple factor which when multiplied by the balance of the individual investment accounts of policy holders likely to file claims in the future year, results in preserving a reserve of funds from which to pay claims and operating expenses in the future year.

17. The computer-readable signal of claim 16, wherein the instructions comprise steps for determining the medical multiple factor by:

estimating totals for a plurality of policy owners of annual premium receipts, annual claims liability, and annual investment income, wherein investment income is a sum of income of both a pool of the individual investment accounts and the general reserve fund; and

estimating an amount to use as the medical multiple factor which when multiplied by a balance of the individual investment accounts of policy holders likely to file claims in a future year, results in preserving a reserve of funds from which to pay claims and operating expenses.

18. The computer readable signal of claim 17, wherein the instructions comprise steps for redetermining the medical multiple factor by:

obtaining actual performance information for the total of the plurality of policy owners of annual premium receipts, annual claims liability, and annual investment income;

determining estimates of future annual premium receipts, annual claims liability, and annual investment income wherein the estimates factor in the actual performance information; and

redetermining an amount to use as the medical multiple factor which when multiplied by the balance of the individual investment accounts of policy holders likely to file claims in the future year, results in preserving a reserve of funds from which to pay claims and operating expenses in the future year.

13. Computer-readable media in communication with a computer processor for managing health insurance benefits, the media provided with instructions, the instructions which when executed instruct the processor to:

a) record a choice by a policy owner of a premium amount to be paid by the policy owner for health insurance;

(b) enter a payment of the premium amount from the policy owner in a ledger;

(c) allocate the premium amount of the policy owner between an individual investment account and a general reserve fund and record ownership by the policy owner of a portion of the premium amount allocated to the individual investment account of the policy owner;

(d) post a claim from the policy owner for medical expenses caused by a medical event;

(e) process the claim for payment, wherein processing the claim comprises determining whether the policy owner has satisfied a waiting period prior to being eligible for use of the general reserve fund for payment of a portion of a processed claim, to the extent provided by a medical multiple factor; and

(f) print a check authorizing payment of the claim based on the processed claim.

16. A computer-readable signal in communication with a computer processor for managing health insurance benefits, the signal provided with instructions, the instructions which when executed instruct the processor to:

a) record a choice by a policy owner of a premium amount to be paid by the policy owner for health insurance;

(b) enter a payment of the premium amount from the policy owner in a ledger;

(c) allocate the premium amount of the policy owner between an individual investment account and a general reserve fund and recording ownership by the policy owner of a portion of the premium amount allocated to the individual investment account of the policy owner;

(d) post a claim from the policy owner for medical expenses caused by a medical event;

(e) process the claim for payment, wherein processing the claim comprises determining whether the policy owner has satisfied a waiting period prior to being eligible for use of the general reserve fund for payment of a portion of a processed claim, to the extent provided by a medical multiple factor; and

(f) print a check authorizing payment of the claim to the policy owner based on the processed claim.