Insurance Coverage Modeler with Claim Scenario Generator
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Solution Overview
Problem
Consumers face challenges in determining optimal insurance coverage levels due to lack of awareness and difficulty in interpreting historical or statistical claim information, often resulting in underinsurance or overinsurance, with professionals also struggling to balance coverage and premium costs effectively.
Innovation Solution
A system and method for modeling insurance coverage using a claim scenario generator that displays and adjusts coverage parameters within a user interface, allowing policy holders to select claim scenario parameters, generate claim scenarios, and modify coverage parameters to optimize coverage levels, while automatically adjusting premiums and generating new policies.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Loss of information
If consumers rely on historical or statistical claim information to determine coverage levels, then coverage decisions can be more informed, but the complexity of interpreting and applying this information increases significantly
Solution Approach 1:
The patent introduces an insurance coverage modeler as an intermediary tool that sits between the raw claim information and the consumer. This modeler automatically processes historical and statistical claim data, applies it to the consumer's specific situation, and generates coverage recommendations without requiring the consumer to manually interpret complex statistics. The modeler translates difficult-to-understand claim information into actionable coverage guidance.
Solution Approach 2:
The system enables consumers to independently determine optimal coverage levels by providing them with a self-service tool that automatically analyzes their specific needs against historical claim data. The consumer inputs their basic information and preferences, and the system self-optimizes coverage recommendations without requiring external professional intervention, thus making complex information accessible to ordinary consumers.
2Reliability
If consumers increase insurance coverage to protect against unforeseen liabilities, then financial protection improves, but premium costs increase
Solution Approach 1:
The patent employs parameter changes by allowing consumers to adjust coverage parameters (such as deductible amounts, coverage limits, and policy conditions) and immediately seeing how these changes affect both protection levels and premium costs. The system dynamically recalculates coverage recommendations based on modified parameters, enabling consumers to find the optimal balance between reliability and cost for their specific circumstances.
Solution Approach 2:
The system implements feedback mechanisms where consumers can see real-time updates to coverage recommendations and premium cost estimates as they modify their coverage parameters. This feedback loop allows consumers to understand the direct relationship between coverage choices and costs, enabling informed decision-making that balances financial protection needs with budget constraints.
3Measurement precision
If consumers seek professional insurance services to determine optimal coverage, then coverage accuracy improves, but service cost and accessibility decrease
Solution Approach 1:
The patent transforms the professional service model into a self-service digital tool that consumers can access independently. The insurance coverage modeler replicates the analytical capabilities previously available only to insurance professionals, enabling consumers to accurately determine their own optimal coverage levels without needing to schedule appointments, pay consultation fees, or navigate complex professional workflows.
Solution Approach 2:
The system copies the expertise and analytical methods of insurance professionals into an accessible digital platform. By encoding professional knowledge algorithms and claim analysis methodologies into the modeler, the system reproduces professional-level coverage determination accuracy in a format that is freely accessible to any consumer with internet access, eliminating the need for direct professional engagement.
Data Source
AI summary
A method, system and computer-usable medium are disclosed for the modeling of insurance coverage. Coverage parameters of a policy are displayed as graphical elements within a user interface (UI) of a computing device along with a plurality of claim scenario parameters for selection by a user. Once selected, the claim scenario parameters are applied to relevant claim data and a claim scenario is generated. The claim scenario is then applied to the policy coverage parameters of the policy to determine and graphically display coverage parameter disparities, which are then graphically modified to offset any coverage parameter disparities. As coverage parameters are modified, corresponding adjustments to the premium of the current policy are made and displayed within the UI. A resulting policy is generated, using the modified coverage parameters of the current policy and adjusted premiums, and then fulfilled, electronically or physically.