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Insurance Abstract
A system and method for the automatic linking of expired, current,
and future insurance policies is provided. Within each insurance
policy is a plurality of conditions frequently used in the determination
of an insurance policy premium or rate quote. Such terms are calculated
based upon information either associated with or obtained from a
particular policyholder. By automatically linking policy information
and policy terms from prior insurance policies, information previously
submitted by a policyholder or calculated in regards to activity
on a particular policy is used in automatic calculation and generation
of a future policy term. Thus, straight-thru processing is achieved
via organizing of prior policies for assistance in renewals, loss
ratio calculations, shifts in payroll numbers (i.e., the number
of employees insured under a single policy), and previous claim
activity under the same type of policy.
Insurance Claims
1. A method to link, access, and search current and expired insurance
policy terms in the renewal of insurance policies; said method comprising:
a. linking a root underwriting folder for a renewal policy for a
current calendar year to at least one expired policy for a calendar
year prior to said calendar year; b. traversing links to perform
any of the following operations: adjusting claims for a prior calendar
year, underwriting a new insurance policy, calculating policy terms
for said renewal policy, and canceling a current insurance policy;
c. linking said renewal policy to said current policy and propagating
said calculated policy terms if said renewal policy was created;
and d. modifying designations of said current and expired policies
if either a renewal policy was created or an insurance policy was
canceled in said traversing step.
2. A method to link, access, and search current and expired insurance
policy terms, as per claim 1, wherein said modifying further comprises:
a. designating a current insurance policy as an expired policy,
in a calendar year subsequent to said current calendar year; and
b. designating a renewed insurance policy as a current policy, in
a calendar year subsequent to said current calendar year.
3. A method to link, access, and search current and expired insurance
policy terms, as per claim 1, wherein said renewal insurance policy
terms are determined by any of: insurance application, supplemental
application, underwriter activity sheet, E-mod worksheet, schedule
mod worksheet, Dun and Bradstreet.TM. report, officer election,
drug-free workplace (DFWP) form, managed care form, loss run, and
loss control survey information.
4. A method to link, access, and search current and expired insurance
policy terms, as per claim 1, wherein any of said: adjusting of
claims; underwriting of a new insurance policy; and calculation
of renewal policy terms results in an automated search of policy
terms on expired policies from calendar years prior to said current
calendar year.
5. A method to link, access, and search current and expired insurance
policy terms, as per claim 4, wherein said policy terms from said
expired insurance policy are linked to said current insurance policy.
6. A method to link, access, and search current and expired insurance
policy terms, as per claim 4, wherein said policy terms from said
current insurance policy are linked to said renewed insurance policy.
7. A method to reference and modify current, expired, and renewed
policies in an insurance policy renewal chain; said method comprising:
a. creating an object representing an insured, effective range date
of an insurance policy premium and policy status; b. linking a current
policy for a current calendar year to at least one of: an expired
policy for a calendar year prior to said current calendar year and
a renewal policy issued for a following calendar year; and c. traversing
said links to perform any of: adjusting claims for a prior calendar
year, underwriting an insurance policy, creating a renewal policy,
and canceling an insurance policy operations.
8. An article of manufacture comprising a computer usable medium
having computer readable program code embodied therein which implements
a method for referencing and modifying current, expired, and renewed
policies in an insurance policy renewal chain; said medium comprising:
a. computer readable program code creating an object representing
an insured, effective range date of an insurance policy premium
and policy status; b. computer readable program code linking a current
policy for a current calendar year to at least one of: an expired
policy for a calendar year prior to said current calendar year and
a renewal policy issued for a following calendar year; and c. computer
readable program code traversing said links to perform any of: adjusting
claims for a prior calendar year, underwriting an insurance policy,
creating a renewal policy, and canceling an insurance policy operations.
9. An article of manufacture comprising a computer usable medium
having computer readable program code, as per claim 8, wherein said
medium further comprises: a. computer readable program code designating
a current insurance policy as an expired policy, in a calendar year
subsequent to said current calendar year; and b. computer readable
program code designating a renewed insurance policy as a current
policy, in a calendar year subsequent to said current calendar year.
10. An article of manufacture comprising a computer usable medium
having computer readable program code, as per claim 8, wherein said
renewed insurance policies are determined by any of: insurance application,
supplemental application, underwriter activity sheet, E-mod worksheet,
schedule mod worksheet, Dun and Bradstreet.TM. report, officer election,
DFWP form, managed care form, loss run, and loss control survey
information.
11. An article of manufacture comprising a computer usable medium
having computer readable program code, as per claim 8, wherein any
of said: adjusting of claims; underwriting of an insurance policy;
and creation of a renewal policy invokes computer readable program
code to perform an automated search of policy terms on expired policies
from calendar years prior to said current calendar year.
12. An article of manufacture comprising a computer usable medium
having computer readable program code, as per claim 11, wherein
said policy terms from said expired insurance policy are linked
to said current insurance policy.
13. An article of manufacture comprising a computer usable medium
having computer readable program code, as per claim 11, wherein
said policy terms from said current insurance policy are linked
to said renewed insurance policy.
Insurance Description
BACKGROUND OF INVENTION
[0001] The present invention relates generally to the field of
insurance policy issuance and management. More specifically, the
present invention is related to the automated search for and linking
of expired and current insurance policy terms to aid in the calculation
of future policy terms.
DISCUSSION OF PRIOR ART
[0002] In the determination of insurance policy premiums and the
calculation of future policy terms, and even when adjusting claims
and calculating loss runs for policyholders insured under prior
insurance policies, it becomes beneficial to maintain archives of
and provide efficient access to the characteristics and data of
previously issued policies. Currently, industry-wide standards typically
call for existing policies, that are about to expire, to be renewed.
The process of recalculating policy terms, in order to renew an
insurance policy for a subsequent calendar year; is known as the
"renewal" process. Because most companies do not retain
expired insurance policies, the "renewal" process requires
the manual re-computation of policy terms from information that
must once again be gathered from the policyholder. In addition,
policies that may have been incorrectly issued, either because of
incomplete or inaccurate policy conditions, must be put through
a process known as "cancel-flat re-issue". This process
is very similar to the renewal process in that the policy terms
and conditions must be carried forward to a new iteration of the
policy's existence.
[0003] Often times, to assist in a re-computation of terms, a "pull
forward" subfolder is created in which to "pull"
and keep information from prior paper-based policies. In this manner,
information from a prior policy's folder is copied and stored in
the new policy's folder without having to have the entire prior
policy folder pulled from the paper system.
[0004] For example, recalculating a workers compensation premium
would require collecting from the policyholder, information such
as number of accidents in the previous year, number of employees
on payroll, the amount of payroll per employee, the job classification
of the employees, experience modifications, merit modifications,
etc. This process is not only duplicative and redundant; it is wasteful
of resources that could be better allocated, i.e., to claims adjustment
and new policyholder application issuance. Thus, there is a need
in the industry for a resource conscious method of storing prior
insurance policies.
[0005] Prior art methods relating to archival and version management
include a method for storing related information in a single container
data structure. U.S. Pat. No. 5,857,207 to Lo et al. discloses a
method of pooling containers having multiple versions of a distinct
document. Pooling containers are divided into layers wherein at
most one unique version of a document is stored. Also disclosed
is a mechanism for manipulating the distinct document to be used
at a given time. However, Lo et al. fail to mention linking of or
referencing between the distinct versions; the reference merely
discusses distinct versions of a single document collocated within
the same container.
[0006] U.S. Pat. No. 6,499,206 to Rivette et al. discloses a method
for grouping documents automatically by utilizing system and user
grouping constraints. Documents associated with the group may be
mapped, linked to forwards and backwards citations, as well as bracketed
and clustered. However, Rivette et al. limit their discussion to
the location and grouping of keywords manually selected and input
by the user; the system only searches for different grammatical
variants of the user-input keyword. No mention is made of an automated
search predicated solely on system-generated terms nor is any made
of an allowance for terms having either constant or variable values.
[0007] U.S. Pat. No. 6,539,396 to Bowman-Amuah discloses a system
and method for associating multiple versions of business objects
with one another. A legacy system interconnected with a client via
an integration architecture uses a legacy wrapper to communicate
with a client. Although the calculation of insurance rates are mentioned,
the calculation referred to pertains to communication regarding
a single customer component of an insurance rate quote between a
newer system of an independent agency and a legacy system of an
insurance company. Bowman-Amuah fails to discuss or even mention
accessing legacy information in the calculation of insurance rates.
Rather, facilitating communication between legacy and newer protocols
is discussed.
[0008] U.S. patent application publication 2003/01355520 A1 to
Mitchell et al. discloses a method for storing different versions
of a body of statutory law and judicial precedent. Different versions
of bodies of law are linked and associated via pointers. A version
of interest is accessed by navigating through a display along a
hierarchical path. Also disclosed is a method of hyper-linking information
included in the same file, record, or structured document. However,
Mitchell et al. simply provide for a display of dates in association
with selected versions of a particular portion of a body of law.
Furthermore, particular portions of a body of law are simply linked
based on their physical locations within a statute or code; no mention
is made of a linking based on content or meaning of a particular
portion or section of a selected body of law.
[0009] Although it is common practice to sort and search by either
an insured business name or a tax identification number to find
prior policies issued to a particular business, name searches are
limited in their ability to provide prior policy information when
an insured changes their business name, or, in the event that a
search keyed on a tax identification number was performed, a business
would appear to have duplicative insurance policy coverage, one
policy for each tax identification number. Thus, the ability to
accurately find, evaluate, and present all prior policy information
corresponding to a particular insured business in a concise, chronological
order is hindered.
[0010] Whatever the precise merits, features, and advantages of
the above cited references, none of them achieves or fulfills the
purposes of the present invention.
SUMMARY OF THE INVENTION
[0011] The system and method of the present invention provide for
the automatic linking of expired, current, and future insurance
policies. Within each insurance policy is a plurality of terms frequently
used in the determination of an insurance policy premium or rate
quote. Such terms are calculated based on information either associated
with or obtained from a particular policyholder. By automatically
linking policy information and policy terms from prior insurance
policies, the present invention allows policy information previously
submitted by a policyholder or calculated in regards to activity
on a particular policy to be used in automatic calculation and generation
of a future policy term. Also associated with a particular insurance
policy for each insured member under the same policy are member
identification (ID) information, effective coverage date range,
policy premium information, and policy status. Policy status includes
a designation of whether the policy was cancelled flat and reissued,
expired and renewed, or cancelled and reinstated.
[0012] Utilizing a logical linked list to all of an insured's policies
maintained by the system of the present invention ensures that policies
are presented in chronological order regardless of changes in either
a policyholder's name or tax identification number. In this manner,
it is possible to collocate historical information and documents
for all policies associated with a particular policyholder and to
obtain immediate access to desired policy information. Thus, the
need to sort policy information is obviated as is the need to perform
an exhaustive manual search or even an electronic keyword search
is obviated.
[0013] Thus, the present invention achieves straight-thru processing
in organizing prior policies for assistance in renewals, loss ratio
calculations, shifts in payroll numbers (i.e., the number of employees
insured under a single policy), and previous claims activity under
the same type of policy. Using the present invention, loss representatives
are able to analyze new, system-generated calculations that are
determined via triggers pulled from prior policies, as opposed to
manually searching for prior policy terms and manually generating
new policy terms.
BRIEF DESCRIPTION OF THE DRAWINGS
[0014] FIG. 1 is a screenshot of a Graphical User Interface (GUI)
of the system of the present invention.
[0015] FIG. 2 illustrates a folder view of an insurance policy
under review.
[0016] FIG. 3 illustrates items pulled forward and linked to an
insurance policy under review and the propagation of a policy term
to previous policy years.
[0017] FIG. 4 is a process flow diagram for the method of the present
invention.
DESCRIPTION OF THE PREFERRED EMBODIMENTS
[0018] While this invention is illustrated and described in a preferred
embodiment, the invention may be produced in many different configurations.
There is depicted in the drawings, and will herein be described
in detail, a preferred embodiment of the invention, with the understanding
that the present disclosure is to be considered as an exemplification
of the principles of the invention and the associated functional
specifications for its construction and is not intended to limit
the invention to the embodiment illustrated. Those skilled in the
art will envision many other possible variations within the scope
of the present invention.
[0019] Because the volume of the base of insured policy members
increases on a day-to-day basis, it is unlikely that simply archiving
insurance policies would allow for efficient access on a need-to-know
basis. For this reason, it is necessary to have some sort of consistent
and efficient method of accessing the information contained within
insurance policies previously issued for current policyholders.
[0020] Referring now to FIG. 1, a screenshot depicting a graphical
user interface (GUI) of the present invention is shown. Policy terms
calculated for previous years and for the current year are collocated
in a single insurance policy folder. Each policy is also collocated
with a root underwriting file, which functions as a placeholder
for policy subfolders located at lower levels of hierarchy. A root
folder is also used to store items that a user (i.e., an underwriter,
adjustor, loss control representative, litigator, or subrogation
specialist) needs to be immediately aware of. Essentially, items
stored in a root folder are "red-flagged." For example,
a policy that is currently the subject of litigation is noted such
that a user is given ample notice to proceed with caution when working
on the noted policy. When a user receives correspondence pertaining
to a particular policy or a particular insured member's policy information,
the correspondence becomes a part of the underwriting folder of
the noted policy. Once the correspondence item is placed into the
underwriting root folder of the noted policy, it becomes possible
to "pull forward" certain application items to aid in
the renewal process.
[0021] Items "pulled forward" are not physically removed
from original policy folder locations, rather, a logical linked
list is placed in the folder that "point" back to documents
held in either expired or expiring policy folders. Thus, no manual
process is required to actually "pull forward" or move
or copy documents from one folder to another folder. The system
of the present invention automatically creates a linked list linking
documents from prior policies; these documents are chosen for linking
based on business logic that changes from month to month, year to
year.
[0022] Suggested items to be "pulled forward" include
an insurance policy application, supplemental application, and account
analysis; if the item is over three years old, a diary note is attached
as a reminder to obtain a new or updated application prior to renewal.
Other items to be pulled forward include, but are not limited to,
the latest: underwriter activity sheets, E-mod (Q-mod) worksheets,
schedule mod worksheets, Dun and Bradstreet.TM. reports, Drug-free
workplace (DFWP) forms, managed care forms, loss runs, and loss
control surveys. Other items of interest that may influence a future
underwriter decision include officer election information. Once
these items are pulled forward and placed in the underwriting folder
of the noted policy, and underwriter is provided access necessary
to determine new policy terms, without having to obtain or collect
redundant data.
[0023] Shown in FIG. 2 is a policy folder 200 corresponding to
an insurance policy currently under review by an underwriter. A
root underwriting folder 202 is maintained within policy folder
200 and links to items either manually or automatically pulled forward
204a-d.
[0024] Referring now to FIG. 3, items pulled forward from root
underwriting folders 302a, b of policies issued in prior years 300a,
b are linked to root underwriting folder 302c, for a policy currently
under review 300c. Pulled forward items are evaluated to calculate
a term or terms for policy under review 300c and used to adjust
the renewal process. Changes made to policy under review 300c propagate
all the way through prior policies 300a, b.
[0025] Referring now to FIG. 4, a process flow diagram for calculating
policy terms for an insurance policy of interest is shown. In step
400, items of interest in calculating renewal policy terms are marked
as "pulled forward". In one embodiment, such items are
comprised of the latest: insurance applications filled out by the
insured, supplemental applications, underwriter activity sheets,
E-mod worksheets, schedule mod worksheets, Dun and Bradstreet.TM.
reports, officer election information, Drug-free workplace (DFWP)
forms, managed care forms, loss runs, and loss control surveys.
Items marked as "pulled forward" are then linked to a
root underwriting folder collocated with the insurance policy of
interest in step 402.
[0026] Subsequently in step 404, links are traversed to obtain
specific information from any one of the items marked as pulled
forward. If the location of the specific information is known, it
is possible to access the information directly. Following in step
406, claims are adjusted, renewal policy terms are calculated, new
insurance policy terms are underwritten, or a current policy is
cancelled based on the insurance policy of interest. If it is determined
in step 406 that a renewal policy is created, policy terms determined
for the renewal policy are propagated to policies previously issued
in step 408. In step 410, the policy of interest for which policy
terms were calculated is designated as a current policy and a current
policy is designated as expired. If it is determined in step 406
that the policy of interest was cancelled, the policy of interest
is designated as expired in step 412.
[0027] Furthermore, the method of the present invention does not
require navigation along a path; if the identity of a prior or previous
insurance policy term is known, direct access is possible. This
obviates the need for a manual search, terms such as payroll numbers
are located instantaneously; relevant terms in previously issued
policies are flagged for review in underwriting a current policy.
[0028] Additionally, the present invention provides for an article
of manufacture comprising computer readable program code contained
within implementing one or more modules to link previous insurance
policy information to a current insurance policy under review. Furthermore,
the present invention includes a computer program code-based product,
which is a storage medium having program code stored therein which
can be used to instruct a computer to perform any of the methods
associated with the present invention. The computer storage medium
includes any of, but is not limited to, the following: CD-ROM, DVD,
magnetic tape, optical disc, hard drive, floppy disk, ferroelectric
memory, flash memory, ferromagnetic memory, optical storage, charge
coupled devices, magnetic or optical cards, smart cards, EEPROM,
EPROM, RAM, ROM, DRAM, SRAM, SDRAM, or any other appropriate static
or dynamic memory or data storage devices.
[0029] Implemented in computer program code based products are
software modules for: (a) linking policy terms and information used
in underwriting a prior policy term; (b) calculating policy terms
for a current policy under review; (c) propagating calculated policy
terms to prior policies; and (d) providing instantaneous access
to policy terms from prior years.
[0030] Also, implemented in computer program based products are
software modules for:
[0031] creating an object representing an insured, effective range
date of an insurance policy premium and policy status;
[0032] linking a current policy for a current calendar year to
at least one of: an expired policy for a calendar year prior to
said current calendar year and a renewal policy issued for a following
calendar year; and
[0033] traversing said links to perform any of: adjusting claims
for a prior calendar year, underwriting an insurance policy, creating
a renewal policy, and canceling an insurance policy operations.
CONCLUSION
[0034] A system and method has been shown in the above embodiments
for the effective implementation of an insurance policy renewal
chain in a digital paperless environment. While various preferred
embodiments have been shown and described, it will be understood
that there is no intent to limit the invention by such disclosure,
but rather, it is intended to cover all modifications falling within
the spirit and scope of the invention, as defined in the appended
claims. For example, the present invention should not be limited
by software/program, computing environment, or specific computing
hardware, subject matter of term calculation.
[0035] The above enhancements are implemented in various computing
environments. For example, the present invention may be implemented
on a multi-nodal system (e.g., LAN) or networking system (e.g.,
Internet, WWW, wireless web). All programming and data related thereto
are stored in computer memory, static or dynamic, and may be retrieved
by the user in any of: conventional computer storage, display (i.e.,
CRT) and/or hardcopy (i.e., printed) formats. The programming of
the present invention may be implemented by one of skill in the
art of insurance policy issuance/management and database programming.
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