Insurance product model-based apparatus and method

• US 7,885,831 B2
• Filed: 02/07/2006
• Issued: 02/08/2011
• Est. Priority Date: 01/05/2006
• Status: Active Grant

• Current Assignee: Guidewire Software Incorporated
• Original Assignee: Guidewire Software Incorporated
• Inventors: Eloy, Benjamin Buendia, Burton, James Michael, Branson, Kenneth William
• Primary Examiner(s): PATEL, JAGDISH
• Application Number:
  US11/349,456
• Publication Number:
  US 20070156463A1
• Time in Patent Office: 1,827 Days
• Field of Search: 705/4
• US Class Current: 705/4
• CPC Class Codes: G06Q 40/08 Insurance

Abstract

An insurance product model comprising insurance policy metadata is provided (101) in a computer memory. The insurance policy metadata may comprise, at least in part, data that describes information that comprises a given corresponding insurance policy. A computer then serves to substantively interpret (102) this insurance product model to facilitate obtaining supplemental policy-specific data. The supplemental policy-specific data and the insurance policy metadata comprise separate and discrete data models and may, if desired, be stored (103) separately from one another. So configured, these teachings further support using (104) the insurance product model and the supplemental policy-specific data to facilitate an insurance-related action.

Claims

1. A method for use with a computer, comprising:

providing in a computer memory an insurance product model comprising insurance policy metadata that includes;

a plurality of policy patterns, and relationships between at least some of the plurality of policy patterns, wherein;

the plurality of policy patterns include a risk unit pattern and a coverage term pattern;

the relationships include a relationship between the risk unit pattern and the coverage term pattern; and

the plurality of policy patterns and relationships between at least some of the plurality of policy patterns define a plurality of allowable combinations of policy elements associated with a policy product, the plurality of allowable combinations of policy elements including a plurality of allowable coverages, a plurality of allowable coverage terms associated with the plurality of allowable coverages, and a plurality of allowable coverage term values associated with the plurality of allowable coverage terms;

substantively interpreting, in the computer, the insurance product model using the relationships between at least some of the plurality of policy patterns of the insurance product model to thereby facilitate obtaining supplemental policy-specific data, including;

receiving, at the computer, information about a risk unit to be covered by a policy;

determining, one or more available coverages associated with the risk unit, one or more available coverage terms associated with the one or more available coverages, and one or more available coverage term values associated with the one or more available coverage terms, the determination being based on the insurance product model, the risk unit pattern and the coverage term pattern of the insurance product model, and the relationship between the risk unit pattern and coverage term pattern;

receiving, at the computer, a plurality of selections including a selected one of the one or more available coverages, a selected one of the one or more available coverage terms, and a selected one of the one or more available coverage term values; and

constructing an insurance policy based on the plurality of selections.

2. The method of claim 1 wherein the insurance policy metadata comprises, at least in part, data that is common to a plurality of derived insurance policies.

3. The method of claim 1 further comprising:

using the insurance product model in combination with the supplemental policy-specific data to define a corresponding insurance policy that comprises one of a plurality of candidate insurance products that correspond to the insurance product model.

4. The method of claim 1 wherein the insurance policy metadata defines at least one of:

a policy line;

at least one risk unit type;

insurance coverage types;

insurance coverage forms;

contractual terms associated with insurance coverages;

options associated with coverage terms;

an available endorsement.

5. The method of claim 4 wherein the contractual terms comprise at least one of:

coverage limits;

coverage deductibles;

elective coverage options.

6. The method of claim 4 wherein the options associated with coverage terms comprise at least one of:

an available coverage limit;

an available deductible choice.

7. The method of claim 4 wherein the insurance policy metadata further comprises information regarding availability of at least one item of insurance policy metadata as a function of at least one of:

a given jurisdiction;

a given date;

a given underwriting entity.

8. The method of claim 1 wherein the supplemental policy-specific data comprises, at least in part, information regarding at least one of:

coverage limits;

coverage deductibles;

coverage elections;

risks being covered;

a period of coverage;

cost;

elected coverages;

applied endorsements;

insured entity data.

9. The method of claim 1 wherein substantively interpreting comprises, at least in part, identifying specific coverages to include in a resultant insurance policy.

10. The method of claim 1 wherein substantively interpreting comprises, at least in part, identifying specific coverages having a corresponding inclusion requirement as a function of another insurance policy circumstance.

11. The method of claim 10 wherein the corresponding inclusion requirement comprises at least one of:

mandatory inclusion;

mandatory exclusion;

optional inclusion.

12. The method of claim 10 wherein the another insurance policy circumstance comprises at least one of:

a given jurisdiction;

a given date;

a given entity to be covered;

a given underwriting entity.

13. The method of claim 1 wherein substantively interpreting comprises, at least in part, identifying specific risk units to include in a resultant insurance policy.

14. The method of claim 1 wherein substantively interpreting comprises, at least in part, identifying specific policy lines to include in a resultant insurance policy.

15. The method of claim 1 wherein substantively interpreting comprises, at least in part, identifying coverage terms to specify for a coverage.

16. The method of claim 1 wherein substantively interpreting comprises, at least in part, identifying options that are available when specifying terms for a coverage.

17. The method of claim 1 wherein substantively interpreting comprises, at least in part, identifying which forms should be used to comprise a corresponding policy contract document.

18. The method of claim 1 wherein substantively interpreting comprises, at least in part, identifying information required to describe each risk unit.

19. The method of claim 1 wherein substantively interpreting, in a computer, the insurance product model to thereby facilitate obtaining supplemental policy-specific data comprises prompting a user to provide at least a portion of the supplemental policy-specific data.

20. The method of claim 1 further comprising:

storing in a second computer memory the supplemental policy-specific data.

21. The method of claim 20 wherein the second computer memory is physically and logically discrete with respect to the insurance product model.

22. The method of claim 1 further comprising:

using the insurance product model and the supplemental policy-specific data to facilitate an insurance-related action.

23. The method of claim 22 wherein the insurance-related action comprises creating a new insurance policy.

24. The method of claim 22 wherein the insurance-related action comprises determining whether an insurance policy provides coverage with respect to a particular event.

25. The method of claim 22 wherein the insurance-related action comprises collecting additional information with respect to a particular event.

26. The method of claim 25 wherein the insurance policy metadata comprises, at least in part, loss-coverage mapping information and wherein collecting additional information with respect to a particular event comprises using the loss-coverage mapping information to facilitate collecting event-specific data to thereby facilitate determining corresponding coverage and payment.

27. The method of claim 22 wherein the insurance-related action comprises identifying at least one insurance policy that is available to offer to an entity from amongst a plurality of candidate insurance policies.

28. The method of claim 22 wherein the insurance-related action comprises providing information to a user regarding which risk units are permitted to be covered by a given corresponding insurance policy.

29. The method of claim 22 wherein the insurance-related action comprises at least one of:

storing;

renewing;

amending;

terminating;

reinstating;

pricing;

auditing;

reporting on;

a corresponding insurance policy.

30. An apparatus comprising:

a computer memory having stored therein an insurance product model comprising insurance policy metadata that that includes;

a plurality of policy patterns, and relationships between at least some of the plurality of policy patterns, wherein;

the plurality of policy patterns include a risk unit pattern and a coverage term pattern;

the relationships include a relationship between the risk unit pattern and the coverage term pattern; and

the plurality of policy patterns and relationships between at least some of the plurality of policy patterns define a plurality of allowable combinations of policy elements associated with a policy product, the plurality of allowable combinations of policy elements including a plurality of allowable coverages, a plurality of allowable coverage terms associated with the plurality of allowable coverages, and a plurality of allowable coverage term values associated with the plurality of allowable coverage terms;

an interpreter being operably coupled to the computer memory and being configured and arranged to substantively interpret the insurance product model using the relationships between at least some of the plurality of policy patterns of the insurance product model to thereby facilitate obtaining supplemental policy-specific data, including;

receiving information about a risk unit to be covered by a policy;

determining, one or more available coverages associated with the risk unit, one or more available coverage terms associated with the one or more available coverages, and one or more available coverage term values associated with the one or more available coverage terms, the determination being based on the insurance product model, the risk unit pattern and the coverage term pattern of the insurance product model, and the relationship between the risk unit pattern and coverage term pattern;

receiving a plurality of selections including a selected one of the one or more available coverages, a selected one of the one or more available coverage terms, and a selected one of the one or more available coverage term values; and

constructing an insurance policy based on the plurality of selections.

31. The apparatus of claim 30 wherein the insurance policy metadata comprises, at least in part, data that is common to a plurality of corresponding insurance policies.

32. The apparatus of claim 30 wherein the insurance policy metadata defines at least one of:

a policy line;

at least one risk unit type;

insurance coverage types.

33. The apparatus of claim 30 further comprising:

a combiner operably coupled to receive the insurance product model and the supplemental policy-specific data and being configured and arranged to use the product model in combination with the supplemental policy-specific data to define a corresponding insurance policy that comprises one of a plurality of candidate insurance products that correspond to the insurance product model.

34. The apparatus of claim 30 further comprising:

a user interface operably coupled to the interpreter to thereby facilitate obtaining the supplemental policy-specific data from a user.

35. The apparatus of claim 30 further comprising:

a second computer memory operably coupled to the interpreter and having the supplemental policy-specific data stored therein.

36. The apparatus of claim 30 wherein the second computer memory is physically and logically discrete with respect to the computer memory.