System and method of managing an insurance scheme

• US 8,386,279 B2
• Filed: 06/03/2009
• Issued: 02/26/2013
• Est. Priority Date: 06/03/2008
• Status: Active Grant

• Current Assignee: Vitality Group International, Inc. (Discovery Limited)
• Original Assignee: Discovery Limited Holdings
• Inventors: Gore, Adrian, Mayers, Herschel Phillip, Rabson, Kenneth Steven
• Primary Examiner(s): PAULS, JOHN A
• Application Number:
  US12/477,189
• Publication Number:
  US 20090299774A1
• Time in Patent Office: 1,364 Days
• Field of Search: 705 2- 4, 705/26, 705/35
• 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

Abstract

A system for managing an insurance scheme includes a calculation module to, on the occurrence of an insured event for an insured person, calculate a subsidy for expenses for the insured person or a nominated beneficiary. The subsidy is calculated by accessing data defining a plurality of categories of expenses and determining for each category a spend amount. The spend amount is either an average historical spend amount over a period of time prior to the insured event or an actual spend amount for a period of time after the insured event. A percentage is then calculated using the insured person'"'"'s participation with a wellness program. Finally, the amount of the subsidy is calculated by multiplying the percentage by the spend amount. A payment module effects payment of the subsidy to the insured person, the nominated beneficiary or a third party goods or services provider.

Claims

1. A system for managing an insurance plan, comprising:

at least one computer server;

software stored on non-transitory storage medium and executable by said at least one computer, the software configured to;

(a) receive data relating to the occurrence of an insured event relating to disability, disease, or death with respect to an insured, including time information relating to the insured event,

(b) receive data relating to spending, unrelated to insurance premiums, by the insured;

(c) receive data relating to a degree of participation by the insured in wellness activities of a wellness program directed to reducing a likelihood of disability, disease, or death of the insured;

(d) calculate, on the occurrence of the insured event

(i) a spend amount relating to an amount spent by the insured over a period of time,

(ii) a percentage amount relating to a status level indicative of the degree of participation by the insured in the wellness program,

(iii) a subsidy amount by multiplying the calculated percentage amount by the calculated spend amount, and

(e) cause to effect payment of the subsidy amount to the insured person or a nominated beneficiary.

2. The system according to claim 1, the software further configured to receive information pertaining to a plurality of categories of expenses, and to calculate the subsidy amount for each of the received plurality of categories of expenses.

3. The system according to claim 2, wherein the plurality of categories of expenses includes at least one of food, clothing, transport, utilities, communication and accommodation expenses.

4. The system according to claim 1, wherein the data relating to spending received includes historical spending on the insured'"'"'s credit card or debit card.

5. The system according to claim 1, wherein the data received pertaining to participation includes data pertaining to monitoring of the insured by a third party with respect to compliance in the wellness program by the insured person.

6. The system according to claim 1, wherein the data relating to the degree of participation received includes information associated with a plurality of separate and distinct occurrences of wellness program participation by the insured person.

7. The system according to claim 1, wherein the percentage amount calculated is based on a points value associated with the insured person for the wellness program, wherein the points value indicates the degree of participation in the wellness program.

8. A system for managing an insurance plan, comprising:

at least one computer server;

software stored on non-transitory storage medium and executable by said at least one computer, the software configured to;

(a) receive data relating to the occurrence of an insured event relating to disability, disease, or death with respect to an insured, including time information relating to the insured event,

(b) receive data relating to spending, unrelated to insurance premiums, by the insured;

(c) receive data relating to a degree of participation by the insured in at least one of approved related facilities, or services, of a wellness program directed to reducing a likelihood of disability, disease, or death of the insured;

(d) calculate, on the occurrence of the insured event

(i) a spend amount relating to an amount spent by the insured over a period of time,

(ii) a percentage amount relating to a status level indicative of the degree of participation by the insured in the wellness program, a higher percentage amount being associated with a higher degree of participation,

(iii) a subsidy amount by multiplying the calculated percentage amount by the calculated spend amount, and

(e) cause to effect payment of the subsidy amount to the insured person or a nominated beneficiary.

9. The apparatus according to claim 8, the software further configured to receive data defining the plurality of categories of expenses.

10. The apparatus according to claim 9 wherein the plurality of categories of expenses includes at least one of the group consisting of food, clothing, transport, utilities, communication, and housing accommodation.

11. The apparatus according to claim 8, the software further configured to receive data defining a wellness program and data pertaining to monitoring the compliance of the insured in the wellness program.

12. A method for managing an insurance plan, comprising:

using at least one computer server to execute software stored on non-transitory storage medium connected to said at least one computer, the software configured to

(a) receive data relating to the occurrence of an insured event relating to disability, disease, or death with respect to an insured, including time information relating to the insured event,

(b) receive data relating to spending, unrelated to insurance premiums, by the insured;

(c) receive data relating to a degree of participation by the insured in at least one of approved related facilities, or services, of a wellness program directed to reducing a likelihood of disability, disease, or death of the insured of the insured;

(d) calculate, on the occurrence of the insured event

(i) a spend amount relating to an amount spent by the insured over a period of time,

(ii) a percentage amount relating to a status level indicative of the degree of participation by the insured in the healthcare program,

(iii) a subsidy amount by multiplying the calculated percentage amount by the calculated spend amount, and

(e) cause to effect payment of the subsidy amount to the insured person or a nominated beneficiary during the lifetime of the insured.

13. The method of claim 12 wherein the data received relating to spending includes data pertaining to food, clothing, transport, utilities, communication, and housing.

14. The method of claim 12, wherein the insured event is at least one of one of childbirth and change in job.

15. The method according to claim 12, wherein the data received pertaining to participation includes data pertaining to monitoring of the insured with respect to compliance in the wellness program.

16. The method according to claim 15, wherein monitoring of the insured is performed by a third party.

17. The method according to claim 15, wherein monitoring of the insured relates to compliance with a wellness program.

18. The method according to claim 12, wherein participation in the healthcare program includes participation by the insured in at least one of gymnasium exercise, smoking cessation program, and weight loss program.

19. The method according to claim 12, wherein the status level is determined by relating a degree of participation to a point value, and the point value is compared to a plurality of point ranges, each point range in the plurality of point ranges being associated with a status level.

20. The method according to claim 12, wherein the nominated beneficiary is a third party goods or services provider.

21. The method according to claim 12, wherein the spend amount over a period time is calculated as one of an average historical spend amount or an actual spend amount.