SYSTEM AND METHOD FOR ADMINISTERING INSURANCE POLICIES ISSUED BEFORE COMPREHENSIVE UNDERWRITING

• US 20110125536A1
• Filed: 12/02/2010
• Published: 05/26/2011
• Est. Priority Date: 11/23/2009
• Status: Active Grant

• Current Assignee: Prudential Insurance Company of America (Prudential Financial Incorporated)
• Original Assignee: Hartford Fire Insurance Company (The Hartford Financial Services Group, Inc.)
• Inventors: Rasmussen, Kimberly Ann, Roscoe, Michael J., Lindquist, Greg D., Reynolds, Leslie Ann, Williams, Steven J.
• Granted Patent: US 8,571,897 B2
• Time in Patent Office: Days
• US Class Current: 705/4
• CPC Class Codes: G06Q 40/00 Finance; Insurance; Tax strategies; Processing of corporate or income taxes
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

A computer system for administering applications for life insurance has a processor and a memory storage device in communication with the processor. The processor is configured to receive data indicative of an application and an initial premium payment from a proposed insured for life insurance; based on the received data, determine whether the proposed insured is eligible for life insurance issued before completion of comprehensive underwriting; responsive to a determination that the proposed insured is eligible, generate an output signal having data indicative of a decision to respond to the application by issuing a policy and by commencing a comprehensive underwriting process. The processor may be configured to receive data indicative of a result of the comprehensive underwriting process and based on the result of the comprehensive underwriting process, provide an output signal indicative of policy changes.

Claims

1. A computer system for administering applications for insurance, comprising:

a processor;

a memory storage device having stored data indicative of criteria for eligibility for issue of a life insurance policy prior to comprehensive underwriting, in communication with the processor;

the processor configured to;

receive data indicative of an application by a proposed insured for life insurance, the data including data indicative of responses furnished by the proposed insured relating to health conditions of the proposed insured known to the proposed insured, and requested policy data, including data indicative of proposed insured information, requested death benefit amount, type of policy, identification of beneficiary, and initial premium paid;

store in the memory storage device the received health condition data and requested policy data;

access from the memory storage device the stored data indicative of criteria for eligibility for issue of a life insurance policy prior to comprehensive underwriting;

determine based on the received data relating to the health conditions of the proposed insured and the accessed data indicative of criteria for eligibility, whether the proposed insured is eligible for life insurance; and

responsive to a determination that the proposed insured is eligible, generate an output signal having data indicative of instructions to issue a life insurance policy on the life of the proposed insured, and an output signal having data indicative of instructions to commence comprehensive underwriting of the proposed insured.

2. The computer system of claim 1, wherein the processor is further configured to determine whether the proposed insured is eligible for life insurance in real time responsive to receipt of the received data relating to the health conditions of the proposed insured.

3. The computer system of claim 1, wherein the processor is further configured to determine whether the proposed insured is eligible for life insurance within five business days of receipt of the received data relating to the health conditions of the proposed insured.

4. The computer system of claim 1, further comprising a commissions and accounting computer system in communication with the processor for determining a first commission amount responsive to receiving data indicative of issue of an initial policy issued upon the determination that the proposed insured is eligible, and for determining a second commission amount responsive to receiving data indicative of a final issued policy after completion of comprehensive underwriting.

5. The computer system of claim 4, further comprising an insurance document generation system, in communication with the processor, for generating first life insurance policy documents upon the determination that the proposed insured is eligible and for generating second life insurance policy documents after completion of comprehensive underwriting.

6. The computer system of claim 5, further comprising a reinsurance administration computer system, in communication with the processor, for determining a first reinsurance premium associated with a life insurance policy issued upon the determination that the proposed insured is eligible, and for determining a second reinsurance premium associated with the life insurance policy after completion of comprehensive underwriting.

7. The computer system of claim 1, wherein the processor is further configured to, responsive to a determination that the proposed insured is not eligible for life insurance, generate an output signal having data indicative of a decision to respond to the application by declining to issue a policy.

8. The computer system of claim 1, further comprising an insurance document generation system in communication with the processor for receiving the output signal from the processor and generating life insurance policy documents for delivery to the proposed insured.

9. The computer system of claim 1, wherein the data indicative of responses furnished by the proposed insured relating to health conditions of the proposed insured known to the proposed insured comprises data indicative of whether the proposed insured has been diagnosed with or treated for a condition indicative of a substantially shortened life expectancy.

10. The computer system of claim 9, wherein the condition indicative of a substantially shortened life expectancy comprises at least one of cancer, heart disease, drug abuse, alcohol abuse and neurological disorders.

11. The computer system of claim 1, wherein the data indicative of responses furnished by the proposed insured relating to health conditions of the proposed insured known to the proposed insured comprises data indicative of whether the proposed insured has been diagnosed with or treated for a condition indicative of uncertainty as to life expectancy.

12. The computer system of claim 11, wherein the condition indicative of uncertainty as to life expectancy comprises a recently-diagnosed cancer.

13. The computer system of claim 1, wherein the data indicative of responses furnished by the proposed insured relating to health conditions of the proposed insured known to the proposed insured comprises data indicative of whether the proposed insured has been rejected for life insurance.

14. The computer system of claim 1, wherein the processor is further configured to, responsive to receipt of data indicative of receipt of an application for life insurance and a premium, provide an output signal having data indicative of an instruction to provide a binding premium receipt reflecting life insurance coverage on the life of the proposed insured.

15. The computer system of claim 14, wherein the processor is configured to, responsive to the determination that the proposed insured is eligible, provide an output signal indicative of termination of life insurance coverage pursuant to the binding premium receipt.

16. The computer system of claim 1, wherein the data indicative of responses furnished by the proposed insured relating to health conditions of the proposed insured known to the proposed insured comprises data for avoiding adverse selection of an insurance policy issued prior to comprehensive underwriting by proposed insureds knowing of health which provide an increased mortality compared to the general population.

17. The computer system of claim 1, wherein the processor is further configured to, responsive to receipt of data indicative of a result of a comprehensive underwriting process, determine a rating category of the proposed insured.

18. The computer system of claim 1, wherein the processor is further configured to, responsive to receipt of data indicative of the comprehensive underwriting process, that indicates knowledge by the proposed insured in contradiction to the received health data, provide an output signal indicative of cancellation of the policy.

19. A computer-implemented method for administering applications for insurance, comprising:

receiving by a processor of a computer system data associated with an application by a proposed insured for a life insurance policy, the data including data indicative of information furnished by the proposed insured relating to health of the proposed insured, and data indicative of requested policy data, including data indicative of proposed insured information, requested death benefit amount, type of policy, identification of beneficiary, and premium paid;

storing by the processor in a memory storage device of the computer system the received binary affirmative or negative response data and requested policy data;

accessing by the processor from the memory storage device data indicative of criteria for responses to the questions to establish eligibility for issue of a life insurance policy prior to comprehensive underwriting;

determining by the processor, based on the received data indicative of binary affirmative or negative responses and the accessed data indicative of criteria for eligibility, whether the proposed insured is eligible for issue of a life insurance policy prior to comprehensive underwriting; and

responsive to a determination that the proposed insured is eligible, generating by the processor an output signal having data indicative of instructions to generate and deliver to the proposed insured a life insurance policy on the life of the proposed insured.

20. The computer-implemented method of claim 19, wherein data indicative of information furnished by the proposed insured relating to health of the proposed insured comprises binary affirmative or negative responses of the proposed insured to questions relating to the health of the proposed insured.

21. The computer-implemented method of claim 19, wherein the generating by the processor the output signal is performed within four business days of the receiving of the data.

22. The computer-implemented method of claim 19, wherein the data indicative of binary affirmative or negative responses comprises data indicative of responses to not more than ten questions.

23. The computer-implemented method of claim 22, wherein the determining comprises a step of determining whether complete application data and a premium of appropriate amount have been received, and a step of determining eligibility, the step of determining eligibility based solely on the received binary affirmative or negative response data.

24. The computer-implemented method system of claim 19, further comprising, responsive to a determination that the proposed insured is not eligible for life insurance, generating an output signal having data indicative of a decision to respond to the application by declining to issue a policy.

25. The computer-implemented method of claim 19, wherein the data indicative of responses furnished by the proposed insured relating to health conditions of the proposed insured known to the proposed insured comprises data indicative of whether the proposed insured has been diagnosed with or treated for a condition indicative of a substantially shortened life expectancy.

26. The computer-implemented method of claim 25, wherein the condition indicative of a substantially shortened life expectancy comprises at least one of cancer, heart disease, drug abuse, alcohol abuse and neurological disorders.

27. The computer-implemented method of claim 19, wherein the data indicative of responses furnished by the proposed insured relating to health conditions of the proposed insured known to the proposed insured comprises data indicative of whether the proposed insured has been diagnosed with or treated for a condition indicative of uncertainty as to life expectancy.

28. The computer-implemented method of claim 27, wherein the condition indicative of uncertainty as to life expectancy comprises a recently-diagnosed cancer.

29. The computer-implemented method of claim 19, wherein the data indicative of responses furnished by the proposed insured relating to health conditions of the proposed insured known to the proposed insured comprises data indicative of whether the proposed insured has been assigned a rating lower than a standard rating in connection with an application for life insurance.

30. A computer system for administering applications for insurance, comprising:

a processor;

a memory storage device having stored data indicative of criteria for eligibility for issue of a life insurance policy prior to comprehensive underwriting, in communication with the processor;

the processor configured to;

receive data indicative of an application by a proposed insured for life insurance for issue prior to comprehensive underwriting;

determine, based on the received data, whether the proposed insured is eligible for life insurance for issue prior to comprehensive underwriting;

responsive to a determination that the proposed insured is eligible, generate an output signal having data indicative of instructions to issue a life insurance policy on the life of the proposed insured, and an output signal having data indicative of instructions to commence comprehensive underwriting of the proposed insured.

provide to an insurance process administration computer system data relating to the issued initial policy for determining insurance data associated with the issued initial policy;

receive data indicative of a result of the comprehensive underwriting process;

based on the result of the comprehensive underwriting process, determine terms of a final issued policy; and

provide to the insurance process administration computer system data relating to the final issued policy.

31. The system of claim 30, wherein the insurance process administration computer system is a reinsurance administration computer system, the insurance data associated with the issued initial policy being risk associated with the issued initial policy to be ceded to a reinsurer.

32. The system of claim 30, wherein the insurance process administration computer system is a policy owner reporting computer system configured to print policy documents.

33. The system of claim 32, wherein the policy owner reporting computer system is configured to print first selected documents responsive to receiving data indicative of the initial issued policy, and to print second selected documents responsive to receiving data indicative of the final issued policy.

34. The system of claim 33, wherein the first selected documents comprise documents relating to riders effective upon issue of the policy.

35. The system of claim 34, wherein the second selected documents comprise documents relating to riders effective after completion of comprehensive underwriting.

36. The system of claim 30, wherein the insurance process administration computer system is a commissions and accounting computer system.

37. The system of claim 30, wherein the commissions and accounting computer system is configured to determine a first commission amount responsive to receiving data indicative of the initial issued policy, and to determine a second commission amount responsive to receiving data indicative of the final issued policy.

38. A computer-implemented method for administration of insurance, comprising:

receiving by a processor, and storing by the processor in a memory device in communication with the processor, data indicative of an application and an initial premium payment from a proposed insured for life insurance for issue prior to comprehensive underwriting;

based on the received data, determining by the processor whether the proposed insured is eligible for life insurance issued prior to comprehensive underwriting;

responsive to a determination that the proposed insured is eligible, generating by the processor an output signal having data indicative of a decision to respond to the application by issuing an initial policy and commencing a comprehensive underwriting process, and providing to an insurance process administration computer system data relating to the issued initial policy for determining insurance data associated with the issued initial policy;

receiving by the processor data indicative of a result of the comprehensive underwriting process;

based on the result of the comprehensive underwriting process, determining by the processor terms of a final issued policy; and

providing to the insurance process administration computer system data relating to the final issued policy.

39. The method of claim 38, further comprising determining by the insurance process administration computer system, responsive to receiving the data relating to the initial issued policy an amount of risk associated with the issued initial policy to be ceded to a reinsurer.

40. The method of claim 39, further comprising determining by the insurance process administration computer system, responsive to receiving the data relating to the final issued policy, an amount of risk associated with the final issued policy to be ceded to a reinsurer.

41. The method of claim 38, further comprising determining by the insurance process administration computer system, responsive to receiving the data relating to the initial issued policy, first selected policy documents for printing and delivery to the insured.

42. The method of claim 41, further comprising determining by the insurance process administration computer system, responsive to receiving the data relating to the final policy, second selected policy documents for printing and delivery to the insured.

43. The method of claim 42, wherein the first selected documents comprise documents relating to riders effective upon issue of the policy, and the second selected documents comprise documents relating to riders effective after completion of comprehensive underwriting.

44. The method of claim 38, further comprising determining by the insurance process administration computer system, responsive to receiving the data relating to the initial issued policy, a first commission amount, and determining by the insurance process administration computer system, a second commission amount responsive to receiving data indicative of the final issued policy.

45. A computer system for issue and administration of life insurance policies, comprising:

a processing module, comprising a processor, for receiving data indicative of an application and an initial premium payment from a proposed insured for life insurance for issue prior to comprehensive underwriting and for determining, based on the received data, whether the proposed insured is eligible for issue of life insurance issued prior to underwriting;

an administration module, comprising a processor, for, responsive to a determination by the processing module that the proposed insured is eligible, administering a comprehensive underwriting process; and

for determining risk data based on a result of the comprehensive underwriting process; and

an issuance module, comprising a processor, for issuing a life insurance policy to the proposed insured responsive to the determination by the processing module that the proposed insured is eligible.

46. The computer system of claim 45, further comprising a communications module for providing to an insurance process administration computer system data relating to the issued policy responsive to issue and responsive to determining the risk data.

47. The computer system of claim 46, wherein the insurance process administration computer system is a computer system for generating policy documents, and the communications module is further for providing data relating to the issued policy responsive to issue and responsive to determining the risk data to a reinsurance administration computer system.

48. The computer system of claim 47, wherein the communications module is further for providing data relating to the issued policy responsive to issue and responsive to determining the risk data to a computer system for determining commissions.

49. A computer-implemented method for issue and administration of life insurance policies, comprising:

receiving by a processing module, comprising a processor, data indicative of an application and an initial premium payment from a proposed insured for life insurance for issue prior to comprehensive underwriting;

determining by the processing module, based on the received data, whether the proposed insured is eligible for issue of life insurance issued prior to underwriting;

administering by an administration module, comprising a processor, responsive to a determination by the processing module that the proposed insured is eligible, administering a comprehensive underwriting process;

determining by the administration module risk data based on a result of the comprehensive underwriting process; and

issuing by an issuance module, comprising a processor, a life insurance policy to the proposed insured responsive to the determination by the processing module that the proposed insured is eligible.

50. The computer-implemented method of claim 49, wherein the determined risk data comprises a rating classification.

51. The computer-implemented method of claim 49, wherein the data indicative of an application comprises data indicative of a first death benefit amount requested for a period prior to comprehensive underwriting and a second death benefit amount requested for a period after completion of comprehensive underwriting.