Abstract:
A system and method for using simulation to evaluate the injury claims of individuals involved in motor vehicle accidents. The system uses a computer system configured to accept accident data collected during the insurance claims process, provide an analysis of the impact forces and provide information about the forces and accelerations on body parts of the individuals claiming injuries. By substantially automating the conversion of accident data into occupant dynamics simulation information, injury claims can be cost-effectively analyzed using simulation.

Description:
FIELD OF THE INVENTION  
         [0001]    This invention relates to simulation systems that assist users in reconstructing automobile accidents.  
         BACKGROUND OF THE INVENTION  
         [0002]    Fraud is an expensive problem for the automobile insurance industry, particularly in the area of soft-tissue injuries. Soft-tissue injuries are muscle sprains and strains that cannot be objectively verified by medical evidence. These are often the only types of injuries claimed in low impact accidents. The most common example is a neck sprain/strain, commonly known as “whiplash.” These injuries do not show up on Computer Aided Tomography (CAT) scans or Magnetic Resonance Imaging (MRI) diagnostics. As a result, it is very difficult to prove or disprove that a claimant suffered a soft-tissue injury as a result of a car accident. This difficulty, combined with a public attitude of acceptance of insurance fraud, has resulted in a bodily injury claim fraud rate estimated at 35%-52% by the RAND Institute. This type of fraud is estimated to cost automobile insurance companies between $10-$20 Billion per year.  
           [0003]    Insurance companies have a duty to their insureds to promptly pay for valid soft-tissue injury claims. The challenge for insurance claims adjusters is to identify which soft-tissue injury claims are valid in order to fulfill this duty, while denying fraudulent claims that impact insurance company profitability and cause premiums to increase. There can be several specific decision adjusters must make in order to process a soft-tissue injury claim. For example, the adjuster can pay the claim as submitted, pay a reduced amount they negotiate, deny the claim, refer the matter to litigation counsel or request further information such as having an Independent Medical Examination performed. Because there is no objective evidence that these injuries exist, claims adjusters must look at evidence regarding the injury potential of the accident and make judgements about whether the forces were sufficient to cause the claimed injuries. Currently, little information is available to insurance claims adjusters upon which to base claims handling decisions. The available information usually includes photographs of the body damage to the claimant&#39;s vehicle, property damage estimates, a police report (which generally includes a diagram of how the cars struck each other) and a statement by the claimant about the accident and their injuries. Essentially, the claims adjuster must to some extent perform the role of an accident reconstruction expert—not to determine conclusively what happened, but to guide their claims handling decisions.  
           [0004]    Of these items of evidence, claims adjusters tend to rely most heavily on the photographs of vehicle body damage in order to make claims handling decisions. In general, the greater the body damage the more likely the adjuster is to pay the claim. Conversely, the lesser the body damage the more likely the adjuster is to deny the claim, request further information or analysis, or refer the claim to litigation. There are several fundamental drawbacks caused by this process.  
           [0005]    First, the decisions claims adjusters often make based on body damage often run counter to the laws of physics. Automotive engineers constantly improve the ability of vehicle structures to absorb crash energy by crumpling. In many cases the greater the body deformation, the more crash energy that was absorbed by the vehicle structure and not transferred to the body of the occupant. Insurance claims adjusters do not generally have the mathematical background, computing resources or information that would enable them to analyze these photographs in light of the structural characteristics of each vehicle model and other factors that would impact the crash forces for a given accident.  
           [0006]    Second, the use of photographs alone ignores the other factors that can have a significant impact on how crash forces are transferred to the body parts of an occupant. It is well established that the dynamics characteristics of seats, seat belts, head restraints and airbags can have a significant effect on injury forces in low impact accidents. In addition, other factors will impact injury potential such as direction of force, occupant dimensions, occupant position and fit within the cabin structures, occupant age and gender. As a result of these deficiencies, several problems arise for the automobile insurance company.  
           [0007]    First, the insurance company has difficulty fairly compensating claimants with legitimate soft tissue injuries. Based on the highly inaccurate process used to make claims handling decisions, many of these claimants will have their claim denied or referred to litigation. They may never receive payment from the insurance company for their injuries or lost wages, or may have payment delayed substantially.  
           [0008]    Second, the insurance company spends an excessive amount of premiums paying for fraudulent medical and lost wages expenses that are based on fraudulent injury claims.  
           [0009]    Third, the insurance company ends up spending an excessive amount of premiums on attorneys&#39; fees and costs associated with resolving these issues in litigation.  
           [0010]    Until development of the present invention, there was no viable alternative for the insurance company to resolve these drawbacks in their claims handling process.  
         SUMMARY OF THE INVENTION  
         [0011]    According to one aspect of the invention, a method for analyzing injuries for insurance claims includes receiving impact data from a claims center, running an occupant simulation, and generating a simulation output.  
           [0012]    A more complete understanding of the present invention, as well as well as further features and advantages of the present invention, will be obtained by reference to the following detailed description, drawings and appended claims. The descriptions in this application are explanatory only and are intended to provide further explanation of the invention. 
       
    
    
     BRIEF DESCRIPTION OF THE DRAWINGS  
       [0013]    [0013]FIG. 1 a  is a diagram of an automobile accident;  
         [0014]    [0014]FIG. 1 b  is a Venn diagram of claims data;  
         [0015]    [0015]FIG. 1 c  is a simplified diagram of the overall system;  
         [0016]    [0016]FIG. 2 is a schematic block diagram of the overall system;  
         [0017]    [0017]FIG. 3 is a flowchart illustrating a process for making a claims-handling decision;  
         [0018]    [0018]FIG. 6 is a schematic bock diagram of an occupant simulation system;  
         [0019]    [0019]FIG. 7 is a schematic block diagram of a data management system;  
         [0020]    [0020]FIG. 8 is a flowchart illustrating a run management process  
         [0021]    [0021]FIG. 9 a  is an exemplary account access form;  
         [0022]    [0022]FIG. 9 b  is an exemplary user access database;  
         [0023]    [0023]FIG. 10 is an exemplary claimant specification form;  
         [0024]    [0024]FIG. 11 a  is an exemplary vehicle specification form;  
         [0025]    [0025]FIG. 11 b  is an exemplary object specification form;  
         [0026]    [0026]FIG. 12 is an exemplary injury specification form;  
         [0027]    [0027]FIG. 13 is an exemplary data download form;  
         [0028]    [0028]FIG. 14 is an exemplary components database;  
         [0029]    [0029]FIG. 15 is an exemplary case input database;  
         [0030]    [0030]FIG. 16 is an exemplary case output database;  
         [0031]    [0031]FIG. 18 is an exemplary expert system for analysis of injury potential;  
         [0032]    [0032]FIG. 22 is a schematic block diagram of an impact analysis system;  
         [0033]    [0033]FIG. 23 is a flowchart illustrating an impact management process;  
         [0034]    [0034]FIG. 24 a  is an exemplary photo vehicle model;  
         [0035]    [0035]FIG. 24 b  is an exemplary stored vehicle model;  
         [0036]    [0036]FIG. 25 is an exemplary crush analysis overlay;  
         [0037]    [0037]FIG. 26 is an exemplary crush dimension graphical indicator; and  
         [0038]    [0038]FIG. 30 is a block diagram for using the system in settlement negotiations. 
     
    
     DETAILED DESCRIPTION OF THE INVENTION  
       [0039]    [0039]FIG. 1 c  shows an overview block diagram of the Injury Analysis System which enables remote analysis of the injury potential of an automobile crash. When a vehicle is involved in a crash as shown in FIG. 1 b,  various forms of Claims Data  30  are generated as shown in FIG. 1 c.  The Injury Analysis System shown in FIG. 1 c  enables this Claims Data  30  to be remotely analyzed by a Crash Analysis Center  80 .  
         [0040]    An automobile crash will typically include at least one Claimant  10  and the Claimant&#39;s Vehicle  15  and an Impacted Object  20 —shown here as another vehicle. Impacted Object  20  could also be any type of object that causes damage to a vehicle or injuries to a vehicle occupant, such as a pole or tree, or a road surface in the event of a solo-vehicle rollover. A Claimant  10  is defined herein as someone who asserts an insurance claim or lawsuit against an insurance, company, individual or other organization alleging injuries from the crash. Claimant&#39;s Vehicle  15  is defined herein as the vehicle which Claimant  10  is riding in at the time of the accident. Claimant  10  could be a passenger, owner or driver.  
         [0041]    Various forms of Claims Data  30  shown in FIG. 1 b  may be generated in different ways. In a typical case, a police officer will respond to the scene of a vehicle crash and will perform some investigative work. This investigative work is usually documented by the police officer in the form of a Police Report  34 . Sometimes an insurance claims adjuster will respond to the accident scene and take Body Damage Photos  32 . Often, Body Damage Photos are taken by an employee at a body shop that is providing an estimate on either the Claimant Vehicle  15  or the Impacted Object  20  in cases where Impacted Object  20  is also a vehicle. Body Damage Photos  32  could be taken by numerous others, including vehicle occupants, police, witnesses, investigators or attorneys. These photographs can be film photographs or can be digital photographs. After the vehicle has left the scene, it will often be taken to one or more body shops to obtain Property Damage Estimates  36 . Property Damage Estimates  36  will list specific vehicle parts that are damaged and are either in need of repair or replacement. Once a Claimant  10  has filed a claim with an insurance company, the insurance company will usually obtain a Claimant Statement  40  about how the accident occurred and how the Claimant  10  was injured and their medical treatment history. Other information may include whether the Claimant  10  has ongoing medical problems, had to miss work, or other information that could relate to the damages the Claimant  10  suffered in the crash. The insurance company will also generally obtain copies of the Medical Records  38  of the Claimant that are relevant to the crash. Other Data  42  may include the results of an independent medical examination, loss of work records or accident reconstruction information.  
         [0042]    The Injury Analysis System as shown in FIG. 1 c  enables an Investigator  70  to obtain an analysis of the injuries claimed in the crash by transferring some of the Claims Data  30  to a remote Crash Analysis Center  80  through Network  100 . Investigator may be anyone interested in analyzing the injury potential of a crash, including an insurance claims adjuster, attorney, accident reconstruction professional or a police officer. Investigation Center  60  may be an insurance claims operation, a law firm, an expert witness firm or other organization interested in the analysis of a crash. Network  100  is preferably the Internet, but could be any form of Wide Area Network (WAN). Input Device  75  could be any form of computing device that includes an input device (e.g. keyboard) and a display that can be connected to Network  100 . Crash Analysis Center  80  is shown here as including a Crash Analysis System  85  and a Crash Analyst  90 . Crash Analysis Center  80  could include multiple Crash Analysts  90  and Analysis Devices  95 . Analysis Device  95  could be any form of computing device that includes an input device (e.g. keyboard) and a display that can be connected to Network  100 .  
         [0043]    [0043]FIG. 2 is a data flow diagram showing greater detail of the Crash Analysis System  85 . Crash Analysis System  85  is shown here as including a Data Management System  120 , Impact Analysis System  130  and Occupant Simulation System  140 . Claims Data  30  flows into the Investigation Center  60 . Portions of the Claims Data  30  needed for analysis are selected out, and the resulting Input Data  110  is passed through Network  100  to the Crash Analysis System  85  where it is directed into the Data Management System  120 . The Data Management System  120  provides Impact Data  132  to the Impact Analysis System  130  which performs impact analysis and returns Impact Output  135  to the Data Management System  120 . The Data Management System  120  also provides Simulation Data  142  to the Occupant Simulation System  140 , which performs simulation runs and returns Simulation Output  145  to the Data Management System  120 . Data Management System  120  produces System Output  125  which is sent back through Network  100  to the Investigation Center  60 .  
         [0044]    [0044]FIG. 3 is a flowchart illustrating a process for executing a claims handling decision. In step  300  a claims center receives an injury claim.  
         [0045]    [0045]FIG. 6 depicts an Occupant Simulation System  140 , which could be any computer housing occupant simulation software that is known in the art. Several occupant simulation software packages exist. The most widely used are the Articulated Total Body (ATB) model and MADYMO—both of which utilize rigid body dynamics for modeling. The ATB model was originally developed by the United States Air Force, and is maintained by Wright Patterson Air Force Base. Commercial versions are available from several companies, including Veridian Engineering in Buffalo, N.Y. MADYMO is sold by TNO Automotive located in the Netherlands and is widely used in evaluating automotive safety and vehicle design by research entities, automobile manufacturers and suppliers, and government agencies. An exemplary Occupant Simulation System  140  is shown in FIG. 6 as a server including a Communication Port  610  in communication with the Data Management System  120  and the Impact Analysis System  130 . It is further shown as including a Memory  620 , a Processor  630  and a Data Storage Device  640  for storing the computer code that instructs the particular Simulation Process  650  (e.g. ATB, MADYMO).  
         [0046]    [0046]FIG. 7 depicts an exemplary block diagram of a Data Management System  120 . The Data Management System  120  includes a Communication Port  710 , Memory  720  and Processor  730  for managing the operations of the Crash Analysis System  85 , which may include: (1) managing user access to the system and payment for simulation services; (2) managing simulation components; (3) storing and retrieving historical data for users; (4) instructing the Impact Analysis System  130  to perform impact analysis; (5) instructing the Occupant Simulation System  140  to run occupant simulations; (6) analyzing the injury potential of the results from simulation runs; (7) managing the format and display of output data. A Data Storage Device  740  is also shown as part of the Data Management System  120  which may contain a variety of databases including a User Access Database  750  for managing user system access and payment information, Components Database  755  for storing and managing the components used in simulation runs, Case Input Database  760  for capturing and managing the data that is input into the Impact Analysis System  130  and the Occupant Simulation System  140 , Case Output Database  765  for storing and managing the results of simulation runs and calculations performed by the Data Management System  120 , Historical Case Database  770  for long term storage of user records, Injury Tolerance Database  775  for storing parameter and formulas that correlate Simulation Output  145  to injury potential, and Comparison Case Database  780  for storing simulations that can be used as a reference for injury potential. In addition, Data Storage Device  740  is shown in FIG. 7 as including a Run Management Process  785  for managing the operations of the Occupant Simulation System  140  and the Impact Analysis System  130  and an Injury Analysis Process  790  for analyzing the injury potential for a given simulation run.  
         [0047]    [0047]FIG. 8 shows an exemplary Run Management Process  785 . Initially, the Data Management System activates a user&#39;s account  315 . Once an account is activated, the Data Management System receives input data  800  and then sends the input data to the impact analysis system  803 . The impact analysis system generates impact output  806 , and then transfers it  809  back to the data management system. The data management system retrieves simulation components  812  and then transfers the simulation components and the impact output (“simulation data”) to the occupant simulation system  815 . The occupant simulation system generates simulation output  818  and transfers the simulation output to the data management system  821 . The data management system then analyzes the system output  824 , formats the system output  827  and sends the system output to the user  830 .  
         [0048]    [0048]FIG. 9 a  shows an exemplary Account Access Form  905  that enables a user to input a User ID  910  and Password  915 , then instruct  920  the Data Management System  120  to authorize account access. This information is stored within a User Access Database  750 , an example of which is shown in FIG. 9 b,  along with user Name  925 , contact information such as Email  930  as well as payment identification information such as the credit card and corporate account information shown by reference numerals  935 - 960 .  
         [0049]    [0049]FIG. 10 is an exemplary Claimant Specification Form  1005  that enables a user to cause the Data Management System  120  to generate a virtual representation of Claimant  10  by inputting specifications into the form and clicking the Set Button  835 . Here, Claimant  10  is shown generated from specifying Gender  1010 , Height  1015 , Weight  1020  and Age  1025 . Software capable of generating a virtual human from these data inputs is known in the art for human and dummy representation, such as the Bodybuilder and Anthropos products by the TecMath corporation and Mannequin Pro from NexGen Ergonomics. Restraint use for claimant may also be specified, here shown as specifying Seatbelt Use  1030  and Airbag Deployment  1035 .  
         [0050]    [0050]FIG. 11 a  is an exemplary Vehicle Specification Form  1105  that enables a user to cause the Data Management System to select a specific vehicle file from its Components Database  755  by specifying the vehicle. Here, vehicle is shown specified by Vehicle Year  1110 , Vehicle Make  1115  and Vehicle Model  1120 . Alternatively, the specific vehicle could be selected by VIN number with Components Database  755  indexing vehicles by VIN number.  
         [0051]    [0051]FIG. 11 b  is an exemplary Object Specification Form  1140  that enables a user to cause the Data Management System  120  to select a specific vehicle or object file from its Components Database  755  and communicate to the Damage Location  1160  of the impacted object to the Crash Analysis System  85 .  
         [0052]    [0052]FIG. 12 is an exemplary Injury Specification Form  1205  that enables a user to inform the Crash Analysis System  85  of the anatomical location and severity of the claimed injury. FIG. 13 is an exemplary Data Download Form  1305  that enables a user to download data to the Crash Analysis System  85 . Data can be downloaded regarding either the claimant vehicle, the impacting vehicle or both. Claimant vehicle data may include photographs  1310 , Police Report  1315 , Estimate  1340  or EDR Data File  1325 . Similar data may also be downloaded for the impacting vehicle ( 1330 - 1345 ). The user may instruct the Data Management System  120  to run the simulation by clicking the Run Simulation  1350  button.  
         [0053]    [0053]FIG. 14 is an exemplary Components Database  755 . Components are shown as including a Component ID  1410 , Filename  1415 , Component Type  1420 , Component Specs  1425  and Component Parameters  1430 .  
         [0054]    [0054]FIG. 15 is an exemplary Case Input Database  760 . Case ID  1510  is an identifier for the particular claim that is being analyzed, and could be a court case number or an internal claim number. Run ID  1515  identifies the particular simulation run, which corresponds to a particular set of input conditions and graphical simulation output. Components  1410  are shown as including a vehicle ID, Seat Component ID and Occupant Component ID. Other Input Data  110  are shown in FIG. 15 ( 1520 - 1535 ).  
         [0055]    [0055]FIG. 16 depicts an exemplary Case Output Database  765 . Here shown as including several reference identifiers including Case ID  1510 , Run ID  1515 , Run Date  1605  and User ID  910 . System Output  125  is also shown as including Peak g Head  1610 , NIC  1615  and Run View File  1620 . Peak G Head  1610  is a common measure of occupant head acceleration and NIC is a standard measure of neck force information in automotive safety. Run View File  1620  contains a particular file location that enables a user to view the graphical simulation output file.  
         [0056]    [0056]FIG. 18 shows an application within the Crash Analysis System  85  in the form of an expert system which automatically generates Data Analysis Results  1880  based on Expert System Input Data  1805 . An Inference Engine  1810  is used to generate Data Analysis Results  1880  based on Rules  1815  Established by experts in various Expert Knowledge Domains  1820  including Human Injury Tolerance  1825 , Animal Injury Tolerance  1830 , Cadaver Injury Tolerance  1835  and Biomechanics of Human Injury  1840 . Data Analysis Results  1880  may also be generated by a Case Based Reasoning System  1850  which utilizes Cases  1860  as a knowledge base by linking attributes of a crash event to attributes of cases using a Case History Attribute Index  1855 . Cases  1860  may include Cadaver Biomechanics Studies  1862 , Animal Biomechanics Studies  1864 , Human Biomechanics Studies  1866 , Historical Accident Cases  1868 , Vehicle Crash Testing  1870 , Impact and Acceleration Testing  1872  and Human Activity Testing  1874 .  
         [0057]    Inference Engine  1810  may utilize any rules-based logic scheme, including use of Boolean algorithms to generate Data Analysis Results  1880  from Rules  1815 . Case Based Reasoning System  1850  may utilize any form of comparison logic scheme, including probability-based algorithms (including Bayesian algorithms) to determine the relative probabilities of the presence or absence of particular injuries.  
         [0058]    [0058]FIG. 22 depicts an exemplary block diagram of an Impact Analysis System  130 . The Impact Analysis System  130  includes a Communication Port  2210  in communication with Occupant Simulation System  140  and Data Management System  120 . Impact Analysis System  130  further includes a Memory  2220  and Processor  2230  for managing the operations of the Impact Analysis System  130 , which include selecting and executing an impact analysis process that assists with the calculation of delta V, peak g and delta t from either body damage information or EDR data. A Data Storage Device  2240  is also shown as part of the Impact Analysis System  130  which may contain a variety of databases, including a Vehicle Impact Database  2250 . In addition, Data Storage Device  2240  is shown in FIG. 22 as including an Impact Analysis Process  2260  for managing the operations of the Impact Analysis System  130 , an EDR Data Analysis Process  2265  for converting EDR data into simulation input data, a Crush Analysis Process  2270  for converting crush data obtained from vehicle photographs into simulation input data, a Dent Analysis Process  2275  for converting dent data obtained from vehicle photographs and property damage estimates into simulation input data and a Bumper Analysis Process  2280  for using bumper strength measurements to determine the maximum delta V, delta t and peak g for a given impact.  
         [0059]    [0059]FIG. 23 is a flowchart illustrating an Impact Management Process  2260 , which involves interaction between a Crash Analyst  90  and an Impact Analysis System  130 . A Crash Analyst  90  will receive Input Data  300  and decide what type of analysis to run within the Impact Analysis System  130 . If EDR data is received  2310  the Crash Analyst  90  will instruct the Impact Analysis System  130  to Run EDR Data Analysis Process  2315 . If not, the Crash Analyst  90  will view the Photographs and Property Damage Estimates  2320 . If Measurable Crush  2325  exists, the Crash Analyst  90  will instruct the Impact Analysis System  130  to Run Crush Analysis Process  2330 . If not, the Crash Analyst  90  will determine if Body Damage exists  2335 . If so, the Crash Analyst  90  will instruct the Impact Analysis System  130  to Run Dent Analysis Process  2340 . If not, the Crash Analyst  90  will instruct the Impact Analysis System  130  to Run Bumper Analysis Process  2345 .  
         [0060]    [0060]FIG. 24 a  shows an exemplary Photo Vehicle Model  2410  that is utilized in the Crush Analysis Process  2270 . Photo Vehicle Model  2410  is a 3D representation of the Claimant Vehicle  15  or Impacted Object  20  that is created based on photogrammetery analysis of Body Damage Photos  32 . Photogrammetery is a process for creating 3D images from 2D photographs. Those skilled in the art of photogrammetry will be familiar with this process, which can be performed using common software packages such as PhotoModeler available from the EOS Corporation. FIG. 24 b  shows an exemplary Stored Vehicle Model  2420 , which is a stored 3D model of a vehicle stored within the Crash Analysis System  85 . As shown in FIG. 25, these images are overlaid and imposed on a Scaling Grid  2510 . Measurements of the amount of crush present on Photo Vehicle Model  2410  can then be determined based on measuring the dimensional differences between Photo Vehicle Model  2410  and the Stored Vehicle Model  2420 . One manner of accomplishing this measurement is to highlight the Crush Space  2610  as shown in FIG. 26, and measure the area occupied by the Crush Space  2610 .  
         [0061]    Those skilled in the art will understand that the embodiments of the present invention described above exemplify the present invention and do not limit the scope of the invention to these specifically illustrated and described embodiments. The scope of the invention is determined by the terms of the appended claims and their legal equivalents, rather than by the described examples. In addition, the exemplary embodiments provide a foundation from which numerous alternatives and modifications may be made, which alternatives and modifications are also within the scope of the present invention as defined in the appended claims.