CN102057389A - 用于管理保险方案的系统及方法 - Google Patents
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Abstract
本发明提供了一种用于管理保险方案的系统,所述系统包括:事故模块,为受保人限定至少一个保险事故;计算模块,计算在发生至少一个保险事故的情况下应支付的至少一笔保险费,其中所述至少一笔保险费根据受保人的家属人数进行调整;以及授予模块,在发生至少一个保险事故的情况下时,为受保人提供计算的至少一笔保险费。
Description
技术领域
本发明涉及一种用于管理保险方案的系统及方法。
背景技术
本发明可由传统的人寿保险计划经营者对其参保人员实施或由另一方实施。
按照惯例,保险单,如人寿保险单,根据如下基础操作:被保险人(有时称作受保人)支付保险金给人寿保险承保人,当保险事故发生时,人寿保险承保人将预先约定的金额(称作保险金额)赔付给受保人或其受益人。具有代表性的保险事故为:受保人伤残、重大疾病或死亡。
但是,目前对疾病或伤残的赔偿仅一般性地考虑例如疾病或伤残等的影响,而没有考虑该疾病或伤残对特定受保人的具体影响。
本发明使得能够对例如特定疾病或伤残对于特定个人的经济影响进行估计,并据此调整要求赔付的数额。
本发明提供了一种系统及其方法来处理这种问题。
发明内容
根据一示例性实施例,提供了一种管理保险方案的系统,该系统包括:
事故模块,为受保人限定至少一个保险事故;
计算模块,计算在发生至少一个保险事故的情况下应支付的至少一笔保险费,其中所述至少一笔保险费数额根据受保人家属(dependent)人数进行调整;以及
授予(award)模块,在发生至少一个保险事故的情况下,为受保人提供计算的至少一笔保险费。
所述事故模块可以限定多个保险事故,包括伤残、重大疾病或死亡中的至少一种。
所述计算模块可以进一步根据包括保险事故对受保人造成的生活影响的多个因素计算至少一笔保险费的数额。
在一实例中,所述计算模块进一步计算保险事故对生活影响的程度,并为这个程度分配一个分值(score)。
所述计算模块可以把生活影响分解为一个或多个如下评判标准,例如:影响的持续时间、外科手术的侵入(invasiveness)、药物学方面的标准(pharmacological)、所需治疗和康复、化学疗法或放射疗法、所需辅助装置或需要的护理,并为每项标准分配一个分值,所述计算模块随后把分配的分值进行加和,以确定生活影响总分值,该生活影响总分值被作为保险事故对受保人造成的生活影响的衡量指标。
在一个实施例中,所述计算模块根据生活影响总分值计算至少一笔保险费,并根据家属人数更改所计算的至少一笔保险费。
例如,计算模块先计算出至少一笔保险费,然后根据家属人数确定与所述至少一笔保险费相乘的百分比,以获得修正后的至少一笔保险费值,该修正后的至少一笔保险费值将由授予模块进行授予。
在另一实施例中,所述计算模块为家属人数分配一个分值,把该分值加入所计算的生活影响总分值中,以产生一个更高的总分值,接着,计算模块利用该分值对至少一笔保险费进行调整,调整后的至少一笔保险费将由授予模块进行授予。
所述计算模块可以访问存储器,把计算的至少一笔保险费数额储存到存储器内。
根据一示例性实施例,提供了一种管理保险方案的设备,该设备包括:
一装置,为受保人限定至少一个保险事故;
一装置,计算在发生至少一个保险事故的情况下应支付的至少一笔保险费,其中所述至少一笔保险费根据受保人家属人数进行调整;以及
一装置,在发生至少一个保险事故的情况下,为受保人提供计算的至少一笔保险费。
根据另一示例性实施例,提供了一种管理保险方案的方法,该方法包括:
为受保人限定至少一个保险事故;
计算在发生至少一个保险事故的情况下应支付的至少一笔保险费,其中所述至少一笔保险费数额根据包括受保人家属人数的多个因素进行计算;以及
在发生至少一个保险事故发生的情况下,为受保人提供计算的至少一笔保险费。
至少一笔保险费的计算包括:计算保险事故对受保人造成的生活影响并利用所述影响计算所述至少一笔保险费。
保险事故造成的生活影响可以根据以下标准中的一个或多个进行计算:影响的持续时间、外科手术的侵入、药物学方面的标准、所需治疗和康复、化学疗法或放射疗法、所需辅助装置或需要的护理。
所述方法可以进一步包括:为每项标准分配一个分值,计算所分配的分值总和以确定总分值,其中,总分值用于确定保险事故造成的生活影响,其中,总分值越高,保险事故造成的生活影响越大。
该总分值可以与多个总分值段(band)进行比较,对每个总分值段指定一个生活影响率(status),并以这种方式对生活影响进行评估。
在一个实施例中,所述方法进一步包括:计算至少一笔保险费的数额,如果受保人家属人数较多,所述保险费的数额相对较高。
附图说明
图1为示出一示例性实施例的方法的流程图;
图2为示出实现所述方法的示例性系统的方框图。
具体实施方式
所述系统和方法涉及一种管理保险方案的系统及方法,如以人寿保险方案为例。
按照惯例,人寿保险方案按照如下基础操作:被保险人(称作受保人)定期地支付保险金给人寿保险承保人,并明确当保险事故发生时所需赔付的金额。例如,当受保人死亡时,预先约定的死亡保险费将支付给受保人指定的受益人。如果受保人残疾或遭受重大疾病,则支付不同的较少的数额。
下面将结合这些类型的方案来阐述该方法和系统,但应明白的是,该方法和系统也可同样地运用于其他类型的保险方案。
应明白的是,该系统和方法可由相关人员或组织实施。例如,该系统和方法可由操作人寿保险方案的组织实施或由其他相关组织实施。在一实例中,该系统和方法可由发放信用卡给其成员的金融机构实施。
仅为了详细说明的目的,本文中的系统和方法将描述为由人寿保险方案的管理者操作。
参照图1,管理保险方案的方法包括:为受保人限定至少一个保险事故(框10)。该至少一个保险事故可以包括例如受伤或遭受疾病。该受伤可以指暂时性受伤或永久性伤害等。所述疾病可以指重大疾病等。
应明白的是,限定的保险事故数量可能较大,也可能有所不同,且当然不限于上述例子。
计算在发生至少一个保险事故的情况下应支付的至少一笔保险费(框12)。
该至少一笔保险费的数额根据包括受保人家属人数的多个因素进行计算。
在一示例性实施例中,利用保险事故的生活影响确定该至少一笔保险费。
在一示例性实施例中,该生活影响根据以下标准中的一个或多个进行计算:影响的持续时间、外科手术的侵入、药物学方面的标准、所需治疗和康复、化学疗法或放射疗法、所需辅助装置或需要的护理。
在一示例性实施例中,为每项标准指定一个分值,计算分值总和,以确定总分值。该总分值用于确定保险事故造成的生活影响。
在一示例性实施例中,为该标准分配分值,以获得一总分值,该总分值的范围在0到15之间。
疾病 | 1 | 2 | 3 | 4 | 5 | 6 |
艾滋病 | 2 | 0 | 3 | 0 | 0 | 2 |
霍奇金氏癌 | 6 | 0 | 0 | 0 | 3 | 0 |
耳硬化症 | 4 | 1 | 0 | 0 | 0 | 1 |
心房纤颤 | 8 | 0 | 1 | 1 | 0 | 0 |
其中,上表中的标准是:
1-影响的持续时间;
2-外科手术的侵入;
3-药物学方面的标准;
4-所需治疗或康复;
5-化学疗法或放射疗法;以及
6-所需辅助装置或需要的护理。
因此,总分值越高,保险事故造成的生活影响越大。
在另一示例实施例中,总分值与多段总分值进行比较,对每个段限定一个生活影响率,并以这种方式对生活影响进行评估。因此,例如:
寿命影响 分值
无/低 0-5
中 6-8
中高 9-12
很高 13-15
该方法进一步包括:计算至少一笔保险费的数额,如果受保人家属人数较多,所述保险费的数额相对较高。例如:
可替换地,家属人数也可以作为标准之一累计到总值中。在本实例中,家属人数可以在总分数中计入以下分数,例如:
0-1
1-2
2-3
3-4
4-5
采用这种方法,总值较高,且示例性的值表可以如下:
总寿命影响值 | 寿命影响类别 | 赔付额度* |
0-4 | 1 | 100% |
5-8 | 2 | 115% |
9-11 | 3 | 125% |
12-13 | 4 | 135% |
14-15 | 5 | 145% |
16 | 6 | 155% |
17 | 7 | 175% |
18+ | 8 | 200% |
在发生至少一个保险事故的情况下,为受保人提供所计算的至少一笔保险费。
采用上述第一个表的实例如下。假设受保人年龄40岁,男性,不抽烟,有4位家属。在现有技术的情节(scenario)中,受保人的人寿保险数额为R1百万元,重大疾病保险费为R1百万元。
在这样的现有技术保险方案中,在发生以下保险事故的情况下,受保人将获得赔偿:
赔偿款:情节1:
癌症IV级-严重程度A=R1百万元
赔偿款:情节2:
截瘫-严重程度A=R1百万元
根据本发明,对癌症IV级的生活影响评估如下:
疾病对人寿命影响的持续时间-中等;
正在进行的治疗的持续时间、需要的看护和装置-中等;以及
总体生活影响-中等。
根据本发明的上述例表,计算的保险费为160%,即R1.6百万元。
在另一实例中,截瘫造成的生活影响确定为具有非常高的生活影响。
根据本发明的上述例表,计算的保险费为200%,即R2百万元。
因此,应明白的是,把个人的特殊情况以及例如特定疾病或伤残对特定受保个人等造成的影响纳入考虑范围。
图2示出了用于实施上述方法的一个示例性系统。
服务器22包括实施上述方法的多个模块。
事故模块24为受保人限定多个保险事故。
模块24被构造成用于限定多个保险事故,在一实施例中,这些保险事故包括伤残、患重大疾病或死亡中的至少一个,这些事故均为人寿保险方案中投保的代表性事故。尽管如此,应明白在其他环境中,这些造成生活变故(1ife changing)的事故可以是其他的事故。
一旦事故模块24限定了多个造成生活变故的事故,模块24就访问存储器并将所限定的多个费用类别储存于存储器中。
计算模块26被构造成用于在发生至少一个保险事故的情况下计算应支付的至少一笔保险费。
该至少一笔保险费的数额由计算模块根据包括受保人家属人数的多个因素进行计算。
另外,计算模块26还被构造成用于根据保险事故对受保人造成的生活影响以及家属人数来计算保险费。
在此示例性实施例中,计算模块26被构造成用于计算保险事故造成的生活影响,并为该生活影响分配一个值。计算模块26可以通过把生活影响分解为一个或多个如下标准来获得该值,这些标准例如:影响的持续时间、外科手术的侵入、药物学方面的标准、所需治疗和康复、化学疗法或放射疗法、所需辅助装置或需要的护理。
在一实例中,计算模块26为每项标准分配一个分值,随后计算所分配的分值的加和,以确定生活影响总分值。该生活影响总分值作为保险事故对受保人造成的生活影响的衡量指标。因此,总分值越高,保险事故的生活影响越大。该情况的实例已经在上文中进行了说明。
在一实例中,计算模块26被构造成用于根据生活影响总分值计算保险费,并根据家属人数更改所述计算的保险费。
在本实施例中,根据家属人数确定与保险费相乘的百分比,以获得新的保险费数额,该保险费数额将由授予模块28进行授予,具体细节如下所述。
在另一示例性实施例中,计算模块26被构造成用于为家属人数指定一个分值,把这个分值加入如上所述计算的生活影响总分值中。这会产生一个更高的总分值,接着根据该总分值对保险费进行调整,调整后的保险费将由授予模块28进行授予,具体细节如下所述。
任何情况下,计算模块26访问存储器并将计算的保险费数额储存到该存储器中,存储器可以是数据库30。
授予模块28用于在发生至少一个保险事故的情况下,为受保人提供所计算的至少一笔保险费。
在一实例中,授予模块28通过通信网络,例如通信网络32,连接到一个金融机构,授予模块指示(instruct)金融机构对受保人或其指定的受益人赔付一定数额的现金。
该系统包括用于存储一个或多个上述模块所需数据的至少一个相关数据库30。
另外,典型地,服务器连接到通信网络32以与其他计算机通信而实施上述方法。
上述模块可由体现为指令的机器可读媒介实施,当机器执行该指令时,该指令可使机器执行上述任一方法。
在另一示例性实施例中,模块可由专门编程的固件(firware)实施以执行上述方法。
应明白的是,本发明的实施例并不限于此架构,也能同样地应用于分布式或对等(peer-to-peer)架构系统。因此,所述模块可位于由一个或多个机构操作的一个或多个服务器上。
还应明白的是,在所述的任一情况中,这些模块形成一具有专门用于执行上述方法的步骤的物理模块的物理装置。
Claims (16)
1.一种用于管理保险方案的系统,所述系统包括:
事故模块,为受保人限定至少一个保险事故;
计算模块,计算在发生所述至少一个保险事故的情况下应支付的至少一笔保险费,其中,所述至少一笔保险费根据所述受保人的家属人数进行调整;以及
授予模块,在发生所述至少一种保险事故的情况下,为所述受保人提供计算的至少一笔保险费。
2.根据权利要求1所述的系统,其特征在于,所述事故模块限定多个保险事故,所述保险事故包括伤残、患重大疾病或死亡中的至少一个。
3.根据权利要求1或2所述的系统,其特征在于,所述计算模块进一步利用包括所述保险事故对所述受保人造成的生活影响的多个因素来计算所述至少一笔保险费的数额。
4.根据权利要求3所述的系统,其特征在于,所述计算模块进一步计算所述保险事故造成的生活影响的程度,并为所述程度分配一个分值。
5.根据权利要求3所述的系统,其特征在于,所述计算模块把所述生活影响分解为下列标准中的一个或多个,这些标准例如:
影响的持续时间、外科手术的侵入、药物学方面的标准、所需治疗或康复、化学疗法或放射疗法、所需辅助装置或需要的护理,并且所述计算模块为每项标准分配一个分值,所述计算模块随后把分配的分值进行加和,以确定生活影响总分值,所述生活影响总分值被作为所述保险事故对所述受保人造成的生活影响的衡量指标。
6.根据权利要求3至5中任一项所述的系统,其特征在于,所述计算模块根据所述生活影响总分值计算所述至少一笔保险费,然后利用所述家属人数更改该计算后的所述至少一笔保险费。
7.根据权利要求6所述的系统,其特征在于,所述计算模块首先计算所述至少一笔保险费,接着利用所述家属人数确定与所述至少一笔保险费相乘的百分比,以获得修正后的至少一笔保险费值,所述修正后的至少一笔保险费值将由所述授予模块进行授予。
8.根据权利要求6所述的系统,其特征在于,所述计算模块为所述家属人数分配一个分值并将该分值加入计算的生活影响总分值中,以产生一个更高的总分值,所述计算模块随后利用该更高的总分值对所述至少一笔保险费进行调整,调整后的至少一笔赔偿费将由所述授予模块进行授予。
9.根据前述权利要求中任一项所述的系统,其特征在于,所述计算模块访问存储器并将计算的至少一笔保险费金额储存到所述存储器内。
10.一种用于管理保险方案的设备,所述设备包括:
一装置,为受保人限定至少一个保险事故;
一装置,计算在发生所述至少一个保险事故的情况下应支付的至少一笔保险费,其中,所述至少一笔保险费的数额根据所述受保人的家属人数进行调整;以及
一装置,在发生所述至少一个保险事故的情况下,为所述受保人提供计算的至少一笔保险费。
11.一种用于管理保险方案的方法,所述方法包括:
为受保人限定至少一个保险事故;
计算在发生所述至少一个保险事故的情况下应支付的至少一笔保险费,其中,根据包括所述受保人的家属人数的多个因素计算所述至少一笔保险费的数额;以及
在发生所述至少一个保险事故的情况下,为所述受保人提供计算的至少一笔保险费。
12.根据权利要求11所述的方法,其特征在于,所述至少一笔保险费的计算包括:计算所述保险事故对所述受保人造成的生活影响并利用该生活影响计算所述至少一笔保险费。
13.根据权利要求12所述的方法,其特征在于,根据以下标准中的一个或多个计算所述保险事故造成的生活影响,所述标准包括:影响的持续时间、外科手术的侵入、药物学方面的标准、所需治疗或康复、化学疗法或放射疗法、所需辅助装置或需要的护理。
14.根据权利要求13所述的方法,其特征在于,所述方法进一步包括:为每项标准设定一个分值,接着计算所分配的分值总和,以确定总分值,其中,所述总分值用于确定所述保险事故造成的生活影响,其中,所述总分值越高,所述保险事故造成的生活影响越大。
15.根据权利要求14所述的方法,其特征在于,将所述总分值与多个总分值段进行比较,其中,对每个总分值段限定一个生活影响率,并以这种方式对生活影响进行评估。
16.根据权利要求11至15中任一项所述的方法,其特征在于,所述方法进一步包括:计算所述至少一笔保险费的数额,如果所述受保人的家属人数较多,则所述至少一笔保险费的数额相对较高。
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CN (1) | CN102057389A (zh) |
AU (1) | AU2009202204A1 (zh) |
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Also Published As
Publication number | Publication date |
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WO2009147593A1 (en) | 2009-12-10 |
AU2009202204A1 (en) | 2009-12-17 |
US20090307015A1 (en) | 2009-12-10 |
ZA200903753B (en) | 2010-03-31 |
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