AI ENHANCED PREDICTIVE HEALTH MANAGEMENT SYSTEM FOR INSURANCE PLANS

Abstract

AI ENHANCED PREDICTIVE HEALTH MANAGEMENT SYSTEM FOR INSURANCE PLANS The present invention relates to assess, predict, and manage individual health risks using artificial intelligence (AI) for insurance plans. The system includes AI based predictive analytics engine to periodically retrain its models using new health data to improve prediction accuracy for evolving health conditions. A data collection module includes secure connections to wearable devices that provide real time monitoring of physiological metrics such as heart rate, blood pressure, and activity levels. The recommendation engine can integrate with the insurance provider’s backend system to suggest modifications in coverage, including preventive care incentives or premium adjustments based on the user’s health risk profile.

Specification

Description:4. DESCRIPTION

Technical Field of the invention

The present invention relates to predictive health management systems integrated with insurance plans. Specifically, the present invention relates to specifically using artificial intelligence to assess, predict, and manage individual health risks.

Background of the invention

Traditional health insurance systems primarily rely on historical data to determine premiums and manage claims after health events have occurred. With the growing potential of AI and predictive analytics, a system that can anticipate health risks and allow for preventive measures could transform the insurance landscape.

This invention proposes an AI driven health management system designed to provide actionable insights for both insurance providers and policyholders, promoting better health outcomes and more effective insurance plan customization.

Brief Summary of the invention

The following presents a simplified summary of the disclosure in order to provide a basic understanding to the reader. This summary is not an extensive overview of the disclosure and it does not identify key/critical elements of the invention or delineate the scope of the invention. Its sole purpose is to present some concepts disclosed herein in a simplified form as a prelude to the more detailed description that is presented later.

It is a primary object of the present invention to provide predictive health management systems integrated with insurance plans.
The AI Enhanced Predictive Health Management System integrates user health data from diverse sources, such as medical records, lifestyle assessments, and wearable devices, to analyze health trends and predict potential future risks. This system uses machine learning algorithms to create personalized health recommendations, allowing policyholders to proactively manage their health. Insurance providers can leverage these insights to optimize plan offerings, tailor premiums based on realtime risk assessments, and support preventive care initiatives.

Detailed Description of the invention

It is to be understood that the present disclosure is not limited in its application to the details of construction and the arrangement of components set forth in the following description or illustrated in the drawings. The present disclosure is capable of other embodiments and of being practiced or of being carried out in various ways. In addition, it is to be understood that the phraseology and terminology used herein is for the purpose of description and should not be regarded as limiting.

The use of "including", "comprising" or "having" and variations thereof herein is meant to encompass the items listed thereafter and equivalents thereof as well as additional items. The terms "a" and "an" herein do not denote a limitation of quantity, but rather denote the presence of at least one of the referenced items. Further, the use of terms "first", "second", and "third", and the like, herein do not denote any order, quantity, or importance, but rather are used to distinguish one element from another.

According to one embodiment of the invention, an artificial intelligence (AI) enhanced predictive health management system for insurance plans is disclosed. The system includes AI based predictive analytics engine to periodically retrain its models using new health data to improve prediction accuracy for evolving health conditions.

Further, the data collection module includes secure connections to wearable devices that provide real time monitoring of physiological metrics such as heart rate, blood pressure, and activity levels.

In addition the system comprises a user interface that allows users to view their health risk scores, recommended preventive measures, and projected health outcomes if they adhere to the recommendations. The AI based predictive analytics engine integrates unstructured data from EHRs, including physician notes, to enhance the predictive accuracy of potential health risks.

According to one embodiment of the invention, the risk scoring module uses both demographic and health behavior data to provide a holistic risk assessment and dynamic insurance premium suggestions.

Further, the AI based predictive analytics engine analyzes genetic predispositions, environmental factors, and social determinants of health to create a comprehensive health risk profile for each user. The recommendation engine can integrate with the insurance provider's backend system to suggest modifications in coverage, including preventive care incentives or premium adjustments based on the user's health risk profile.

The system further comprises an AI driven plan optimization module that recommends insurance plan adjustments or new plan options to policyholders based on their evolving health conditions and risk factors. The data collection module includes privacy and security protocols, including data encryption and access control mechanisms, to ensure compliance with health data privacy regulations.

The system also comprises a reporting module that allows insurers to view aggregate health risk insights for their user base, enabling data driven adjustments to insurance offerings and health policy structuring.


The following are the key features of the invention:

System Architecture: A description of system components, including data collection modules, AI processing units, user interfaces, and notification systems.

Predictive Analytics Process: An explanation of how health data is collected, processed, and analyzed by machine learning models to forecast potential health issues.

User Personalization: Details on how AI adjusts and personalizes recommendations based on evolving user data.

Integration with Insurance Plans: Explanation of how the predictive insights inform insurance coverage options, wellness programs, and preventive care incentives.

Security and Privacy Measures: Outline of data security protocols and compliance with health data privacy laws.

It will be recognized that the above described subject matter may be embodied in other specific forms without departing from the scope or essential characteristics of the disclosure. Thus, it is understood that, the subject matter is not to be limited by the foregoing illustrative details, but it is rather to be defined by the appended claims.

While specific embodiments of the invention have been shown and described in detail to illustrate the novel and inventive features of the invention, it is understood that the invention may be embodied otherwise without departing from such principles.
, Claims:1. An artificial intelligence (AI) enhanced predictive health management system for insurance plans, the system comprising AI based predictive analytics engine to periodically retrain its models using new health data to improve prediction accuracy for evolving health conditions.

2. The system as claimed in claim 1, wherein a data collection module includes secure connections to wearable devices that provide real time monitoring of physiological metrics such as heart rate, blood pressure, and activity levels.

3. The system as claimed in claim 1, further comprising a user interface that allows users to view their health risk scores, recommended preventive measures, and projected health outcomes if they adhere to the recommendations.

4. The system as claimed in claim 1, wherein the AI based predictive analytics engine integrates unstructured data from EHRs, including physician notes, to enhance the predictive accuracy of potential health risks.

5. The system as claimed in claim 1, wherein the risk scoring module uses both demographic and health behavior data to provide a holistic risk assessment and dynamic insurance premium suggestions.

6. The system as claimed in claim 1, wherein the AI based predictive analytics engine analyzes genetic predispositions, environmental factors, and social determinants of health to create a comprehensive health risk profile for each user.

7. The system as claimed in claim 1, wherein the recommendation engine can integrate with the insurance provider's backend system to suggest modifications in coverage, including preventive care incentives or premium adjustments based on the user's health risk profile.

8. The system as claimed in claim 1, further comprising an AI driven plan optimization module that recommends insurance plan adjustments or new plan options to policyholders based on their evolving health conditions and risk factors.

9. The system as claimed in claim 1, wherein the data collection module includes privacy and security protocols, including data encryption and access control mechanisms, to ensure compliance with health data privacy regulations.

10. The system as claimed in claim 1, further comprising a reporting module that allows insurers to view aggregate health risk insights for their user base, enabling data driven adjustments to insurance offerings and health policy structuring.

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