Insurance Coverage Modeling System with Claim Scenario Analysis

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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 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, coverage recommendation module, and competitive comparison module, which allows users to select claim scenario parameters, generate claim scenarios, modify coverage parameters, and compare policies, providing automated assistance and recommendations to optimize coverage levels.

Engineering Contradictions & Design Principles

VSEngineering Contradiction Analysis

1Loss of energy

If consumers purchase insurance coverage without professional analysis, then they may save on premium costs, but they risk being underinsured and exposed to financial liabilities

Engineering Contradiction:

Improvepremium costsVSAvoidadequacy of coverage

Core Design Contradiction:

Loss of energyVSReliability

Solution Approach 1:

The system enables consumers to independently analyze and determine optimal coverage levels through automated modeling tools, eliminating the need for professional intermediaries while ensuring adequate coverage through systematic claim scenario analysis

Inventive Principle:

Principle #25Self-service

Solution Approach 2:

The system performs preliminary coverage analysis by generating claim scenarios and modeling potential losses before the consumer makes a purchasing decision, allowing them to proactively identify appropriate coverage levels rather than relying on post-purchase discoveries

Inventive Principle:

Principle #10Preliminary action

2Reliability

If consumers increase insurance coverage to ensure adequate protection, then their financial security improves, but their premium costs increase

Engineering Contradiction:

Improveadequacy of coverageVSAvoidpremium costs

Core Design Contradiction:

ReliabilityVSLoss of energy

Solution Approach 1:

The system systematically varies coverage parameters across multiple claim scenarios to identify the optimal coverage level that provides adequate protection while minimizing premium costs, transforming the coverage determination from a binary choice to a optimized parameter selection

Inventive Principle:

Principle #35Parameter changes

Solution Approach 2:

The system analyzes coverage levels that may exceed minimum requirements by modeling various claim scenarios, allowing consumers to identify the precise point where additional coverage becomes unnecessary, thereby avoiding excessive premium payments

Inventive Principle:

Principle #16Partial or excessive action

3Loss of information

If consumers rely on historical claim information to determine coverage, then they may make informed decisions, but the complexity of interpreting this data becomes a barrier

Engineering Contradiction:

Improveinterpretation of claim dataVSAvoidcomplexity of analysis process

Core Design Contradiction:

Loss of informationVSDevice complexity

Solution Approach 1:

The system acts as an intermediary between raw historical claim data and consumer decision-making, automatically processing and interpreting complex data to generate actionable coverage recommendations without requiring consumers to directly analyze the underlying complexity

Inventive Principle:

Principle #24Intermediary (Mediator)

4Ease of operation

If consumers seek professional insurance advice, then they receive expert guidance on coverage optimization, but the time and effort required increases

Engineering Contradiction:

Improveaccess to expert guidanceVSAvoidtime for coverage analysis

Core Design Contradiction:

Ease of operationVSLoss of time

Solution Approach 1:

The system replaces the mechanical process of consulting human professionals with an automated computational model that performs coverage analysis instantaneously, eliminating time losses associated with scheduling and conducting professional consultations

Inventive Principle:

Principle #28Mechanics substitution (Replace mechanical system)

Data Source

PatentUS7983938B1Systems and methods for modeling recommended insurance coverage

Publication Date: 2011.07.19 UNITED SERVICES AUTOMOBILE ASSOCIATION (USAA)

AI summary

A method, system and computer-usable medium are disclosed for modeling recommended 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 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. Recommendations for modifying the coverage parameters are provided by help windows, an assistance wizard, or live help. An analysis of competitive policies with equivalent coverage is performed and an optimum policy choice is recommended. A resulting policy is generated, using the modified coverage parameters of the current policy and adjusted premiums, and then fulfilled, electronically or physically.