TWM597470U - Mutual insurance system - Google Patents

Abstract

A mutual insurance system includes a database, a claims subsystem, a premium subsystem, and an underwriting subsystem. The database stores a group insurance roster. The claims subsystem reviews claims and calculates the amount of prime minister’s compensation for the day. The premium subsystem calculates the amount of prime minister’s compensation for that day divided by the corresponding insured in the group insurance roster. The total amount, and get a share of the cost of the day, and generate multiple instructions for paying premiums to the insured in the group insurance register. The underwriting subsystem deletes the to-be-insured information that has passed the claims review in the group insurance register from 0:00 on the day following the claim review date to generate and store the updated group insurance register in the database. With this, a mutual insurance method for managing mutual insurance can be implemented.

Description

Mutual insurance system

The present invention relates to an insurance system, especially a mutual insurance system for managing mutual insurance.

The traditional commercial insurance system usually cooperates with the commodity structure, adopts annual, quarterly, or monthly regular payment methods, and determines each payment rate through actuarial pricing. In addition, the insured's payment obligation has nothing to do with the actual claim status of the commodity. Often, when no one is in danger, the insured still has to pay a fixed amount regularly. Therefore, whether there is another insurance system to solve the conventional insurance model has become a problem to be solved.

Therefore, the purpose of the present invention is to provide a mutual insurance system and mutual insurance method for managing mutual insurance.

Therefore, the present invention provides a mutual assistance insurance system suitable for multiple computer devices, and includes a database, a claims subsystem, a premium subsystem, and an underwriting subsystem.

The database stores a group insurance roster corresponding to a group insurance. The group insurance roster contains a plurality of data to be insured corresponding to a plurality of insured persons. The claims subsystem is electrically connected to the database, and executes claims review based on at least one claim data corresponding to at least one of the computer devices to generate a one-day Prime Minister’s claim amount and a payment claim instruction that passed the claim review, Each of the claims information corresponds to one of the insureds in the group insurance register.

The premium subsystem is electrically connected to the claims subsystem and the database, and calculates the prime minister’s compensation amount for that day divided by the total number of valid insured persons corresponding to the group insurance roster to obtain a share of the day’s cost and incur Respectively pay multiple premium instructions for such insured persons in the group insurance register. The amount corresponding to each of the premium payment instructions is the apportioned cost, and the upper limit of the apportioned cost for each insured is the pre-determined annual premium paid by the insured less the one paid by the insured Join the fee, and then subtract one of the insured's assessed contributions paid.

The underwriting subsystem is electrically connected to the database and the claims subsystem, and based on the at least one claim information and the group insurance roster passed the claim review, the group insurance register has been deleted from the group insurance register from the zero day following the claim review date. The reviewed at least one insured data corresponding to the at least one insured to generate and store the updated group insurance roster in the database.

In some implementation aspects, wherein, initially, the underwriting subsystem based on the to-be-insured data from the computer devices and corresponding to the insured persons, respectively, and performs an inspection on the to-be-insured data to: Generate a verification roster including the information to be secured for the verification, and generate an initial roster of group insurance based on the roster of verification and a registration fee paid, and store the roster of group insurance in the database . The premium sub-system is electrically connected to the underwriting sub-system to receive the verification roster, and executes a corresponding withholding and joining fee for each payment method corresponding to each of the data to be insured in the verification roster to generate a deduction If the paid entry fee list of the materials to be secured is successfully paid, the amount of the entry fee is equal to the paid entry fee.

In some implementation aspects, wherein the insurance period corresponding to the group insurance roster is one year from the start date, the premium subsystem will check each insured person who joins the audit roster on the start date. The corresponding payment method is executed to withhold the joining fee. Within that year, the underwriting subsystem based on the insured data from any one of the computer devices and corresponding to the insured, and performs an inspection on the insured data to generate the insured including the successful inspection The audit roster of information. The premium subsystem executes the corresponding withholding of the joining fee for the payment method corresponding to the to-be-insured data of the verification roster, so as to generate a roster of paid-in joining fees including the to-be-insured data withheld successfully. The underwriting subsystem then generates an updated group insurance roster based on the inspection roster and the paid entry fee roster, and stores it in the database.

In some implementations, where the premium subsystem calculates each insured member in the group insurance roster on the last day of the year, based on the group insurance roster of the day and all the assessed expenses within the year The one-year premium payment difference to be paid by the person, and a corresponding final payment instruction is generated, and after receiving the annual premium payment difference of each insured in the group insurance roster, an experience refund of the group insurance is paid , The difference of each year’s premium paid by the insured is equal to the predetermined year’s premium paid minus the joining fee, and then the sum of all the apportioned expenses of the insured in the year, the experience of the group insurance The refund is equal to K* (income of premiums payable-operating expenses-claims expenses)-accumulated losses for the previous N years. K is greater than or equal to 0 and less than or equal to 100%, and N is equal to 0 or a positive integer.

In some embodiments, when the premium subsystem receives an exit application from one of the computer devices on an exit date, it calculates the premium payable and the premium payable to the insured corresponding to the computer device. A difference in premiums paid, and when it is judged that the difference is less than zero, a refund instruction corresponding to the difference is generated, and when it is judged that the difference is greater than or equal to zero, and then the decision before the exit date A minimum of the total amount of premiums owed and the difference is equal to a supplementary payment amount to generate a supplementary payment instruction whose amount corresponds to the supplementary payment amount. The actually paid premium is equal to the sum of the corresponding joining cost and the paid assessed cost of the insured. Based on the withdrawal application, the underwriting subsystem deletes the insured information corresponding to the insured in the group insurance register from 0:00 on the day following the withdrawal date to generate and store the updated group insurance register in the database .

The effect of the new model is that the premium subsystem calculates the assessed expenses on the day of the day, so that the insured persons participating in the mutual insurance only receive claims when there is an insurer among them (that is, the claim information) Corresponding payment notice (that is, the payment of the premium instruction and the corresponding amount is the shared cost), so it is not necessary to pay a fixed amount of the model regularly as required by conventional insurance.

Before the present invention is described in detail, it should be noted that in the following description, similar elements are denoted by the same number.

Referring to FIG. 1, an embodiment of the new mutual insurance system 100 is applicable to multiple computer devices 91, 92, and includes an underwriting subsystem 1, a claims subsystem 2, a premium subsystem 3, and a database 4. And a network service system 5. The computer devices 91 and 92 respectively correspond to multiple users, and are, for example, smart phones, tablet computers, or other computer devices with network functions. In addition, for simplicity and clarity of the drawings, FIG. 1 only exemplarily depicts two computer devices 91, 92, and does not limit the number.

The mutual insurance system 100 belongs to an insurance company. The network service system 5 provides, for example, a web service to allow the computer devices 91 and 92 to establish connections to access information through the network, and to electrically connect the underwriting subsystem 1 and the premium subsystem 3. The claims subsystem 2 is electrically connected to the underwriting subsystem 1 and the premium subsystem 3. The database 4 is electrically connected to the claims subsystem 2, the underwriting subsystem 1, and the premium subsystem 3. Any one of the underwriting subsystem 1, the claims subsystem 2, the premium subsystem 3, the database 4, and the network service system 5 is, for example, one or more server hosts, cloud servers of the insurance company Devices, large computer mainframes, or other computer equipment, and an electrical connection is formed by a network cable, for example.

Referring to FIGS. 1 and 2, FIG. 2 is an aspect of the mutual insurance method implemented by the mutual insurance system 100. The mutual insurance method includes steps S1 to S8.

In step S1, initially, the underwriting subsystem 1 performs inspection on the insured data based on multiple insured data from some of the computer devices 91 and 92 and corresponding to multiple insured persons respectively Verification to generate a verification roster that includes the data to be secured for verification. The premium subsystem 3 receives the verification roster and performs a corresponding withholding and joining fee on each payment method corresponding to each of the data to be insured on the verification roster at the beginning date of the verification roster to generate including the successful deduction Of the materials to be protected shall be paid to join the roster of fees.

For example, 10,000 insured persons belong to employees of the same enterprise, and use their computer devices 91, 92 to provide 10,000 pieces of insurance data through the network service system 5 to join the mutual insurance system 100. Mutual assistance insurance provided, such as specific cancer insurance for the first time. The underwriting subsystem 1 checks each of the insured materials in relation to the insured’s age, insured amount, health statement, major claim history, incident verification, exclusions, money laundering prevention, etc. For example, if all of them pass the verification, the verification roster will contain the 10,000 items to be protected. Each of the data to be protected also includes information such as a credit card authorization letter (that is, the payment method), and the joining fee is preset, for example, 50 yuan.

In step S2, the underwriting subsystem 1 generates an initial group risk register based on the verification register and the paid entry fee register, and stores the group insurance register in the database 4. The group insurance roster contains the data to be insured corresponding to the insured persons, respectively, and the insurance period corresponding to the group insurance roster is, for example, one year from the start date.

In step S3, within the year, the underwriting insurance system based on the to-be-insured data from any one of the computer devices 91, 92 and corresponding to the insured, and performs a check on the to-be-insured data to generate (That is, to update) the audit roster including the information to be secured that was successfully audited. The premium sub-system 3 executes corresponding withholding of the joining fee on the payment method corresponding to the to-be-insured data of the verification roster, so as to generate a roster of paid-in joining fees including the to-be-insured data withheld successfully. The underwriting subsystem 1 then generates an updated group insurance roster based on the verification register and the paid entry fee register, and stores the group insurance register in the database 4. In other words, after the start date, any insured person who wants to join the mutual insurance, such as a new employee of the enterprise, must pay the joining fee, such as 50 yuan, on the day of joining.

In step S4, the claims subsystem 2 executes claims review based on at least one claim information corresponding to at least one of the computer devices 91, 92 to generate a prime claim amount and a pay claim command that pass the claim review on the same day Each of the claims information corresponds to one of the insureds in the group insurance register. For example, the underwriting subsystem 1 makes, for each of the claims data, the claims records, non-payment records, special records, prepayment records, medical records, high-risk lists of money laundering, etc. related to the insured insured. Review and sum up all the claims that passed the claims review on that day to obtain the amount of the Prime Minister’s compensation for that day. The payment claims instruction provides the payment method provided by the corresponding data to be protected, for example, the execution of the corresponding remittance.

In step S5, the premium subsystem 3 calculates the prime minister’s compensation amount on that day divided by the total number of valid insured persons corresponding to the group insurance roster to obtain a share of the cost of the day, and generates a corresponding share of the group insurance roster The multiple premium payment instructions of such insured persons, the amount corresponding to each premium payment instruction is the apportioned expenses, and the upper limit of the apportioned expenses is the insured’s predetermined annual premium payment minus the deduction of the The insured person’s paid joining fee, minus the insured person’s paid sharing fee (excluding the current one). For example, on a certain day within the year, there were only one insured who filed a claim, and the total number of valid insured persons in the group insurance register was 10,000. Assuming that the Prime Minister’s compensation amount on that day If it is 300,000 yuan, then the apportioned cost is equal to 30 yuan (that is, 300,000 yuan / 10,000 individuals). Each of the premium payment instructions executes the corresponding deduction through the corresponding payment method (such as credit card authorization letter and other information) contained in the data to be insured.

In step S6, the underwriting subsystem 1 deletes the at least one insured person who has passed the claims review in the group insurance register from 0:00 on the day following the claim review date based on the at least one claim information and the group insurance register that have passed the claim review The at least one insurance data corresponding to the person to generate the updated group insurance roster and store the group insurance roster in the database 4. In other words, the insurance contract of the mutual insurance has been terminated for the insured insured.

In step S7, when the premium subsystem 3 receives an exit application from one of the computer devices 91, 92 on an exit day, it calculates a due payment for the insured corresponding to the computer devices 91, 92 A difference between the premium and a paid premium, and when it is judged that the difference is less than zero, a refund instruction corresponding to the difference is generated, and when it is judged that the difference is greater than or equal to zero, and then decided on the exit date The smallest of the previous total amount of premiums owed and the difference is equal to a supplementary payment amount to generate a supplementary payment instruction whose amount corresponds to the supplementary payment amount. The actually paid premium is equal to the sum of the corresponding joining cost and the paid assessed cost of the insured. The underwriting subsystem 1 also deletes the insured information corresponding to the insured in the group insurance roster from 0:00 on the day following the withdrawal day according to the withdrawal application, so as to generate and store an updated group insurance roster. The refund instruction and the supplementary receipt instruction operate similarly to the payment claim instruction and the premium payment instruction, respectively. For example, the calculation of the premium payable is the premium paid for the predetermined year (such as 365 yuan) * (Min (withdrawal effective date, contract expiration date)-joining date) / (contract expiration date-contract effective date). This product (that is, the mutual insurance) is a group insurance, the effective date of the contract is the effective date when the contract is signed, and the joining date is the date when each insured adds insurance.

At step S8, on the last day of the year, the premium subsystem 3 calculates the amount of each insured person in the group insurance register to be paid based on the group insurance register on that day and all the apportioned expenses within the year One year's premium payment difference, and a corresponding final payment instruction is generated, and after receiving the annual premium payment difference of each insured in the group insurance register, an experience refund of the group insurance is paid. The difference of each year’s premium paid by the insured is equal to the premium paid in the predetermined year minus the joining fee, and then the sum of all the apportioned expenses of the insured in that year. The experience refund of the group insurance (that is, the mutual insurance) is equal to K* (income of premiums payable-operating expenses-claims expenses)-accumulated losses in the previous N years, K is greater than or equal to 0 and less than or equal to 100%, and N is equal to 0 or positive integer. The final payment instruction and the payment premium instruction operate in a similar manner. For example, the premium payment for the scheduled year is 365 yuan. Assuming that no insured person is in danger throughout the year, the difference in premium payment for the year is 365 minus 50 equals 315 yuan. For another example, assuming that one of the insured's shared expenses for the whole year is equal to 257 yuan, the difference in premiums paid for that year is 365 minus 50 and 257 is equal to 58 yuan. The income of the premium payable refers to the total value of the premium payable corresponding to each insured person during the insurance period of the year, for example, no one adds a surrender midway through the year, and all insured persons have an insurance period of 365 Day, and each insured person's premium payable in the year is 365 yuan, then the income of the premium payable from the experience refund in the year is 365 yuan times the total number of insured; K value range is 0~ 100% (100% in this case), N is an integer greater than or equal to zero (in this case, the first year is 0, the second year is 1, the third year is 2, and so on).

In addition, it should be particularly noted that step S7 can also be placed between any two adjacent steps between steps S3~S6, or step S3 can also be placed between any two adjacent steps between steps S4~S7. It does not affect the implementation and operation of the mutual insurance method. Similarly,

In summary, by the premium subsystem charging the joining fee for each insured first on the starting day, and when the claim is submitted and passed by the at least one insured on a daily basis, the The cost-sharing allows those insureds participating in mutual insurance to receive the corresponding payment notice when they are in danger (that is, the premium payment instruction and the corresponding amount is the cost-sharing), and finally at the last year of the year The daily payment of the difference in premiums paid in that year. The mutual insurance system and method not only need to pay a fixed amount regularly like conventional insurance, but also implement the mutual insurance based on the structure of group insurance, and use the experience refund unique to group insurance to achieve the essence The mutual aid cycle increases the incentives for companies to insure their employees, so they can use the characteristics of group insurance products to negotiate and experience refunds to further achieve a new concept of overall risk allocation, so it can really achieve the new purpose of cost.

However, the above are only examples of the new model. When the scope of the new model cannot be limited by this, all simple equivalent changes and modifications made according to the patent application scope and patent specification content of the new model are still classified as Within the scope of this new patent.

100: Mutual assistance insurance system 1: underwriting subsystem 2: Claims subsystem 3: Premium subsystem 4: database 5: Internet service system 91: Computer device 92: Computer device S1~S8: Step

Other features and functions of the present invention will be clearly presented in the embodiments with reference to the drawings, in which: FIG. 1 is a block diagram illustrating an embodiment of the new mutual insurance system; and FIG. 2 is a flowchart illustrating the mutual insurance method implemented by this embodiment of the new mutual insurance system.

100: Mutual assistance insurance system

1: underwriting subsystem

2: Claims subsystem

3: Premium subsystem

4: database

5: Internet service system

91: Computer device

92: Computer device

Claims (5)

A mutual insurance system, suitable for multiple computer devices, and includes: A database to store a group insurance roster corresponding to a group insurance, the group insurance roster contains multiple data to be insured corresponding to multiple insured persons; A claims subsystem, electrically connected to the database, and according to at least one claim data corresponding to at least one of the computer devices, perform claim review to generate a day-to-day Prime Minister’s claim amount and a payment claim instruction that passed the claim review , Each of the claims information corresponds to one of the insureds in the group insurance register; A premium subsystem, which is electrically connected to the claims subsystem and the database, and calculates the daily prime minister’s compensation amount on that day divided by the total number of valid insured persons corresponding to the group insurance roster to obtain a share of the cost of the day, and Generate multiple premium payment instructions that correspond to the insureds in the group insurance register, and the amount corresponding to each premium payment instruction is the apportioned cost, corresponding to the apportioned cost of each insured The upper limit is a predetermined annual premium paid by the insured person minus a paid joining fee of the insured person, and then minus a paid assessed fee of the insured person; and An underwriting insurance subsystem, which is electrically connected to the database and the claims subsystem, and deletes the group insurance register from 0: 00 on the day following the claim review date based on the at least one claim information and the group insurance register that have passed the claim review The at least one insured data corresponding to the at least one insured reviewed by the claim, to be generated and stored in the updated group insurance roster of the database. The mutual insurance system as described in claim 1, wherein: Initially, the underwriting subsystem based on the data to be insured from the computer devices and corresponding to the insureds respectively, and performs an inspection on the data to be insured to generate the requirements including the successful inspection A verification roster of information, and based on the verification roster and a roster of paid-in fees, the initial group insurance roster is generated, and the group insurance roster is stored in the database, The premium sub-system is electrically connected to the underwriting sub-system to receive the verification roster, and executes a corresponding withholding and joining fee for each payment method corresponding to each of the data to be insured in the verification roster to generate a deduction If the paid entry fee list of the materials to be secured is successfully paid, the amount of the entry fee is equal to the paid entry fee. The mutual insurance system as described in claim 2, wherein the insurance period corresponding to the group insurance roster is one year from the start date, and the premium subsystem The payment method corresponding to the insured performs the corresponding withholding of the joining fee, Within that year, the underwriting subsystem based on the insured data from any one of the computer devices and corresponding to the insured, and performs an inspection on the insured data to generate the insured including the successful inspection In the verification roster of data, the premium subsystem performs corresponding deduction of the entry fee for the payment method corresponding to the data to be insured in the verification roster to generate After paying the entry fee roster, the underwriting subsystem then generates an updated group insurance roster based on the verification roster and the paid entry fee roster, and stores it in the database. The mutual insurance system as described in claim 3, wherein, on the last day of the year, the premium subsystem calculates each of the group insurance rosters based on the group insurance roster of the day and all the assessed expenses within the year A one-year premium difference to be paid by the insured, and a corresponding final payment instruction is generated, and the group insurance is paid after receiving the annual premium payment difference of each insured in the group insurance register For experience refunds, the difference in the premiums paid by the insured in the year equals the scheduled premiums paid in the year minus the joining fee, and then the sum of all the apportioned expenses of the insured in the year. The experience refund of the insurance is equal to K* (income of premiums payable-operating expenses-claims expenses)-accumulated losses for the previous N years. K is greater than or equal to 0 and less than or equal to 100%, and N is equal to 0 or a positive integer. The mutual insurance system as described in claim 4, wherein, when the premium subsystem receives an application for withdrawal from one of the computer devices on an exit date, it calculates the number of the insured corresponding to the computer device A difference between the premium payable and a premium actually paid, and when it is judged that the difference is less than zero, a refund instruction corresponding to the difference is generated, and when it is judged that the difference is greater than or equal to zero, and then decided on the The minimum of the difference between the total amount of arrears of premiums paid before the date of withdrawal and the difference is equal to a supplementary payment amount to generate a supplementary receipt instruction whose amount corresponds to the supplementary payment amount, and the actual premium paid is equal to that of the corresponding insured person. The sum of the joining fee and the assessed cost paid, Based on the withdrawal application, the underwriting subsystem deletes the insured information corresponding to the insured in the group insurance register from 0:00 on the day following the withdrawal date to generate and store the updated group insurance register in the database .

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