Process for summarizing information for insurance underwriting suitable for use by an automated system
First Claim
1. A process for summarizing and standardizing attending physician statements for use in an insurance application underwriting system comprising the steps of:
- accessing a general form for a patient;
verifying that the attending physician statement to be summarized and standardized corresponds to the patient associated with the general form;
entering information into a plurality of data fields within the general form based on information contained within the attending physician statement, where the plurality of data fields comprise at least one required field;
presenting the completed general form for validation, where validation comprises ensuring that the information has been entered into the at least one required data field and that it satisfies at least one of;
a) being within a specified numerical range; and
b) having a membership within a restricted class;
selecting at least one condition specific form;
entering information into a plurality of condition specific data fields within the at least one condition specific form based on information contained within the attending physician statement, where the plurality of condition specific data fields comprise at least one required data field; and
presenting the completed at least one condition specific form for validation.
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Abstract
A process to structure and summarize the key information required by automated decision-making systems for insurance underwriting is described. The automated underwriting system may be based on rules corresponding to underwriting components, wherein based on the degree of satisfaction of each rule, a component may be assigned to a category, and based on the category for each component, the insurance application may be assigned an underwriting category, or the automated underwriting system may be based on an evaluation of the similarity of a given application to previous application requests, to decide an underwriting category. Most of the key information required for automated insurance underwriting is structured and standardized, except for the Attending Physician Statement (APS), which is almost as unique as each individual physician. The process to structure and summarize the APS information captures the relevant variables that characterize a given medical impairment, allowing an automated reasoning system to determine the degree of severity of such impairment and to estimate the underlying insurance risk.
170 Citations
76 Claims
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1. A process for summarizing and standardizing attending physician statements for use in an insurance application underwriting system comprising the steps of:
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accessing a general form for a patient;
verifying that the attending physician statement to be summarized and standardized corresponds to the patient associated with the general form;
entering information into a plurality of data fields within the general form based on information contained within the attending physician statement, where the plurality of data fields comprise at least one required field;
presenting the completed general form for validation, where validation comprises ensuring that the information has been entered into the at least one required data field and that it satisfies at least one of;
a) being within a specified numerical range; and
b) having a membership within a restricted class;
selecting at least one condition specific form;
entering information into a plurality of condition specific data fields within the at least one condition specific form based on information contained within the attending physician statement, where the plurality of condition specific data fields comprise at least one required data field; and
presenting the completed at least one condition specific form for validation. - View Dependent Claims (2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12)
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13. A process for summarizing and standardizing an information submission for use in an insurance application underwriting system comprising the steps of:
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accessing a general form for an applicant;
verifying that the information submission to be summarized and standardized corresponds to the applicant associated with the general form;
entering information into a plurality of data fields within the general form based on information contained within the information submission, where the plurality of data fields comprise at least one required field;
presenting the completed general form for validation, where validation comprises ensuring that the information has been entered into the at least one required data field and may include data validation such as verifying that a number is within a specific range or ranges or that a text entry is within a predefined membership list, such as yes or no;
selecting at least one supplemental form;
entering information into a plurality of supplemental data fields within the at least one supplemental form based on information contained within the information submission, where the plurality of supplemental data fields comprises at least one required data field; and
presenting the completed at least one condition specific form for validation. - View Dependent Claims (14, 15, 16, 17, 18, 19, 20, 21, 22)
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23. A process for summarizing and standardizing attending physician statements for use in an insurance application underwriting system comprising the steps of:
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accessing a general form for a patient;
verifying that the attending physician statement to be summarized and standardized corresponds to the patient associated with the general form;
entering information into a plurality of data fields within the general form based on information contained within the attending physician statement, where the plurality of data fields comprise at least one required field; and
presenting the completed general form for validation, where validation comprises ensuring that the information has been entered into the at least one required data field. - View Dependent Claims (24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38)
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39. A medium storing code for causing a processor to summarize and standardize attending physician statements for use in an insurance application underwriting system, the medium comprising:
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code for accessing a general form for a patient;
code for verifying that the attending physician statement to be summarized and standardized corresponds to the patient associated with the general form;
code for entering information into a plurality of data fields within the general form based on information contained within the attending physician statement, where the plurality of data fields comprise at least one required field;
code for presenting the completed general form for validation, where validation comprises ensuring that the information has been entered into the at least one required data field and may include data validation such as verifying that a number is within a specific range or ranges or that a text entry is within a predefined membership list, such as yes or no;
code for selecting at least one condition specific form;
code for entering information into a plurality of data fields within the at least one condition specific form based on information contained within the attending physician statement, where the plurality of data fields comprise at least one required data field; and
code for presenting the completed at least one condition specific form for validation. - View Dependent Claims (40, 41, 42, 43, 44, 45, 46, 47, 48, 49, 50)
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51. A medium storing code for causing a processor to summarize and standardize an information submission for use in an insurance underwriting system, the medium comprising:
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code for accessing a general form for an applicant;
code for verifying that the information submission to be summarized and standardized corresponds to the applicant associated with the general form;
code for entering information into a plurality of data fields within the general form based on information contained within the information submission, where the plurality of data fields comprise at least one required field;
code for presenting the completed general form for validation, where validation comprises ensuring that the information has been entered into the at least one required data field and may include data validation such as verifying that a number is within a specific range or ranges or that a text entry is within a predefined membership list, such as yes or no;
code for selecting at least one supplemental form;
code for entering information into a plurality of supplemental data fields within the at least one supplemental form based on information contained within the information submission, where the plurality of supplemental data fields comprises at least one required data field; and
code for presenting the completed at least one condition specific form for validation. - View Dependent Claims (52, 53, 54, 55, 56, 57, 58, 59, 60)
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61. A medium storing code for causing a processor to summarize and standardize attending physician statements for use in an insurance application underwriting system, the medium comprising:
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code for accessing a general form for a patient;
code for verifying that the attending physician statement to be summarized and standardized corresponds to the patient associated with the general form;
code for entering information into a plurality of data fields within the general form based on information contained within the attending physician statement, where the plurality of data fields comprises at least one required field; and
code for presenting the completed general form for validation, where validation comprises ensuring that the information has been entered into the at least one required data field and may include data validation such as verifying that a number is within a specific range or ranges or that a text entry is within a predefined membership list, such as yes or no. - View Dependent Claims (62, 63, 64, 65, 66, 67, 68, 69, 70, 71, 72, 73, 74, 75, 76)
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Specification