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GUI FOR RISK PROFILES

  • US 20130297354A1
  • Filed: 04/09/2013
  • Published: 11/07/2013
  • Est. Priority Date: 01/17/2012
  • Status: Abandoned Application
First Claim
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1. A memory device storing machine-readable instructions, the instructions executable by a processor to cause the processor to:

  • retrieve a first set of data from a database, the data including information about a plurality of insurance claims;

    perform an analysis of the first set of data to determine a first result associated with a first key performance indicator;

    obtain a first set of benchmark values corresponding to the first key performance indicator;

    compare the first result to the first set of benchmark values to determine the relationship of the first result to the set of benchmark values; and

    generate a risk profile report for output to the user that includes the relationship between the first result and the first set of benchmark valueswherein the key performance indicator is one of the group consisting of;

    a percentage of workers compensation claims that include temporary total disability payments;

    an average number of days per temporary total disability claim;

    an average value of indemnity claims;

    a medical-to-indemnity conversion rate;

    a claim closure, rate for workers compensation claims;

    an average time between a date of loss, and a date reported to a third party;

    a percentage of total claim payments attributable to medical costs;

    a percentage of medical costs attributable to pharmacy costs;

    a PPO penetration rate;

    a percentage of claims litigated;

    a percentage of total claim payments attributable to expenses;

    a percentage of total claim payments attributable to legal expenses;

    a trend relationship related to an actuarially based claim frequency rate;

    a variance related to an incidence rate of Occupational Safety &

    Health Administration (OSHA) claims;

    a variance related to a lost work date rate; and

    a loss rate calculated based on claim frequency and claim severity.

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