System and method for processing data related to group insurance for multiple risks

Abstract

A computer system for processing of data associated with insurance coverage includes a data storage device storing data indicative of: an insured; a maximum benefit amount payable under the insurance coverage; a first category of risks; a second category of risks; a first benefit allocation corresponding to the first category of risks; and a second benefit allocation corresponding to the second category of risks; the benefit allocations being fractions of and totaling the maximum benefit amount. A processor of the system is configured to, responsive to the receipt of data indicative of a claim, determine eligibility for a benefit, and responsive to determining that the insured is eligible, provide output data indicative of a benefit amount, the benefit amount for each of the categories of risks having a maximum equal to the corresponding benefit allocation.

What is claimed is: 
     
         1 . A computer system for processing of data associated with insurance coverage available for eligible employees through an employer, comprising:
 a communication device configured to provide data communications between two or more devices;   a hardware server computer in communication with the communication device and comprising:   one or more data storage devices storing non-transitory computer-readable program code;   one or more processors, in communication with the one or more data storage devices and the communication device, the program code causing the one or more processors to:
 configure for display on a display device available insurance coverage parameters for employee choice, including:
 a maximum benefit amount for the insurance coverage; 
 a plurality of available categories of risks for the insurance coverage; and 
 a benefit allocation corresponding to each of the categories of risks for the insurance coverage; 
 
 receive via the communication device data indicative of employee choices of insurance coverage parameters, including:
 a maximum benefit amount payable under the insurance coverage; 
 a first category of risks under the insurance coverage; 
 a second category of risks under the insurance coverage; 
 a first benefit allocation corresponding to the first category of risks; and 
 a second benefit allocation corresponding to the second category of risks; 
 the employee-chosen benefit allocations being fractions of and totaling the employee-chosen maximum benefit amount payable under the insurance coverage; 
 
 responsive to receipt of the employee choices of insurance coverage parameters, determine eligibility of the employee for the employee-chosen coverage; and 
 responsive to determining that the employee is eligible for the employee-chosen coverage, issue coverage to the employee in accordance with the employee-chosen coverage, the issuing comprising storing in the data storage device data indicative of the employee-chosen insurance coverage parameters and instructions for approval of benefit amounts responsive to approved claims under the coverage, the benefit amount for each of the categories of risks having a maximum equal to the corresponding benefit allocation. 
   
     
     
         2 . The computer system of  claim 1 , wherein the first category of risks comprises one or more risks relating to accidents. 
     
     
         3 . The computer system of  claim 2 , wherein said one or more risks relating to accidents comprise at least one of health risks relating to accidents and at least one of risks other than health risks relating to accidents. 
     
     
         4 . The computer system of  claim 1 , wherein said first category of risks comprises health risks and said second category of risks comprises one or more categories of risks other than health risks. 
     
     
         5 . The computer system of  claim 1 , wherein the program code further causes the one or more processors to store in the one or more data storage devices instructions for determining eligibility of a received claim for benefits by accessing data indicative of one or more risk factors associated with each of the employee-chosen categories of risks, and by determining that the claim is eligible only upon determining that received claim data identifying a risk factor corresponds to the stored data indicative of one or more risk factors for the category of risks. 
     
     
         6 . The computer system of  claim 5 , wherein said data indicative of risk factors comprises data indicative of at least one of the following: cause of illness, type of illness, cause of accident, type of accident, cause of disability, type of disability, and cause of death. 
     
     
         7 . The computer system of  claim 1 , wherein said program code further causes the one or more processors to store data indicative of instructions to, responsive to receipt of data indicative of a claim based on death of the employee, determine a benefit amount equal to: said maximum benefit amount minus a total amount of benefits paid under the insurance coverage for the employee for all categories of risks up to the date of death. 
     
     
         8 . The computer system of  claim 1 , wherein said program code further causes the one or more processors to receive data indicative of an employee choice of a third category of risks under the insurance coverage and data indicative of a third benefit allocation corresponding to the third category of risks, and the computer program code further causes the one or more processors to, responsive to receipt of data indicative of an employee decision to cancel coverage with respect to the third category of risks, determine and store in the data storage device data indicative of a reallocation of the third benefit allocation equally among all remaining categories of risks. 
     
     
         9 . The computer system of  claim 1 , further comprising a payout module in communication with the communication device, the payout module configured to receive data from the server indicative of a benefit amount, and to effect payment to the employee in accordance with the received data indicative of the benefit amount. 
     
     
         10 . A computer-implemented method for processing data associated with insurance coverage available to eligible members of a group, comprising:
 configuring by one or more processors of a hardware server, for display on a display device, available insurance coverage parameters for group member choice, including:
 a maximum benefit amount for the insurance coverage; 
 a plurality of categories of risks for the insurance coverage; and 
 a benefit allocation corresponding to each of the categories of risks for the insurance coverage; 
   receiving by the one or more processors from an input device data indicative of group member choices of insurance coverage parameters, including:
 a maximum benefit amount payable under the insurance coverage; 
 a first category of risks under the insurance coverage; 
 a second category of risks under the insurance coverage; 
 a first benefit allocation corresponding to the first category of risks; and 
 a second benefit allocation corresponding to the second category of risks; 
 the group member-chosen benefit allocations being fractions of and totaling the group member-chosen maximum benefit amount payable under the insurance coverage; 
   responsive to receipt of the group member choices of insurance coverage parameters, determining by the one or more processors eligibility of the group member for the group member-chosen coverage; and   responsive to determining that the group member is eligible for the group member-chosen coverage, determining by the one or more processors to issue coverage to the group member in accordance with the group member-chosen coverage parameters, the issuing comprising storing in a data storage device in communication with the one or more processors data indicative of the group member-chosen parameters and instructions for approval of benefit amounts responsive to approved claims under the coverage, the benefit amount for each of the categories of risks having a maximum equal to the corresponding benefit allocation.   
     
     
         11 . The computer-implemented method of  claim 10 , wherein the first and second categories of risks comprise at least two insurable risks relating to accidents. 
     
     
         12 . The computer-implemented method of  claim 10 , wherein the first category comprises at least one of health risks relating to accidents and the second category comprises at least one of risks other than health risks relating to accidents. 
     
     
         13 . The computer-implemented method of  claim 10 , further comprising storing in the data storage device data indicative of a payout structure associated with each category of risks for payment of a determined benefit amount, the data indicative of a payout structure for each category of risks being data indicative of one of lump sum payment, multiple payments of predetermined amount, or multiple payments of variable amount based on investment performance of an investment vehicle. 
     
     
         14 . The computer-implemented method of  claim 13 , further comprising receiving by the one or more processors data indicative of a group member designation of a beneficiary under the coverage, storing in the data storage device the data indicative of a beneficiary under the insurance coverage, and instructions for causing a payout module to effect one or more payments to the group member or the beneficiary in accordance with the stored data indicative of the payout structure. 
     
     
         15 . The computer-implemented method of  claim 10 , further comprising receiving by the one or more processors a group member choice of a third category of risks under the insurance coverage and data indicative of a third benefit allocation corresponding to the third category of risks, and, responsive to receipt of data indicative of a group member decision to cancel coverage with respect to the third category of risks, determining by the one or more processors and storing in the data storage device data indicative of a reallocation of the third benefit allocation equally among all remaining categories of risks. 
     
     
         16 . The computer-implemented method of  claim 10 , further comprising storing in the data storage device data indicative of a pre-established set of criteria for permitting the group member to convert the coverage to portable coverage upon the member leaving the group. 
     
     
         17 . A non-transitory computer-readable medium having processor-executable instructions stored thereon, which instructions, when executed by one or more processors, cause one or more processors to:
 configure, for display on a display device, available insurance coverage parameters for choice by a member of a group, including:
 a maximum benefit amount for the insurance coverage; 
 a plurality of categories of risks for the insurance coverage; and 
 a benefit allocation corresponding to each of the categories of risks for the insurance coverage; 
   receive from an input device data indicative of group member choices of insurance coverage parameters, including:
 a maximum benefit amount payable under the insurance coverage; 
 a first category of risks under the insurance coverage; 
 a second category of risks under the insurance coverage; 
 a first benefit allocation corresponding to the first category of risks; and 
 a second benefit allocation corresponding to the second category of risks; 
 the group member-chosen benefit allocations being fractions of and totaling the group member-chosen maximum benefit amount payable under the insurance coverage; 
   responsive to receipt of the group member choices of insurance coverage parameters, determine eligibility of the group member for the group member-chosen coverage; and   responsive to determining that the group member is eligible for the group member-chosen coverage, determine to issue coverage to the group member in accordance with the group member-chosen coverage, the issuing comprising storing in a data storage device in communication with the one or more processors data indicative of the group member-chosen insurance coverage parameters and instructions for approval of benefit amounts responsive to approved claims under the coverage, the benefit amount for each of the categories of risks having a maximum equal to the corresponding benefit allocation.   
     
     
         18 . The non-transitory computer-readable medium of  claim 17 , wherein the plurality of categories of risks comprise death, accident, illness and disability. 
     
     
         19 . The non-transitory computer-readable medium of  claim 17 , wherein the instructions, when executed by the one or more processors, further cause the one or more processors to receive data indicative of a third category of risks under the insurance coverage and data indicative of a third benefit allocation corresponding to the third category of risks, and wherein the instructions, when executed by the one or more processors, further cause the one or more processors to, responsive to receipt of data indicative of achievement of a predetermined age of the group member, process data to effect cancellation of the third category of risk coverage and to reallocate the third benefit allocation among the remaining categories of risk coverage. 
     
     
         20 . The non-transitory computer-readable medium of  claim 17 , wherein the data indicative of first and second categories of risk comprises data indicative of at least one of health risks relating to accidents and at least one of risks other than health risks relating to accidents.