Patent Application
20190180379
The present invention relates to automated life and/or mortality classification, signaling and automated underwriting systems for real-time risk assessment and adjustment. Based on the real-time risk assessment and adjustment, specific risks associated with a risk-exposed individual are transferable from the risk-exposed individual to an automated insurance system by means of an expert system providing a fully automated underwriting risk transfer process based on the expert risk assessment and forecast classification.
The problems associated with risk transfer and risk pooling are integral elements in the operation of life insurance systems. By grouping individuals' risk, the insurance systems are able to cover losses based on possibly future arising risks, out of a common pool of resources captured by the insurance systems from associated individuals for the transfer of their risks. However, in order to maintain some degree of equity among individuals exhibiting different mortality risks, i.e., in order to derive a balance between a specific individual's transferred risk and the amount of its resources pooled in return, the insurance systems must capture, assess and classify the individual's risk according to appropriately selected or filtered criteria and accepted characteristics. Automated classification is the process of assigning an input pattern to one of a predefined set of classes. Classification problems exist in many real-world applications, such as medical diagnosis, machine fault diagnosis, handwriting character recognition, fingerprint recognition, and credit scoring, to name a few. Broadly speaking, classification problems can be categorized into two types: dichotomous classification and polychotomous classification. Dichotomous classification deals with two-class classification problems, while polychotomous classification deals with classification problems that have more than two classes.
Classification consists of developing a functional relationship between the input features and the target classes. Accurately estimating or forecasting such a relationship for future events is key to for precise classifier systems. Instrument or object underwriting, such as requests for human risk transfers, financial credits or loan risk transfers, catastrophe risk transfer or liability risk transfer is another area where these classification problems exist. An automated underwriting process for a risk instrument or object may consist of assigning a given real world object, described by its risk factors and other key input parameters, to one of several risk categories (also referred to as risk or rate classes). A trained human expert traditionally performs risk instrument or object underwriting, since this is normally a highly complex and non-linear process comparable to automated weather forecast systems, cannot be automated as such. A given application of factors for the specific risk instrument or object may be compared to a variety of underwriting rules/standards sets, which are typically predefined. Using underwriting rules/standards enables the instrument or object application to be classified into one of several risk categories available for a type of coverage requested by an applicant. The risk categories can affect the payment transfer structure (e.g., in terms of amount and timing) paid for the applied object or instrument, e.g., the higher the risk category, the higher the overall payment transfer balancing the corresponding risk transfer. A decision to accept or reject the risk transfer for the instrument or object may also be part of this risk classification, as risks above a certain tolerance threshold value may simply be rejected.
One problem associated with this approach in underwriting an instrument request is that there are a large number of features (individual measuring parameter, external or environmental measuring parameters, financial parameters, credit rating parameters, corporate structure parameters, market parameters) and rules/standards that underwriters must take into account in assigning the instrument request to one of several risk categories (or rate classes). With the large number of features, rules/standards and risk categories, it is very difficult and time consuming or even impossible, especially for human experts, to consider all of the information necessary to make a decision; furthermore, the results are often inadequate in terms of consistency and reliability. The inadequacy of this process becomes more apparent as the complexity of object or instrument applications increases.
Another technical problem with automated underwriting processes is that the underwriting standards typically do not cover all possible cases and variations of a request for risk transfer of a real world object or instrument. The underwriting standards may even be self-contradictory or ambiguous, leading to uncertain application of the standards. As a result, the subjective judgment of the underwriter may play a role in the process. Variations in factors such as human underwriter training and experience and a multitude of other effects can cause different underwriters to issue different, inconsistent decisions. Sometimes these decisions can be in disagreement with the established underwriting standards of the risk transfer system, while sometimes they can fall into a “gray area” not explicitly covered by the underwriting standards. Further, there may be cases in which an underwriting decision could still be considered correct, even if it disagrees with the predefined underwriting standards. This situation can be caused when underwriting is based on real-world experience to determine whether the underwriting standards should be adjusted. Different underwriters may make different determinations about when these adjustments are allowed, as they might apply stricter or more liberal interpretations of the underwriting standards. Thus, the judgment of experienced underwriters may be in conflict with the desire to apply the underwriting standards consistently.
Historically, for a given risk transfer with a specific underwriting process, rates have been triggered by age and sex, and approximately nine-tenths of applicants have been accepted at the standard rate, the rest being individually rated or declined. However, beginning in the late 1960s, insurance systems started to measure and consider more criteria; for example, non-smokers were charged lower rates. In the early 1990s, the process of adjusting the insurance systems' risk assessment further expanded to segregated sex and smoker-distinct live risks employing other criteria. This continued segmentation of the standard class attempts to reduce mortality cross-subsidies in which better risks financially subsidize poorer risks, and thus refining and stabilizing the overall operation of the insurance systems. Each of a newer and smaller class is expected to display a narrower distribution of mortality than the larger class from which it emerged. In this application, preferred lives or life risks are risks chosen according to measurable and triggerable criteria in addition to sex and tobacco use and which are expected to experience lower mortality as a group than the remaining non-rated lives of the same age, known as residual lives or residual lives risks or residual standard. So-called preferred life insurance systems are characterized by the generation of separate premium rates for preferred and residual live risks of the same age classified into two or more classes based on expected differing mortality.
A selected preferred group is expected to exhibit, on average, lower mortality than the residual group of individuals' risks. This does not mean that all preferred live risks have a lower expected mortality than all residual lives, but that, when taken as a group, they can be expected to. At a most elementary level in the prior art, the preferred lives concept, implemented in insurance systems, divides the standard sex- and smoker-distinct class into two classes by the use of certain admission criteria, which are objectively defined and measured and which are known to be predictive of relative mortality. At the extreme end of the application of the preferred life insurance system, this method results in a unique rate charged for a particular individual based on that individual's unique mortality risk profile. As long as death remains haphazard, the operational principle of the insurance systems is left intact. By removing any existent mortality cross-subsidy from the insured pool, i.e., the pooled individuals' risks by the insurance system, the most dissected, preferred life insurance systems represents the opposite of charging all pooled, i.e., insured, individuals an identical rate, thereby balancing the risk over all associated individuals whose risk was transferred to the system. Therefore, such systems operate on complete risk transfer equity as opposed to complete risk transfer equality.
A critical point for the operational risk management for such insurance systems typically involves consideration of one or more criteria, which are correlated to an event or events influencing the transferred risk. The ability to predict the frequency or eventual likelihood of occurrence of such critical events has value and utility in many settings. Often, different insurance systems use different sets of criteria to assess the expected occurrence of the same (or similar) events. In some cases, the same insurance systems may also use different criteria sets in differing situations or differing times. Methods and systems for comparing different criteria sets are useful tools in the selection of criteria and the design and development of related products. However, in the case of coupling the insurance system with a second insurance system, such as a mutually synchronized reinsurance system for seamless risk transfer within a negotiated parameter range, or in order to compare products from competing insurance systems, or designing new preferred products to replace or augment existing products, the differing operation of the insurance systems makes it difficult or even impossible to use methods able to take such differences into account. Clearly, such a comparison may also be useful in the selection of criteria and pricing of related products, and in determining the impact of criteria changes or granting various exceptions to criteria on pricing and potential profitability of such products.
Another critical point for the operation of such insurance systems is the complex process for assessing the appropriate risk of an individual on a mortality-consistent basis. A mortality-consistent basis means that a generated mortality assumption for a certain value or parameter is providing a correct value to individuals using the mortality-consistent. This is especially important for coupling a plurality of primary insurance systems to a second insurance system, i.e., a reinsurance system, to hedge the operational risk and improve stability of the first insurance system by transferring the pooled individuals' risks at least partly to the second insurance system. Furthermore, incorporating the thought process of underwriters during risk assessment and risk categorization is technically complex. In the prior art, there are different systems, disclosing an approach to the discussed problems. For example, U.S. Pat. No. 4,975,840 by A. DeTore et al. discloses a system for assessing the insurability of a potentially transferrable, i.e., insurable, risk, wherein the system comprises the ability to correlate selected elements of information in respective databases. Certain elements are assigned weights, e.g., relative risk ratios, based on predetermined relationships existing between elements of information in one database and corresponding elements of information in another. A risk classification is determined for the potentially insurable risk from the assigned weights. However, the weight must necessarily be assigned to a selected element based on the information in the databases manually, e.g., by an underwriter. For example, the underwriter typically must assign a risk classification based on a manual review of data and comparison with existing criteria. Furthermore, the system is not able to provide an easy-to-use, real-time risk assessment by assessing the risks and classifying and/or categorizing them as technically required by preferred life insurance systems, though the systems comprise the ability to assign a different weight to an element of information, to use statistical profiles to adjust assigned weights, and to determine expected profitably resulting from decisions concerning a particular risk manually. Thus, this system is not able to manage and reduce the workload and customize operation of the insurance system, as required. It is also not able to create an easy-to-use risk assessment and risk categorization instrument by automating and/or incorporating up-to-now necessarily, manually conducted processes. Furthermore, U.S. Pat. No. 6,456,979 by B. Flagg shows another system of the prior art for assessing individuals' risks by establishing a benchmark cost of insurance value, obtaining a policy illustration for the transferred risk, resolving a cost of insurance value, and comparing the benchmark cost of insurance value with the illustrated cost of insurance value. Yet another prior art system is disclosed by US 2003/0236685 by E. Buckner et al. In this system for assessing the individual's risk, mortality data are electronically synthesized from a plurality of different insurance systems. A data engine processes the mortality data and synthesizes benchmark data to present the analyses. User inputs at remote computers are requested by the system, wherein these inputs are needed to process the risk assessment relative to one or more preferred life risk scenarios, such as age, height, weight, gender, blood pressure, cholesterol, family history of cancer, family history of heart attack, family history of stroke, smoker or non-smoker status, and smoking history.
However, all of the prior art systems are not able to completely solve the most important technical difficulties that arise from capturing and assessing the risk that is associated with preferred incidents, i.e., the fully automated and easy-to-operate risk assessment system. The prior art systems are not able to perform real-time risk assessment for preferred life insurance system, i.e. a classification-based and/or classification-sensitive risk-transfer system. Moreover, they are not able to perform the risk assessment on a mortality-consistent basis. The ability to arrive at a precise measurement of an individual's preferred risk exposure is fundamental, inter alia, for the technical operation of risk-transfer systems or damage prevention/recovery systems, such as associated automated resource and risk pooling systems or automated insurance systems. The associated problem extends to the fact that the overall risk is typically spread out over various single risks. Correspondingly, the different criteria and classes should be triggered appropriately. The overall associated or pooled risk cannot be captured or weighed on an automated basis by preferred life insurance systems as envisioned by the prior art providing an appropriate risk transfer.
It is an object of the present invention to provide an automated real-time risk assessment, adjustment and underwriting system and method for measuring, accumulating and monitoring life risks, thereby providing an underwriting and signaling system for the transfer of specific risks associated with a risk-exposed individual from the risk-exposed individual to a first insurance system and/or from the first insurance system to an associated second insurance system based on the real-time risk assessment, adjustment and automated underwriting. Furthermore, it is also an object of the present invention to provide a system and method for risk assessment and sharing of life risks on a mortality-consistent basis. It is a further object of the present invention to provide a system and method for real-time risk assessment and sharing of life risks. It is another object of the present invention to provide a system and method making it possible to incorporate and automate the underwriting process, refining the process and allowing for the best possible risk categorization on a completely automated basis. Finally, it is an object of the present invention to provide an automated real-time system for the current underwriting process for life insurance that does not require laboratory tests (blood and/or urinalysis) or other laborious tests to ascertain by measuring the insurance applicant's smoking behavior, and which is less costly and time-intensive compared to the complex systems of the prior art. The system should allow for a rapid, automated process (seconds to minutes), such as an automated “fluid-less” underwriting process and system, competitively generating life insurance risk-transfer terms, i.e., optimized risk-transfer and payment-transfer parameter for the systems to be operated. The system should allow for substituting the mostly non-automatable underwriting process of the prior art, typically conducted by human experts.
According to the present invention, these objects are in particular achieved by the features of the independent claims. In addition, further advantageous embodiments can be derived from the dependent claims and related descriptions.
According to the present invention, the above-mentioned objects related to real-time risk assessment, adjustment, signaling and underwriting are achieved by means of an automated, real-time mortality classification and signaling system based on an automated selective multi-level triage process, wherein risks associated with a plurality of risk-exposed individuals are at least partially transferable from a risk-exposed individual to a first insurance system and/or from the first insurance system to an associated second insurance system, wherein the system comprises a table with retrievable stored risk classes each comprising assigned risk class criteria, wherein individual-specific parameters of the risk exposed individuals are captured relating to criteria of the stored risk classes by means of the system and stored in a repository unit, and wherein a specific risk class associated with the risk of the exposed individual is identified and selected from said stored risk classes via the system based on the captured parameters, in that individual-specific parameters of the risk-exposed individuals comprise at least individual-specific parameters indicating a captured self-declaration of smoking or non-smoking of the risk-exposed individuals, wherein upon triggering the individual-specific parameters indicating a captured self-declaration of smoking of a risk-exposed individual by means of first trigger parameters, the risk-exposed individual is automatically assigned to a first triage channel, in that upon triggering individual-specific parameters indicating a captured self-declaration of non-smoking of risk-exposed individuals by means of second trigger parameters, the triggered individual-specific parameters are processed by a machine learning-based pattern recognition module automatically assigning risk-exposed individuals with detected non-smoking patterns to a second triage channel as predicted non-smokers, and automatically assigning risk-exposed individuals with detected smoking patterns to a third triage channel as predicted smokers, in that for a detected risk-exposed individual in the third triage channel, the system requests and captures laboratory-scaled individual-specific parameters, wherein the laboratory-scaled individual-specific parameters are measured by means of laboratory measuring devices, and the laboratory-scaled individual-specific parameters are triggered for measured smoking and not-measured smoking, in that for the real-time risk assessment, a relative mortality factor is measured based on the captured risk-related individual data and the measured smoking or non-smoking parameter corresponding to the assigned channel, wherein based on the real-time risk assessment by means of the measured relative mortality factor, the risk associated with the risk-exposed individual is transferable from the risk-exposed individual to a first insurance system and/or from the first insurance system to the associated second insurance system. The relative mortality factor can for example be measured based on the captured individual's specific parameter assignable to corresponding risk class criteria of the risk classes, wherein the risk class criteria comprise at least a risk class criterion indicating smoking or non-smoking, and wherein for risk-exposed individuals in the first triage channel, the risk class criteria indicating smoking or non-smoking is automatically set to smoking, for risk-exposed individuals in the second triage channel to non-smoking, and for risk-exposed individuals in the third triage channel according to the laboratory-scaled, measured smoking or non-smoking parameters. For transferring a risk associated with the risk-exposed individual from the risk-exposed individual to a first insurance system and/or from the first insurance system to the associated second insurance system, an appropriate activation signaling is generated by the automated system via the control circuit and transmitted to the first insurance system and/or to the associated second insurance system and wherein the risk transfer is mutually synchronized between the first and second insurance system. The invention has, inter alia, the advantage that a completely automated, “fluid-less” underwriting structure can be provided by the system generating optimized life insurance terms in real-time. No costly and time-intensive processes, such as laboratory tests (blood and/or urinalysis), human interrogations or the like, are required, or are required only for a very small percentage of risk transfer requests. The inventive system is capable of completely substituting the prior art processes in the context of risk transfer underwriting and risk assessment associated with or affected by smoking and non-smoking behavior of risk exposed individual. Furthermore, the system is able to provide a high performance for the inventive, “fluid-less” underwriting process based on detecting “smoker propensity”, wherein the applied smoker detection system and solution provides sensitivity, specificity that equals or exceeds prior art techniques but is fully automated, especially based on the best medical screening tests, and is unachievable thus far by all known prior art systems. The system makes it possible to identify smokers from an insurance application, which is difficult using prior art systems due to the potential large number (typically around 50%) of non-disclosed smokers, i.e., actual smokers claiming to be non-smokers. Though the prevalence of tobacco use in insurance applicants (typically around 2%-10% smokers) is usually below the general population (e.g., US population with 16%-20% smokers), the present system is capable of reliably detecting smokers using smoker characteristics, which no prior art system is able to provide. The system also provides a fully automated structure to analyze the cost impact of prediction errors (i.e., misclassification of smokers as non-smokers) and savings from the absence of lab testing for a majority of applicants. Only a very small portion of risk transfer requests have to undergo lab testing. Using the present system, it is possible to generate, dynamically and in a new way, parameters for age, gender, term, and face amount requirements for a client-specific life product that results in a positive net present value (NPV) or net present worth (NPW), which is the sum of the present values (PVs) of incoming and outgoing cash flows of the first insurance system, i.e., the benefit and cost cash flows, over a defined period of time. Furthermore, the present invention has the general advantage of being capable of providing the technical requirements for risk assessment, underwriting and sharing of life risks on a mortality-consistent basis and in a fully automated way. Further, this invention has the advantage of providing a real-time system and method for real-time risk assessment, underwriting and sharing of life risks. Finally, the present invention makes it possible to incorporate and optimize the process of underwriting by technical means, thereby refining the process and allowing for the best possible risk categorization on a completely automated, fast, real-time basis. In summary, the inventive system allows a new technical approach for automated operated, predictive risk-transfer systems, as expert systems, based on the use of (1) a predictive modelling for learning parameters about risk assessment of risk-exposed individuals; (2) a three channel triage process based on applying the predictive model parameters to captured risk-exposed individuals; (3) Cost-benefit analysis of prediction errors in part-1 in order to design life risk-transfer parameters (e.g. age, gender, term, face amounts) that have high likelihood of generating positive operational NPV (net present values) for applications processed through part-1 and part-2, which is a necessary requirement for the stable, automated operation of the system; (4) an ongoing validation process that diverts a percentage of predicted non-smokers for lab testing in order to collect results about the risk-exposed individual's actual smoking or nonsmoking habit and compare them against predicted smoking or non-smoking habit and re-learn the predictive model if comparison indicates high error rates.
In one alternative embodiment, the machine learning-based pattern recognition module is based on random forest processing as an ensemble learning structure for classification, regression and prediction, wherein the pattern recognition module operates by constructing a multitude of decision trees at training time and outputting the class that is the mode of the classes or mean prediction as regression of the individual trees. This alternative embodiment has the advantage, inter alia, that through the random forest processing, the random decision forests correct for decision trees' habit of overfitting to their training set. By selecting a random subset of features, it is possible to implement the “stochastic discrimination” approach to classification. Therefore, the use of random forest processing has the advantage of applying a method that is resistant to overtraining according to the theory of stochastic discrimination. Furthermore, the random forest structure allows for ranking the importance of variables in the present classification and risk assessment problem in a natural way. Note that if the parameters contain groups of parameters of correlated features of similar relevance, then smaller groups are favored over larger groups. However, in the present invention, only a small number of input parameters are needed, thus avoiding the aforementioned problem. In the present application, Random Forest predictors naturally lead to a dissimilarity measure between the observations. The present system also makes it possible to define a Random Forest dissimilarity measure between the captured data. As a result, the present system also makes it possible, via the Random Forest predictor used, to distinguish measured or captured real data from suitably generated synthetic data. The observed data are the captured unlabeled data, and the generated data are for example drawn from a reference distribution or simulated Monte Carlo distribution. The RF dissimilarity makes it possible to handle mixed variable types without problems, is invariant to monotonic transformations of the input variables, and is robust to outlying observations. The Random Forest dissimilarity also makes it easy to deal with a large number of semi-continuous variables due to its intrinsic variable selection, which is, for example, that it weighs the contribution of each variable according to how dependent it is on other variables. The application of Random Forest has the further advantage of producing for many cases the best results for the present invention.
However, the result may depend on the captured or measured data set.
In another alternative embodiment, the machine learning-based pattern recognition module is based on Gradient boosting (GBM) as a machine learning structure for regression, classification and prediction, wherein the pattern recognition module operates on a set or ensemble of weak prediction structures using classifiers that are only slightly correlated with the true classification and optimization by means of an arbitrary differentiable loss function. This alternative embodiment has the advantage, inter alia, that it provides a prediction model in the form of a set of weak prediction models, which can for example be chosen as decision trees. It thus makes it possible to build the model in a stage-wise fashion, thereby generalizing it by allowing optimization of an arbitrary differentiable loss function.
In another alternative embodiment, the machine learning-based pattern recognition module is based on support vector machines (SVM) as a machine learning structure for regression, classification and prediction, wherein for given sets or ensembles of individual-specific parameters of the risk-exposed individuals, each is marked for one of two definable categories, and wherein the pattern recognition module builds a structure that, by assigning new sets into one category or the other, makes it a non-probabilistic binary linear classifier or a non-linear classifier depending of the chosen kernel. This alternative embodiment has the advantage, inter alia, of providing another technical structure for the machine learning-based pattern recognition module by means of a machine learning support vector machine (SVM, also support vector networks) allowing supervised use of learning patterns and models with controllable, associated learning algorithms in order to process the captured risk-related individual data for risk classification and assessment. However, if supervised learning of the machine learning based pattern recognition module is not possible (e.g., due to lack of appropriate historical or simulated risk-related individual data related to their smoking and/or non-smoking behavior), the support vector machine structure has the advantage that it also allows unsupervised learning for the machine learning-based pattern recognition module, thereby finding natural clustering of the captured risk-related individual data to build up the first, second and third channels of the pattern recognition module. As underlying clustering algorithm to improve the support vector machine structure, support vector clustering can be applied for unlabeled risk-related individual data or to label the captured risk-related individual data by preprocessing the data for a classification pass.
In an even further alternative embodiment, the machine learning-based pattern recognition module is based on logistic regression as a machine learning structure for regression, classification and prediction, wherein the probability of a binary response is estimated based on one or more of the individual-specific parameters as predictors. This alternative embodiment has the advantage, inter alia, of providing another technical structure for the machine learning-based pattern recognition module, which is not a classification method as much, but is much more based on a qualitative response or on discrete choice data processing. As a further advantage, structuring the machine learning-based pattern recognition module by means of logistic regression needs only a few assumptions in the present case, i.e., assuming a standard logistic distribution of errors. However, if the assumptions of linear discriminant analysis hold, i.e., if linear discriminant assumptions are true, the logistic regression assumptions must hold. Since the reverse is not true, logistic regression data processing requires fewer assumptions than other machine learning structures, such as discriminant data processing, and does not make assumptions on the distribution of the independent variables, which can be advantageously due to the unknown distribution of false declared non-smoking risk-exposed individuals within the true declared non-smoking risk-exposed individuals.
In a further alternative embodiment, risks associated with a plurality of risk-exposed individuals are at least partially transferable from a risk-exposed individual to a first insurance system and/or from the first insurance system to an associated second insurance system by means of the automated mortality classification system, wherein an appropriate activation signaling is generated by the automated mortality classification system and transmitted to the first insurance system and/or to the associated second insurance system. This alternative embodiment has, inter alia, the advantage that the risk transfer can be fully automated, controlled and monitored using the system.
In another alternative embodiment, the number of pooled risk exposure components or risk-exposed individuals (as defined below) is dynamically adapted, via the resource pooling system within the automated mortality classification system, to a range where non-covariant, occurring risks covered by the resource pooling system affect only a relatively small proportion of the total pooled risk exposure components at any given time. This alternative has, inter alia, the advantage that it helps to improve the operational and financial stability of the system.
In a further alternative embodiment, the further criteria and/or related measuring parameters, apart from the declared smoking/non-smoking parameter, are dynamically adapted by means of an operating module based on time-correlated incidence data for a life risk condition indicating changes in the condition of the risk component, i.e., the corresponding individual. This variant has, inter alia, the advantage that changes or new occurrence in the criteria or in measurements of the criteria, condition and/or boundary parameters can be dynamically captured by the system and dynamically affect the overall operation of the system based on the risk of the pooled risk exposure of the risk-exposed individual. However, the system is also able to dynamically capture the move of a risk-exposed individual from a declared non-smoker to a declared smoker, or vice versa.
In an alternative embodiment, the system comprises means to automatically negotiate the risk class criteria between the first insurance system and second insurance system. This alternative has, inter alia, the advantage that the system, and especially the coupling of the first and the second insurance system, can be more flexible, and moreover dynamically adapted by the first and second insurance system. As a further alternative, said one or more risk classes can be associated with one or more criteria, and the system further modifies one or more of said criteria and re-determines the relative risk ratio and determines an impact of said modification on the relative risks associated with the products. One or more of said risk classes can for example be associated with different criteria, and the system further compares the risk classes based on said relative risk ratios. Furthermore, the system can for example redefine one or more of said risk classes based on the relative risk ratio. As an alternative, the system can also determine a separate relative risk ratio for sub-groups of risks, also in relation to the parameter of declared smokers/non-smokers. The system also can for example compare the prevalence data to industry empirical data for particular combinations of criteria, and adjusts the stored data to agree with the empirical data. All of these alternatives have, inter alia, the advantage that they make it possible to further improve the operation and the operational stability of the system during operation. Furthermore, they allow a more precise risk assessment for the pooling of life risks.
In yet another alternative embodiment, upon each triggering of an occurrence of measuring parameters indicating the occurrence of a life risk, a non-parametric payment or a total parametric payment is allocated with this triggering, and wherein the total allocated payment is transferrable upon the triggering of the occurrence of the life risk. This has the advantage, inter alia, that the inventive system is able to set amount limits, e.g., minima and maxima, for various first insurance systems and/or risk-exposed individuals. In the alternative embodiment of parametric payment, the payment can be leveled with regard to a predefined total payment sum that is determined at least based on the risk-related individual's data, and/or on the likelihood of the risk exposure for one or a plurality of the pooled risk-exposed individuals based on the risk-related data. The predefined total payments can for example be leveled to any appropriate lump sum or any other sum related to the total transferred risk and the amount of the periodic payments of the risk exposure component. This alternative has the advantage, inter alia, that the overall operation of the real-time automated mortality classification system together with the first and/or second insurance system can be fully automated. Furthermore, the parametric alternative has the advantage, inter alia, that the transfer of the payment by the automated insurance system, which depends on the measuring of an occurrence of a life risk event, allows for an adapted payment of the total sum that is dependent on the determined impact of the life risk event on the risk-exposed individual. In one alternative embodiment, a periodic payment transfer from the risk-exposed individual to a resource pooling system of the first insurance system via a plurality of payment receiving modules is requested by means of a monitoring module of the resource-pooling system, and wherein the risk transfer or protection for the risk-exposed individual is interrupted by the monitoring module, when the periodic transfer is no longer detectable by means of the monitoring module. As an alternative, the request for periodic payment transfers can be interrupted automatically or waived by means of the monitoring module, when the occurrence of indicators for a life risk event is triggered in a data flow pathway associated with a risk-exposed individual. These alternative embodiments have, inter alia, the advantage that the system allows for a further automation of the monitoring operation, especially of its operation with regard to the pooled resources. In addition, an independent verification trigger of the first or second insurance system can for example be activated in cases of a triggering of the occurrence of indicators for a life risk event in the data flow pathway of a risk-exposed individual by means of the trigger module, and wherein the independent verification trigger is additionally triggering for the occurrence of indicators regarding the concerned life risk event in an alternative data flow pathway with independent measuring parameters from the primary data flow pathway of the individual in order to verify the occurrence of the life risk event at the risk-exposed individual. As an alternative, the transfer of payments is only assigned to the corresponding risk-exposed individual if the occurrence of the life risk event at the risk-exposed individual is verified by the independent verification trigger. These alternative embodiments have, inter alia, the advantage that they help improve the operational and financial stability of the first and second insurance system. In addition, the system is rendered less vulnerable relative to fraud and counterfeit.
Finally, in addition to the system as described above and the corresponding method, the present invention also relates to a computer program product that includes computer program code means for controlling one or more processors of the control system in such a manner that the control system performs the proposed method; and it relates, in particular, to a computer program product that includes a computer-readable medium containing the computer program code means for the processors.
The present invention will be explained in more detail by way of example in reference to the drawings, in which:
The operation of the system 1 will be described in detail below. The first and second risk transfer parameters 211, 212, 213/311, 312, 313, can for example comprise parameters defining physical measuring parameters to detect the occurrence of a risk event at the risk-exposed individual 91, 92, 93, by means of the system 1 and/or time- or amount-related threshold values. The risk-exposed individuals 91, 92, 93, . . . can be any type of person associated with a life risk 9. A life risk is related to the probability for the occurrence of a life risk event in relation to risk-exposed individuals 91, 92, 93. The automated mortality classification system 1 includes at least a processor and associated memory modules. The operation of the system 1 is dynamically controlled, monitored and steered by the control module 7 with the associated machine learning-based pattern recognition module 8, in particular generating appropriate signaling and steering the activation and interworking of the various components of the automated mortality classification, signaling and underwriting system 1. The automated mortality classification system 1 can also include one or more display units and operating elements, such as a keyboard, and/or graphic pointing or position capturing devices, such as a computer mouse. The system 1 is a technical device comprising electronic means that can be used in the field of automated risk transfer or insurance technology with regard to risk transfers that are related to life risks 9. The invention seeks to technically capture, manage and automate complex related operations of monitoring and automated underwriting devices in the insurance industry. Another aspect involves synchronizing and adjusting such operations based on the proposed technical means. In contrast to standard approaches, the resource pooling system also achieves reproducible operations and reproducible risk assessment with the desired technical, repetitious accuracy, because it relies completely on technical means, process flow and process control/operation. The automated mortality classification and underwriting system 1 provides a scenario-based, life-risk measurement and determination of the risk exposure of risk-exposed individuals 91, 92, 93, . . . or of an insurance portfolio containing a plurality of risk-exposed individuals 91, 92, 93, . . . by means of the weighted accumulation of the various exposures associated with the corresponding risk classes 101, 102, 103 and risk class criteria 110, 111, 112. For the risk assessment, a distinct channel-based operation structure 81, 82, 83 is applied using appropriate life risk segmentation for smoking and non-smoking risk-exposed individuals 91, 92, 93. The total or maximum exposure 9 is derived by summing up the different exposures 913, 923, 933 per risk class over all accumulated classes, or contracts/treaty contracts in a portfolio.
The distinct channel-based automated mortality classification system 1 for automated real-time risk assessment, real-time underwriting and dynamic adjustment of life risks 9 captures life risks 9 associated with a plurality of risk-exposed individuals 91, 92, 93, which risks are at least partially transferable from a risk-exposed individual 91, 92, 93 to a first insurance system 2 and/or from the first insurance system 2 to an associated second insurance system 3. The risks associated with a plurality of risk-exposed individuals 91, 92, 93 can for example be at least partially transferable on an optional basis by means of the automated mortality classification system 1 from a risk-exposed individual 91, 92, 93 to a first insurance system 2 and/or from the first insurance system 2 to an associated second insurance system 3. In other words, the risk transfer can be accepted or declined autonomously by the automated mortality classification and underwriting system 1, thus allowing an autonomous operation of system 1. The risks 9 associated with the plurality of risk-exposed individuals 91, 92, 93 can for example be at least partially transferable from a risk-exposed individual 91, 92, 93 to a first insurance system 2 and/or from the first insurance system 2 to an associated second insurance system 30 by means of the automated mortality classification system 1, wherein an appropriate activation signaling is generated by the automated mortality classification and underwriting system 1 and transmitted to the first insurance system 2 and/or to the associated second insurance system 3 in order to activate and/or execute the risk transfer. To conduct the automated risk transfer, first and/or second risk transfer parameters 211, 212, 213/311, 312, 313 and the first and/or second payment transfer parameters 221, 222, 223/321, 322, 323 dynamically balance the risk-transfer with the pooled resources.
The system 1 comprises a table 10 with retrievable stored risk classes 101, 102, 103 each comprising assigned risk class criteria 110, 111, 112. Each of the risk classes 101, 102, 103 of the table 10 with retrievable stored risk classes 101, 102, 103 can for example be associated with at least one financial product accessible in a dedicated data store. The system 1 determines, for each of the risk classes 101, 102, 103, an expected occurrence rate, wherein the system 1 divides the expected occurrence rates by an average rate and determines a relative risk ratio as relative mortality factor for each of the risk classes 101, 102, 103 based on the data relating to the criteria 110, 111, 112 associated with said risk classes 101, 102, 103. The system 1 can generate correlated risk ratios between at least two of the risk classes 101, 102, 103 that are identified in said step for identifying and determining a dependence between the at least two different risk classes 101, 102, 103. The system 1 can for example compare the relative risk ratios and the correlated risk ratios with empirical data and generate comparative risk data to characterize the relative risks associated with the plurality of products, wherein the system 1 corrects the relative risk ratios if the comparative risk data is outside a defined range compared with the empirical data. In this case, the system 1 can for example comprise a data interface 11 for outputting or transmitting the corrected risk ratios. Thus, certain embodiment features of the present invention are directed to assessing relative risks, such as mortality risks, for a plurality of financial products, such as insurance products. This can comprise the steps of (i) identifying one or more risk classes 101, 102, 103 associated with the plurality of products, (ii) determining an expected occurrence rate for each of the risk classes 101, 102, 103, (iii) dividing the expected rates by an average rate for standard risks to determine a relative risk ratio for each of the risk classes 101, 102, 103, and (iv) comparing the relative risk ratios to characterize the relative risks associated with the plurality of products. Finally, concerning the criteria, the automated mortality classification system 1 can for example comprise means to automatically negotiate the risk class criteria 110, 111, 112 between the first insurance system 2 and second insurance system 3. This allows a further level of automation of the overall operation of the system.
The individual-specific parameters 911, 921, 931 of the risk-exposed individuals 91, 92, 93 are captured relating to criteria 110, 111, 112 of the stored risk classes 101, 102, 103 by means of the system 1 and/or capturing or measuring devices 914, 924, 934, and stored in a storage or repository unit 6. A specific risk class 101, 102, 103 associated with the life risks 9 of the exposed individual 91, 92, 93 is identified and selected from said stored risk classes 101, 102, 103 via the system 1 based on the captured parameters 911, 921, 931. In summary, the automated, real-time mortality classification and signaling system 1 assesses and adjusts life risks 9 in real-time, and provides an automated, dynamically adaptable underwriting based on the automated selective multi-level triage process 81, 82, 83. The risks 913, 923, 933 associated with the plurality of risk-exposed individuals 91, 92, 93 are thereby at least partially transferable from a risk-exposed individual 91, 92, 93 to the first insurance system 2 and/or from the first insurance system 2 to the associated second insurance system 3.
Individual-specific parameters 911, 921, 931 of the risk-exposed individuals 91, 92, 93 comprise at least individual-specific parameters 916, 926, 936 indicating captured self-declarations of smoking or non-smoking by the risk-exposed individuals 91, 92, 93. Upon triggering the individual-specific parameters 916, 926, 936 by means of a first trigger circuit 711 of a trigger module 71 indicating a captured self-declaration of smoking 8111, 8112, 8113 of a risk-exposed individual 91, 92, 93 via first trigger parameters 7111, 7112, 7113, the risk-exposed individual 91, 92, 93 is automatically assigned to a first triage channel 81 by means of the automated triage process. Upon triggering individual-specific parameters 916, 926, 936 by means of a second trigger circuit 712 of a trigger module 71 indicating a captured self-declaration of non-smoking of risk-exposed individuals 91, 92, 93 by means of second trigger parameters 7121, 7122, 7123, the triggered individual-specific parameters 911, 921, 931 are processed by a machine learning-based pattern recognition module 8 automatically assigning risk-exposed individuals 91, 92, 93 with detected non-smoking patterns 8211, 8212, 8213 to a second triage channel 82 as predicted non-smokers, and automatically assigning risk-exposed individuals 91, 92, 93 with detected smoking patterns 8311, 8312, 8313 to a third triage channel 83 as predicted smokers.
The system 1, in particular the machine-learning based pattern-recognition module 8, does not need to have lab-data of actual smoking-related measuring parameters, as input. For detecting and triaging non-smoking patterns 8211, 8212, 8213 and smoking patterns 8311, 8312, 8313 based on not smoking related data, the system only requires to capture data provided by the risk exposed individual 91, 92, 93 or the respective applicant in a normal risk-transfer or insurance application, as done by the normal prior art risk-transfer systems. The operational requirements of the system 1 are already meet, if the captured input data are primarily about the risk exposed individual 91, 92, 93 including e.g. demographic data, risky avocation participation, risk-transfer benefits requested, employment-related information, previous tobacco usage, applicant's medical condition as well as family history of various impairments. Additionally, based on the residence location of the applicant such as zip code, data is searched for in various open data sources to get a bigger picture of the community the applicant resides in. On the example of the United States, the zip code-level information includes number of households, median income, distribution of the resident population by education level, distribution of the employment statistics in various types of employment, distribution of the resident population by the average number of children in the household, etc. Furthermore, this extended data set can be supplemented by data from third-party providers or accessible databases providing applicant-level information on motor vehicle violations records, results from previous lab tests, and any prescription history. All these data elements are used to build and test a classification model to predict the risk exposed individual 91, 92, 93′s propensity for smoking and non-smoking by means of the machine-learning based pattern-recognition module 8.
The predictive model as generated and tested the machine-learning based pattern-recognition module 8 usually does make errors in predicting non-smokers when applied to applications unseen by the algorithm. The selection of the performance metric for prediction model is based on (1) cost-asymmetry between type-1 (false positives) and type-2 (false negatives) prediction errors, and (2) the distribution of non-smokers to smokers in the applicant population, which is, for example, roughly 85% non-smokers to 15% smokers in the United States. Any type-1 errors when predicting non-smokers will allow smokers to get non-smoker rates and incurring higher mortality costs. Additionally, the skewed distribution of more non-smokers to smokers in the population sets a higher bar for prediction accuracy—one could classify all applicants as non-smokers and still achieve 85% accuracy, 85% precision, and 100% recall. Any prediction model will have to perform much better than this baseline number.
The technical and object approach of the inventive system 1 is to handling prediction errors is to understand their cost-benefit structure of having a systems and process that allows majority of the risk exposed individual 91, 92, 93 to generate operational quote parameters without having to subject the risk exposed individual 91, 92, 93 to invasive lab tests while allowing for a certain miss-classification instances. By understanding the cost-benefit analysis, the system 1 can e.g. be limited to offer straight-through application processing only to a subset of the applicants based on age, gender, coverage term, and face-amounts thereby improving the possibility of accruing a positive net present value (NPV) for the risk-transfer, and allowing a stable automated and autonomous operation of the system 1. Thus the combination of the three elements: predictive analytics and triage based risk exposed individual 91, 92, 93 classifications into smokers and non-smokers pattern, offering straight-through application processing to non-smokers, and identifying the parameters of the product offering including age, gender, and face amount restrictions which nets positive NPV is the essence of the core operation of the system 1.
The machine learning-based pattern recognition module 8 is based on random forest processing as an ensemble learning structure for classification, regression and prediction, wherein the pattern recognition module 8 operates by constructing a multitude of decision trees during training and outputting the class that is the mode of the classes or mean prediction as regression of the individual trees. This has the advantage, inter alia, that through the random forest processing, the random decision forests correct for decision trees' habit of overfitting to their training set. Through the selection of a random subset of features, it is possible to implement the “stochastic discrimination” approach to classification. Therefore, the use of the random forest processing has the advantage of applying a method that is resistant to overtraining according to the theory of stochastic discrimination. Furthermore, the random forest structure allows for ranking the importance of variables in the present classification and risk assessment problem in a natural way. Note that if the parameters contain groups of parameters of correlated features of similar relevance, then smaller groups are favored over larger groups. However, in the present invention, only a small number of input parameters are needed, thus avoiding the aforementioned problem. In the present application, Random Forest predictors naturally lead to a dissimilarity measure between the observations. The present system also makes it possible to define a Random Forest dissimilarity measure between the captured data. Consequently, the present system also makes it possible, via the used Random Forest predictor, to distinguish measured or captured real data from suitably generated synthetic data. The observed data are the captured unlabeled data, and the generated data are for example drawn from a reference distribution or simulated Monte Carlo distribution. The RF dissimilarity makes it possible to handle mixed variable types without problems, is invariant to monotonic transformations of the input variables, and is robust to outlying observations. The Random Forest dissimilarity also makes it easy to deal with a large number of semi-continuous variables due to its intrinsic variable selection, which is, for example, that it weighs the contribution of each variable according to how dependent it is on other variables. The application of Random Forest has the further advantage of producing the best results for the present invention.
As an alternative, the machine learning-based pattern recognition module 8 can be based on Gradient Boosting (GBM) as a machine learning structure for regression, classification and prediction, wherein the pattern recognition module 8 operates on a set, respectively ensemble of weak prediction structures using classifiers that are only slightly correlated with the true classification and optimization by means of an arbitrary differentiable loss function. This has the advantage, inter alia, that it provides a prediction model in the form of a set of weak prediction models, which can for example be chosen as decision trees. Thus, it allows building the models in a stage-wise fashion, thereby generalizing them by allowing optimization of an arbitrary differentiable loss function. The machine learning-based pattern recognition module 8 can also be based on support vector machines (SVM) as a machine learning structure for regression, classification and prediction, wherein for given sets of individual-specific parameters of the risk-exposed individuals, each is marked for one of two definable categories, and wherein the pattern recognition module builds a structure that, by assigning new sets into one category or the other, makes it a non-probabilistic binary linear classifier. This has the advantage, inter alia, of providing another technical structure for the machine learning-based pattern recognition module by means of a machine learning, support vector machine (SVMs, also support vector networks) allowing supervised use of learning patterns and models with controllable, associated learning algorithms in order to process the captured risk-related individual data for risk classification and assessment. However, if supervised learning of the machine learning-based pattern recognition module is not possible (e.g., due to absence of appropriate historical or simulated risk-related individual data related to their smoking and/or non-smoking behavior), the support vector machine structure has the advantage that it also allows unsupervised learning for the machine learning-based pattern recognition module 8, thereby finding natural clustering of the captured risk-related individual data to build up the first, second and third channel of the pattern recognition module. As underlying clustering algorithm to improve the support vector machine structure, support vector clustering can be applied for unlabeled risk-related individual data or to label the captured risk-related individual data by preprocessing the data for a classification pass. Finally, the machine learning-based pattern recognition module 8 can further be based on logistic regression as a machine learning structure for regression, classification and prediction, wherein the probability of a binary response is estimated based on one or more of the individual-specific parameters 911, 921, 931 as predictors. This has the advantage, inter alia, of providing another technical structure for the machine learning-based pattern recognition module 8, which is not a classification method as such, but much more based on a qualitative response or discrete choice data processing. As a further advantage, structuring the machine learning-based pattern recognition module 8 by means of logistic regression needs only a small number of assumptions in the present case, i.e., assuming a standard logistic distribution of errors. However, if the assumptions of linear discriminant analysis hold, i.e., if linear discriminant assumptions are true, the logistic regression assumptions must hold. Since the converse is not true, the logistic regression data processing needs fewer assumptions than other machine learning structures, such as discriminant data processing, and does not make assumptions on the distribution of the independent variables, which can advantageously be due to the unknown distribution of false declared non-smoking risk-exposed individuals within the true declared non-smoking risk-exposed individuals. It is important to note, that the machine-learning based pattern-recognition module 8 operating based on random forest processing, gradient boosting (GBM), support vector machines (SVM) and/or logistic regression as learning structure for classification, regression and prediction, giving just examples. Other machine-learning based learning structures or combinations of machine-learning based learning structures are also imaginable, based on which the pattern-recognition module 8 is operated. The choice of the machine-learning based learning structure of the pattern-recognition module 8 can also depend on the risk-transfer to be performed by the system 1. Explicitly, the operation of the system 1, i.e. the inventive system 1 itself, is not restricted to risk-transfer related to life- or health-risks. The present inventive risk-transfer system 1 can also be applied to risk-transfers related to occurring property or casualty risks, wherein the machine-learning based pattern-recognition module 8 is directed to other parameters, as the validity of input data in the context of smoking/non-smoking patterns of the risk exposed individuals 91, 92, 93.
The system 1 operates on an ongoing validation process that diverts, in the above described manner, a percentage of predicted non-smokers for lab testing in order to collect results about the risk-exposed individual's actual smoking or nonsmoking habit and compare them against predicted smoking or non-smoking habit and re-learn the predictive model if comparison indicates high error rates. These ongoing validation process allows for providing a self-adapting system 1, which is, in its operation, not comparable to a prior art system.
For detected risk-exposed individual 91, 92, 93 of the third triage channel 83, the system 1 measures and captures laboratory-scaled individual-specific parameters 915, 925, 935 via the automated laboratory unit 5, wherein the laboratory-scaled individual-specific parameters 915, 925, 935 are measured by means of laboratory measuring devices 914, 924, 934 of the automated laboratory unit 5, and the laboratory-scaled individual-specific parameters 915, 925, 935 are triggered for measured smoking and not-measured smoking, thereby verifying the declared non-smoking status of the risk-exposed individuals 91, 92, 93 assigned to the third channel 83. For the real-time risk assessment, a relative mortality factor 918, 928, 938 is measured based on the captured risk-related individual data 911, 921, 931 and/or the measured smoking or non-smoking parameter corresponding to the assigned channel 81, . . . , 83, wherein based on the real-time risk assessment by means of the measured relative mortality factor 918, 928, 938, the risk associated with the risk-exposed individual 91, 92, 93 is transferable from the risk-exposed individual 91, 92, 93 to a first insurance system 2 and/or from the first insurance system 2 to the associated second insurance system 3, by means of automated generated first and/or second risk transfer parameters 211, 212, 213/311, 312, 313 and automated generated first and/or second payment parameters 221, 222, 223/321, 322, 323 and/or accordingly generated underwriting parameters. The dynamically generated underwriting parameters are transferable to the risk-exposed individual 91, 92, 93 for confirmation.
To assign the risk classes 101, 102, 103 of the table 10 to a risk-exposed individual 91, 92, 93 of the channels 81, 82, 83, to each of the risk classes 101, 102, 103 of the table 10 with retrievable stored risk classes 101, 102, 103, a tolerance factor can be determined and assigned to the corresponding risk class 101, 102, 103. If the captured parameters 911, 921, 931 of a risk-exposed individual 91, 92, 93 fail to be matched to the criteria 110, 111, 112 for one of the retrievable stored risk classes 101, 102, 103 by means of the system 1, a relative mortality factor of the individual 91, 92, 93 of the parameters 911, 921, 931 can be generated and compared to an average mortality of the closest matched class. Based on the assigned tolerance factor of the direct or closest matched class 101, 102, 103, the system 1 indicates whether to accept or reject a possible risk-transfer for the individual 91, 92, 93 for the direct or closest matched class 101, 102, 103 and generates the appropriate first and/or second risk transfer parameters 211, 212, 213/311, 312, 313 and second payment parameters 221, 222, 223/321, 322, 323 and/or corresponding underwriting parameters.
As mentioned, the system 1 further comprises a trigger module 71 with the first and second trigger circuit 711, 712. The trigger module 71 can be connected to the risk components 91, 92, 93, . . . by means of capturing devices 914, 924, 934 in order to detect and capture measuring values for the captured parameters 911, 921, 931 related to the occurrence of life risk events within the data pathway associated with a risk-exposed individual 91, 92, 93, . . . . The data flow pathway can for example be monitored by the system 1, capturing individual-related measuring parameters at least periodically and/or within predefined time periods. The data flow pathway can, for example, also be dynamically monitored by the automated mortality classification system 1 and/or one of the insurance systems 2/3, by triggering individual measuring parameters of the data flow pathway transmitted from associated measuring systems and adapting the operational parameters, i.e., first and/or second risk transfer parameters 211, 212, 213/311, 312, 313 and second payment parameters 221, 222, 223/321, 322, 323 and/or corresponding underwriting parameters via the system 1. By triggering the data flow pathway, which comprises dynamically recorded measuring of the parameters of the concerned risk-exposed individuals 91, 92, 93, the system 1 is also able to detect the occurrence of a life risk event and dynamically monitor the different stages throughout the occurrence of the life risk event in order to provide appropriately adapted and gradated risk protection for a concerned risk-exposed individual 91, 92, 93, Such a risk protection structure can be based on payments received and stored from the related risk-exposed individual 91, 92, 93, . . . and/or related to the total risk 9 of the insurance system 2 or 3 based on the overall transferred life risks 9 of all pooled risk-exposed individuals 91, 92, 93.
In the first, second and third channel 81, 82, 83, the individual risks 912, 922, 932 are typically mortality risks, and more specifically mortality risks that can be classified by the given plurality of risk criteria 110, 111, 112, but at least on the smoking and non-smoking status of the risk-exposed individual 91, 92, 93, respectively. Thus, these channels 81, 82, 83 can be used to compare and evaluate risk classifications used by different insurance systems in connection with their respective products. Different criteria 110, 111, 112 are often used as operational parameters of different, automated insurance systems 2/3 in determining which risk classes are to be assigned. The embodiment illustrated in
It is to be noted that as a part of putting the automated mortality classification system 1 into operation, the system 1 comprises capturing or determining the rate of occurrence of a criterion (or criteria) 110, 111, 112 among the risk-exposed individuals 91, 92, 93 (or more broadly, an insured population) to be captured by the system 1. This rate of occurrence is often referred to as prevalence. For example, if one of the criteria 110, 111, 112 is the smoking status, information relating to the prevalence of smoking status, which is in this case binary or can be associated with a certain amount of smoked cigarettes, i.e., a “level” of smoking, wherein the levels used as “cut-points” or limits in classifying an individual risk must be captured. To acquire the prevalence relating to the risk-exposed individuals 91, 92, 93, a large laboratory dataset of risk-exposed individuals 91, 92, 93 can be analyzed and filtered to select relevant prevalence information, as provided in the third channel 83 by the laboratory unit 5. The prevalence of criteria 110, 111, 112 is then determined within an insured cohort. A cohort is a risk classification 101, 102, 103, which represents a range of incremental probabilities of occurrence of a life risk event. Therefore, the operation is a determination of the rate of occurrence of the subject criteria 110, 111, 112 among the members of a particular risk classification 101, 102, 103. To exclude correlations that may exist among various criteria 110, 111, 112, i.e., a possible dependence between two or more of the preferred criteria 110, 111, 112, it may be reasonable to take appropriate steps in the operation of the automated mortality classification system 1. For the determination of prevalence for all combinations of correlated criteria 110, 111, 112, i.e., gender, age, smoking status, etc., a numerical representation of the prevalence within a population can for example be determined for each unique combination of criteria 110, 111, 112. If particular combinations of criteria 110, 111, 112 result in non-credible or aberrant results, adjustments must be made accordingly. From the representation, a probability of occurrence can be determined for each combination of criteria 110, 111, 112. The results of this determination can then be compared to the empirical data. If the prevalence of certain combinations varies with what can be analyzed from the empirical data, adjustments are made to match the empirical data. However, if this adjustment process results in anomalies, such anomalies can be detected and corrected by additional steps. When the prevalence results match the empirical evidence, the prevalence results are stored. The prevalence results for each combination of preferred criteria 110, 111, 112 are stored in the system 1 by issuance age, gender, smoking, status, duration, etc.
Another important process for the system 1 is the process for further characterizing risks in addition to the criteria 110, 111, 112 including the smoking status of the risk-exposed individual 91, 92, 93. This process can be performed before and/or contemporaneously to the operation of the automated mortality classification and underwriting system 1, allowing a dynamic adaption of the system 1. This process relates to relative mortality (i.e., rate of death among the classes 101, 102, 103 divided by standard mortality). In a first step, data can be captured from historical mortality data or other sources. This data includes data specific to each of the criteria 110, 111, 112 being considered by the automated mortality classification and underwriting system 1. In addition, other clinical/epidemiological data possibly available in connection with the criteria 110, 111, 112 can be analyzed. Based on the analysis, a relative mortality rate for each of the criteria 110, 111, 112 can be calculated. As in the case with prevalence data, correlations in mortality data among the various criteria 110, 111, 112 should also be considered by the system 1. Finally, relative mortality rates are determined for all combinations of correlated criteria 110, 111, 112. Following these operations, any anomalies in the data have to be identified and resolved. The relative mortality rates determined for the combinations are compared with empirical data or data from studies, e.g., clinical studies, to determine whether the rates match the empirical data. Again, if the determined rates do not match the empirical evidence, adjustments to the relative mortality rates must be made to match the empirical results by the system 1. Following possible adjustments, the data are checked or filtered for anomalies, and any anomalies that occur are detected and corrected. If the relative mortality data is consistent with the empirical data or the data from studies, the data are stored by the automated mortality classification and underwriting system 1. According to the prevalence, the relative mortality results are stored in the system 1 for each correlated combination by issuance age, gender, smoking status and duration, etc. Finally, based on the prevalence and relative mortality results for each correlated combination of criteria, a specific base criteria set 110, 111, 112 can be selected by the automated mortality classification system 1. The selection can by done by the system 1 autonomously and/or for example negotiated automatically between the first and second insurance system 2/3. Based on the base criteria 110, 111, 112, prevalence and relative mortality data can be extracted from the stored parameters for each of such criteria 110, 111, 112, and a relative risk ratio can be generated by the automated mortality classification system 1 for each risk class 101, 102, 103, for example by smoking status, age, gender and duration, etc. The generation for each risk class 101, 102, 103 is based on both prevalence and relative mortality data, as well as on the criteria 110, 111, 112 defining each risk class 101, 102, 103.
This application is a continuation of International Application No. PCT/EP2016/064425, filed Jun. 22, 2016, the contents of which are incorporated herein.
| Number | Date | Country | |
|---|---|---|---|
| Parent | PCT/EP2016/064425 | Jun 2016 | US |
| Child | 16165370 | US |
