Mark S Blumberg

US Patent:

7392201, Jun 24, 2008

Filed:

May 18, 2001

Appl. No.:

09/861379

Inventors:

Gregory S. Binns - Wilmette IL, US
Mark Stuart Blumberg - Oakland CA, US

Assignee:

TruRisk, LLC - Lake Forest IL

International Classification:

G06Q 40/00
G06Q 50/00
G06F 19/00
A61B 5/00

US Classification:

705 4, 705 2, 705 3, 600300

Abstract:

A computer-implemented process of developing a person-level cost model for forecasting future costs attributable to claims from members of a book of business, where person-level data are available for a substantial portion of the members of the book of business for an actual underwriting period, and the forecast of interest is for a policy period is disclosed. The process uses development universe data comprising person-level enrollment data, historical base period health care claims data and historical next period claim amount data for a statistically meaningful number of individuals. The process also provides at least one claim-based risk factor for each historical base period claim based on the claim code associated with the health care claim and provides at least one enrollment-based risk factor based on the enrollment data. The process also develops a cost forecasting model by capturing the predictive ability of the main effects and interactions of claim based risk factors and enrollment-based risk factors, with the development universe data through the application of an interaction capturing technique to the development universe data.

US Patent:

7555438, Jun 30, 2009

Filed:

Jul 21, 2006

Appl. No.:

11/491035

Inventors:

Gregory S. Binns - Lake Forest IL, US
Mark Stuart Blumberg - Oakland CA, US

Assignee:

TruRisk, LLC - Lake Forest IL

International Classification:

G06Q 10/00

US Classification:

705 4, 705 2, 705 3, 600300, 600301

Abstract:

A method of model development for use in underwriting group life insurance for a policy period includes collecting medical claims data for the group to be underwritten, where each medical claim being related to a particular employee of the group. Morbidity categories are provided that categorize the medical claims in the medical claims data. A conditional probability model is developed and applied to the morbidity categories for each employee in the group using his medical claims, thereby calculating the expected conditional probability for each employee dying during the policy period. For each employee, an estimate of the expected life claim cost is estimated using an index of the life coverage to salary. Combining the expected conditional probability for each employee dying during the policy period with the estimate of the expected claim cost of death gives an estimate of the group's total life exposure.

US Patent:

7555439, Jun 30, 2009

Filed:

Jul 21, 2006

Appl. No.:

11/491325

Inventors:

Gregory S. Binns - Lake Forest IL, US
Mark Stuart Blumberg - Oakland CA, US

Assignee:

TruRisk, LLC - Lake Forest IL

International Classification:

G06Q 10/00

US Classification:

705 4, 705 2, 705 3, 600300, 600301

Abstract:

A method of underwriting group life insurance for a policy period includes collecting medical claims data for the group to be underwritten, where each medical claim being related to a particular employee of the group. Morbidity categories are provided that categorize the medical claims in the medical claims data. A conditional probability model is developed and applied to the morbidity categories for each employee in the group using his medical claims, thereby calculating the expected conditional probability for each employee dying during the policy period. For each employee, an estimate of the expected life claim cost is estimated using an index of the life coverage to salary. Combining the expected conditional probability for each employee dying during the policy period with the estimate of the expected claim cost of death gives an estimate of the group's total life exposure.

US Patent:

7664662, Feb 16, 2010

Filed:

Mar 16, 2006

Appl. No.:

11/377068

Inventors:

Gregory S. Binns - Lake Forest IL, US
Mark Stuart Blumberg - Oakland CA, US

Assignee:

TruRisk LLC - Lake Forest IL

International Classification:

G06Q 10/00

US Classification:

705 4, 705 2, 705 3, 600300, 600301

Abstract:

The development and use of a model to estimate disability insurance exposure for a group of individuals to be underwritten for a coverage period is disclosed. The development of the model includes the use of medical claim data having a plurality % of medical claims made by a first model population having at least a respective plurality of first model population members and a disability insurance claim data having a plurality of disability insurance claims made by a second model population having at least a respective plurality of second model population members, which optionally may partially or wholly overlap with the first model population. A clinical medical condition classification system assigns corresponding medical condition causes to the disability insurance claims and the medical claims based on medical condition information. Development then categorizes the disability insurance claims and medical claims classified by medical condition, where each morbidity category comprises one or more medical conditions, to form a plurality of morbidity categories of disability insurance claims. Then, the proportions of the two types of claims are calculated for each morbidity category.

US Patent:

8041585, Oct 18, 2011

Filed:

Dec 17, 2009

Appl. No.:

12/640909

Inventors:

Gregory S. Binns - Lake Forest IL, US
Mark Blumberg - Oakland CA, US

Assignee:

Trurisk LLC - Lake Forest IL

International Classification:

G06Q 10/00

US Classification:

705 4, 705 2, 705 3

Abstract:

The development and use of a model to estimate disability insurance exposure for a group of individuals to be underwritten for a coverage period is disclosed. The development of the model includes the use of medical claim data having a plurality of medical claims made by a first model population having at least a respective plurality of first model population members and a disability insurance claim data having a plurality of disability insurance claims made by a second model population having at least a respective plurality of second model population members, which optionally may partially or wholly overlap with the first model population. A clinical medical condition classification system assigns corresponding medical condition causes to the disability insurance claims and the medical claims based on medical condition information. Development then categorizes the disability insurance claims and medical claims classified by medical condition, where each morbidity category comprises one or more medical conditions, to form a plurality of morbidity categories of disability insurance claims. Then, the proportions of the two types of claims are calculated for each morbidity category.

US Patent:

20090048877, Feb 19, 2009

Filed:

Jun 24, 2008

Appl. No.:

12/145281

Inventors:

Gregory S. Binns - Lake Forest IL, US
Mark Stuart Blumberg - Oakland CA, US

International Classification:

G06Q 40/00

US Classification:

705 4

Abstract:

A computer-implemented process of developing a person-level cost model for forecasting future costs attributable to claims from members of a book of business, where person-level data are available for a substantial portion of the members of the book of business for an actual underwriting period, and the forecast of interest is for a policy period is disclosed. The process uses development universe data comprising person-level enrollment data, historical base period health care claims data and historical next period claim amount data for a statistically meaningful number of individuals. The process also provides at least one claim-based risk factor for each historical base period claim based on the claim code associated with the health care claim and provides at least one enrollment-based risk factor based on the enrollment data. The process also develops a cost forecasting model by capturing the predictive ability of the main effects and interactions of claim based risk factors and enrollment-based risk factors, with the development universe data through the application of an interaction capturing technique to the development universe data.

US Patent:

7249040, Jul 24, 2007

Filed:

Mar 16, 2006

Appl. No.:

11/377059

Inventors:

Gregory S. Binns - Lake Forest IL, US
Mark Stuart Blumberg - Oakland CA, US

Assignee:

TruRisk, L.L.C. - Lake Forest IL

International Classification:

G06Q 10/00

US Classification:

705 4, 705 2, 705 3

Abstract:

A method of underwriting group disability insurance for a policy period includes collecting medical claims data for the group to be underwritten, where each medical claim being related to a particular employee of the group. Morbidity categories are provided that categorize the medical claims in the medical claims data. A conditional probability model is developed and applied to the morbidity categories for each employee in the group using his medical claims, thereby calculating the expected conditional probability for each employee of incurring a disability during the policy period. A further statistical model of the estimated cost of the disability is developed and applied based on the employees' morbidity categories from the medical claims data. For each employee, an estimate of the expected cost of incurring a disability given their morbidity categories is derived from his medical claims data. Combining the expected conditional probability for each employee incurring a disability during the policy period with the estimate of the expected cost of that disability gives an estimate of the group's total disability exposure.