Insurance claim capitation and predictive payment modeling

• US 9,659,331 B1
• Filed: 09/20/2013
• Issued: 05/23/2017
• Est. Priority Date: 09/20/2012
• Status: Active Grant

• Current Assignee: Allstate Insurance Company (Allstate Corporation)
• Original Assignee: Allstate Insurance Company (Allstate Corporation)
• Inventors: Hanson, Randall, Johnson, Robert H., Stricker, Kurt M., Marlow, Clint J.
• Primary Examiner(s): Hamilton, Lalita M
• Application Number:
  US14/032,744
• Time in Patent Office: 1,341 Days
• Field of Search: 705 4, 705 35
• CPC Class Codes: G01S 19/13 Receivers
• CPC Class Codes: G06Q 10/20 Administration of product repair or maintenance
• CPC Class Codes: G06Q 30/0283 Price estimation or determination
• CPC Class Codes: G06Q 40/08 Insurance
• CPC Class Codes: G07C 5/008 communicating information to a remotely located station transmission systems for measured values G08C

Abstract

A claim-based capitation model is proposed for handling vehicle repair insurance claims. Rather than determining a detailed estimate of the expected actual cost of repair, the estimate may be determined using a simpler model. For example, the insurance company and a repair facility may agree to following a predictive payment model in which the insurance company pays a fixed predicted capitated amount of money for each repair claim, regardless of the amount of repair work that will be needed. Alternatively, the insurance company may pre-pay a fixed capitated amount for a predicted number of future insurance claims.

Claims

1. A method for efficiently using computing resources to process insurance claims, comprising:

storing, in a computer-readable medium, first data representing a model that associates a first one or more loss attributes, of a plurality of loss attributes, with a plurality of multipliers,

and that associates a second one or more loss attributes, of the plurality of loss attributes, with a plurality of costs;

receiving, by at least one computing device, via a communication network, second data that comprises information about a vehicle and that comprises vehicle sensor data generated by a sensor device of the vehicle;

selecting, by the at least one computing device, based on the second data, at least a first loss attribute from the first one or more loss attributes and at least a second loss attribute from the second one or more loss attributes;

determining, by the at least one computing device, a capitated cost of repair of the vehicle based on one or more of the plurality of multipliers associated with the at least the first loss attribute, and further based on one or more of the plurality of costs associated with the at least the second loss attribute;

identifying, by the at least one computing device, one or more factors of a customer associated with the vehicle to create a statistical model with the one or more identified factors;

based on the statistical model with the one or more identified factors of the customer, predicting, responsive to a first notice of loss, whether the customer associated with the vehicle will self-repair or let an insurance company manage repair,

transmitting a payment, which includes an amount based on the capitated cost, to the repair facility responsive to a determination that the customer associated with the vehicle has accepted an offer transmitted to the customer upon predicting that the customer will let the insurance company manage the repair; and

repairing the vehicle for the capitated cost.

2. The method of claim 1, wherein said determining the capitated cost of repair of the vehicle comprises determining the capitated cost of repair of the vehicle without inspecting actual damage to the vehicle.

3. The method of claim 1, further comprising;

receiving, by the at least one computing device, third data from the repair facility indicating an actual cost of repair; and

revising the model based on the third data.

4. The method of claim 1, wherein said determining the capitated cost of repair of the vehicle is performed in response to a first notice of loss of an insurance claim for the vehicle.

5. The method of claim 1, wherein the sensor device comprises a sensor and an on-board computing device coupled with the sensor.

6. The method of claim 1, wherein the sensor device comprises an accelerometer of the vehicle and the vehicle sensor data comprises acceleration data in accordance with a measurement of the accelerometer.

7. The method of claim 1,

wherein the determining, by the one or more processors of the at least one computing device, the capitated cost of repair of the vehicle comprises determining the capitated cost of repair of the vehicle based on the second data and historical costs.

8. The method of claim 1, wherein the sensor device comprises a global positioning system sensor of the vehicle and the vehicle sensor data comprises data indicating one or more locations of the vehicle.