Insurance claim capitation and predictive payment modeling

• US 9,665,912 B1
• Filed: 09/20/2013
• Issued: 05/30/2017
• 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:
  US14/032,751
• Time in Patent Office: 1,348 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, the method 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, via a communication network, second data, generated by a first computing device of the vehicle, that comprises information about a vehicle and that further comprises vehicle sensor data, wherein the first computing device comprises an accelerometer configured to sense an acceleration of the vehicle and the first computing device is configured to generate the vehicle sensor data based on the acceleration of the vehicle;

selecting, by at least a second 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 at least the second 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;

transmitting, to a repair facility, a payment including an amount based on the determined capitated cost prior to repair of the vehicle; 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 without inspecting actual damage to the vehicle.

3. The method of claim 1, further comprising;

receiving, via the communication network, 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 the plurality of loss attributes comprises a place of occurrence of an incident involving the vehicle.

5. The method of claim 1, wherein the plurality of loss attributes comprises a date of occurrence of an incident involving the vehicle.

6. The method of claim 1, wherein said transmitting comprises transmitting, to the repair facility, the capitated cost.

7. The method of claim 1, wherein the first computing device further comprises a global positioning sensor configured to sense a location of the vehicle and the first computing device is configured to generate the vehicle sensor data further based on the location of the vehicle.

8. The method of claim 1, wherein the first computing device further comprises a sensor configured to sense a speed of the vehicle and the first computing device is configured to generate the vehicle sensor data further based on the speed of the vehicle.