Integrated group insurance information processing and reporting system based upon an enterprise-wide data structure

• US 5,191,522 A
• Filed: 01/18/1990
• Issued: 03/02/1993
• Est. Priority Date: 01/18/1990
• Status: Expired due to Fees

• Current Assignee: Hartford Life Insurance Company (The Hartford Financial Services Group, Inc.)
• Original Assignee: ITT Corporation (ITT, Inc.)
• Inventors: Annis, David H., Bosco, James J., Prouty, Kathleen M.
• Primary Examiner(s): Hayes, Gail O.
• Application Number:
  US07/467,843
• Time in Patent Office: 1,139 Days
• Field of Search: 364/401, 364/408
• US Class Current: 705/4
• CPC Class Codes: G06Q 40/02 Banking, e.g. interest calculation or account maintenance credit or loans G06Q40/03
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

An integrated information storage processing and reporting system for processing and supervising a plurality of group insurance accounts was contructed with a single enterprise-wide relational data base. The system provides sales, underwriting, administration and actuarial functions through integrated program-controlled data processing systems specific for each function and communicating with a group insurance account data bank. Each function is accessible through a single integrated workstation.

Claims

1. An enterprise-wide integrated computer system for storing, processing and reporting information regarding a plurality of group insurance accounts comprising:

a central processing unit;

a memory;

means for storing data concerning each group insurance account in a single relational data base, the relational data base having a structure comprising a plurality of tables in third normal form, each table concerning a specific data subject and wherein the tables are grouped into a plurality of subject categories, each category corresponding to an operating objective of the enterprise on which data is collected;

means for managing the relational data base;

a plurality of applications workstation sub-systems including sales, underwriting administration and actuarial sub-systems;

the sales sub-system comprising means for processing sales data including means for communicating with the central processing unit, memory and data storage means and means for accessing defined subject categories on the single relational database and for capturing, modifying and processing data contained in tables of a defined subject category which are necessary for the sales sub-system functions;

the underwriting sub-system comprising means for processing underwriting data including means for communicating with the central processing unit, memory and data storage means and means for accessing defined subject categories on the single relational database and for capturing, modifying and processing data contained in tables of a defined subject category which are necessary for the underwriting sub-system functions;

the administration sub-system comprising means for processing administration data including means for communicating with the central processing unit, memory and data storage means and means for accessing defined subject categories on the single relational database and for capturing, modifying and processing data contained in tables of a defined subject category which are necessary for the administration sub-system functions;

the actuarial sub-system comprising means for processing actuarial data including means for communicating with the central processing unit, memory and data storage means and means for accessing defined subject categories on the single relational database and for capturing, modifying and processing data contained in tables of a defined subject category which are necessary for the actuarial sub-system functions;

means for controlling the access of an operator to each of the workstation sub-systems;

a plurality of workstations each workstation comprising means for inputting data, means for displaying data, and means for selecting, accessing and interacting with the memory means and each of the applications workstation sub-systems; and

a printing means.

2. The enterprise-wide integrated system of claim 1 wherein the tables of at least one subject category are clustered and stored in a separate physical location on the means for storing data.

3. An enterprise-wide integrated computer system for storing, processing and reporting information regarding a plurality of group insurance accounts comprising:

a central processing unit;

a memory;

means for storing data concerning each group insurance account, including data on policyholders, coverage rate, participant restrictions, premiums, commissions, clients, claims, products, producers, competitors cases, payments, bills, provisions, obligation conditions, exposure fees, income, schedules, and reinsurance in a single relational data base;

means for managing the relational data base including means for creating tables to contain the data stored on the data base and means for modifying, storing, retrieving and manipulating the data;

the relational data base having a structure comprising a plurality of third normal form tables, grouped in a plurality of subject categories including a Case subject category, a Claims subject category, a Client subject category, a Competitor subject category, a Coverage subject category and a Producer subject category;

a plurality of applications workstation sub-systems including sales, underwriting, administration and actuarial sub-systems;

the sales sub-system comprising means for processing sales data comprising means for tracking the history of each account, means for generating reports on the case history of each account, means for producing policyholder, coverage, rate and participant data, means for generating sales proposals outlining the coverage, rates and restrictions for an account, means for communicating with the central processing unit and memory, and means for modifying and accessing sales data in the single relational data base;

the underwriting sub-system comprising means for processing underwriting data comprising case tracking means for tracking and logging tasks associated with each account after, sale, notification means for generating reports for notifying personnel of tasks to be performed, rate means for calculating rates and generating manual sales based on case and census information, means for generating field bulletins comprising information specified from the underwriting data processing means, means for communicating with the central processing unit and memory, and means for modifying and accessing underwriting data stored in the single relational data base;

the administration sub-system comprising means for processing administration data comprising case management means for maintaining and updating information on each account once the account has issued, means for creating, storing and maintaining records on individual account participants concerning coverage, benefit levels and status, means for generating certificates of insurance and participant identification cards, means for producing printed standard contracts outlining policy provisions, conditions and obligations and other provisions, means for producing printed individual participant certificates outlining selected coverage and conditions, means for generating bills at specified intervals for each account or account participant, means for recording and validating payment of bills, means for reconciling payments received for premiums, fees or income with client data, means for processing premium payments to each account and coverage type, commission processing means for calculating commissions due on each account, taxes, minimum payments and issuing advances on earned commissions, means for storing and providing premium and claim information for accounting and tax purposes, means for communicating with the central processing unit and memory, and means for accessing and modifying the administration data stored on the single relational data base;

the actuarial sub-system comprising means for processing actuarial data comprising means for accessing premium, claim and exposure information at a plurality of levels, means for maintaining and reporting the requirements of any reinsurance agreements for an account, and financial reporting means for storing and providing premium and claim information, means for communicating with the central processing unit and memory, and means for accessing and modifying actuarial data stored on the memory means single relational data base;

security means for controlling the access by an operator of the system to each of the workstation sub-systems;

a plurality of workstations each workstation comprising means for inputting data, means for displaying data, and means for selecting, accessing and interacting with each of the stored program controlled data processing means; and

a printing means.

4. A computerized enterprise-wide integrated group insurance information processing and reporting system, comprising in combination, data entry means, data display means, a central processing unit, a memory, data storage means for storing data in a relational data base, a plurality of applications programs, and a relational data base management systems program, the data base being a single relational data base having a data structure comprising a plurality of third normal form relational tables:

the tables being organized into a plurality of subject categories, each subject category corresponding to an operating objective of the enterprise, the subject categories comprising;

a) a Case subject category comprising tables that contain data on the case description, activity history, coverage available, policy level, participants, coverage in-force, billing, producers and commissions;

b) a Claim subject category comprising tables that contain data concerning the requests from a participant for reimbursement for an incurred procedure or loss;

c) a Client subject category comprising tables that contain data describing the client, client locations, and the insured person;

d) a Competitor subject category comprising tables that contain data on competitor coverage rates;

e) a Coverage subject category comprising tables that contain data concerning rules and options of the insurance products marketed by the enterprise, coverage, services, and funding methods; and

f) a Producer subject category comprising tables containing data on the persons or firms who sell or administer products or services on behalf of the enterprise and commission schedules;

each subject category being acceptable to at least one of the applications programs.

5. The system of claim 4, wherein one or more of the subject categories are stored as a clusters in separate physical locations in the means for storing data.

6. A method of constructing an enterprise wide integrated computer system for storing, processing and reporting information regarding a plurality of group insurance accounts comprising,

providing a computer system which in combination includes, a central processing unit, a memory, means for storing data, a plurality of workstations and printing means,

providing a relational database management system means for managing a relational database and for creating tables to contain data stored on a single relational database and means for modifying, storing and retrieving and manipulating the database,

providing a single relational database having a data structure comprising a plurality of third normal form relational tables,

the tables being organized into a plurality of subject categories, each subject category corresponding to an operating objective of the enterprise, the subject categories comprising:

a) a Case subject category comprising tables that contain data on the case description, activity history, coverage available, policy level, participants, coverage in force, billing, producers and commissions;

b) a Claim category comprising tables that contain data concerning the request from a participant for reimbursement for an incurred procedure or loss;

c) a Client subject category comprising tables that contain data describing the client, client locations, and the insured person;

d) a competitor subject category comprising tables that contain data on competitor coverage rates;

e) a Coverage subject category comprising tables that contain data concerning rules and options of the insurance products marketed by the enterprise, coverage, services and funding methods; and

f) a Producer subject category comprising tables containing data on the persons or firms who sell or administer products or services on behalf of the enterprise and commission schedules;

storing the single relational database on the means for storing data of the computer system;

providing a plurality of workstation application sub-systems including sales, underwriting, administration and actuarial sub-systems, each sub-system comprising a plurality of application program modules, each sub-system application program module comprising means for processing, modifying, storing and manipulating data on the single relational database;

providing security means for controlling the access by an operator of the system to each of the work station application sub-systems, the security means also comprising means for restricting the access of the operator of a specific sub-system application program module to tables on the single relational database which contain data related to the application program module.

7. The method of claim 6 wherein the tables of each of the Claim, Client, Competitor, Coverage, and Producer subject categories are clustered and stored in separate physical locations in the means for storing data.