METHOD AND DEVICE FOR DETERMINING POTENTIAL RISK OF AN INSURANCE CLAIM ON AN INSURER

摘要

The present disclosure relates to a method and a device for determining potential risk of an insurance claim on an insuree by an insurer. In one embodiment, a plurality of insurance claims and data associated with the insurance claims is received and classified into segments. Upon classifying into segments, risk associated with each segment is determined based on which financial impact is predicted. On predicting the financial impact, the probability of availing an insurance policy by a potential insuree is also predicted. By profiling the customers, segments favorable for customers is determined. Further, prediction and forecast of high risk prone customer segments provides better understanding of risk prone customers and enables the companies to take necessary action on the risk prone customers. Further, the method enables automatic calculation of debts associated with the risk prone customers and provides better understanding of policies prone to risk based on debt calculation.

主权项

1. A method for determining potential risk of an insurance claim on an insuree by an insurer, the method comprising:
receiving, by a processor of a risk determination system, a plurality of insurance claims associated with a plurality of insurees; classifying, by the processor, the plurality of insurance claims into a plurality of segments based on an insuree profile associated with each of the plurality of insurees, wherein the insuree profile comprises at least medical data and behavioral data associated with each of the plurality of insurees; and determining, by the processor, risk associated with the plurality of segments based on at least the medical data and behavioral data of the plurality of insurees.