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System for evaluating potential claim outcomes using related historical data

  • US 8,457,984 B2
  • Filed: 01/11/2012
  • Issued: 06/04/2013
  • Est. Priority Date: 05/14/2009
  • Status: Active Grant
First Claim
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1. A computer system comprising:

  • a data storage device for receiving, storing, and providing access to historical claim data;

    a computer processor for executing program instructions and for retrieving the historical claim data from the data storage device;

    a memory, coupled to the computer processor, for storing program instructions for execution by the computer processor;

    a categorical aggregation component comprising program instructions stored in the memory for providing categorized and aggregated historical claim data by determining a first set of claim characteristics, identifying first claims of the historical claim data which exhibit the first set of claim characteristics, determining whether a number of the first claims exceeds a statistical significance threshold, in response to a determination that the number of the first claims exceeds a statistical significance threshold, determining a total severity statistical profile based on a total severity of each of the first claims, determining whether the total severity statistical profile meets predefined profile criteria, and, in response to determining that the total severity statistical profile meets the predefined profile criteria, associating the first set of claim characteristics with a first claim category, identifying claims of the historical claim data associated with the first claim category, assigning each identified claim associated with the first claim category to one of a plurality of total severity ranges based on the total severity of the identified claim, and determining an average cost per claim year divided amongst a plurality of expense categories for claims of each total severity range when executed by the computer processor; and

    a communication device, coupled to the computer processor, to output categorized and aggregated historical claim data including the average cost per claim year for claims of each total severity range.

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