System and method for processing data related to insurance coverage for a plurality of risks

• US 8,265,964 B2
• Filed: 12/30/2011
• Issued: 09/11/2012
• Est. Priority Date: 11/20/2007
• Status: Expired due to Fees

• Current Assignee: Hartford Fire Insurance Company (The Hartford Financial Services Group, Inc.)
• Original Assignee: Hartford Fire Insurance Company (The Hartford Financial Services Group, Inc.)
• Inventors: Read, Katherine, Jaworski, Edward, Shaher, Ahmed, Wadsworth, Theresa, Lukawicz, Robert, Molinsky, Bradley D., Balboni, Richard, McConnell, Steve, Fisher, Karen McQueeney
• Primary Examiner(s): Wong, Eric T
• Application Number:
  US13/341,204
• Publication Number:
  US 20120123809A1
• Time in Patent Office: 256 Days
• Field of Search: 705/4
• 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

A computer system for processing of data associated with insurance coverage includes a data storage device storing data indicative of: an insured; an aggregate benefit amount, the aggregate benefit amount being a maximum benefit amount payable under the insurance coverage; a first category of health risks; a second category of health risks; a first benefit allocation corresponding to the first category of health risks; and a second benefit allocation corresponding to the second category of health risks; the benefit allocations being fractions of and totaling the aggregate benefit amount. A processor of the system is configured to, responsive to the receipt of data indicative of a claim, determine eligibility for a benefit, and responsive to determining that the insured is eligible, provide output data indicative of a benefit amount, the benefit amount for each of the categories of health risks having a maximum equal to the corresponding benefit allocation.

Claims

1. A computer system for processing of data associated with insurance coverage, comprising:

a data storage device storing;

data indicative of an insured under the insurance coverage;

data indicative of an aggregate benefit amount associated with the insurance coverage, the aggregate benefit amount being a maximum benefit amount payable under the insurance coverage;

data indicative of a first category of health risks under the insurance coverage;

data indicative of a second category of health risks under the insurance coverage;

data indicative of a first benefit allocation corresponding to the first category of health risks; and

data indicative of a second benefit allocation corresponding to the second category of health risks;

the benefit allocations being fractions of and totaling the aggregate benefit amount;

a communication device for receiving data indicative of a claim over a network coupled to the communication device; and

a processor, in communication with the communication device and the data storage device, the processor configured to;

receive via the communication device the data indicative of a claim;

responsive to the receipt of the data indicative of a claim, determine eligibility for a benefit based on the claim, and

responsive to determining that the insured is eligible, provide output data indicative of a benefit amount, the benefit amount for each of the categories of health risks having a maximum equal to the corresponding benefit allocation.

2. The computer system of claim 1, wherein said data indicative of categories of health risks includes data indicative of at least two of death, disability, accident, and illness.

3. The computer system of claim 1, wherein said data indicative of at least one of said categories of health risks further comprises data indicative of individual risk factors, wherein said processor is further configured to determine that the insured is eligible for coverage only upon determining that received claim data identifying a risk factor corresponds to the stored data indicative of individual risk factors for the category of health risks.

4. The computer system of claim 3, wherein said data indicative of individual risk factors comprises data indicative of at least one of the following:

cause of illness, type of illness, cause of accident, type of accident, cause of disability, type of disability, and cause of death.

5. The computer system of claim 3, wherein said data storage device stores data indicative of coverage for risk categories comprising illness, accident, disability and death, and data indicative of each of the following risk factors:

cause of illness, type of illness, cause of accident, type of accident, cause of disability, type of disability, and cause of death.

6. The computer system of claim 1, wherein said processor is further configured to, responsive to receipt of data indicative of a claim based on death, determine a benefit amount equal to:

said aggregate benefit amount minus the amount of benefits paid under the insurance coverage for all categories of health risks up to the date of death.

7. The computer system of claim 1, wherein said data storage device further stores data indicative of a third category of health risks under the insurance coverage and data indicative of a third benefit allocation corresponding to the third category of health risks, and the processor is further configured to, responsive to receipt of data indicative of an insured decision to cancel coverage with respect to the third category of health risks, determine and store in the data storage device data indicative of a reallocation of the third benefit allocation equally among all remaining categories of health risks.

8. The computer system of claim 1, wherein said data storage device further stores data indicative of a third category of health risks under the insurance coverage and data indicative of a third benefit allocation corresponding to the third category of health risks, and the processor is further configured to, responsive to receipt of data indicative of an insured decision to cancel coverage with respect to the third category of health risks, determine and store in the data storage device data indicative of a reallocation of the third benefit allocation in its entirety to said first category of health risks.

9. The computer system of claim 1, further comprising a payout module in communication with the processor, the payout module configured to receive data from the processor indicative of the benefit amount, and to effect payment to the insured in accordance with the received data indicative of the benefit amount.

10. A computer-implemented method for processing data relating to insurance coverage furnished to an insured, comprising:

receiving via a communication device data indicative of a claim, and providing the data indicative of the claim to a processor in communication with the communication device;

responsive to receipt by the processor of the data indicative of a claim, accessing by the processor data stored in a data storage device, the data storage device storing data indicative of an insured under the insurance coverage;

data indicative of an aggregate benefit amount associated with the insurance coverage, the aggregate benefit amount being a maximum benefit amount payable under the insurance coverage;

data indicative of a first category of health risks under the insurance coverage;

data indicative of a second category of health risks under the insurance coverage, data indicative of a first benefit allocation corresponding to the first category of health risks; and

data indicative of a second benefit allocation corresponding to the second category of health risks;

the benefit allocations being fractions of and totaling the aggregate benefit amount;

based on the data indicative of a claim and the data accessed from the data storage device, determining by the processor eligibility for a benefit based on the claim, and

responsive to determining that the insured is eligible, providing by the processor output data indicative of a benefit amount, the benefit amount for each of the categories of health risks having a maximum equal to the corresponding benefit allocation.

11. The computer-implemented method of claim 10, wherein the data storage device further stores data indicative of a payout structure associated with each category of health risks for payment of the determined benefit amount, the data indicative of a payout structure for each category of health risks being data indicative of one of lump sum payment, multiple payments of predetermined amount, or multiple payments of variable amount based on investment performance of an investment vehicle.

12. The computer-implemented method of claim 11, wherein the data indicative of a payout structure for at least one category of health risks comprises data indicative of multiple payments of variable amount based on investment performance of an investment vehicle.

13. The computer-implemented method of claim 11, further comprising providing by the processor to a payment module data indicative of payment amounts in accordance with the stored data indicative of a payout structure, and effecting by the payout module payment to the insured in accordance with the data received from the processor.

14. The computer-implemented method of claim 11, wherein the data stored in the data storage device further comprises data indicative of a third category of health risks under the insurance coverage and data indicative of a third benefit allocation corresponding to the third category of health risks, and the method further comprises, responsive to receipt of data indicative of an insured decision to cancel coverage with respect to the third category of health risks, determining by the processor and storing in the data storage device data indicative of a reallocation of the third benefit allocation to remaining categories of health risk in accordance with data indicative of instructions from the insured.

15. The computer-implemented method of claim 11, wherein the data stored in the data storage device further comprises data indicative of a third category of health risks under the insurance coverage and data indicative of a third benefit allocation corresponding to the third category of health risks, and data indicative of instructions for execution by the processor to cancel coverage of the third category of health risks responsive to passage of a predetermined period of time.

16. A non-transitory computer-readable medium having processor-executable instructions stored thereon, which instructions, when executed by the processor, cause the processor to:

responsive to receipt by the processor of data indicative of a claim under insurance coverage furnished to an insured, access data stored in a data storage device, the data storage device storing data indicative of an insured under the insurance coverage;

data indicative of an aggregate benefit amount associated with the insurance coverage, the aggregate benefit amount being a maximum benefit amount payable under the insurance coverage;

data indicative of a first category of health risks under the insurance coverage;

data indicative of a second category of health risks under the insurance coverage, data indicative of a first benefit allocation corresponding to the first category of health risks; and

data indicative of a second benefit allocation corresponding to the second category of health risks;

the benefit allocations being fractions of and totaling the aggregate benefit amount;

based on the data indicative of a claim and the data accessed from the data storage device, determine eligibility for a benefit based on the claim, and

responsive to determining that the insured is eligible, provide output data indicative of a benefit amount, the benefit amount for each of the categories of health risks having a maximum equal to the corresponding benefit allocation.

17. The non-transitory computer-readable medium of claim 16, wherein the data stored in the data storage device further comprises data indicative of a third category of health risks under the insurance coverage and data indicative of a third benefit allocation corresponding to the third category of health risks, and wherein the instructions, when executed by the processor, further cause the processor to, responsive to receipt of data indicative of a life altering event of the insured, process data to effect cancellation of the third category of health risks coverage and to reallocate the third benefit allocation among the remaining categories of health risk coverage.

18. The non-transitory computer-readable medium of claim 17, wherein the data indicative of a life altering event of the insured comprises data indicative of one of marriage, death of spouse and retirement.

19. The non-transitory computer-readable medium of claim 16, wherein the data stored in the data storage device further comprises data indicative of a lifetime term for the insurance coverage and a premium payment schedule of periodic level payment for a period of years, and wherein the instructions, when executed by the processor, further cause the processor to, in determining eligibility, determine whether premium payments have been made to date in accordance with the schedule.

20. The non-transitory computer-readable medium of claim 16, wherein the instructions, when executed by the processor, further cause the processor to, responsive to receipt of data indicative of addition of coverage for a further category of health risks, determine data reallocating the aggregate coverage amount equally among the categories of health risk.