Method and system for providing insurance to consumers against unfavorable outcomes resulting from services, and method of rating risks associated with the services

• US 7,346,525 B1
• Filed: 03/27/2003
• Issued: 03/18/2008
• Est. Priority Date: 03/27/2003
• Status: Active Grant

• Current Assignee: Milanovich Investments, LLC
• Original Assignee: Philip John Milanovich
• Inventors: Milanovich, Philip John
• Primary Examiner(s): Gilligan; C. Luke
• Assistant Examiner(s): KOPPIKAR, VIVEK D
• Application Number:
  US10/249,270
• Time in Patent Office: 1,818 Days
• Field of Search: 705/4
• 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
• CPC Class Codes: G16H 50/30 for calculating health indices; for individual health risk assessment

Abstract

A method of providing insurance (including professional malpractice liability insurance) to consumers against unfavorable outcomes resulting from services, and a method of rating risks associated with services. In the first preferred embodiment, a policy limit is chosen by a patient (or other consumer), a premium based on the policy limit is paid by the patient, and if malpractice is committed by a health care provider (or other professional), the patient is compensated up to the amount of the policy limit. The patient signs an agreement that the liability of the health care provider for malpractice will not exceed the policy limit. Only then are medical services provided. Risk factors are evaluated for the patient, the doctor, hospital or other health care provider, and the procedures that are to be performed, and are used to determine the amount of the premium, taking into account the policy limit chosen by the patient.

Claims

1. A method for providing medical malpractice insurance, comprising the following steps:

(a) inputting a medical code for a particular service;

(b) displaying a menu of policy limits and corresponding premiums for an insurance policy to be purchased by a patient prior to the particular service being provided, said menu being based at least in part on the medical code inputted;

(c) receiving a selection from the patient of one of the policy limits and its corresponding premium;

(d) receiving payment from the patient of the premium corresponding to the policy limit chosen the patient; and

(e) if and only if a breach of a duty of care is committed by a health care provider, the patient is compensated only for the malpractice up to the amount of the policy limit;

receiving from the patient an indication of agreement that the liability of the health care provider for malpractice will not exceed the policy limit.

2. The method for providing medical malpractice insurance according to claim 1, wherein the premium is paid, and the agreement to limit liability is made, before services are provided by the health care provider to the patient, and the particular service being provided is a surgical operation.

3. The method for providing medical malpractice insurance according to claim 1, wherein at least one risk factor is evaluated, and is used to determine the amount of the premium, taking into account the policy limit chosen by the patient.

4. The method for providing medical malpractice insurance according to claim 3, wherein:

at least one risk factor associated with the patient is used to determine a patient rating that is used to determine the amount of the premium.

5. The method for providing medical malpractice insurance according to claim 3, wherein:

at least one risk factor associated with the health care provider is used to determine a provider rating that is used to determine the amount of the premium.

6. The method for providing medical malpractice insurance according to claim 3, wherein:

at least one risk factor associated with a health care procedure to be performed is used to determine a procedure rating that is used to determine the amount of the premium.

7. The method for providing medical malpractice insurance according to claim 3, wherein:

at least one risk factor associated with the patient is used to determine a patient rating;

at least one risk factors associated with the health care provider is used to determine a provider rating;

at least one risk factor associated with a health care procedure to be performed are used to determine a procedure rating; and

the patient rating, the provider rating, and the procedure rating are combined to produce a total rating that is used to determine the amount of the premium.

8. The method for providing medical malpractice insurance according to claim 7, wherein:

there are a plurality of risk factors associated with the patient, including the patient'"'"'s medical history, age, occupation and habits;

there are a plurality of risk factors associated with the health care provider, including the provider'"'"'s specialty and malpractice history; and

there are a plurality of risk factors associated with the health care procedure, including both the condition being treated and the specific procedure.

9. The method for providing medical malpractice insurance according to claim 8, wherein a computer is used to calculate the premium, and the risk factors are stored in at least one data base on at least one computer.

10. The method for providing medical malpractice insurance according to claim 9, wherein information concerning the patient is stored in a device worn by the patient.

11. The method for providing medical malpractice insurance according to claim 10, wherein the device is retained on the patient by a wrist band.

12. The method for providing medical malpractice insurance according to claim 3, wherein:

at least one risk factor associated with a health care institution is used to determine an institution rating that is used to determine the amount of the premium.

13. The method for providing medical malpractice insurance according to claim 3, wherein:

at least one risk factor associated with the patient is used to determine a patient rating;

at least one risk factor associated with the health care provider is used to determine a provider rating;

at least one risk factor associated with a health care procedure to be performed is used to determine a procedure rating;

at least one risk factor associated with a health care institution is used to determine an institution rating; and

the patient rating, the provider rating, the procedure rating, and the institution rating are combined to produce a total rating that is used to determine the amount of the premium.

14. A method for providing professional malpractice insurance, comprising the following steps:

(a) inputting a code for a particular service;

(b) displaying a menu of policy limits and corresponding premiums for an insurance policy to be purchased by a consumer prior to the particular service being provided, said menu being based at least in part on the code inputted;

(c) receiving a selection from the consumer of one of the policy limits and its corresponding premium;

(d) receiving payment from the consumer of the premium corresponding to the policy limit chosen the consumer; and

(e) if and only if a breach of a duty of care is committed by a professional, the consumer is compensated only for the malpractice up to the amount of the policy limit;

receiving from the consumer an indication of agreement that the liability of the professional for malpractice will not exceed the policy limit.

15. The method for providing professional malpractice insurance according to claim 14, wherein the premium is paid, and the agreement to limit liability is made, before services are provided by the professional to the consumer.

16. The method for providing professional malpractice insurance according to claim 14, wherein at least one risk factor is evaluated, and is used to determine the amount of the premium, taking into account the policy limit chosen by the consumer.

17. The method for providing professional malpractice insurance according to claim 16, wherein:

at least one risk factor associated with the consumer is used to determine a consumer rating that is used to determine the amount of the premium.

18. The method for providing professional malpractice insurance according to claim 16, wherein:

at least one risk factor associated with the professional is used to determine a professional rating that is used to determine the amount of the premium.

19. The method for providing professional malpractice insurance according to claim 16, wherein:

at least one risk factor associated with a service to be performed is used to determine a service rating that is used to determine the amount of the premium.

20. The method for providing professional malpractice insurance according to claim 16, wherein:

at least one risk factor associated with the consumer is used to determine a consumer rating;

at least one risk factor associated with the professional is used to determine a professional rating;

at least one risk factor associated with a service to be performed is used to determine a service rating; and

the consumer rating, the professional rating, and the service rating are combined to produce a total rating that is used to determine the amount of the premium.

21. The method for providing professional malpractice insurance according to claim 20, wherein a computer is used to calculate the premium, and the risk factors are stored in at least one data base on at least one computer.