Patent Search
 
Insurance Patent

Digital electrical computer system for determining a premium structure for insurance coverage including for counterclaim coverage

Insurance abstract


A computer system for supporting a plan of counterclaim insurance provided to professionals, optionally along with professional liability insurance, deters frivolous professional malpractice claims. The insurance plan pays expenses, for example, of counterclaims for malicious prosecution when a frivolous claim has been made and tried to a judgment for the accused professional, and an independent review concludes that the claim was frivolous. The names of covered professionals are posted on a publicly accessible database. If potential plaintiffs or their attorneys find a potential defendant's name on the database, they may be deterred from filing weaker claims that might be viewed as frivolous. Upon approval of an applicant for counterclaim insurance, the applicant's name is posted to a public database, which may be accessible through the Internet, including the World Wide Web, or alternatively through a dial-up facility.

Insurance claims


What is claimed is:

1. A computer-implemented method for determining a premium structure for insurance providing coverage including coverage for costs associated with advancing a counterclaim, the method comprising: receiving actuarial data and census data, at least one of said data including indicia of litigation frequency and cost; computing a premium structure, based upon the actuarial data and the census data, for the insurance providing coverage including coverage for costs associated with advancing a counterclaim; and generating insurance documentation including said premium structure.

2. The method of claim 1, wherein: said receiving the actuarial data and census data is carried out with data received from an actuarial computer system; said computing a premium structure is carried out by means of a carrier computer system located remotely from the actuarial computer system; said method further including: communicating the actuarial data and census data from the actuarial computer system to the carrier computer system.

3. The method of claim 2, further including: inputting broker information, including claim data, at a remote computer system; and communicating the information to the carrier computer system; and calculating an updated premium structure based upon the claim data in the broker information.

4. The method of claim 1 further including: administering the insurance policy by: receiving premium payment data for the insurance, and receiving claim data for the insurance; and generating second documentation including at least one of the payment data for the insurance, and the claim data for the insurance.

5. The method of claim 4, wherein: the step of generating second documentation is carried out by means of a carrier computer system, and the step of receiving the premium payment data is carried out by inputting information at a computer system remote from the carrier computer system; said method further including: communicating the information from the remote computer system for the generating second documentation.

6. The method of claim 4, wherein: said generating second documentation is carried out by a carrier computer system and the step of receiving the claim data is carried out by inputting information at a computer system remote from the carrier computer system; said method further including: communicating the information to the carrier computer system.

7. The method of claim 6, further including: inputting the claim data in the information at the computer system remote from the carrier computer system; and communicating the claim data to the carrier computer system; and calculating an updated premium structure based upon the claim data.

8. The method of claim 1, further including: inputting payment data at an insured's accounting system for remote monitoring of payment data.

9. The method of claim 1 further including: receiving premium payment data for the insurance, the payment data including respective names corresponding to coverage by the insurance; posting the names and indicia of the coverage by the insurance on a front end network gateway to provide a warning at remote terminals.

10. The method of claim 9, wherein said posting is carried out using the Internet as the front end network gateway.

11. The method of claim 9, wherein said posting is carried out using the world wide web as the front end network gateway.

12. The method of claim 1 further including: receiving, at an intermediary computer, the actuarial data and census data for the insurance, at least one of said data including indicia of litigation frequency and cost; and performing an independent verification of the premium structure.

13. The method of claim 1 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of suits eliminated.

14. The method of claim 1 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of reduced settlement cost for suits.

15. The method of claim 1 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of defense cost.

16. The method of claim 1 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of frequency of claims.

17. The method of claim 1 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of the cost of the claims.

18. The method of claim 1 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of indemnity savings.

19. The method of any one of claims 1-18 further including: generating marketing documentation including a graphical representation of a pay out pattern corresponding to the insurance coverage.

20. The method of claim 19 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of a reduction in medical malpractice cost.

21. The method of claim 1, wherein said computing the premium structure includes calculating a cost for filing an administrative complaint against an expert for improper conduct in litigation giving rise to the counterclaim.

22. The method of claim 1, wherein said computing the premium structure includes calculating a cost for filing an administrative complaint against an attorney for improper conduct in litigation giving rise to the counterclaim.

23. A computer-implemented method for determining a premium structure for insurance providing coverage including counterclaim coverage, the method comprising: receiving actuarial data and census data, at least one of said data including indicia of litigation frequency and cost; computing a premium structure, based upon the actuarial data and the census data, for the insurance providing coverage including counterclaim coverage, including calculating a premium cost for the counterclaim brought as a countersuit; and generating insurance documentation including said premium structure.

24. The method of claim 23 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of a reduction in medical malpractice cost.

25. The method of claim 23 wherein said computing the premium structure includes calculating a premium cost for the counterclaim including a counterclaim for frivolous litigation.

26. The method of claim 23, wherein: said receiving the actuarial data and census data is carried out with data received from an actuarial computer system; said computing a premium structure is carried out by means of a carrier computer system located remotely from the actuarial computer system; said method further including: communicating the actuarial data and census data from the actuarial computer system to the carrier computer system.

27. The method of claim 26, further including: inputting broker information at a remote computer system; and communicating the information to the carrier computer system; and calculating an updated premium structure based upon the claim data in the broker information.

28. The method of claim 23 further including: administering the insurance policy by sub-steps including receiving premium payment data for the insurance, and receiving claim data for the insurance; generating second documentation including at least one of the payment data for the insurance, and receiving claim data for the insurance.

29. The method of claim 28, wherein: the step of generating second documentation is carried out by means of a carrier computer system, and the step of receiving the premium payment data is carried out by inputting information at a computer system remote from the carrier computer system; said method further including: communicating the information from the remote computer system for the generating second documentation.

30. The method of claim 28, wherein: said generating second documentation is carried out by a carrier computer system and the step of receiving the claim data is carried out by inputting information at a computer system remote from the carrier computer system; said method further including: communicating the information to the carrier computer system.

31. The method of claim 30, further including: inputting the claim data in the information at the computer system remote from the carrier computer system; and communicating the claim data to the carrier computer system; and calculating an updated premium structure based upon the claim data.

32. The method of claim 23, further including: inputting payment data at an insured's accounting system for remote monitoring of payment data.

33. The method of claim 23 further including: receiving premium payment data for the insurance, the payment data including respective names corresponding to coverage by the insurance; posting the names and indicia of the coverage by the insurance on a front end network gateway to provide a warning at remote terminals.

34. The method of claim 33, wherein said posting is carried out using the Internet as the front end network gateway.

35. The method of claim 33, wherein said posting is carried out using the world wide web as the front end network gateway.

36. The method of claim 23 further including: receiving, at an intermediary computer, the actuarial data and census data including for the insurance, at least one of said data including indicia of litigation frequency and cost; and performing an independent verification of the premium structure.

37. The method of claim 23 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of suits eliminated.

38. The method of claim 23 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of reduced settlement cost for suits.

39. The method of claim 23 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of defense cost.

40. The method of claim 23 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of frequency of claims.

41. The method of claim 23 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of the cost of the claims.

42. The method of claim 23 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of indemnity savings.

43. A computer-implemented method for determining a premium structure for insurance providing coverage including counterclaim coverage, the method comprising: receiving actuarial data and census data, at least one of said data including indicia of litigation frequency and cost; computing a premium structure, based upon the actuarial data and the census data, for the insurance providing coverage including counterclaim coverage, including calculating a premium cost for the counterclaim brought as a countersuit to a professional malpractice cause of action; and generating insurance documentation including said premium structure.

44. The method of claim 43 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of counterclaim litigation cost for frivolous litigation, said counterclaim litigation cost not including countersuit cost.

45. The method of claim 43, wherein: said receiving the actuarial data and census data is carried out with data received from an actuarial computer system; said computing a premium structure is carried out by means of a carrier computer system located remotely from the actuarial computer system; said method further including: communicating the actuarial data and census data from the actuarial computer system to the carrier computer system.

46. The method of claim 45, further including: inputting broker information at a remote computer system; and communicating the information to the carrier computer system; and calculating an updated premium structure based upon the claim data in the broker information.

47. The method of claim 43 further including: administering the insurance policy by sub-steps including receiving premium payment data for the insurance, and receiving claim data for the insurance; generating second documentation including at least one of the payment data for the insurance, and receiving claim data for the insurance.

48. The method of claim 47, wherein: the step of generating second documentation is carried out by means of a carrier computer system, and the step of receiving the premium payment data is carried out by inputting information at a computer system remote from the carrier computer system; said method further including: communicating the information from the remote computer system for the generating second documentation.

49. The method of claim 47, wherein: said generating second documentation is carried out by a carrier computer system and the step of receiving the claim data is carried out by inputting information at a computer system remote from the carrier computer system; said method further including: communicating the information to the carrier computer system.

50. The method of claim 49, further including: inputting the claim data in the information at the computer system remote from the carrier computer system; and communicating the claim data to the carrier computer system; and calculating an updated premium structure based upon the claim data.

51. The method of claim 43, further including: inputting payment data at an insured's accounting system for remote monitoring of payment data.

52. The method of claim 43 further including: receiving premium payment data for the insurance, the payment data including respective names corresponding to coverage by the insurance; posting the names and indicia of the coverage by the insurance on a front end network gateway to provide a warning at remote terminals.

53. The method of claim 52, wherein said posting is carried out using the Internet as the front end network gateway.

54. The method of claim 52, wherein said posting is carried out using the world wide web as the front end network gateway.

55. The method of claim 43 further including: receiving, at an intermediary computer, the actuarial data and census data including for the insurance, at least one of said data including indicia of litigation frequency and cost; and performing an independent verification of the premium structure.

56. The method of claim 43 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of suits eliminated.

57. The method of claim 43 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of reduced settlement cost for suits.

58. The method of claim 43 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of defense cost.

59. The method of claim 43 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of frequency of claims.

60. The method of claim 43 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of the cost of the claims.

61. The method of claim 43 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of indemnity savings.

62. A computer-implemented method for determining a premium structure for insurance providing coverage including counterclaim coverage, the method comprising: receiving actuarial data and census data, at least one of said data including indicia of litigation frequency and cost; computing a premium structure, based upon the actuarial data and the census data, for the insurance providing coverage including counterclaim coverage, including calculating a premium cost for the counterclaim brought in a medical malpractice cause of action; and generating insurance documentation including said premium structure.

63. The method of claim 62 wherein said computing the premium structure includes calculating a premium cost for the counterclaim as counterclaim litigation only for frivolous litigation.

64. The method of claim 62, wherein: said receiving the actuarial data and census data is carried out with data received from an actuarial computer system; said computing a premium structure is carried out by means of a carrier computer system located remotely from the actuarial computer system; said method further including: communicating the actuarial data and census data from the actuarial computer system to the carrier computer system.

65. The method of claim 64, further including: inputting broker information at a remote computer system; and communicating the information to the carrier computer system; and calculating an updated premium structure based upon the claim data in the broker information.

66. The method of claim 62 further including: administering the insurance policy by sub-steps including receiving premium payment data for the insurance, and receiving claim data for the insurance; generating second documentation including at least one of the payment data for the insurance, and receiving claim data for the insurance.

67. The method of claim 66, wherein: the step of generating second documentation is carried out by means of a carrier computer system, and the step of receiving the premium payment data is carried out by inputting information at a computer system remote from the carrier computer system; said method further including: communicating the information from the remote computer system for the generating second documentation.

68. The method of claim 66, wherein: said generating second documentation is carried out by a carrier computer system and the step of receiving the claim data is carried out by inputting information at a computer system remote from the carrier computer system; said method further including: communicating the information to the carrier computer system.

69. The method of claim 68, further including: inputting the claim data in the information at the computer system remote from the carrier computer system; and communicating the claim data to the carrier computer system; and calculating an updated premium structure based upon the claim data.

70. The method of claim 62, further including: inputting payment data at an insured's accounting system for remote monitoring of payment data.

71. The method of claim 62 further including: receiving premium payment data for the insurance, the payment data including respective names corresponding to coverage by the insurance; posting the names and indicia of the coverage by the insurance on a front end network gateway to provide a warning at remote terminals.

72. The method of claim 71, wherein said posting is carried out using the Internet as the front end network gateway.

73. The method of claim 71, wherein said posting is carried out using the world wide web as the front end network gateway.

74. The method of claim 62 further including: receiving, at an intermediary computer, the actuarial data and census data including for the insurance, at least one of said data including indicia of litigation frequency and cost; and performing an independent verification of the premium structure.

75. The method of claim 62 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of suits eliminated.

76. The method of claim 62 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of reduced settlement cost for suits.

77. The method of claim 62 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of defense cost.

78. The method of claim 62 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of frequency of claims.

79. The method of claim 62 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of the cost of the claims.

80. The method of claim 62 wherein said receiving the actuarial data is carried out with actuarial data including an indicium of indemnity savings.

81. A digital electrical computer and data processing system comprising: a digital electrical computer, an input device for inputting data electrically connected to the digital electrical computer, and an output device electrically connected to the digital electrical computer, wherein the digital electrical computer is controlled by a computer program to form a programmed digital electrical computer for processing input electrical signals, the input electrical signals being produced in response to information entered at the input device, the information including actuarial data and census data, at least one of said data including indicia of litigation frequency and cost, the processing including modifying the input electrical signals into output electrical signals representing a premium structure, based upon the actuarial data and the census data, for insurance funding of countersuit litigation for a frivolous medical malpractice claim, the output electrical signals being communicated to the output device which, in response to the output electrical signals, generates a depiction of the premium structure.

82. A method for making a programmed digital electrical computer and data processing system, the method including the steps of: providing a digital electrical computer having a programmable processor, an input device for inputting data electrically connected to the digital electrical computer, an output device electrically connected to the digital electrical computer; programming the processor to control the digital electrical computer for processing input electrical signals, the input electrical signals being produced in response to information entered at the input device, the information including actuarial data and census data, at least one of said data including indicia of litigation frequency and cost, the data in a format specified by the computer program, the processing including modifying the input electrical signals into output electrical signals representing a premium structure, based upon the actuarial data and the census data, for insurance funding of countersuit litigation for a frivolous medical malpractice claim, the output electrical signals being communicated to the output device which, in response to the output electrical signals, generates a depiction of the premium structure.

Insurance description

BACKGROUND OF THE INVENTION

A. Copyright Notice

A portion of the disclosure of this patent document contains material which is subject to copyright protection. The copyright owner has no objection to a statutory fair use of this material, as it appears in the files of the files or records of the U.S. Patent and Trademark Office, but otherwise reserves all copyright rights whatsoever.

B. Field of Invention

This invention relates to the reduction of frivolous professional liability claims. More particularly, this invention relates to the provision of insurance to pay the costs of counter litigation, especially, but not necessarily only for malicious prosecution of frivolous professional liability claims, including publicizing the identities of holders of such insurance as a deterrent.

Still more particularly, present invention is in the field of digital electrical apparatus and methods for making and using the same, and products produced thereby. More particularly, the present invention is directed to a digital electrical apparatus and method for data processing, data management, and computer communications, having particular utility in the fields of insurance, accounting, marketing, etc. Still more particularly, the present invention pertains to a a digital electrical apparatus and method for making and using it to process and produce digital electrical signals relating to insurance coverage for funding counterlitigation, counterclaim, and countersuit cost, or other counter proceedings.

C. Background of Invention

As society has become more litigious, any reason for people to amicably resolve their differences by other avenues would be worthwhile. Unfortunately, people have found themselves defending litigation more frequently, and sometimes counterclaiming or countersuing where they would have otherwise walked away.

Consider an example. Professionals (including physicians, attorneys, architects and others) have found themselves defending an increasing number of professional liability claims brought by patients or clients unhappy with the quality of the professional services rendered, or with the results of those services. In some cases, charges of professional misconduct are warranted. However, in many cases, the charges are unwarranted; despite competent services rendered at or above the appropriate level of care, concern and attention, and without fault on the part of the professional, the desired result may not be achieved in all cases. Nevertheless, to avoid the disruption of a protracted legal action, such frivolous cases are frequently settled by the accused professionals for their nuisance value.

A frivolous charge of professional misconduct may be brought on behalf of an unhappy patient or client simply because there is no adequate disincentive not to do so. Although it may be possible, if the frivolous nature of the complaint can be proven, to pursue counter litigation (for example, a "countersuit" for wrongful or malicious prosecution against the proponents of frivolous claims, e.g., the patient/client or his or her attorney), such countersuits frequently are not instituted or pursued because of the commitment in time, and particularly in legal fees, that is involved.

Although these problems affect anyone and many different professional fields as discussed above, the problem is particularly acute in the case of physicians. Therefore, the remainder of this specification will be addressed to medical malpractice counterclaim insurance, it being understood that the discussion applies equally well to other counterclaims, including separate countersuits and non-court activity, such as expert witness or attorney disciplinary proceedings; administrative action, presentations to prosecuting attorneys, and the like. The discussion also applies to different types of legal subject matter, professional liability claims, and insurance.

Even though medical malpractice claims usually are covered by insurance, they have many negative implications. First, one's competence is challenged and one's reputation is damaged,threatening one's future livelihood. Second, the stress of practicing medicine is increased. Third, the physician-patient relationship is damaged. Fourth, physicians are encouraged to practice cost-inefficient defensive medicine. Fifth, the physician is required to prepare for the lawsuit, spending time away from the office that does not generate income. Sixth, the premiums for malpractice liability insurance may increase, possibly even after a successful defense. Seventh, the physician is placed in a vulnerable and uncomfortable position as a witness. Eighth, the physician may be pitted against another physician (a) in trying to allocate blame if more than one physician was involved, or (b) where another physician appears as an expert witness on behalf of the plaintiff. Ninth, stress develops at home between the physician and his or her spouse and family. Tenth, the joy is taken out of practicing medicine. Eleventh, a judgment over the maximum coverage limits of a physician's malpractice insurance policy can bankrupt the physician.

For these reasons it would be desirable to be able to provide an improved deterrent to the filing and prosecution of litigation, especially frivolous professional liability claims.

SUMMARY OF THE INVENTION

A. Objects of the Invention

It is an object of this invention to attempt to provide an improved deterrent to the filing and prosecution of litigation, especially frivolous professional liability claims.

It is another object of this invention to provide computer support for the improved deterrent.

It is yet another object of this invention to provide an integrated system of multiple computer support systems for efficiently supporting the improved deterrent.

In accordance with this invention, there is provided a method of deterring litigation claims such as prosecution of frivolous professional liability claims against professionals.

B. Summary of the Invention

The method includes offering to professionals a plan of insurance for paying costs of prosecuting a claim against a proponent of a frivolous professional liability claim. Applications are received from professionals for the insurance, including by means of one or more of the computer systems discussed subsequently herein. Professionals (i.e., those from whom the applications are received) are provided with insurance coverage by significant computer support, including support for determining a suitable premium structure, generating insurance documentation, accounting, marketing, intra and inter-computer data processing, handling claims, updating premium structures, and auditing financial operations. A database of professionals covered under the plan of insurance is maintained as professionals are accepted into and added to the plan of insurance. The database is linked to a publicly-accessible communications interface for viewing by any computer of a member of the public, and the existence of the database is publicized.

Accordingly, the invention includes apparatus, method for making the apparatus, and method for using the apparatus, articles of manufacture (e.g., program with storage medium) data base and data structures and necessary intermediates.

A broad view of the invention is as follows: A computer-implemented method for determining a premium structure for insurance providing coverage including counterclaim coverage, the method comprising the steps of: receiving actuarial data and census data, at least one of said data including indicia of litigation frequency and cost; computing a premium structure, based upon the actuarial data and the census data, for the insurance providing coverage including counterclaim coverage; and generating insurance documentation including premium structure.

D. BRIEF DESCRIPTION OF THE DRAWINGS

The above and other objects and advantages of the invention will be apparent upon consideration of the following detailed description, taken in conjunction with the accompanying drawings, in which like reference characters refer to like parts throughout, and in which:

FIG. 1 is a flow diagram representing a preferred embodiment of a process according to the present invention from the initial application for coverage through the completion of a counterclaim brought on behalf of the insured;

FIG. 2 is a flow diagram of the application/issuance module of the process of FIG. 1, including database posting according to the invention;

FIG. 2A is flow diagram of an alternative embodiment of the database posting shown in FIG. 2;

FIG. 3 is a flow diagram of the claims processing/counterclaim qualification module of the process of FIG. 1;

FIG. 4 is a flow diagram of the counterclaim administration module of the process of FIG. 1;

FIG. 5 is a schematic view of a preferred embodiment of a local hardware system for implementing the present invention;

FIG. 6 is a schematic view of a preferred embodiment of a systemic hardware system for implementing the present invention;

FIG. 7 is a flow diagram for an Intermediary Computer System for the present invention;

FIG. 8 is a flow diagram for a Carrier Computer System for the present invention;

FIG. 9 is a flow diagram for an Actuary Computer System for the present invention;

FIG. 10 is a flow diagram for a Broker Computer System for the present invention;

FIG. 11 is a flow diagram for respective Marketing Computer Systems for the present invention;

FIGS. 12a and 12b (hereinafter collectively referred to as FIG. 12) are a data processing map for the Intermediary Computer System for the present invention;

FIGS. 13a and 13b (hereinafter collectively referred to as FIG. 13) are a data processing map for the Actuary Computer System for the present invention;

FIG. 14 is another data processing map for the Actuary Computer System for the present invention;

FIG. 15 is still another data processing map for the Actuary Computer System for the present invention;

FIG. 16 is yet another data processing map for the Actuary Computer System for the present invention;

FIG. 17 is an additional data processing map for the Actuary Computer System for the present invention;

FIG. 18 is a further data processing map for the Actuary Computer System for the present invention;

FIGS. 19a, 19b, 19c and 19d (hereinafter collectively referred to as FIG. 19) are a data processing map for the Carrier Computer System for the present invention;

FIGS. 20a and 20b (hereinafter collectively referred to as FIG. 20) are another data processing map for the Carrier Computer System for the present invention;

FIG. 21 is still another data processing map for the Carrier Computer System for the present invention;

FIG. 22 is yet another data processing map for the Carrier Computer System for the present invention;

FIGS. 23a and 23b (hereinafter collectively referred to as FIG. 23) are an additional data processing map for the Carrier Computer System for the present invention;

FIGS. 24a and 24b (hereinafter collectively referred to as FIG. 24) are a further data processing map for the Carrier Computer System for the present invention;

FIGS. 25a and 25b (hereinafter collectively referred to as FIG. 25) are still a further data processing map for the Carrier Computer System for the present invention;

FIGS. 26a and 26b (hereinafter collectively referred to as FIG. 26) are a data processing map for the Underwriting Computer System for the present invention;

FIGS. 27a and 27b (hereinafter collectively referred to as FIG. 27) are another data processing map for the Underwriting Computer System for the present invention;

FIG. 28 is a data processing map for the Claims Handling Computer System for the present invention;

FIGS. 29a and 29b (hereinafter collectively referred to as FIG. 29) are a data processing map for the Front End Network Gateway Computer System for the present invention;

FIGS. 30a and 30b (hereinafter collectively referred to as FIG. 30) are a data processing map for the Broker's Computer System for the present invention;

FIGS. 31a and 31b (hereinafter collectively referred to as FIG. 31) are a data processing map for the Intermediary's Marketing Computer System for the present invention;

FIGS. 32a and 32b (hereinafter collectively referred to as FIG. 32) is a data processing map for the Carrier's Marketing Computer System for the present invention;

FIG. 33 is a data processing map for the Broker's Marketing Computer System for the present invention;

FIG. 34 is a data processing map for Terminal Computer Systems for the present invention;

FIGS. 35a and 35b (hereinafter collectively referred to as FIG. 35) are a data processing map for the Insured's Attorney's Computer System for the present invention;

FIG. 36 is a data processing map for the Insured's Computer System for the present invention;

FIGS. 37a and 37b (hereinafter collectively referred to as FIG. 37) are a data processing map for the Accounting Computer System for the present invention;

FIGS. 38a and 38b (hereinafter collectively referred to as FIG. 38) are a data processing map for the Third Party Database Computer System for the present invention;

FIGS. 39a and 39b (hereinafter collectively referred to as FIG. 39) are another data processing map for the Third Party Database Computer System for the present invention;

FIG. 40 is a home page for the present invention;

FIG. 41 is a web page for the present invention;

FIG. 42 is another web page for the present invention;

FIGS. 43a and 43b (hereinafter collectively referred to as FIG. 43) are a web page for the present invention;

FIG. 44 is another web page for the present invention;

FIG. 45 is a first specimen of representative output generated in connection with determining a premium structure for the present invention;

FIG. 46 is a second specimen of representative output generated in connection with determining a premium structure for the present invention;

FIG. 47 is a third specimen of representative output generated in connection with determining a premium structure for the present invention;

FIG. 48 is a forth specimen of representative output generated in connection with determining a premium structure for the present invention;

FIG. 49 is a fifth specimen of representative output generated in connection with determining a premium structure for the present invention;

FIG. 50 is a sixth specimen of representative output generated in connection with determining a premium structure for the present invention;

FIGS. 51a and 51b (hereinafter collectively referred to as FIG. 51) is a seventh specimen of representative output generated in connection with determining a premium structure for the present invention;

FIG. 52 is a eighth specimen of representative output generated in connection with determining a premium structure for the present invention;

FIG. 53 is a ninth specimen of representative data useful in connection with determining a premium structure for the present invention;

FIG. 54 is a tenth specimen of representative data useful in connection with determining a premium structure for the present invention;

FIG. 55 is an eleventh specimen of representative data useful in connection with determining a premium structure for the present invention;

FIG. 56 is a twelfth specimen of representative data useful in connection with determining a premium structure for the present invention;

FIG. 57 is a thirteenth specimen of representative data useful in connection with determining a premium structure for the present invention;

FIG. 58 is a fourteenth specimen of representative data useful in connection with determining a premium structure for the present invention;

FIG. 59 is a specimen of representative marketing documentation including a graphical representation of a pay out pattern for the present invention; and

FIG. 60 is a fifteenth specimen of representative data useful in connection with determining a premium structure for the present invention.

DETAILED DESCRIPTION OF THE INVENTION

According to the present invention, the incidence of litigation (especially medical malpractice claims) is reduced because a credible threat of a funded counterclaim (claims within the suit, or separate countersuit, say for prosecution of a frivolous claim) exists. That threat is created and backed up by the availability of "counterclaim insurance" which, under appropriate conditions, will pay the costs of any counter litigation against the proponent of a claim and/or complaint. Potential defendants in such a counterclaim could include the original plaintiff (i.e., in a medical malpractice context, the patient who had claimed injury), the original plaintiff's attorney, and any expert on behalf of the original plaintiff. The insurance of the invention could be offered as a separate insurance policy, but more preferably could be offered as a rider, e.g., to a standard medical malpractice insurance policy.

Once an applicant has been accepted for coverage under a policy or rider of the insurance according to the present invention, the insured's name and other data would be entered into the carrier's computer system. In addition to all the standard processing that would normally be carried out in connection with the issuance and support of a policy of insurance, the system would copy the insured's name to a database of covered individuals to be publicized. It is believed that the publicizing of names of those insured, such as physicians covered by the insurance, will deter the filing of such claims as frivolous medical malpractice claims because those who might bring such claims would have to consider the possibility that the physician might prevail in defending against the claim and would then institute a counterclaim, e.g., for malicious prosecution.

Note again that the counterclaim insurance could work the other way around, for example, if an attorney files suit for non-payment of a legal bill, the insurance policy could fund a malpractice counterclaim or separate proceeding against the attorney. In providing an incentive not to litigate, the insurance could fund completely unrelated causes of action: slip-and-fall complaint by a sailor could trigger a maritime countersuit, or whatever.

The database of names of those covered preferably will be available to the public via a public data network such as the Internet or World Wide Web. However, the database could also be available on a private network, or on a dial-up "BBS" or "bulletin board system." Preferably, all providers of counterclaim insurance would make their databases of those covered available at a common location.

It is preferred that public access to the database be without cost to the computer-querying member of the public, so as not to discourage potential plaintiffs or their attorneys from querying the database. In the case of a dial-up or BBS embodiment, a toll-free telephone number can be provided.

In the most particularly, preferred embodiment of the invention, each insurance carrier or broker would maintain its own database of covered individuals linked to, and accessible by, a common search engine on a single World Wide Web site on the Internet or other front end network gateway. Alternatively, each insurance carrier or broker would upload the names from its proprietary database to a single data base accessible from a single World Wide Web site. According to any of these alternatives, those who query the database would be advised to do so again after a suitable interval (e.g., a few days later) in case a covered's name is in the process of being added to the database or, particularly in the case where the public site is a common search engine that searches the databases of several insurance companies to which it is linked, because the connection to one or more of the linked databases may be temporarily inoperative.

Whatever public access vehicle is chosen, its existence would be publicized by advertisements, e.g., in the general press and in publications aimed at attorneys who handle plaintiff's cases, such as medical malpractice litigation. The advertising would encourage potential plaintiffs or their representatives to check the database for the name of any potential defendant prior to initiating legal action. It then would be foolish for anyone to initiate a frivolous medical malpractice action without checking the database.

Counterclaim insurance according to the invention can be offered either as a separate policy or as a rider preferably to a professional (e.g., medical) malpractice liability insurance policy. Either way, in a preferred embodiment, if a counterclaim, claim, suit, administrative proceeding, or the like is brought under the policy, and damages are awarded against the proponent, then the insurer will collect a portion (e.g., between 30% and 60%) of the damages as compensation for funding the suit, and to cover administrative costs of administering the program for all policyholders. Therefore, in a preferred embodiment, any premium charged to policyholders will be minimal. Indeed, if insurance according to the invention is offered as a rider to a malpractice insurance policy, there may not need to be any additional charge beyond the premium charged for the underlying malpractice insurance policy, though of course there would be a premium for the overall coverage including the counterclaim coverage. This is because the damages recovered in successful counterclaims, plus the reduction in nuisance settlement payments on underlying malpractice claims, preferably would offset for the costs of offering and administering the insurance program and the costs of prosecuting counterclaim.

In addition, almost anyone who desired the added coverage would be eligible. At one extreme is the "good" physician whose competence is beyond question and who is rarely sued. Such a physician is a good risk for counterclaim insurance because the physician will rarely, if ever, make a claim for insurance benefits. At the opposite extreme is the "bad" physician who is sued frequently and frequently settles or loses. This physician also is a good risk for counterclaim insurance. In a preferred embodiment, the requirements for eligibility for insurance benefits with respect to a particular claim are that the underlying lawsuit proceeded to a favorable termination for the covered individual or company. In another preferred embodiment, the benefit requirements can be more restrictive, e.g., favorable judgment or even favorable judgment without being settled. In yet another preferred embodiment, the benefit requirements can be even more restrictive, e.g., that an independent review of the underlying claim concludes that the underlying claim was frivolous. Therefore, depending on the restrictiveness of the benefits, the "bad" physician who settles the underlying claim would not be eligible for benefits. For the cases where the "bad" physician does not settle and prevails on the underlying claim, there is no reason why that physician should not be eligible for benefits if the malpractice claim was frivolous.

The worst risk from the point of view of the insurer could be the physician who is sued frequently but always prevails. Preferably, the insurer's share of the recovery in a successful counterclaim would be available to fund other counterclaims on behalf of other covered physicians, spreading the cost of counterclaims over all covered physicians. In the case of a physician who is sued frequently, always wins, and then always counterclaims, any counterclaim recoveries would go toward funding subsequent counterclaims on behalf of the same physician, possibly without leaving enough to fund counterclaims on behalf of other covered physicians. Still, it is also possible that the recoveries would have a punitive component such that the recoveries would be well in excess of the cost.

As discussed above, benefits can be structured so that they are not available in connection with a claim that is settled, or, of course, lost. Moreover, even if a case is won, it is still possible that the claim was not frivolous. Therefore, depending on the benefit structuring, as discussed above, as part of the plan of insurance, an independent review of the underlying claim, to determine whether or not it could be proved to have been frivolous, is conducted when a claim for counterclaim benefits is made.

In a preferred embodiment, the independent review is conducted by an attorney retained by the carrier. The attorney could be an in-house attorney, but could be one of several outside attorneys retained by the carrier for this purpose. Alternatively, it may be possible to develop a set of criteria that could allow an objective determination of the qualification for benefits to be made, at least in the first instance, by a computer, based, e.g., on responses by the physician to a questionnaire developed for this purpose. If a computer is used to make the initial determination of qualification for benefits, then preferably there is opportunity for human review of that decision. In one embodiment, human review would come only if the determination was made that there was no frivolousness, in which case the covered physician could ask for a review. In another embodiment, the computer determination would include a quantitative ranking, and whenever that ranking was not overwhelmingly toward the determination that was made (either for or against the benefits) a review would be conducted. As a failsafe, any determination of frivolousness would receive a de facto review by the attorney to whom the counterclaim was assigned, as part of his or her preparations for bringing the counterclaim.

In carrying out a preferred embodiment, as viewed from a computer'science standpoint, there is a computer-assisted or computer-implemented method for determining a premium structure for insurance providing coverage including funding counterclaim (i.e., both counterclaim litigation within the context of one suit and separate countersuit litigation, or even a motion, etc.--responsive to a frivolous position). The invention includes apparatus (machine), method of making and method of using the same, an article of manufacture (e.g., software on a disk), data base, data structures, and necessary intermediates, all of which can be summarized with reference to the method for the sake of brevity). The method include receiving actuarial data and census data, at least one of said data including indicia of litigation frequency and cost, the data in a predetermined format corresponding to computer operations; calculating a premium structure, based upon the actuarial data and the census data, for the insurance; and generating insurance documentation including premium structure.

More particularly, the step of receiving the actuarial data and census data can be carried out at an actuarial or other computer system; the step of calculating a premium structure can be carried out at a carrier computer system located remotely from the actuarial or other computer system; and there can further be the step of: communicating the actuarial data and census data from the actuarial computer system to the carrier computer system by a computer-to-computer communications device, such as a modem or the like.

In any of the embodiments, the there can be further steps of: receiving premium payment data for the insurance; receiving claim data for the insurance; calculating an updated premium structure, based upon the claims data, for the insurance; and generating documentation including the updated premium structure for the insurance.

More over, the step of generating can be carried out by a carrier computer system and the step of receiving the premium payment data can be carried out by inputting information (preferably) at a computer system remote from the carrier computer system and (preferably) by further including the step of: communicating the information to the carrier computer system by a computer-to-computer communications device.

Any of the embodiments can further include the steps of: inputting broker information at the computer system remote from the carrier computer system; communicating the information to the carrier computer system; and calculating an updated premium structure based upon broker information.

Again, in any of the embodiments, the step of generating can be carried out by a carrier computer system and the step of receiving the claim and/or payment data can be carried out by inputting information (preferably) at a computer system remote from the carrier computer system and (preferably) by further including the step of: communicating the information to the carrier computer system by a computer-to-computer communications device. This is especially preferable in connection with calculating an updated premium structure based upon the claim information, say, from a claimant computer and payment data from an insured's computer system.

Still again, in any of the embodiments, the invention can be carried out by further including the steps of receiving premium payment data for the insurance, the payment data including respective names corresponding to coverage by the insurance; posting the names and indicia of the coverage by the insurance on a front end network gateway to provide a warning at remote terminals, especially by using the Internet--particularly the World Wide Web--as the front end network gateway.

Additionally, any of the embodiments can further include the steps of: receiving, at an intermediary computer (for example), the actuarial data and census data, at least one of said data including indicia of litigation frequency and cost, the data in a predetermined format; and calculating, at the intermediary computer (for example), a premium structure, based upon the actuarial data and the census data, for an independent verification of the premium structure.

Also, in any of the embodiments, the actuarial data can include indicia of suits eliminated, reduced settlement cost for suits, defense cost, frequency of claims, the cost of the claims, reduction in medical malpractice cost, and/or indemnity savings.

Note that, in any of the foregoing, calculating the premium structure can include calculating a premium cost for the counterclaim brought as a counterclaim, a separate countersuit, or an administrative complaint, especially for frivolous suit or litigation.

All of the embodiments can be carried out by further including the steps of: generating marketing documentation including a graphical representation of a pay out pattern corresponding to the insurance coverage, especially where the actuarial data is carried out with actuarial data including indicia of a reduction in medical malpractice cost. However, as previously mentioned, the invention embodiments can be viewed such that the step of calculating the premium structure includes calculating a premium cost for the counterclaim brought as a countersuit to a professional malpractice cause of action, especially for litigation cost for really any frivolous litigation, including or not including counterclaim cost. It is only preferred that the step of calculating the premium structure includes calculating a premium cost for the counterclaim brought as a medical malpractice cause of action.

It is envisioned that in carrying out the foregoing method, there can be at least one digital electrical computer and data processing system comprising: a digital electrical computer, an input device for inputting data electrically connected to the digital electrical computer, and an output device electrically connected to the digital electrical computer, wherein the digital electrical computer is controlled by a computer program to form a programmed digital electrical computer for processing input electrical signals, the input electrical signals being produced in response to information entered at the input device, the information including actuarial data and census data, at least one of said data including indicia of litigation frequency and cost, the data in a format specified by the computer program, the processing including modifying the input electrical signals into output electrical signals representing a projection of a premium structure, based upon the actuarial data and the census data, for insurance funding of a counterclaim, the output electrical signals being communicated to the output device which, in response to the output electrical signals, generates a depiction of the projection. The foregoing computer system can be made by providing a digital electrical computer having a programmable processor, an input device for inputting data electrically connected to the digital electrical computer, an output device electrically connected to the digital electrical computer; programming the processor (preferably with an article of manufacture such as a program stored on memory such as a diskette), to control the digital electrical computer for processing input electrical signals, the input electrical signals being produced in response to information entered at the input device.


Methods and apparatus for selecting an insurance carrier for an online insurance policy purchase
System and method for generating and executing insurance policies for foreign exchange losses
Insurance form indicia system

PAT. NO. Title
7,203,734 Methods and apparatus for selecting an insurance carrier for an online insurance policy purchase
7,203,654 Method of expediting insurance claims
7,194,416 Interactive creation and adjudication of health care insurance claims
7,143,051 Method and system for quoting, issuing, and administering insurance policies including determining whether insurance policies are self bill or list bill
6,615,181 Digital electrical computer system for determining a premium structure for insurance coverage including for counterclaim coverage
6,604,080 Computer system and methods for supporting workers' compensation/employers liability insurance
6,598,879 Method of playing blackjack with hit insurance
6,594,635 Data processing system for providing an efficient market for insurance and reinsurance
6,585,588 Multiple play high card game with insurance bet
6,584,446 System for underwriting a combined joint life and long term care insurance policy which is actuarially responsive to long term care demands and life expectancies of the individual insureds
6,561,903 System and method for generating and executing insurance policies for gambling losses
6,540,230 Method and apparatus for playing a card game including a bust insurance option
6,526,386 System and method for automatically generating automobile insurance certificates from a remote computer terminal
6,456,979 Method of evaluating a permanent life insurance policy
6,386,444 System and methods for card payment instrument with rebate applied to an insurance premium
6,347,302 Apparatus and method for processing lease insurance information
6,343,272 System for analyzing and managing equity participation life insurance and annuity contracts
6,343,271 Electronic creation, submission, adjudication, and payment of health insurance claims
6,338,040 Method for delaying the development in pest species of resistance to control techniques, using insurance to encourage correct uses of refuges
6,330,541 System and method for controlling and securitizing the cash value growth and/or death benefits of a large pool of insurance policies
6,254,482 System and method for generating and executing insurance policies for gambling losses
6,236,973 Apparatus and method for providing collateral construction loan insurance coverage
6,233,563 Insurance verification system and method
6,185,540 Insurance estimating system
6,182,048 System and method for automated risk-based pricing of a vehicle warranty insurance policy

  Copyright © 2006 - 2015 Patent Information Search