Patent Application Titled “System for Long-Term Care Mitigation Providing a Secured Multi-step Trigger Cycle, and Method Thereof” Published Online (USPTO 20230290518): Swiss Reinsurance Company Ltd.

2023 OCT 04 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- According to news reporting originating from Washington, D.C., by NewsRx journalists, a patent application by the inventors MARTIN, Alan (Romney Marsh Kent, GB); RICHARDSON, Eva (London, GB); SINGLETON, Matthew William (Rickmansworth Hertfordshire, GB); WHITE, Sean (Bredgar Kent, GB), filed on May 17, 2023, was made available online on September 14, 2023.

The assignee for this patent application is Swiss Reinsurance Company Ltd. (Zurich, Switzerland).

Reporters obtained the following quote from the background information supplied by the inventors: “Long-term care (LTC) mitigation or risk-transfer is based on risk-transfer covers that provide support and hedges resources that help cover the cost of long-term care a person might need in the event of a chronic illness and unable to perform without substantial assistance at least some of the activities of daily living (bathing, continence, dressing, eating, toileting, transferring) or require substantial supervision due to a cognitive impairment, such as Alzheimer’s disease. By helping to protect the person’s assets, and giving the person choice and control over where he or she receives care, including in the person’s own home, LTC risk-transfer helps a person and his or her family face the future with confidence.

“In the prior art, there are various technical contributions to the insurance technology field of immediate and deferred care plan schemes, as Long Term Care (LTC) risk-transfer, mortgage life risk-transfer and disability risk-transfer systems. Immediate and deferred care plan schemes are long term risk-transfer covers which are designed to pay a regular, typically tax-free monetary amount (income) to the risk-exposed person’s care provider to help meet the costs of his/her care. Deferred care plans for long term care pay out after a few months or years, instead of paying out benefits immediately, and are typically cheaper than immediate care plan schemes. There are at least two risk-transfer scheme, namely (i) Immediate Need Annuity (INA) and (ii) Lifetime mortgage (LTM-equity release): (i) INA is a type of annuity, also known as Immediate Care Plan or Care Fees Annuity, that pay out a guaranteed income for life to help cover the cost of the insured care fees in exchange for a one-off lump sum payment. The payments are typically set to pay a level benefit, or are index linked to raise over time. The advantages of the INA insurance scheme are that it has no time or cost limit. INA pays out, as long as it is needed by the insured. However, the one-time upfront fee, i.e. the product costs, are typically high, e.g. around 150,000 Euros (e.g. inter alia depending on the insured’s level of income), and the insured cannot normally cancel or get the lump sum premium back, except during the statutory cooling-off period (e.g. 6 weeks: the insured normally need to pay an extra premium for some form of short-term mortality cover) after purchase; (ii) In the LTM scheme, a loan secured on the insured’s estate (a mortgage loan) is made. Compounded interest is added to the capital throughout the term of the loan, which is then repaid by selling the property when the borrower (or borrowing couple) dies or moves out (perhaps into a care home). The borrower retains legal title to the home whilst living in it, and also retains the responsibilities and costs of ownership. The advantages of LTM are, inter alia, that it bears only a small amount of arrangement costs (e.g. 1,500 Euros). However, there are time (e.g. 8 years) and cost (e.g. 250,000 Euros) limits for the payout. Once the insured reaches one of the limits and is still alive, he/she will have to find other means to pay for the care. It is to be noted that LTMs are mainly sold for income/lump sum purchase purposes usually at a younger age. Thus, in certain cases, LTM is difficult to get as an instrument to fund care.

“Over the last years, some of the disclosed risk-transfer systems tried to link their pooled resources to capital markets, thus exploring ways to diversify risk traditionally associated with exposure measures to fixed income, real estate, foreign exchange markets and commodities. As a result, the pooled financial resources are made available for use as alternative investment vehicles. One technical area has been the linkage of capital markets in the life risk-transfer industry. Life risk-transfer as an asset class is generally considered uncorrelated to the other segments of the financial markets, i.e., because mortality events measured to occur irrespective of the performance or condition of other economic metrics in the financial markets. Premium determination and allocation and life settlements have been specific technical areas in the life risk-transfer sector. Premium allocation as used herein is the allocation of premiums based on defining risk-transfer parameter settings, which are typically defined by policies. Moreover, life settlements as used herein are life risk-transfer policies sold by their owners to third parties in return for a lump sum payment. One technical alternative approach is the resource pooling in life risk-transfers through longevity arbitrage, which is being viewed by an increasing number of capital sources as an attractive alternative to traditional risk exposure. As a result, various longevity risk strategies and schemes exist. Traditionally, capital sources have primarily used the senior life settlement market to buy longevity exposure. Buying longevity exposure through the senior life settlement market, however, does not allow investors to effectively acquire the level of longevity assets necessary to achieve the desired risk diversification. In addition, most of these structures have major draw-backs under the technical requirement to be provided by an automated system.

“Accordingly, it is desirable to provide automated systems and methods for safeguarding against longevity risk, as Long Term Care risks, without significant exposure to the shortcomings of the existing risk-transfer systems and methods. Additionally, the prior art risk-transfer systems invariably confronts chronically ill, physically or cognitively disabled, or frail elderly health care receivers with significant inadequacies of the processes of LTC risk-safeguarding, care management, planning and appropriate resource funding. First, many parts of the risk-transfer mechanisms are complicated, inconsistent and disconnected. Indeed, the only point of convergence and continuity in the current systems is the client. Patients and clients are often passed from system to system, and are often subjected to redundant assessments and evaluations, with little information passing from one risk-transfer resource pool to another risk-transfer resource pool. Second, the information clients are given from one system to another system is often non-transparent, incomplete, inaccurate, and in their actual consequences difficult to understand for a user. This results, inter alia, from no consistent, standardized assessments and no standardized structures. Third, because of short-term-stay structures and models that dominate in-patient health care, and because of short-term and intermittent care models in rehabilitation and home health care services, and because of large caseloads in community-based aging and disability services, clients in need of long-term care support services have difficulties to orientate themselves in the market of complex systems. Moreover, as is the case for most people, such care receivers cannot afford to buy long-term care risk-transfer policies, or are ineligible for coverage to begin with, or they cannot afford to pay for the care they need for as long as they need such long-term care. Fifth, and perhaps most importantly, there is no resource-planning structure that allows long-term care consumers to develop care-funding plans that will enable them to actually organize their own resources and/or acquire the resources they need to pay for the prevention-focused, long-term care that supports and promotes the reduction of unplanned hospitalization and emergency room visits among those most vulnerable to requiring unplanned in-patient care.

“Finally, US 2017/0301032 A1 discloses an automated system for multi-pillar triggered risk-transfer intended to prolonge independent living under elderly illness occurrence. The system filters age-related parameters of elderly persons requesting to assign to the exposure-cover provided by the system by parameter values greater than a predefined age-threshold value. The system comprise a generated trigger-table with predefined searchable acute and/or chronic elderly illness parameters triggered in a patient dataflow pathway by a first trigger level for the occurrence of serious elderly illnesses, and in a second trigger level for the occurrence of an acute broken bone trauma, and in a third trigger level for long-term care indications, and in a fifth trigger level for assisted living indications, and the predefined parameters of a fifth-layer data structure providing measuring parameters for extended assistance indications, as defined by the trigger table. The system allows to be triggered multiple occurrences of acute and/or chronic elderly illnesses, and in consequence to dynamically adapt the cover due to the sequence of triggered acute and/or chronic elderly illnesses, which was not possible before.

“In summary, there are significant physical, and emotional strains on a person and the person’s family when he/she needs care, in particular long-term care. The financial complexities on top of this are most unwelcome. The options facing those persons are limited, and circumstances can often result in having to sell the family home against the person’s care wishes. Thus, there should be a simple and automatable system benchmarked on its ability to automatically cover and to service financial care obligations of expectedly or unexpectedly arising long-term care needs, in particularly being designed to prevent persons with long-term care needs having to sell their home immediately and/or being forced to move out of their homes-perhaps ever. The system should work whether receiving care in the own home or in a specialist facility. There is an urgent need for transparent, technical solutions to the problems created by the present non-standardized process and prior art systems of long-term care funding and long-term care risk-transfer structures.”

In addition to obtaining background information on this patent application, NewsRx editors also obtained the inventors’ summary information for this patent application: “It is an object of the invention to provide an automation based on a new long-term care risk mitigation system and structure covering care needs of risk-exposed individuals in case off or in the event of becoming a long-term care-receiver, thereby providing a secured multi-step trigger cycle for risk-exposed individuals. Therefore, a system enabled to cover immediate needs and also enabling possible future pre-pay-based structures. The novel system end method shall not only be able to cover and capture risks of the cost of long-term care, but also the risks of the occurring needs, in particular financial needs to cover possible treatments during the duration of the need, which cannot be handled by the traditional life or health risk-transfer systems and structures. Thus, the inventive system shall be able to provide a new risk-transfer landscape capable of handling the discussed risk-transfer gaps. Further, it is an object of the invention to provide a new event-driven and triggered system for automated optimization and adaption in signaling generation by dynamically triggering and/or monitoring new occurring individual measuring parameters associated with long-term care risks. The invention should specifically allow for mitigating the payment of care costs, using stable funding sources. Thus, the invention should further allow for providing the option to receive care in own home, or in a care home, at the will of the care receiver. It should further allow to remove the emotional burden and costs related to a rushed property sale in case of sudden long-term care needs. The invention should also allow to optimize tax benefit requirements when paying for care and for inheritance. The invention should also allow homeowners, in case of becoming a long-term care receiver, to retain, if possible, their asset until death/house sale, where e.g. their families can retain property when repaying the amount used. It should also allow families to benefit from any property appreciation. The invention should also allow to provide the option to rent out the home to help fund care and/or inheritance.

“According to the present invention, these objects are achieved particularly through the features of the independent claims. In addition, further advantageous embodiments follow from the dependent claims and the description.

“According to the present invention, the abovementioned objects for an automated system for long-term care risk mitigation associated with immediate care needs of risk-exposed individuals in case of becoming a long-term care-receiver, are particularly achieved by the described system, wherein the system provides a secured multi-step trigger cycle for risk-exposed individuals thereby mitigating possibly occurring long-term care needs by means of the automated system based on a sufficient state of disability, the state of disability of the risk-exposed individual being characterized by a definable set of risk-exposed individual measuring parameters, wherein individual measuring parameter values being captured and monitored by the automated system, in that the long-term care risk mitigation is triggered by means of an event-driven risk-exposed individual trigger providing the secured multi-step trigger cycle, the event-driven risk-exposed individual trigger comprising a staged multi-tier structure gradually triggering threshold values of a first and second set of individual measuring parameters in an autogenic dataflow pathway of a risk-exposed individual, wherein for each long-term care risk mitigation, long-term care mitigation data are held in a persistence storage of the system comprising at least one assigned relationship between an associated risk-exposed individual, an asset of the risk-exposed individual and a remedial measure ratio dependent on the asset of the risk-exposed individual, in that the staged multi-tier structure comprises a first trigger stage triggering on a sufficient state of disability of a selected risk-exposed individual by a first set of individual measuring parameter values captured in the dataflow pathway of the risk-exposed individual, the individual measuring parameter being segmentable in critical categories of individual measuring data at least comprising first trigger threshold parameter values providing a definable measure for individual’s physical functional status parameters and/or current cognitive and/or sensory functional status parameters and/or prospective functional status parameters including physical and/or cognitive and/or sensory parameters and/or living environmental status parameters and/or long term care resource parameters, the trigger threshold parameter values triggered by means of monitored and measured values of the first set of individual measuring parameters in the autogenic dataflow pathway of a risk-exposed individual, in that upon detection of the sufficient state of disability based on the individual measuring parameters, the covering by means of remedial measures is activated by signal transmission to a risk-cover structure of the automated system and by transferring the remedial measures to the risk-exposed individual, in that the multi-tier trigger structure comprises a second stage trigger triggering a second set of individual measuring parameter values captured in the dataflow pathway of the risk-exposed individual based on second trigger threshold parameter values providing a definable measure for indicators for an occurred death of the risk-exposed individual and/or the sale of the real estate assigned to the risk-exposed individual, and the second threshold parameter values triggered by means of monitored and measured values of the measuring parameters in the dataflow pathway of the risk-exposed individual, and in that upon detection of the indicators for an occurred death of the risk-exposed individual and/or the sale of the asset assigned to the risk-exposed individual, the remedial measures transferred by the risk-cover structure of the system are returned to the system. Thus, the system can be based the two elements of the an upfront payment transfer (i.e. the risk-transfer or insurance element) and the repayment (i.e. the loan element which is the value of drawn-down home equity with no interest).

“The inventive system has inter alia the advantage that it allows to provide an automatable, new risk mitigation and risk assessment structure for covering and mitigating long-term care risks in the context of life and health care technology. The system is able to complement the traditional risk-transfer cover in the life and health risk landscape, filling the gaps for long-term care risks. The system may be realized as a part of the classical risk-transfer multi-step trigger cycle. The invention further has the advantage to specifically allow for mitigating the payment of care costs, using stable funding sources, namely using an illiquid asset as the care-receivers residential property. The invention further allows for providing the option to receive care in own home, or in a care home, at the will of the care receiver. It further allows to remove the emotional burden and costs related to a rushed property sale in case of sudden long-term care needs. The invention also allows to optimize tax benefit requirements when paying for care and for inheritance. The invention also allows homeowners, in case of becoming a long-term care receiver, to retain their asset until death/house sale, where e.g. their families can retain property when repaying the amount used. The invention has the further advantage to allow families to benefit from any property appreciation, and to allow to provide the option to rent out the home to help fund care and/or inheritance. Upon reaching a sufficient state of disability, the potential long-term care receiver as annuitant pays an up-front longevity premium. The reaching of a sufficient state of disability typically is connected with reaching a certain age, as e.g. at an age 65+. However, the initiating age could be also extended to younger ages. In triggering all three steps, the system has the advantage for long-term care receivers to receive a pre-agreed annual income with optional escalation to help fund their care needs. Further, the invention has finally also the advantage to provide and trigger charges upfront for interest on a drawdown mortgage based on longevity. This enables homeowners to not sell a home nor run up significant interest debts (unknown) alongside it.”

The claims supplied by the inventors are:

“1. An automated, event-driven, and triggered system for long-term care risk mitigation associated with detected and/or measured immediate care needs of risk-exposed individuals in case of becoming a long-term care-receiver, the automated system providing a secured multi-step trigger and/or detection cycle for a risk-exposed individual based on measured sensory measuring data thereby mitigating possibly occurring long-term care needs by means of the automated system based on a sufficient state of disability of the risk-exposed individual, the sufficient state of disability being characterized by a definable set of risk-exposed individual measuring parameters, and individual measuring parameter values being captured and monitored by the automated system, the automated system being configured to: monitor a dataflow pathway of the risk-exposed individual by capturing risk-related clinical and/or health-related measuring data and asset-related data in different dataflow pathways associated with personal data of the risk-exposed individual periodically or within predefined time frames, and trigger the long-term care risk mitigation by means of an event-driven risk-exposed individual trigger providing the secured multi-step trigger cycle, wherein the event-driven risk-exposed individual trigger includes a staged multi-tier structure gradually triggering threshold values of a first and second set of individual measuring parameters in an autogenic dataflow pathway of the risk-exposed individual, for each long-term care risk mitigation, long-term care mitigation data are held in a persistence storage of the automated system and include at least one assigned relationship between the risk-exposed individual, an asset of the risk-exposed individual, and a remedial measure ratio dependent on the asset of the risk-exposed individual, the staged multi-tier structure includes a first trigger stage triggering on the sufficient state of disability of the risk-exposed individual by a first set of the individual measuring parameter values captured in the dataflow pathway of the risk-exposed individual, the first set of the individual measuring parameter values are segmentable in critical categories of individual measuring data at least including first trigger threshold parameter values providing a definable measure for individual physical functional status parameters and/or current cognitive and/or sensory functional status parameters and/or prospective functional status parameters including physical and/or cognitive and/or sensory parameters and/or living environmental status parameters and/or long term care resource parameters, the first trigger threshold parameter values are triggered by means of monitored and measured values of the first set of the individual measuring parameter values in the autogenic dataflow pathway of the risk-exposed individual departing from averaged historical parameter values and their value variations in time, upon detection of the sufficient state of disability based on the first set of the individual measuring parameter values, covering by means of remedial measures is activated by electronic signal transmission to an automated risk-cover structure of the automated system being steerable by the electronic signal transmission and by transferring the remedial measures to the risk-exposed individual, the multi-tier trigger structure includes a second stage trigger triggering a second set of the individual measuring parameter values captured in the dataflow pathway of the risk-exposed individual based on second trigger threshold parameter values providing a definable measure for indicators for an occurred death of the risk-exposed individual and/or a sale of the asset assigned to the risk-exposed individual, the second threshold parameter values are triggered by means of monitored and measured values of the second set of the individual measuring parameter values in the autogenic dataflow pathway of the risk-exposed individual, the second stage trigger is dynamically adapted by means of an operating module based on time-correlated incidence data indicative of a risk for attaining the sufficient state of disability by the risk-exposed individual accounting for improvements in diagnosis or treatment and related risk measurements, upon detection of the indicators for the occurred death of the risk-exposed individual and/or the sale of the asset assigned to the risk-exposed individual, the remedial measures transferred by the automated risk-cover structure of the automated system are returned to the automated system, and an amount of the remedial measures being returned to the automated system is a total nominal value of total remedial measures transferred between the triggering of the first trigger stage and the triggering of the second trigger stage.

“2. The automated system according to claim 1, wherein the asset assigned to the risk-exposed individual is a real estate of the risk-exposed individual.

“3. The automated system according to claim 1, wherein the remedial measures include transferred monetary remedial measures, and transferal of the monetary remedial measures is limited to a monetary amount determined by a predefined percentage of a market value of the asset.

“4. The automated system according to claim 3, wherein the market value of the asset is measured at a time point of establishing the assigned relationship between the risk-exposed individual and the asset of the risk-exposed individual.

“5. The automated system according to claim 3, wherein the market value of the asset is measured or reevaluated at a time point of detecting or triggering the sufficient state of disability.

“6. The automated system according to claim 3, wherein the predefined percentage amounts to equal or less than 50% to 80% of the market value of the asset.

“7. The automated system according to claim 1, wherein upon the detection of the indicators for the occurred death of the risk-exposed individual and/or the sale of the asset assigned to the risk-exposed individual, a time trigger is initialized by setting up a definable time window threshold for returning the remedial measures transferred by the automated risk-cover structure to the automated system.

“8. The automated system according to claim 7, wherein the time window threshold is set to a size between 6 to 24 months.

“9. The automated system according to claim 8, wherein the time window threshold is set to 12 months.

“10. The automated system according claim 1, wherein in case of triggering the sufficient state of disability in combination with an age-related individual measuring parameter having a predefined threshold value amounting to a number of years, the at least one assigned relationship between the risk-exposed individual and the asset of the risk-exposed individual further comprises an up-front monetary amount generated by the automated system, and the long-term care risk mitigation is triggered by the automated system upon detected transfer of the up-front monetary amount to the automated system.

“11. The automated system according to claim 1, wherein in case of triggering a healthy health status of the risk-exposed individual based on the risk-exposed individual measuring parameter in combination with an age-related individual measuring parameter having a predefined threshold value amounting to a number of years, the at least one assigned relationship between the risk-exposed individual and the asset of the risk-exposed individual further comprises an up-front monetary amount generated by the automated system, the long-term care risk mitigation is triggered by the automated system upon detected transfer of the up-front monetary amount to the automated system, and the up-front monetary amount is either transferrable as an up-front monetary amount or as a draw-down payment transfer over a pre-defined time.

“12. The automated system according to claim 10, wherein the predefined threshold value amounting to the number of years is set to 65 years or more.

“13. The automated system according to claim 11, wherein in case of the draw-down payment transfer, the automated risk-cover structure includes a monitoring module requesting a periodic payment transfer from the risk-exposed individual to the automated risk-cover structure by means of a plurality of payment receiving modules, and the long-term care risk mitigation is interrupted by the monitoring module when the periodic payment transfer is no longer detectable by means of the monitoring module and/or the up-front monetary amount is not reached.

“14. The automated system according to claim 1, wherein the remedial measures include transferred monetary remedial measures, and transferal of the monetary remedial measures is realized as periodic monetary remedial transfer to the risk-exposed individual providing a predefined annual income or annuity to the to the risk-exposed individual.

“15. The automated system according to claim 14, wherein a total amount of the periodic monetary remedial transfer is limited by the automated system to a monetary amount determined by a predefined percentage of a market value of the asset.

“16. The automated system according to claim 15, wherein the predefined percentage amounts to 50% to 80% of the market value of the asset.

“17. The automated system according to claim 1, wherein detection of the sufficient state of disability is verified by an independent verification and detection system based on the risk-exposed individual measuring parameters, and the covering by means of the remedial measures is only activated upon additional verification confirmation of the independent verification and detection system.”

There are additional claims. Please visit full patent to read further.

For more information, see this patent application: MARTIN, Alan; RICHARDSON, Eva; SINGLETON, Matthew William; WHITE, Sean. System for Long-Term Care Mitigation Providing a Secured Multi-step Trigger Cycle, and Method Thereof. U.S. Patent Application Number 20230290518, filed May 17, 2023 and posted September 14, 2023. Patent URL (for desktop use only): https://ppubs.uspto.gov/pubwebapp/external.html?q=(20230290518)&db=US-PGPUB&type=ids

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