Patent Publication Number: US-11651439-B2

Title: System and method for pre-qualifying a consumer for life and health insurance products or services, benefits products or services based on eligibility and referring a qualified customer to a licensed insurance agent, producer or broker to facilitate the enrollment process

Description:
BACKGROUND OF THE INVENTION 
     Field of the Invention 
     The present invention relates to a system and method for automatically referring a qualified buyer of life and health insurance, or benefits products and services (hereinafter “benefits products”) from an insurance carrier, benefits company, healthcare discount plan provider, health care sharing ministry, or similar entities (hereinafter “benefits provider”) to a benefits consultant, qualified salesperson, duly licensed insurance agent, producer or broker (hereinafter “producer”). 
     Description of the Related Art 
     Consumers of individual benefits products commonly use comparison shopping internet websites to research benefits products. The benefits products competitive landscape is disarrayed, consisting of benefits products ranging from federally and U.S. regulated types of health and life products, levels of coverage, premium, and limitations that put the consumer at risk for adverse selection. Also, due to the nature of the chaotic environment, the marketplace is an outlet for fraudulent benefits products. In many cases, consumers seek the assistance of a producer to select a product or service. In some cases, prior to speaking with a live producer directly, the consumer will be filtered through a third-party lead generation service designed to allow only qualified buyers to pass through to the producer. 
     Conventional third-party lead generation services employ human phone sales support representatives to ask the consumer qualifying questions to determine the product or service to be referred to the consumer. Examples of qualifying questions range from location, date of birth and gender to health history, medications and affordability. The cost to acquire a consumer customer includes the cost of human phone sales support representatives in the prequalification phase of many enrollments. 
     Conventional systems have been used for extracting user data to identify available benefits products based on responses from the consumer. U.S. Pat. No. 9,495,700 describes the use of branded virtual characters on a server computer which are accessed by an employee at a remote client computer over a network in order to engage and educate users regarding alternate benefit plans. Throughout the process, the system employs a portfolio-driven approach to identify inter-dependencies among different benefit products and plans and prioritize and recommend “portfolio-level” benefit solutions. The employee can be automatically enrolled in the selected benefit plan. This system has the drawback of needing a computer interface to access the system over the internet and can be cumbersome for a person to navigate, especially for unsophisticated computer users. 
     It is desirable to provide an artificial intelligence-based telephonic system and method to collect user data using telephonic communication, automatically determine from the user data relevant to the benefits products and automatically refer a qualified buyer to a qualified producer. 
     SUMMARY OF THE INVENTION 
     The present invention relates to an artificial intelligence-based multi-channel system and method to evaluate a buyer or consumer&#39;s intent to purchase benefits products in real time. The system and method determine the buyer or consumer&#39;s needs, identifies and presents relevant benefits products based on eligibility to the buyer or consumer. The system and method can transfer the buyer or consumer to a live producer to facilitate an enrollment process for the benefits products. 
     In one embodiment, a session is initiated by a user, such as either the buyer or consumer or system. The user can initiate the session by phone, SMS, chat, mobile app, or Messenger. Once a session is initiated, the user is introduced to a virtual assistant. The virtual assistant has an audio interface to present audio to a user and receive audio from the user. The virtual assistant can greet and prompt the user to answer a series of pre-qualifying questions. The virtual assistant is artificial intelligence enabled to receive voice via an audio interface which is transferred to a server to be interpreted with artificial intelligence. Responses from the server can be sent back via audio to the user&#39;s audio interface. The virtual assistant can be implemented in a conversational manner for receiving information from a user and generating responses using cognitive learning abilities during the conversation. The virtual assistant can include natural language processing. The virtual assistant can implement context switching during the conversation. The cognitive learning abilities of the virtual assistant can include a semantic memory, episodic memory for learning from past conversations, analytic memory for understanding trend of data, and affective memory for understanding emotion and deep back projection networks for learning process flows via empirical learning. The virtual assistant can be considered to be a “trusted” virtual producer for the user as compared to a human, motivated to make any sale. 
     In one embodiment, the system can internalize the user&#39;s answers and not repeat questions which limits buyer or consumer frustration; and in the session, accent and tone of the virtual assistant accommodates the user. Using the virtual assistant and further prompting, the system can evaluate the user&#39;s level of intent or urgency to purchase benefits products. The virtual assistant can utilize third party rate quoting services and benefits providers&#39; specific underwriting guidelines and requirements from multiple benefits providers to identify and present relevant benefits products through the virtual assistant to the user. In one embodiment, the virtual assistant can scan a network of live producers in a resident state of a buyer or consumer to identify a producer offering benefits products presented to the user during the session. The virtual assistant can transfer the buyer or consumer to the producer for enrollment. 
     The system can provide security of the user interface and transmitted data. In one embodiment, data encryption can be used during transport of data. 
     The invention will be more fully described by reference to the following drawings. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG.  1    is a flow diagram of one embodiment of a method for pre-qualifying a consumer for benefits products based on eligibility and referring a producer to facilitate the enrollment process performed by a system of the present invention. 
         FIG.  2    is a block diagram of an embodiment of an artificial intelligence-based multi-channel system of the present invention. 
         FIG.  3    is a flow diagram of an illustrative embodiment of a method for evaluating a user&#39;s level of intent or urgency to purchase a benefits product. 
         FIG.  4 A  is a schematic diagram of sample statements which can be uttered by the virtual assistant or by a user. 
         FIG.  4 B  is a schematic diagram of sample results from tone analysis. 
         FIG.  4 C  is a schematic diagram of a sample analysis summary. 
         FIG.  4 D  is a schematic diagram of a sample analysis of tones scores to tone tolerances for determining to transfer or terminate the user to a producer. 
         FIG.  4 E  is a schematic diagram of a sample statement which can be uttered by the virtual assistant. 
     
    
    
     DETAILED DESCRIPTION 
     Reference will now be made in greater detail to a preferred embodiment of the invention, an example of which is illustrated in the accompanying drawings. Wherever possible, the same reference numerals will be used throughout the drawings and the description to refer to the same or like parts. 
     As used in this application, the terms “component”, module,” “system,” “interface,” or the like are generally intended to refer to a computer-related entity, either hardware, a combination of hardware and software, software, or software in execution. For example, a component can be, but is not limited to being, a process running on a processor, a processor, an object, an executable, a thread of execution, a program, and/or a computer. By way of illustration, both an application running on a controller and the controller can be a component. One or more components can reside within a process and/or thread of execution and a component can be localized on one computer and/or distributed between two or more computers. As another example, an interface can include I/O components as well as associated processor, application, and/or API components. 
       FIG.  1    is a flow diagram of an embodiment of interactive method  10  for interactively presenting one or more relevant benefits products based on eligibility to a user and enrolling of the user with determined benefits products. In step  11 , a session with a virtual assistant is initiated through an interface. For example, the user can initiate the session with the system using an interface of a phone, SMS, chat, mobile app, or Messenger. Once a session is initiated, in step  11 , the user is introduced to a virtual assistant. The virtual assistant can greet and prompt the user to answer a series of pre-qualifying questions in step  12 . In one embodiment, the system can internalize the user&#39;s answers and not repeat questions which limits buyer or consumer frustration. The virtual assistant presents audio to the user and receives audio from the user. The virtual assistant is artificial intelligence based to receive voice via an audio interface which is transferred to a server to be interpreted with artificial intelligence in real time. Responses from the server can be sent back via audio to the user&#39;s audio interface. 
     In step  13 , during the session between the user and the virtual assistant, the system can adjust parameters of the virtual assistant to accommodate the user. For example, language and tone of the virtual assistant can be selected or adjusted. The virtual assistant can utilize commercial technologies including, for example, Sentiment Analysis, Tone Analyzer and Personality Insights to adjust parameters of the virtual assistant. 
     In step  14 , the virtual assistant prompts the user to describe the benefits products which are of interest to the user for purchase. In step  15 , the system can evaluate the user&#39;s level of intent or urgency to purchase the benefits product in real time. In step  16 , the system can identify and present relevant benefits products to the user through the virtual assistant based on eligibility determined by responses from the user presented to the virtual assistant. In one embodiment, the virtual assistant can utilize third party rate quoting services and specific underwriting guidelines and requirements from multiple benefits providers to identify and present relevant benefits products through the virtual assistant to the user. 
     In step  17 , the virtual assistant can scan a network of live producers in a resident state of a user to identify a producer offering benefits products presented to the user during the session. In step  18 , the virtual assistant can transfer the user, which can be a buyer or consumer, to a selected producer for enrollment. In one embodiment, the virtual assistant automatically transfers the user to the selected producer for enrollment. In some embodiments, the transfer of the user to a producer is made via a telephone or audio connection. Alternatively, the transfer of the user to a producer is made via an email or text. The user can select the medium for the type of transfer. In some embodiments, if after step  11 , step  12  cannot be completed, the virtual assistant can transfer the buyer or consumer to a selected producer enrollment in step  18 . In some embodiments, if after step  12 , step  13  cannot be completed, the virtual assistant can transfer the buyer or consumer to a selected producer for enrollment in step  18 . In some embodiments, if after step  13 , step  14  cannot be completed, the virtual assistant can transfer the buyer or consumer to a selected producer for enrollment in step  18 . In some embodiments, if after step  14 , step  15  cannot be completed, the virtual assistant can transfer the buyer or consumer to a selected producer for enrollment in step  18 . In some embodiments, if after step  15 , step  16  cannot be completed, the virtual assistant can transfer the buyer or consumer to a selected producer for enrollment in step  18 . 
       FIG.  2    is a schematic diagram of an implementation of system  100 . System  100  includes user interface  102  which is accessed by user  101 . User interface  102  can be an electronic device such as a mobile telephony device including for example a mobile device, cell phone or smartphone. Mobile telephony devices can communicate with fourth generation (4G) or fifth generation (5G) cellular communications. It will be appreciated that other mobile telephony devices and networks can be used in accordance with the teachings of the present invention. User interface  102  communicates audio  103  to virtual assistant  104 . Alternatively, user  101  communicates directly with virtual assistant  104 . 
     Virtual assistant  104  can be a component which is artificial intelligence based to receive audio  103 . Audio  103  can be digitized or interpreted by virtual assistant  104  into data  105 . In one embodiment automated speech recognition (ASR)  120  can be performed at virtual assistant  104  or automated speech recognition (ASR)  121  can be performed server  108  to digitally convert received audible speech into transcribed text. Virtual assistant  104  can utilize commercial technologies including for example Sentiment Analysis, Tone Analyzer and Personality Insights to analyze data  105  and adjust parameters of virtual assistant  104 . Virtual assistant  104  can be implemented in a natural language conversational manner for receiving information from user  101  and automatically generating responses to user  101  during the conversation. Virtual assistant  104  can have cognitive learning abilities. Virtual assistant  104  can include natural language processing and context switching. Virtual assistant  104  can include semantic memory, episodic memory for learning from past conversations, analytic memory for understanding trend of data, affective memory for understanding emotion and deep back projection networks for learning process flows via empirical learning. In some embodiments, the part of speech of content of the utterance of virtual assistant  104  is determined based on using a natural language parser (e.g., Stanford Natural Language Processing Group software or others as are known in the art) to parse the utterance. The part of speech of content of the utterance can indicate if the content is a noun phrase, verb phrase, and/or theme. In some embodiments, the type of speech of content of the utterance of virtual assistant  104  is determined based on using a natural language parser (e.g., Stanford Natural Language Processing Group software or others as are known in the art) to parse the utterance. Virtual assistant  104  using artificial intelligence techniques can employ one of numerous methodologies for learning from data and then drawing inferences and/or making determinations related to dynamically storing information across multiple storage units (e.g., Hidden Markov Models (HMMs) and related prototypical dependency models, more general probabilistic graphical models, such as Bayesian networks, e.g., created by structure search using a Bayesian model score or approximation, linear classifiers, such as support vector machines (SVMs), non-linear classifiers, such as methods referred to as “neural network” methodologies, fuzzy logic methodologies, and other approaches that perform data fusion, etc.) in accordance with implementing various automated aspects described herein. The type of speech of content of the utterance can indicate if the content is a noun phrase, verb phrase, and/or theme. In some embodiments, the domain of the content of the utterance of virtual assistant  104  is determined based on pattern matching. Virtual assistant  104  can include components such as a processor, memory, storage, microphone, learning module, and operating system. An example, virtual assistant or virtual producer is described in U.S. Pat. No. 9,812,151 hereby incorporated by reference into this application. 
     Data  105  is transferred over network  106  to server  108 . For example, network  106  can be the Internet. Server  108  accesses third party data interface  109 . For example, server  108  can access data  105  directly from databases of third party providers. For example, third party data interface  109  can be an interface to a third-party system for accessing third-party rate quote data. For example, server  108  can access third party data  115  directly from databases of third party providers. In one embodiment, application programming interface (API)  113  of server  108  or application programming interface (API)  111  of virtual assistant  104  is activated to communicate with application programming interface (API)  114  of third party data interface  109  to access data  115  from third party data interface  109 . Alternatively, server  108  can access data  115  over network  106 . For example, third party data interface  109  can include third party rate quoting services and specific underwriting guidelines and requirements from multiple benefits providers. Virtual assistant  104  may include a server, computer, laptop, PC, mobile device, or the like that includes a processor, a memory, and a communication device. Virtual assistant  104  and server  108  may include a plurality of computing devices connected together, e.g., via a network. The processor may include any general purpose or application-specific processor. The memory may include one or more tangible, non-transitory, machine-readable media. 
     Virtual assistant  104  and server  108  can connect to benefits providers&#39; interface  110  over network  106 . In one embodiment, benefits providers&#39; interface  110  includes one or more application programming interface(s) (API(s))  132 . One or more benefits providers  112  communicate data  131  directed to benefits products using benefits providers&#39; interface  110 . In one embodiment, application programming interface (API)  113  of server  108  or application programming interface (API)  111  of virtual assistant  104  is activated to communicate with application programming interface (API)  132  of benefits providers interface  110  to access data  131  from benefits provider interface  110 . Virtual assistant  104  or server  108  can scan one or more benefits providers  112  over network  106 . Virtual assistant  104  can establish a connection between one or more benefits providers  112  and user  101  using virtual assistant  104  and user interface  102 . Data  105 , third-party data  115  and application requirements data  131  can be stored in memory  150  of system server  108 . In one embodiment, API  111 , API  113 , API  114  and API  132  are web based APIs. 
       FIG.  3    is a flow diagram of an illustrative embodiment of a method to implement step  15  of  FIG.  1    for evaluating a user&#39;s level of intent or urgency to purchase a benefits product. In step  302 , the description of the benefits products which are of interest to the user for purchase which was received by the virtual assistant is converted to text. For example, a speech to text conversion can be performed at server  108  with automated speech recognition (ASR)  121  or virtual assistant  105  with automated speech recognition (ASR)  120  as shown in  FIG.  2   . The text can include one or more words, phrases or sentences. 
     Referring to  FIG.  3   , in step  304 , a value of a tone score for each word, phrase or sentence in the text is determined. The tone score can be based on each individual word within the phrase or sentence. The tone score is the likelihood the word, phrase or sentence has characteristics of a particular tone. Example, tones can include tentative, anger, analytical, fear, joy, sadness and confidence. The tone score can be determined on a scale of 0 to 1.0 with a minimum score of 0 and a maximum score of 1.0. It will be appreciated that other scales can be used in accordance with the teachings of the present invention. In step  306 , an analysis of the tone scores determined for one or more pre-selected types of tones is performed. For example, the analysis of the tone scores can be an average of each of the tone scores received for a particular tone, such as for example, tentative, anger and analytical. 
     In step  308 , from the analysis of the tone scores, a determination is made to either transfer the call or to terminate the call. For example, it can be determined if the call should be transferred to a producer. The determination can be made from comparing the analyzed tone scores to a threshold tolerance value. For example, if one or more of the analyzed tone scores are less than the threshold tolerance value, the call will be transferred, and if one or more of the analyzed tone scores are greater than the threshold tolerance value, the call will be terminated. 
     An example of implementation of the method for evaluating a user&#39;s level of intent or urgency to purchase a benefits product is described by reference to  FIGS.  2 ,  3  and  4 A- 4 E . An example, virtual assistant statement  402  can be uttered by virtual assistant  104  as shown in  FIG.  2    and  FIG.  4 A . In response to virtual assistant statement  402 , a user statement  404  is uttered by user  101  at user interface  102 . Speech to text conversion of user statement  404  can be performed at server  108  or virtual assistant  104 . Referring to  FIG.  4 B , each sentence of text  405  of user statement  404  is assigned a sentence identification  406 . An implementation of step  304  determines a value of a tone score  408  of each type of tone  409  for each sentence identification  406 . Referring to  FIG.  4 C , an implementation of step  306 , determines analysis score  410  of tone scores  408  for each type of tone  409 . For example, analysis score  410  of tone scores  408  can be an average of each of the tone scores  408  received for a particular tone  409 . Referring to  FIG.  4 D , an implementation of step  308  determines result  420  from analysis score  410  of tone scores  404  to either transfer the call or to terminate the call based on a comparison of analysis score  410  to threshold tolerance value  422 . If result  420  indicates it is acceptable to transfer since analysis score  410  is less than threshold score  422 , virtual assistant  104  utters virtual assistant statement  430 . If result  420  indicates the call should be terminated since analysis score  410  is greater than threshold score  422 , virtual assistant  105  or server  108  terminates the call session. 
     Embodiments of the present invention can be implemented in connection with a special purpose or general purpose computer device that includes both hardware and/or software components, including special purpose or general purpose computers. 
     Embodiments can also include physical computer-readable media and/or intangible computer-readable media for carrying or having computer-executable instructions, data structures, and/or data signals stored thereon. Such physical computer-readable media and/or intangible computer-readable media can be any available media that can be accessed by a general purpose or special purpose computer. By way of example, and not limitation, such physical computer-readable media can include RAM, ROM, EEPROM, CD-ROM or other optical disk storage, magnetic disk storage or other magnetic storage devices, other semiconductor storage media, or any other physical medium which can be used to store desired data in the form of computer-executable instructions, data structures and/or data signals, and which can be accessed by a general purpose or special purpose computer. Within a general purpose or special purpose computer, intangible computer-readable media can include electromagnetic means for conveying a data signal from one part of the computer to another, such as through circuitry residing in the computer. 
     When information is transferred or provided over a network or another communications connection (either hardwired, wireless, or a combination of hardwired or wireless) to a computer, hardwired devices for sending and receiving computer-executable instructions, data structures, and/or data signals (e.g., wires, cables, optical fibers, electronic circuitry, chemical, and the like) should properly be viewed as physical computer-readable mediums while wireless carriers or wireless mediums for sending and/or receiving computer-executable instructions, data structures, and/or data signals (e.g., radio communications, satellite communications, infrared communications, and the like) should properly be viewed as intangible computer-readable mediums. Combinations of the above should also be included within the scope of computer-readable media. 
     Computer-executable instructions include, for example, instructions, data, and/or data signals which cause a general purpose computer, special purpose computer, or special purpose processing device to perform a certain function or group of functions. Although not required, aspects of the invention have been described herein in the general context of computer-executable instructions, such as program modules, being executed by computers, in network environments and/or non-network environments. Generally, program modules include routines, programs, objects, components, and content structures that perform particular tasks or implement particular abstract content types. Computer-executable instructions, associated content structures, and program modules represent examples of program code for executing aspects of the methods disclosed herein. 
     While the subject matter has been described above in the general context of computer-executable instructions of a program that runs on one or more computers, those skilled in the art will recognize that the subject matter described herein also can be implemented in combination with other program modules. Generally, program modules include routines, programs, components, data structures, etc. that perform particular tasks and/or implement particular abstract data types. Moreover, those skilled in the art will appreciate that the inventive methods can be practiced with other computer system configurations, including single-processor, multiprocessor or multi-core processor computer systems, mini-computing devices, mainframe computers, as well as personal computers, hand-held computing devices (e.g., personal digital assistant (PDA), phone, watch . . . ), microprocessor-based or programmable consumer or industrial electronics, and the like. The illustrated aspects can also be practiced in distributed computing environments where tasks are performed by remote processing devices that are linked through a communications network. However, some, if not all aspects of the claimed subject matter can be practiced on stand-alone computers. In a distributed computing environment, program modules can be located in both local and remote memory storage devices. 
     Embodiments may also include computer program products for use in the systems of the present invention, the computer program product having a physical computer-readable medium having computer readable program code stored thereon, the computer readable program code comprising computer executable instructions that, when executed by a processor, cause the system to perform the methods of the present invention. 
     It is to be understood that the above described embodiments are illustrative of only a few of the many possible specific embodiments, which can represent applications of the principles of the invention. Numerous and varied other arrangements can be readily devised in accordance with these principles by those skilled in the art without departing from the spirit and scope of the invention.