Data processing: financial – business practice – management – or co – Automated electrical financial or business practice or... – Insurance
Reexamination Certificate
2006-07-21
2009-06-30
Koppikar, Vivek D. (Department: 3686)
Data processing: financial, business practice, management, or co
Automated electrical financial or business practice or...
Insurance
C705S002000, C705S003000, C600S300000, C600S301000
Reexamination Certificate
active
07555439
ABSTRACT:
A method of underwriting group life insurance for a policy period includes collecting medical claims data for the group to be underwritten, where each medical claim being related to a particular employee of the group. Morbidity categories are provided that categorize the medical claims in the medical claims data. A conditional probability model is developed and applied to the morbidity categories for each employee in the group using his medical claims, thereby calculating the expected conditional probability for each employee dying during the policy period. For each employee, an estimate of the expected life claim cost is estimated using an index of the life coverage to salary. Combining the expected conditional probability for each employee dying during the policy period with the estimate of the expected claim cost of death gives an estimate of the group's total life exposure.
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: 5835897 (1998-11-01), Dang
patent: 5873066 (1999-02-01), Underwood et al.
patent: 5893072 (1999-04-01), Zizzamia
patent: 5918208 (1999-06-01), Javitt
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
patent: 2002-49745 (2002-02-01), None
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, p. 121-170, Jun. 2002.
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 (CRGs) HIS Research Report.” Sep. 1999, 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, pp. 92-109, Mar. 2000.
Mark S. Blumber, “Potentials and Limitations of Database Research, Statistics in Medicine,” vol. 10, No. 4, p. 637, 1987.
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.
“Medical Scientists Inc. Selects MEDSTAT for 3 Year Data Agreement,” PR Newswire, p. 7992, Jul. 26, 2000.
Binns Gregory S.
Blumberg Mark Stuart
Husch Blackwell Sanders Welsh & Katz
Koppikar Vivek D.
TruRisk LLC
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