JP4969035B2 - Insurance business management system - Google Patents

Description

  The present invention relates to an insurance business management system, and in particular, by improving the efficiency and rationalization of paperwork related to insurance business management, and by reducing the mortality rate of insured persons and increasing the profit margin. And a technology that makes it possible to reduce insurance premiums as much as possible.

As described in Non-Patent Document 1 below, insurance is defined as follows: “For a risk that may occur in the future, the subscriber will share a certain amount of premiums commensurate with the probability of an accident occurring, It is a system of help that was born from the spirit of mutual assistance to prepare for an accident, and is one of the most reasonable defensive measures to protect life and property from various accidents and disasters surrounding us.
In general, insurance business revenue generally includes (1) “mortality gains” due to the fact that the actual mortality rate / accident rate of the insured person is lower than the planned mortality rate / accident rate, and (2) the performance of the reserve fund "Profit margin" due to exceeding the planned interest rate, and (3) "Expense margin" due to actual expenses falling below the planned expenses.

Therefore, the following measures can be considered to improve the performance of insurance companies.
(1) Increase mortality by reducing the death rate and accident rate of insured persons.
(2) Increase profit margins by improving the performance of reserve funds.
(3) Increase cost margins by reducing expenses.
If the profits of the insurance company increase by realizing the above (1) to (3), the management can be stabilized and the insurance premiums can be reduced, and it can be said that there are merits for subscribers.
Japan Insurance Company Association / Basic Knowledge of Insurance / Insurance [Search October 12, 2004] Internet URL: http://www.nihondaikyo.or.jp/c_chishiki/01.html Life Insurance Association of Japan [October 12, 2004 search] Internet URL: http://www.seiho.or.jp/

However, until now, Japanese insurance companies have been only interested in increasing the number of insurance contracts, and there has been little idea of expanding the profit margin by increasing the health of the insured.
Even in its sales style, so-called “insurance aunts” were placed on the forefront, and human naval tactics that made full use of in-laws, humanity, and presents were the mainstream, and this was quite contrary to the reduction of necessary expenses.
Moreover, under the long-term low interest rate policy, there is no way to hope to improve the performance of the reserve fund (see each company's financial information page in Non-Patent Document 2 above).
For this reason, it can be said that Japanese insurance companies have collected premium premiums from insured persons to compensate for losses caused by their inefficient business operations.

This invention was made to solve the problems of the conventional insurance business described above, and as much as possible the insurance premium as much as possible by streamlining and rationalizing the paperwork involved in the operation of the insurance business. The first object is to provide a technique that can be reduced.
A second object of the present invention is to provide a technology that can reduce the insurance premium as much as possible by reducing the death rate of the insured person and increasing the profit margin.

In order to achieve the above object, the insurance business management system according to claim 1 includes a telephone subscriber database held by a telephone carrier in which information such as a telephone subscriber's name, address, and call charge debit account is stored. The insurance product database that stores information on insurance products, the insurance fee calculation standard database that stores the insurance fee calculation standard for each insurance product, the name and address of the insured person, the name of the insurance recipient and An insurance contract database that stores information such as address, insurance type, amount of insurance, period of enrollment, etc., an operational performance database that stores operational performance information such as collected premiums and insurance payments for each insurance product, and insurance coverage The insurance menu screen is sent to the client terminal of the applicant, indicating that the user has selected a specific insurance from the client terminal and means for prompting the user to select an arbitrary insurance. When the information is sent, send the application form for the insurance, and enter necessary information such as name, address, age, gender, health status, name and address of the beneficiary, e-mail address, etc. , Means for confirming that the name and address transmitted from the client terminal match the data stored in the telephone subscriber database, and calculating the insurance premium for the input data transmitted from the client terminal. A method for calculating insurance premiums according to the criteria, a means for sending a screen showing the insurance premiums to the client terminal and requesting the intention to join, and information indicating a subscription application from the client terminal Means for registering the record of the insurance applicant with the code indicating the provisional contract added to the insurance contract database, and the insurance contract A means for generating a confirmation e-mail with a description and a request for requesting the intention of this contract, sending it to the e-mail address of the applicant, and an e-mail with the intention of this contract Is sent to the corresponding record in the insurance contract database, and the insurance fee is equivalent to the insurance fee from the call charge debit account stored in the telephone subscriber database of the insurance subscriber. A means for requesting the withdrawal of the amount from the computer of the financial institution associated with the account, a means for registering information indicating the collection of insurance premiums in the above operation result database, and a payment request for insurance money are transmitted from the client terminal. In this case, the means for requesting input of necessary items by sending a payment application form and the input data transmitted from the client terminal are A means for confirming whether or not it matches the data stored in the service, and if it matches, the insurance money equivalent for the call charge withdrawal account stored in the telephone subscriber database of the insurance payment applicant Means for requesting the remittance processing to a computer of a predetermined financial institution, means for registering information indicating insurance payment in the operation results database, and payment insurance amount data accumulated in the operation results database, When the amount of insurance actually paid to the insurance claim applicant falls below the planned amount, it is determined that dividend payment is required, and when the amount of insurance actually paid to the claim payment applicant exceeds the planned amount means for determining the need to collect additional premiums, if the payment of dividends is required, and the means for calculating a dividend of one person per insured person, the telephone subscriber data of each insured person Remittance processing of the dividend equivalent amount with respect to the stored toll debit account in the database, and the means to ask of a given financial institution computer, and the means for registering information indicating the payment of dividends on the management track record database, add If insurance premium collection is required, a means for calculating additional premiums per insured and equivalent to additional premiums from the call charge debit account stored in the telephone subscriber database for each insured A means for requesting the debit of the amount to the computer of the financial institution associated with the account, and a means for registering information indicating collection of additional premiums in the above-mentioned operational performance database , and each insured person The client terminal is connected to a health data collection device and an application program for transmitting health data measured by the health data collection device. Means for registering health data transmitted from the client terminal in association with the insured person in a predetermined storage means, health data accumulated in the storage means, and attribute information of the insured person Applying the above to the prepared health criteria, calculate the health evaluation points and store them in a predetermined storage means, and the above dividend according to the insured's health evaluation points or health data reporting rate And a means for adjusting (adjusting) the amount of money and additional insurance premiums .
The above “insurance” includes “mutual aid” that performs the same social function as insurance (the same shall apply hereinafter).

In the insurance business management system according to the present invention, the identity of the insurance subscriber is verified based on a highly reliable telephone subscriber database managed by the telephone carrier. Online insurance can be realized, and it becomes possible to greatly improve the efficiency and rationalization of paperwork.
Moreover, since the insurance premium is deducted from the bank account for call charge settlement, the insurance company can safely conclude a contract without any risk of bad debt.
In addition, since the insurance money is transferred to the bank account for settlement of call charges, the insurance money is paid to an uncertain person while assuming online insurance payment processing. Can be effectively prevented.
In addition , it is possible to flexibly modify premiums by paying dividends or collecting additional premiums according to the performance of the investment. It is possible to impose a premium.
As a result of the above, it is possible to reduce the necessary expenses associated with the operation of the insurance business, and it is possible to reduce the insurance premiums imposed on the insured person based on the increase in the cost margin.
In addition, since it has a mechanism that adjusts the amount of dividends and additional premiums according to the health level and health maintenance activities of the insured person, it can raise the health awareness of the insured person and the death of the insured person The rate and hospitalization rate can be expected to decrease.
As a result, the insurance payment amount is reduced overall, and the profit margin is increased. As a result, dividends can be increased, insurance premiums can be reduced, and additional insurance premiums can be reduced.

FIG. 1 is a conceptual diagram showing a functional configuration at the time of insurance subscription in the insurance business management system 10 according to the present invention, which is operated by an insurance business management server (hereinafter referred to as “operation server 12”) which is the core of the system and an operator. A management terminal 14 such as a PC, a plurality of client terminals 16 such as a PC operated by a user, a plurality of external servers 18 managed by a medical institution, and a bank host computer (hereinafter referred to as “user”) provided with a user account And a bank host computer (hereinafter referred to as an “operator bank computer 22”) in which an account of an insurance business operator is provided.
This insurance business operation system 10 is basically assumed to be operated by the telephone company itself or an insurance company entrusted by the telephone company.

The management server 12 and each client terminal 16 and the external server 18 are connected via a communication network 24 such as the Internet.
The management terminal 14 is connected to the client terminal 16 and the external server 18 via the communication network 24, and is connected to the management server 12 via the in-house LAN.
The operation server 12 and the computer 20 of the user bank are connected via a dedicated line.
Further, the computer 20 at the user bank and the computer 22 at the operator bank are also connected via an interbank network.

The administration server 12 includes an insurance subscription processing unit 26, an insurance premium calculation unit 28, an email processing unit 30, an insurance premium collection processing unit 32, an insurance contract database 34, a telephone subscriber database 36, and an insurance product database 37. And an insurance premium calculation standard database 38 and an operation result database 40.
The insurance enrollment processing unit 26, insurance fee calculation unit 28, mail processing unit 30, and insurance fee collection processing unit 32 are realized by the CPU of the operation server 12 executing necessary processes according to the OS and a dedicated application program. The
In addition, the insurance contract database 34, the telephone subscriber database 36, the insurance product database 37, the insurance premium calculation reference database 38, and the operation result database 40 are provided in the hard disk of the operation server 12.
The telephone subscriber database 36 stores personal information such as names and addresses of telephone subscribers owned by the telephone carrier, telephone numbers, and bank accounts for reducing call charges.
The insurance product database 37 stores various types of information related to insurance products that can be provided by the system 10.

This system 10 is premised on one-year retirement insurance regardless of whether it is life insurance or non-life insurance.
In addition, only subscribers of the telephone business (mobile phone or landline phone) related to the operator of the system 10 can be insurance subscribers (insured persons) and beneficiaries of insurance money.

Next, a processing procedure when a general user joins the insurance operated by the system 10 will be described with reference to the flowchart of FIG.
First, when a user who wishes to join the insurance accesses a predetermined URL in the operation server 12 via the Web browser program of the client terminal 16, a menu screen is transmitted from the insurance joining processing unit 26 (S10). It appears on the display.
In this menu screen, the titles of the insurance stored in the insurance product database 37 are listed, and when the user clicks on the title of each insurance, a detailed explanation screen is transmitted from the insurance participation processing unit 26 (S11), It appears on the display.

When the user selects a specific insurance on the menu screen, the insurance application processing unit 26 transmits the insurance application form (S12).
As a result, although not shown, the subscription application form is displayed on the display of the client terminal 16.
In this application form, you can enter the desired security amount selection field, subscription period selection field, name, address, phone number, date of birth, age, gender, etc., personal information input field, insurance recipient's name, address, relationship Column, a questionnaire column (notification column) is provided for reporting the past illness and the current health condition.
On the other hand, the user inputs necessary data for each item and clicks the send button.

In response to this, the insurance subscription processing unit 26 (S13) first checks whether the telephone number, address, and name transmitted from the client terminal 16 match the data registered in the telephone subscriber database 36 (S14). ), If both are signed, the insurance premium calculation unit 28 is instructed to calculate the insurance premium.
In response to this, the insurance premium calculation unit 28 compares the user's age, gender, subscription period, pre-existing disease, etc. with the insurance premium calculation table stored in the insurance premium calculation reference database 38, thereby providing specific insurance premiums. Is calculated (S15) and output to the insurance subscription processing unit 26.
The insurance subscription processing unit 26 generates a screen for displaying the insurance premium and transmits it to the client terminal 16 (S16).

When the user is satisfied with the insurance premium displayed on the display, the user clicks an “apply” button to formally apply for insurance.
Upon receipt of this, the insurance enrollment processing unit 26 registers necessary data such as the insurance type code, the security amount, the period, the applicant's name, address, telephone number, date of birth, etc. in the insurance contract database 34 (S17). . However, at this stage, since it is in the state of “provisional contract” scheduled to be established, a code indicating the status of the temporary contract is recorded in the corresponding record. In addition, the bank account information of the applicant stored in the telephone subscriber database 36 is also recorded in this record.

When a new record is registered in the insurance contract database 34 as described above, the mail processing unit 30 generates a confirmation e-mail and transmits it to the client terminal (S18).
The confirmation e-mail contains the necessary information such as the covered insurance type, beneficiary, insurance policy, etc. or attached to a file, and if the applicant is satisfied with the contents, a reply e-mail stating that fact A request message that mail should be sent is described.
Upon receiving the confirmation e-mail, the applicant confirms the contents, writes an intention to sign the formal application, and sends a reply to a predetermined e-mail address.
This e-mail is received by the management terminal 14 (S19), and after confirming the contents by the operator, if there is no problem, the insurance subscription processing unit 26 outputs a command for conversion to the “main contract”.
Receiving this, the insurance subscription processing unit 26 registers a code indicating “main contract” in the record of the applicant in the insurance contract database 34 (S20).

When the code indicating this contract is registered in the insurance contract database 34 as described above, the insurance fee collection processing unit 32 is activated and requests the user bank computer 20 to process the remittance of the insurance premium (S21).
Upon receiving this, the computer 20 of the user bank executes a remittance process from the applicant's bank account to the operator's bank account.
In addition, the insurance fee collection processing unit 32 registers the fact that the remittance processing is completed as payment information in the operation result database 40 (S22).

When the above procedure is completed, the insurance subscription processing unit 26 outputs information indicating the completion of the subscription procedure to the management terminal 14 (S23). Upon receiving the request, the operator transfers this information to the staff of the department in charge and requests mailing of a document indicating the conclusion of the contract.
As a result, a document describing the contents of the insurance contract is mailed to the user's home within a few days. At this time, the flow of provisional contract → this contract → contract establishment is completed, and “consent” regarding the establishment of insurance which is a consent contract is notified in writing.
In the case of this system 10, since a cooling off period of one month that is much longer than the usual 8 days is set, the user is allowed to freely cancel the contract at any time during this period.

In this system 10, issuance of paper insurance policy is omitted to save revenue stamp fee, but third-party authentication is required for users who need payment details / proof for income tax deduction An electronic certificate can be issued by an institution.
In addition, even if the policyholder is the telephone company and the insured is the telephone subscriber insured, if you submit the details of the payment of the insurance premium, you will be able to receive the income deduction and the insurance policy. Can be kept on a single sheet and tax payments can be largely omitted.
When the user dies, an insured card is issued by the operator to notify the bereaved family of the contract details.

  In the case of this system 10, since the input data transmitted from the client terminal 16 is checked against the registration information of the telephone subscriber database 36 with extremely high reliability, the identity of the applicant is confirmed. As described above, it is possible to complete an insurance contract online using the Internet WWW or e-mail, and it becomes possible to greatly improve the efficiency and rationalization of the paperwork related to the insurance contract.

  In the above, an example is shown in which the user himself / herself enters information indicating his / her health condition in the questionnaire field (notification field) of the subscription application form, but electronic data that already proves his / her health condition is reliable. When the information is stored in an organization / organization (hospital, health insurance association, etc.), a system that can support this via the network can be provided in the operation server 12 to reduce the burden on the user.

In this system 10, insurance policies and manuals for changing contracts are distributed in advance as paper media to each user who wishes to join the insurance, and detailed confirmation of the contents is always available to the user. It is assumed that a base environment is provided.
These documents are provided together with manuals for these devices when, for example, a mobile phone or a personal computer is purchased.

  FIG. 3 is a conceptual diagram showing a functional configuration at the time of insurance payment in the system 10, and includes a management server 12, a management terminal 14 operated by an operator, and a plurality of persons operated by an insured person or insurance beneficiary. The client terminal 16 includes a plurality of external servers 18 managed by medical institutions, local governments, etc., a user bank computer 20, and an operator bank computer 22.

In this case, the operation server 12 includes an insurance payment processing unit 42, an insurance premium settlement processing unit 44, an insurance contract database 34, and an operation performance database 40.
The insurance payment processing unit 42 and the insurance fee settlement processing unit 44 are realized by the CPU of the management server 12 executing necessary processes according to the OS and a dedicated application program.

Next, in accordance with the flowcharts of FIGS. 4 and 5, a processing procedure when the insured person or the insurance beneficiary receives the payment of the insurance money will be described.
For example, when an insured person is hospitalized due to an injury and requests payment of insurance money (hospital benefit), when a client terminal 16 accesses a predetermined URL in the management server 12, a payment application form from the insurance payment processing unit 42 Is transmitted (S30 in FIG. 4) and displayed on the display of the client terminal 16.
Enter the necessary information such as name, insured code, hospitalization period, medical institution, etc. in this payment application form, and reply to the management server 12, the insurance payment processing unit 42 that received this (S31) sends The inputted data is collated with the registered data in the insurance contract database 34 (S32), and the validity of the applicant (claimee) is confirmed.
Further, the insurance payment processing unit 42 accesses the external server 18 of the medical institution in which the insured is hospitalized, and requests an inquiry about the fact of hospitalization, the hospitalization period, etc. of the user (S33).

Then, when data indicating that the patient has been hospitalized for a certain period of time is transmitted from the external server 18, the insurance payment processing unit 42 sends the invoiced account withdrawn account of the insured person to the computer 22 of the operator bank. A remittance process is requested (S34).
On the other hand, the computer 22 of the manager bank transfers insurance money to the computer 20 of the bank where the insured has opened an account.
When the bank transfer of the insurance money is completed, the insurance money payment processing unit 42 registers the data indicating the insurance money payment and the amount data in the operation result database 40 (S35).

In addition, when the insured person dies and the insurance beneficiary accesses a predetermined URL in the management server 12 from the client terminal 16, a payment application form is transmitted from the insurance payment processing unit 42 (S40 in FIG. 5). ) And displayed on the display of the client terminal 16.
When necessary information such as the name of the insured person and the name of the beneficiary are entered in response to this payment application form and sent back to the management server 12, the insurance payment processing unit 42 receiving the information (S41) The transmitted input data is collated with registered data in the insurance contract database 34 (S42), and the validity of the applicant (claimee) is confirmed.
In addition, it accesses the external server 18 of the local government where the insured resided, and requests the user's death fact inquiry (S43).

Then, when data indicating that there is no doubt that the external server 18 has been transmitted, the insurance payment processing unit 42 insures the insurance for the account payee debiting account of the insurance recipient to the computer 22 of the operator bank. A request for remittance of gold is requested (S44).
On the other hand, the computer 22 of the manager bank sends the insurance money to the computer 20 of the bank where the insurance recipient has an account.
When the bank transfer of the insurance money is completed, the insurance money payment processing unit 42 stores data indicating the insurance money payment in the operation result database 40 (S45).
When paying death insurance claims, it is possible to have an external research organization investigate the facts just in case, and wait for a report that there is no mistake before executing the insurance remittance processing.

In order to prevent the occurrence of insurance fraud, it can be operated such that the insurance payment is refused for two years after joining the insurance, or no guarantee is given for less than one year and 50% is guaranteed for less than two years.
In this way, it is possible to avoid troubles between applicants (claimees) and claims of claim payments by claiming periodical conditions for claim payments. And cost savings.
Instead, after two years have passed, the user can be given a merit by paying the insurance money unconditionally.
Or, even during the above non-secure period (non-guaranteed period), when highly reliable electronic data indicating that the insured person is in good health is disclosed and the operator consents The non-secure period can be shortened or eliminated individually.

This system 10 has a function of automatically transferring dividends to an insured person based on the insurance operation results and a function of automatically collecting additional insurance premiums from the insured person.
Hereinafter, according to the flowchart of FIG. 6, the automatic remittance function for dividends and the automatic collection function for additional premiums will be described.
In other words, as described above, the system 10 is based on the assumption of one-year retirement insurance as a general rule. Therefore, the insurance fee settlement processing unit 44 is stored in the operation results database 40 when one year has passed since the insurance application deadline. (S50) and data of all subscribers stored in the insurance contract database 34 are extracted (S51), and these data are extracted. By applying the predetermined criteria, it is determined whether or not dividend payment is required and additional insurance premium collection is required (S52).

Basically, when the amount of insurance actually paid to the insured or the beneficiary is less than the planned amount, the insurance fee settlement processing unit 44 determines that “payment of dividends required”. If the actual amount of insurance paid exceeds the planned amount, it is determined as “collection of additional premium required”.
In addition, the insurance fee settlement processing unit 44 calculates the dividend per insured when it is determined that “payment of dividends required” and determines that it is “collection of additional premiums required”. Calculate additional premiums per insurer.
If the actual amount of insurance paid and the planned amount are exactly balanced, the insurance fee settlement processing unit 44 determines that neither payment of dividends nor collection of additional insurance premiums is necessary.

If it is determined that dividend payment is necessary, the insurance fee settlement processing unit 44 requests the operator bank computer 22 to process dividend remittance processing for all insured persons' call charge debit accounts. (S53).
At the same time, the insurance fee settlement processing unit 44 registers data indicating the payment of dividends in the insurance contract database 34 and the operation performance database 40 (S54).

On the other hand, if it is determined that additional insurance premiums must be collected, the insurance premium settlement processing unit 44 makes an amount equivalent to the additional insurance premiums from the invoiced account of each insured person to the computer 20 of the user bank. And request to transfer money to the bank account of the operator (S55).
At the same time, the insurance premium settlement processing unit 44 registers data indicating collection of additional insurance premiums in the insurance contract database 34 and the operation performance database 40 (S56).

  As described above, in the case of this system 10, when a certain amount of profit is generated according to the operation results, it is returned to each user as a dividend, and when a certain amount of loss occurs, an additional premium is paid. Since it is assumed that collection is performed, as a result, it is possible to collect the minimum insurance premium necessary for the user.

In the above, an example is shown in which dividend payments and collection of additional premiums are executed equally for each insured, but there are differences depending on the health level or health maintenance activities of each insured. It is also possible to operate as it occurs.
FIG. 7 is a conceptual diagram showing the functional configuration of the system 10 in that case, which is managed by the operation server 12, the management terminal 14 operated by the operator, the plurality of client terminals 16 operated by the insured, and the medical institution or the like. A plurality of external servers 18, a user-side bank computer 20, and an operator-side bank computer 22.
Each client terminal 16 is connected to a health data collection device 50 such as an electronic body fat scale, an electronic weight scale, and an electronic blood pressure monitor via a predetermined interface.

In this case, the management server 12 includes the health data registration processing unit 52, the health level determination processing unit 54, the insurance fee settlement processing unit 32, the insurance contract database 34, the management performance database 40, and the health level determination standard database 56. It has.
The health data registration processing unit 52 and the health level determination processing unit 54 are realized by the CPU of the management server 12 executing necessary processes according to the OS and a dedicated application program.
In addition, the health degree criterion database 56 is provided in the hard disk of the management server 12.

Next, a processing procedure in the case where payment of different dividends or collection of additional premiums is executed in accordance with the health level and health maintenance activities of each insured will be described.
First, the insured measures his / her health data regularly (for example, weekly) using an electronic body fat scale, an electronic blood pressure monitor, or the like while the client terminal 16 is running a dedicated application program.
As a result, the measurement data is automatically transmitted from the application program to the operation server 12 and registered in the insurance contract database 34 via the health data registration processing unit 52.

Thus, by using the dedicated application program and the health data collection device 50 connected to the client terminal 16, there is an advantage that the health data is automatically transmitted to the management server 12 simultaneously with the measurement. The registration method is not limited to this.
For example, when the insured person accesses the system operator's home page and requests registration of health data, the health data registration processing unit 52 transmits an input form dedicated to the user and is displayed on the display of the client terminal 16.
In response to this, the user inputs the health data such as body weight, body fat percentage, and blood pressure measured by himself / herself and transmits them to the management server 12.
Receiving this, the health data registration processing unit 52 registers it in the insurance contract database 34.

The health data registered in the insurance contract database 34 through the health data registration processing unit 52 is not limited to the data measured by the user as described above.
For example, a user is obliged to perform a health check for a predetermined examination item in a specific medical in advance, and the health data registration processing unit 52 stores the user's health data transmitted from the external server 18 of the medical institution in the insurance contract database 34. You can also register for.

The health level determination processing unit 54 periodically executes the health level determination process on the user health data registered in the insurance contract database 34 as described above.
In other words, the health level judgment reference database 56 stores a health level judgment table for each age and gender, and the health level judgment processing unit 54 stores the health data, age, sex, etc. of each insured person. By applying the attribute information, evaluation points representing the degree of health (for example, three-level evaluation of A, B, and C) are calculated and registered in the insurance contract database 34.

The health data and health level judgment points of each insured person registered in the insurance contract database 34 are referred to by the insurance fee adjustment processing unit 44 at the time of insurance fee adjustment processing, and will influence dividends and additional insurance premiums. .
For example, regardless of the health evaluation points, when respecting the regular declaration of health data at a set interval, dividends and additional premiums for each person depending on the health data declaration rate Calculation rules that cause differences are programmed, and the insurance fee settlement processing unit 44 assigns high dividends and low additional premiums to users with high declaration rates, and low dividends to users with low declaration rates. Gold and high additional premiums will be allocated.

On the other hand, when giving priority to the absolute health level, a calculation rule is programmed so that a difference in each person's dividend or additional premium is generated according to the health level evaluation point.
As a result, the insurance fee settlement processing unit 44 assigns a high dividend or a low additional insurance premium to a user with a high health evaluation point, and assigns a low dividend or a high additional insurance premium to a user with a low health score.

The health data and health level determination points of each user registered in the insurance contract database can also be used as a standard for calculating insurance premiums at the time of renewal in the next year.
In this case, a calculation rule that causes a difference in the dividends and additional premiums of each person according to the health data reporting rate and the health evaluation point is stored in the insurance premium calculation reference database 38 in advance.
As a result, for example, the premium calculation unit 28 calculates a relatively low premium for a user with a high health data declaration rate in the previous year, and calculates a relatively high premium for a user with a low declaration rate. .
Alternatively, the premium calculation unit 28 calculates a relatively low premium for a user who has obtained a high health evaluation point in the previous year, and calculates a relatively high premium for a user who has a low health evaluation point. .

When an insured person having a significant health condition is detected by the health level determination processing unit 54, the data is transmitted to the management terminal 14.
In response to this, the operator contacts the insured person by e-mail, telephone or the like, and gives advice to consult a doctor.

As described above, by requiring the insured to regularly submit health data and medical examinations at medical institutions, it is possible to raise each person's health awareness, and to reduce the overall mortality rate and hospitalization rate. It can be reduced.
As a result, the payment amount of the insurance money is reduced as a whole, and the so-called “mortality gain” can be maximized.
In addition, by improving the operating results of System 10 in this way, the effect of reducing premiums, increasing dividends, or reducing additional premiums can be achieved, which contributes to the benefits of the insured. Become.

In the above description, a one-year renewal insurance has been explained. However, it is naturally possible to apply this insurance business management system 10 to a long-term insurance for two years or more.
In this case, it is required for the insured person to open another account (second account) in another bank in addition to the call charge debit account (first account).

Long-term insurance generally collects relatively high premiums in the first half of the insurance period, and surplus deposits that are the difference between planned spending and actual expenses are used to cover the latter half However, there are an increasing number of insurance companies that are driven to bankruptcy due to recent reverses and phenomena.
Therefore, in this system 10, even in the case of long-term insurance for two years or more, the premium settlement processing unit 44 settles the difference between the planned expenditure amount and the actual result in units of one year, and the actual result falls below the planned value. A rule is adopted in which the dividend is temporarily returned to the user's second account as a dividend.
In other words, the company intends to operate the insurance business in a sound manner by completely eliminating the “pursuit of profits from investment management”, which has a very long-term investment risk of 50 to 60 years.

However, since the funds accumulated in this second account are to cover the shortage of premiums in the second half of the insurance period, the pledge by the operator is set in advance, and the insured can withdraw this freely. I can't.
Of course, when canceling the insurance contract on the way, the accumulated money of the second account is returned to the user's first account after subtracting the unpaid call charges and the like so far.

It is a conceptual diagram which shows the function structure of the insurance business management system at the time of insurance subscription. It is a flowchart which shows the process sequence of the insurance business management system at the time of insurance subscription. It is a conceptual diagram which shows the function structure of the insurance business management system at the time of insurance payment and insurance premium settlement. It is a flowchart which shows the process sequence at the time of an insured person receiving payment of insurance money. It is a flowchart which shows the process sequence at the time of an insurance beneficiary receiving payment of insurance money. It is a flowchart which shows the process sequence at the time of insurance premium settlement. It is a conceptual diagram which shows the function structure of an insurance business management system in the case of providing a difference in a dividend or an additional insurance premium according to the health degree or health maintenance activity for every insured.

10 Insurance business management system
12 Insurance business management server
14 Management terminal
16 Client terminal
18 External server
20 User bank computer
22 Operator bank computer
24 communication network
26 Insurance processing department
28 Insurance premium calculation department
30 Mail processing part
32 Insurance fee collection processing department
32 Insurance premium settlement processing department
34 Insurance contract database
36 Telephone subscriber database
38 Insurance premium calculation database
40 Operational results database
42 Insurance payment processing department
44 Insurance premium settlement processing department
50 Health data collection device
52 Health Data Registration Processing Department
54 Health judgment processing section
56 Health criteria database

Claims (1)

A telephone subscriber database held by a telephone carrier that stores information such as the name, address, and call charge debit account of the telephone subscriber,
An insurance product database that stores information about insurance products;
A premium calculation standard database that stores premium calculation standards for each insurance product;
An insurance contract database that stores information such as the name and address of the insured, the name and address of the beneficiary, the insurance type, the amount of insurance, and the enrollment period;
For each insurance product, an operational performance database that stores operational performance information such as collected premiums and insurance claims paid,
A means for sending an insurance menu screen to the client terminal of the insurance applicant and prompting them to select an arbitrary insurance;
When information indicating that a specific insurance has been selected is sent from the client terminal, an application form for the insurance is sent, the name, address, age, gender, health information, and the name of the beneficiary And means for prompting the user to input necessary information such as address and e-mail address,
Means for confirming that the name and address transmitted from the client terminal match the data stored in the telephone subscriber database;
Means for applying the input data transmitted from the client terminal to the above-mentioned premium calculation standard, and calculating the premium;
A means for sending a screen showing the insurance premium to the client terminal and requesting the intention to join;
Means for registering a record of the insurance application applicant with a code indicating a provisional contract added to the insurance contract database when information indicating the application for application is transmitted from the client terminal;
A means for generating a confirmation e-mail in which a description of the contents of the insurance contract and a request for requesting the intention of this contract are generated and sending it to the e-mail address of the applicant;
Means for registering a code indicating the contract in the corresponding record of the insurance contract database when an e-mail in which an intention of the contract is expressed is transmitted;
Means for requesting the computer of the financial institution related to the account to withdraw the insurance fee equivalent amount from the call charge debit account stored in the telephone subscriber database of the insurance subscriber;
Means for registering information indicating the collection of insurance premiums in the above operational performance database;
When an insurance payment request is sent from a client terminal, a means for sending a payment application form and requesting input of necessary items,
Means for confirming whether the input data transmitted from the client terminal matches the data stored in the insurance contract database;
Means for requesting a computer of a predetermined financial institution to remit the amount equivalent to the insurance money for the call charge debiting account stored in the telephone subscriber database of the insurance claim payment applicant if they match,
Means for registering information indicating the insurance payment in the above-mentioned operation result database;
With reference to the insurance amount data accumulated in the above operating results database, it is determined that dividend payment is required when the insurance amount actually paid to the applicant for insurance payment falls below the planned amount, and the insurance payment Means for determining that additional premiums must be collected if the amount of insurance actually paid to the applicant exceeds the planned amount;
A means for calculating the dividend per insured, if dividend payment is required;
Means for requesting a computer of a predetermined financial institution to perform a remittance processing equivalent to a dividend to a call charge debit account stored in the telephone subscriber database of each insured;
Means for registering information indicating the payment of dividends in the above-mentioned operation result database;
If additional premiums need to be collected, a means for calculating additional premiums per insured,
Means for requesting the computer of the financial institution related to the account to withdraw the amount equivalent to the additional insurance premium from the call charge withdrawal account stored in the telephone subscriber database of each insured;
Means for registering information indicating collection of additional insurance premiums in the above-mentioned operational performance database;
An insurance business management system characterized by comprising:
Each insured's client terminal is connected to a health data collection device and is equipped with an application program for transmitting health data measured by the health data collection device,
Means for registering health data transmitted from the client terminal in a predetermined storage means in association with the insured;
Means for applying the health data accumulated in the storage means and the attribute information of the insured person to a prepared health degree determination criterion to calculate a health degree evaluation point, and storing the health degree evaluation points in a predetermined storage means;
Means for adjusting the amount of dividends and additional premiums according to the insured's health evaluation points or the rate of declaration of health data;
An insurance business management system characterized by comprising

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