Computerized medical modeling of group life and disability...

Data processing: financial – business practice – management – or co – Automated electrical financial or business practice or... – Insurance

Reexamination Certificate

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C705S002000, C705S003000, C600S300000, C600S301000

Reexamination Certificate

active

07664662

ABSTRACT:
The development and use of a model to estimate disability insurance exposure for a group of individuals to be underwritten for a coverage period is disclosed. The development of the model includes the use of medical claim data having a plurality % of medical claims made by a first model population having at least a respective plurality of first model population members and a disability insurance claim data having a plurality of disability insurance claims made by a second model population having at least a respective plurality of second model population members, which optionally may partially or wholly overlap with the first model population. A clinical medical condition classification system assigns corresponding medical condition causes to the disability insurance claims and the medical claims based on medical condition information.Development then categorizes the disability insurance claims and medical claims classified by medical condition, where each morbidity category comprises one or more medical conditions, to form a plurality of morbidity categories of disability insurance claims. Then, the proportions of the two types of claims are calculated for each morbidity category. Then, for each of the morbidity categories, a probability of having a disability claim during the coverage period is calculated using at least one conditional probability, the conditional probability being based on at least the proportion of disability insurance claims and the proportion of medical claims for each of the morbidity categories. From that, for each of the morbidity categories, an estimated the disability claim duration or cost is calculated.

REFERENCES:
patent: 4667292 (1987-05-01), Mohlenbrock et al.
patent: 4750121 (1988-06-01), Halley et al.
patent: 4975840 (1990-12-01), DeTore et al.
patent: 5018067 (1991-05-01), Mohlenbrock et al.
patent: 5544044 (1996-08-01), Leatherman
patent: 5557514 (1996-09-01), Seare et al.
patent: 5613072 (1997-03-01), Hammond et al.
patent: 5652842 (1997-07-01), Siegrist, Jr. et al.
patent: 5712984 (1998-01-01), Hammond et al.
patent: 5724379 (1998-03-01), Perkins et al.
patent: 5754980 (1998-05-01), Anderson et al.
patent: 5809478 (1998-09-01), Greco et al.
patent: 5819259 (1998-10-01), Duke-Moran et al.
patent: 5835897 (1998-11-01), Dang
patent: 5873066 (1999-02-01), Underwood et al.
patent: 5893072 (1999-04-01), Zizzamia et al.
patent: 5918208 (1999-06-01), Javitt et al.
patent: 5926800 (1999-07-01), Baronowski et al.
patent: 5970464 (1999-10-01), Apte et al.
patent: 5976082 (1999-11-01), Wong et al.
patent: 6061657 (2000-05-01), Whiting-O'Keefe
patent: 6078890 (2000-06-01), Mangin et al.
patent: 6223164 (2001-04-01), Seare et al.
patent: 6611815 (2003-08-01), Lewis et al.
patent: 6647374 (2003-11-01), Kansal
patent: 7249040 (2007-07-01), Binns et al.
patent: 2002/0188480 (2002-12-01), Liebeskind et al.
patent: 2003/0093304 (2003-05-01), Keller et al.
patent: 2003/0187697 (2003-10-01), Bonissone et al.
patent: 2003/0200121 (2003-10-01), Santoloci
patent: 2003/0200123 (2003-10-01), Burge et al.
patent: 2004/0236611 (2004-11-01), Bonissone et al.
patent: 2006/0015373 (2006-01-01), Cuypers
patent: 2002-049745 (2002-02-01), None
“Using Claims Data to Examine Mortality Trends Following Hospitalization for Heart Attack in Medicare” by Ash et al.; Health Services Research, Oct. 2003 (38) 5: 1253-1262.
List of Diagnosis Related Groups (DRGs), FY 1995: http://www.hcfa.gov/stats/drg95dsc.xls.
R.F. Averill et al., Development and Evaluation of Clinical Risk Groups (CRCs) HIS Research Report 9-99 http:// www.hcfa.gov/stats/ss95both—xls.
Mark S. Blumberg M.D., Maryland Mortality for Non-Elective Surgery: A Prototype Ramo System (May 6, 1987).
D.L. Dunn et al., A Comparative Analysis of Methods of Health Risk Assessment Final Report, Society of Actuaries, Dec. 21, 1995.
G. Thomas Ray, et al., The Cost of Health Conditions in a Health Maintenance Organization, Medical Care Research and Review, vol. 57, No. 1, (Mar. 2000) pp. 92-109.
Mark S. Blumberg, Potentials and Limitations of Database Research, Statistics in Medicine, vol. 10, No. 4, p. 637.
Annemarie V. Wouters, Disaggragated Annual Health Services Expenditures: Their Predictability and Role as Predictors, Heath Services Research vol. 26, pp. 247-272, Jun. 1991.
G. Binns et al., Extracting More Profits from Small Group Renewals presentation to Conseco Health, Dec. 7, 1999.
G. Binns et al., Mining the Data for Smarter Renewals presentation to Fortis, Nov. 15, 1999.
English translation of abstract of JP 2002049745A.
Ash et al., “Using Claims Data to Examine Mortality Trends Following Hospitalization for Heart Attack in Medicare” Health Services Research, (38) 5:1253-1262, Oct. 2003.
“Harvard Pilgrim/DxCG,” Insurance & Technology, vol. 27, No. 10, p. 10, Sep. 2002.
Steven Boyce et al., “The cost of pension insurance,” Journal of Risk & Insurance; vol. 69, No. 2, pp. 121-170, Jun. 2002. I.
“Medical Scientists Inc. Selects MEDSTAT for 3 Year Data Agreement,” PR Newswire, p. 7992, Jul. 26, 2000.

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