CN107784117A - The declaration form of settlement of insurance claim case determines method and apparatus - Google Patents
The declaration form of settlement of insurance claim case determines method and apparatus Download PDFInfo
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- CN107784117A CN107784117A CN201711113078.4A CN201711113078A CN107784117A CN 107784117 A CN107784117 A CN 107784117A CN 201711113078 A CN201711113078 A CN 201711113078A CN 107784117 A CN107784117 A CN 107784117A
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Abstract
This application discloses a kind of declaration form of settlement of insurance claim case to determine method and apparatus, and wherein methods described includes：Obtain multiple declaration form data of settlement of insurance claim case；According to predetermined from eligibility criteria is examined, multiple declaration form data are carried out respectively to verify from careful qualification；It is predetermined from the corresponding priority of declaration form data configuration for examining eligibility criteria to meet with reference to predetermined priority configuration rule；According to configuration result, the declaration form data of highest priority are defined as target declaration form data.By such scheme, can the automatic checking verification multiple declaration form data related to settlement of insurance claim case, and therefrom select with the most suitable declaration form data of settlement of insurance claim case, as target declaration form data.The selection process of whole target declaration form data is all automatically performed, and can save human resources, reduces error rate, effectively improves the timeliness and accuracy of settlement of insurance claim.
Description
Technical field
The application belongs to settlement of insurance claim technical field, more particularly to a kind of declaration form of settlement of insurance claim case determine method and
Device.
Background technology
Improved with the living standard of present people, increasing people can cause part fund input insurance company
Insurance company needs settlement of insurance claim case to be processed more and more, and user is needed to insurance company's rope after settlement of insurance claim case occurs
Compensate, if more parts of insurance products have pre-purchase according to the needs of itself in the user, now insurance company is just needed from this
The declaration form that highest priority is searched in each declaration form of settlement of insurance claim case enters row major compensation.
It is desirable to artificial screening declaration form is gone by special staff, from input system and settlement of insurance claim case phase
Searched in corresponding each declaration form, manually audited one by one, select the declaration form of highest priority.For example, user buys simultaneously
High-end insurance products and the insurance products of middle-end, the insurance products that staff is bought by manually checking the user, meeting
Manual priority selects high-end declaration form, preferentially carries out follow-up Claims Resolution operation.
But the mode of this manual examination and verification declaration form needs to take substantial amounts of human resources, one is being carried out to each declaration form
The more time can be wasted during one examination ＆ verification, and error rate is higher, and then have impact on the timeliness and accuracy of settlement of insurance claim.
The content of the invention
In view of this, this application provides a kind of declaration form of settlement of insurance claim case to determine method and apparatus, and main purpose exists
In solving staff when for settlement of insurance claim case progress manual examination and verification declaration form, the human resources of occupancy are more, audit time
The problem of long, and error rate is higher.
First aspect according to the application, there is provided a kind of declaration form of settlement of insurance claim case determines method, and methods described includes：
Obtain multiple declaration form data of settlement of insurance claim case；
According to predetermined from eligibility criteria is examined, the multiple declaration form data are carried out respectively to verify from careful qualification；
It is described predetermined corresponding from the declaration form data configuration for examining eligibility criteria to meet with reference to predetermined priority configuration rule
Priority；
According to configuration result, the declaration form data of highest priority are defined as target declaration form data.
Second aspect according to the application, there is provided a kind of declaration form determining device of settlement of insurance claim case, described device include：
Acquiring unit, for obtaining multiple declaration form data of settlement of insurance claim case；
Verification unit, for, from eligibility criteria is examined, carrying out examining qualification certainly respectively to the multiple declaration form data according to predetermined
Verification；
Priority dispensing unit, it is described predetermined from careful eligibility criteria to meet for reference predetermined priority configuration rule
The corresponding priority of declaration form data configuration；
Determining unit, for according to configuration result, the declaration form data of highest priority to be defined as into target declaration form data.
The third aspect according to the application, there is provided a kind of storage device, be stored thereon with computer program, described program quilt
Realize that the declaration form of the settlement of insurance claim case described in first aspect determines method during computing device.
Fourth aspect according to the application, there is provided the entity apparatus that a kind of settlement of insurance claim case declaration form determines, described device
Including storage device and processor,
The storage device, for storing computer program；
The processor, for performing the computer program to realize the guarantor of the settlement of insurance claim case described in first aspect
It is single to determine method.
By above-mentioned technical proposal, a kind of declaration form for settlement of insurance claim case that the application provides determines method and apparatus, with
Compared at present by way of artificial screening declaration form, the application is first to multiple declaration form data of settlement of insurance claim case according to predetermined
Carry out, from qualification verification is examined, referring next to predetermined priority configuration rule, making a reservation for examine money certainly to meet respectively from careful eligibility criteria
The declaration form data of highest priority are finally defined as target declaration form number by the accurate corresponding priority of declaration form data configuration of case marker
According to.Complete to carry out automatic Verification to multiple declaration form data of the settlement of insurance claim case and choose the mistake of suitable target declaration form data
Journey, so that the later stage compensates the amount of money according to the target declaration form data for the adjustment of settlement of insurance claim case.The choosing of whole target declaration form data
Take process to be all automatically performed, can save human resources, reduce error rate, effectively improve the timeliness of settlement of insurance claim and accurate
Property.
Described above is only the general introduction of technical scheme, in order to better understand the technological means of the application,
And can be practiced according to the content of specification, and in order to allow above and other objects, features and advantages of the application can
Become apparent, below especially exemplified by the embodiment of the application.
Brief description of the drawings
By reading the detailed description of hereafter preferred embodiment, it is various other the advantages of and benefit it is common for this area
Technical staff will be clear understanding.Accompanying drawing is only used for showing the purpose of preferred embodiment, and is not considered as to the application
Limitation.And in whole accompanying drawing, identical part is denoted by the same reference numerals.In the accompanying drawings：
Fig. 1 is the method flow diagram that the declaration form of the settlement of insurance claim case of the application determines one embodiment of method；
Fig. 2 is the method flow diagram that the declaration form of the settlement of insurance claim case of the application determines another embodiment of method；
Fig. 3 is the structural representation of one embodiment of the declaration form determining device of the settlement of insurance claim case of the application；
Fig. 4 is the structural representation of another embodiment of the declaration form determining device of the settlement of insurance claim case of the application；
Fig. 5 is the structural representation that the declaration form of the settlement of insurance claim case of the application determines the embodiment of entity apparatus.
Embodiment
The exemplary embodiment of the disclosure is more fully described below with reference to accompanying drawings.Although the disclosure is shown in accompanying drawing
Exemplary embodiment, it being understood, however, that may be realized in various forms the disclosure without should be by embodiments set forth here
Limited.On the contrary, these embodiments are provided to facilitate a more thoroughly understanding of the present invention, and can be by the scope of the present disclosure
Completely it is communicated to those skilled in the art.
Because user may have purchased multiple insurance products, including high-end or low-end product etc. simultaneously, when the user occurs
When asking for reparation to insurance company after settlement of insurance claim case, traditional approach needs staff by manually checking that the user buys
Each insurance products, can manual priority select high-end declaration form, preferentially carry out follow-up Claims Resolution operation, but this mode is imitated
Rate and accuracy are all very low, and in order to solve the technical problem, the embodiment of the present application provides a kind of declaration form of settlement of insurance claim case
Method is determined, most suitable target declaration form data can be filtered out in multiple declaration form data from settlement of insurance claim case of intelligence,
Without manually participating in, the time is saved, effectively reduces error rate.
As shown in figure 1, the declaration form for the settlement of insurance claim case that the present embodiment provides includes the step of determining method：
Step 101, multiple declaration form data of settlement of insurance claim case are obtained.
Wherein, declaration form data include：Declaration form insurance kind information, policy type information, declaration form insured amount information, declaration form responsibility
Managing detailed catalogue etc.；Declaration form responsibility managing detailed catalogue includes：The detailed mark of responsibility, ratio is compensated, scope is compensated, compensates limit, compensates
Condition etc..
Executive agent for the present embodiment can be that realization can be from multiple declaration form data of settlement of insurance claim case certainly
It is dynamic to filter out the device of most sorrow declaration form, and then can help to accelerate settlement of insurance claim processing.It will be protected in the staff of insurance company
The relevant information of danger Claims Resolution case is input to after settlement of insurance claim system, and the device in settlement of insurance claim system will obtain automatically
The multiple insurance products related to the settlement of insurance claim case, and according to declaration form data corresponding to the title lookup of insurance products.Will
This multiple declaration form data and the settlement of insurance claim case are carried out correspondingly, and are stored in temporary storage.Wherein, an insurance production
All insurance products and its corresponding declaration form data have all been carried out list by the corresponding declaration form data of product, settlement of insurance claim system
Storage.
Step 102, according to predetermined from eligibility criteria is examined, multiple declaration form data are carried out respectively to verify from careful qualification.
Wherein, make a reservation for be set in advance according to insurance practical business demand from careful eligibility criteria, for example, for one
The declaration form data of a little specific policy insurance kinds could be by from qualification verification is examined, being audited, finding optimal declaration form automatically to it
Data, these specific declaration form insurance kinds can be chosen according to the actual business demand of insurance, such as the guarantor of these declaration form insurance kinds
Forms data can expend more time in manual examination and verification, or these declaration form insurance kinds are the of a relatively high insurance productions of some volumes of insuring
Product, and then automatic declaration form auditing flow can be walked, accelerate the processing progress of settlement of insurance claim.
For another example can check that settlement of insurance claim case is insured user accordingly, if the user is member user, it is bought
More parts of declaration form data can by from examine qualification verify, and then can improve the user settlement of insurance claim processing timeliness.
In the above-mentioned technical solutions, multiple declaration form numbers corresponding with the settlement of insurance claim case are transferred from temporary storage
According to, it is predetermined from examining eligibility criteria to judge whether these declaration form data meet, if so, then corresponding declaration form data are retained carry out it is follow-up
The automatic configuration process of step 103, if it is not, then delete these declaration form data from temporary storage, subsequently can be to these
Declaration form data carry out manual examination and verification and find optimal declaration form data, or retain a period of time and periodic detection its whether meet it is predetermined
From careful eligibility criteria, and automatically determining described in subsequent step 103 to 104 is carried out again when it meets predetermined careful eligibility criteria certainly
The process of optimal declaration form data.
Step 103, it is predetermined from the declaration form data configuration phase for examining eligibility criteria to meet with reference to predetermined priority configuration rule
The priority answered.
Wherein, predetermined priority configuration rule can be set in advance according to the actual demand of insurance business, for example, can
Met with detection it is predetermined from examining these declaration form data of eligibility criteria corresponding volume of insuring respectively, according to the volume of insuring from more to few
Sequentially, corresponding priority is respectively configured for these declaration form data；Or these declaration form data corresponding guarantor respectively can be detected
Dangerous product level, according to the order of insurance products rank from high to low, corresponding priority is respectively configured for these declaration form data.
Step 104, according to configuration result, the declaration form data of highest priority are defined as target declaration form data.
In the above-mentioned technical solutions, if meeting the predetermined declaration form data from careful eligibility criteria only has one, without to this
Declaration form data configuration priority, the declaration form data are directly defined as target declaration form data.If meet predetermined from auditing standards
Declaration form data have multiple, then are the plurality of declaration form data configuration priority according to predetermined priority configuration rule.Then according to excellent
The order of first level from high to low is arranged the plurality of declaration form data, and the declaration form data of highest priority in permutation table are determined
For target declaration form data, and then complete to choose the process of most suitable target declaration form data for corresponding settlement of insurance claim case automatically.
In addition, the scheme of the application can choose optimal declaration form data, and meeting for multiple settlement of insurance claim cases simultaneously
Automatically it is thesaurus corresponding to the foundation of each settlement of insurance claim case, each settlement of insurance claim case is being chosen respective objects declaration form number
It can independently of each other be carried out during, can so avoid multiple settlement of insurance claim cases from the situation of data corruption occur.
After selecting target declaration form data, the billing data in settlement of insurance claim case is obtained, and extracts target guarantor
Each responsibility managing detailed catalogue in forms data.By the bill expense in billing data and diagnosis and treatment type and these responsibility managing detailed catalogues
Matched respectively, and then filter out the most suitable responsibility managing detailed catalogue of the settlement of insurance claim case.Then it is most suitable according to this
Responsibility managing detailed catalogue carries out verification adjustment to the billing data of settlement of insurance claim case, adjusts out and is managed corresponding to each single item bill expense
Pay for the amount of money and added up, final Claims Resolution total value is obtained, for insurance company according to the Claims Resolution total value to settlement of insurance claim case
User compensated.
Pass through above-mentioned technical proposal, can the automatic checking verification multiple declaration form data related to settlement of insurance claim case, and
Therefrom select with the most suitable declaration form data of settlement of insurance claim case, as target declaration form data.So that the later stage is according to this
Target declaration form data are that the amount of money is compensated in the adjustment of settlement of insurance claim case.The selection process of whole target declaration form data is all automatically performed
, human resources can be saved, reduce error rate, effectively improve the timeliness and accuracy of settlement of insurance claim.
In a particular embodiment, in order to illustrate the specific implementation process of step 102, step 102 specifically includes：
Step 1021, judge whether corresponding declaration form classification is predetermined white list classification to multiple declaration form data respectively；Or sentence
Whether multiple declaration form data of breaking meet rejecting standard.
Wherein, predetermined white list classification can be set in advance according to the actual demand of insurance business, such as pre- ding white ware
List classification can be individual life insurance's classification, group's personal accident danger classification etc., have for the declaration form classification of declaration form data
Body can be distinguished by declaration form insurance kind；Rejecting standard can include：Time of policy purchase in declaration form data reject in the time and/
Or insurer of the warrantee in declaration form data in big customer's list, and/or in declaration form data in blacklist, and/or protects
Content comprising personal verification declaration form in remark information in forms data etc..
Step 1022, it is not predetermined white list classification or the declaration form data for meeting rejecting standard by declaration form classification, it is determined that
It is predetermined from the declaration form data for examining eligibility criteria not meet.
For example, the declaration form insurance kind of three declaration form data is respectively H512, H703, H101, predetermined white list classification is searched for, really
H512 and H703 are made in predetermined white list classification, H101 is not in predetermined white list classification, then by H512 and H703
Corresponding two declaration form data retain, and declaration form data corresponding to H101 are defined as not meet the predetermined declaration form from careful eligibility criteria
Data.
In the above-mentioned technical solutions, it can also be that different settlement of insurance claim cases divide case classification, and be tied according to division
Fruit configures predetermined white list classification and rejects standard.So before step 1021, each settlement of insurance claim case is first obtained
Case classification, step 1021 is then performed to 1022 processes, will not be predetermined white list classification or meet rejecting standard
Declaration form data delete, reservation is predetermined white list classification and do not meet the declaration form data of rejecting standard.And then it can complete
Qualification checking procedure is examined certainly to multiple declaration form data.
In a particular embodiment, in order to ensure to treat that each declaration form data of selection are all valid data, step 103 is specifically wrapped
Include：
Step 1031, according to the effective time of declaration form data, obtained from meeting in the predetermined declaration form data for examining eligibility criteria certainly
Negated lapsed policy data.
In the above-mentioned technical solutions, according to meeting the predetermined date and effectively of insuring from the declaration form data for examining eligibility criteria
Time calculates the term of validity of declaration form data.Then whether before the deadline current date is judged, if then will correspondingly meet predetermined
It is defined as non-failed declaration form data from the declaration form data of careful eligibility criteria, otherwise will meets predetermined from the declaration form number for examining eligibility criteria
According to being defined as lapsed policy data and delete.
Step 1032, the declaration form amount of money and/or day of due date inquired about in non-failed declaration form data.
Step 1033, according to the original that the bigger priority of declaration form amount of money numerical value is higher, and/or the more early priority of day of due date is higher
Then, it is the non-failed corresponding priority of declaration form data configuration.
In the above-mentioned technical solutions, non-failed declaration form data are subjected to priority according to the descending order of the declaration form amount of money
Arrangement, or priority arrangement is carried out by the early order to evening according to day of due date.Can also the collective reference declaration form amount of money and expiry
Day carries out priority arrangement to non-failed declaration form data, specifically, corresponding weighted value is configured for the declaration form amount of money and day of due date, it is right
The weighted value of the two is weighted processing, and the numerical value after then being handled according to weighting carries out priority row to non-failed declaration form data
Row.
Or priority arrangement can also be carried out to non-failed declaration form data in the following manner：
First determine whether that the declaration form amount of money is contrasted with high-end protection amount, be then more than or equal to the declaration form amount of money high-end insured amount non-
Lapsed policy data are defined as high-end declaration form.If the high-end declaration form quantity obtained is one, using the high-end declaration form as preferential
Level highest declaration form data, it is excellent by early being carried out to late order according to day of due date if the high-end declaration form quantity obtained is multiple
First level arranges (i.e. the more early priority of day of due date is higher), because the declaration form data that day of due date is more early, illustrates that it will fail, and more should
The priority treatment.
If the declaration form amount of money be present is less than high-end insured amount non-failed declaration form data, by the declaration form amount of money and the insured amount progress of low side
Contrast, the declaration form amount of money is less than or equal to the insured amount non-failed declaration form data of low side and is defined as low side declaration form.If the low side obtained is protected
Odd number amount is one, then using the low side declaration form declaration form data minimum as priority, if the low side declaration form quantity obtained is more
It is individual, then priority arrangement (i.e. the more early priority of day of due date is higher) is carried out by the early order to evening according to day of due date.
The non-failed declaration form data being in for the declaration form amount of money between high-end insured amount and low side protection amount, then according to the declaration form amount of money
The principle that the bigger priority of numerical value is higher or the more early priority of day of due date is higher, for middle non-failed declaration form data configuration phase
The priority answered.
Then all non-failed declaration form data are arranged according to the priority order from high to low of above-mentioned setting.
In a particular embodiment, it is that non-failed declaration form data configuration is suitable in order to combine the combined influence of different factors
Priority, step 1033 specifically include：
Step 10331, each self-corresponding weighted value is respectively configured for declaration form money item and day of due date item in advance.
Step 10332, by presetting calculation formula, and weighted value is combined, is that non-failed declaration form data configuration is excellent accordingly
First level.
In a particular embodiment, step 10332 specifically includes：
(1) remaining time that day of due date in non-failed declaration form data handles day apart from current settlement of insurance claim case is calculated.
(2) it is inverted to remaining time and be multiplied by weighted value corresponding to day of due date, along with being protected in non-failed declaration form data
Single amount of money numerical value is multiplied by the product value of weighted value corresponding to the declaration form amount of money.
(3) the non-failed corresponding priority of declaration form data is determined according to result of calculation.
Then presetting calculation formula is：Wherein a, which is that day of due date distance is current in non-failed declaration form data, to be protected
The remaining time of danger Claims Resolution case processing day, b are weighted value corresponding to day of due date, and c is the declaration form amount of money in non-failed declaration form data
Numerical value, d are weighted value corresponding to the declaration form amount of money.
In a particular embodiment, before step 102, method also includes：
Step 102 ', by predetermined certainly careful eligibility criteria and predetermined priority configuration rule is developed and encapsulation process, obtains
Eligibility criteria and predetermined priority configuration rule corresponding application programming interface API respectively are examined certainly to predetermined.
In the above-mentioned technical solutions, pre-establish out and meet the predetermined from careful eligibility criteria and predetermined priority of actual requirement
Configuration rule, is then developed using regulation engine DROOLS and encapsulation process respectively to the two, respectively obtain with it is predetermined from
Examine api interface corresponding to eligibility criteria, and api interface corresponding with predetermined priority configuration rule.
Step 102 specifically includes：
Step 102a, multiple declaration form data are carried out with conversion process respectively, generate multiple pending declaration form objects.
Step 102b, api interface corresponding to predetermined certainly careful eligibility criteria is transferred, realization utilizes predetermined certainly careful eligibility criteria,
Multiple pending declaration form objects are carried out respectively to verify from careful qualification.
In the above-mentioned technical solutions, it is converted to：From declaration form extracting data with predetermined from careful eligibility criteria rule phase
The data message of pass, and data message is verified, qualified data message will be verified and be defined as pending declaration form object.So
Transfer again afterwards predetermined predetermined from careful qualification mark using DROOLS acquisitions from api interface corresponding to careful eligibility criteria, startup DROOLS
Power function corresponding to standard, multiple pending declaration form objects verify from careful qualification according to the step of the power function.
Wherein data message includes but is not limited at least one following：
Insure the date, day expiration of policy, declaration form quantity, declaration form insurance kind, policy type, insurer's information, warrantee's information,
Insure unit information, the declaration form amount of money.
For example, the declaration form insurance kind of pending declaration form object is H512 and H703 individual dangerous declaration form, to H512 and H703 guarantor
Single type is examined in eligibility criteria certainly predetermined, therefore H512 and H703 individual dangerous declaration form is met and makes a reservation for examine treating for eligibility criteria certainly
Handle declaration form object.Or it will not be inconsistent according to predetermined from the rejecting standard examined in eligibility criteria in multiple pending declaration form objects
The predetermined declaration form data filtering from careful eligibility criteria is closed to fall.Specifically, rejected pending declaration form object claimed below is met：
The group insurance declaration form in (before 1 day January in 2015) in special time period or point single, group insurance of the warrantee in big customer's list
Declaration form or point single, insurer include the content of personal verification declaration form in the group insurance declaration form or point single, remark information in blacklist
Group insurance declaration form or point single.
Step 103 specifically includes：
Api interface corresponding to predetermined priority configuration rule is transferred, realization utilizes predetermined priority configuration rule, to meet
It is predetermined to configure corresponding priority from the pending declaration form object for examining eligibility criteria.
In the above-mentioned technical solutions, api interface corresponding to predetermined priority configuration rule is transferred, is started
DROOLS, power function corresponding to predetermined priority configuration rule is obtained using DROOLS, and according to the function letter
Several steps is to meet the predetermined pending declaration form object from careful eligibility criteria to configure corresponding priority, finally according to priority
Order from high to low is arranged.
In a particular embodiment, after step 102, method also includes：
Step 102 ", by by being shown from declaration form data-pushing to the front end page for examining qualification verification.
Step 102 " ', the modification received according to front end page instructs, to by entering from the declaration form data for examining qualification verification
Row modification.
Step 102 " ", amended declaration form data are defined as to meet the predetermined declaration form data from careful eligibility criteria.
In the above-mentioned technical solutions, each declaration form data are carried out from after examining qualification verification, will be by examining qualification school certainly
The declaration form data-pushing tested is to front end page, so that user audits and changes.Verified when user has found to pass through from careful qualification
Declaration form data in it is in need addition or deletion declaration form data when, directly can be added or delete in front end page, directly
Click confirmation button when being satisfied with to user to the declaration form data by being verified from careful qualification, formed and finally meet predetermined certainly careful qualification
The declaration form data of standard.
As shown in Fig. 2 in a particular embodiment, method also includes：
Step 10a, carried out periodically or non-periodically more from careful eligibility criteria and/or predetermined priority configuration rule to predetermined
Newly.
Step 102 specifically includes：
According to the predetermined certainly careful eligibility criteria after renewal, multiple declaration form data are carried out respectively to verify from careful qualification.
Step 103 specifically includes：
It is predetermined from the declaration form data configuration phase for examining eligibility criteria to meet with reference to the predetermined priority configuration rule after renewal
The priority answered.
In the above-mentioned technical solutions, can be periodically or non-periodically to predetermined from careful eligibility criteria and predetermined priority configuration rule
Then it is updated.The renewal can be addition new predetermined certainly careful eligibility criteria and predetermined priority configuration rule or delete pre-
Fixed certainly careful eligibility criteria and predetermined priority configuration rule or modification make a reservation for configure rule from careful eligibility criteria and predetermined priority
Then.
, can be according to the interval time of setting, periodically to specific website or server if this is updated to regularly update
It is predetermined from the more new content for examining eligibility criteria or predetermined priority configuration rule whether search has, if so, then from website or clothes
The predetermined certainly careful eligibility criteria or predetermined priority configuration rule for needing to update are downloaded in business device, and to local predetermined from careful qualification
Standard and predetermined priority configuration rule are updated.If again to specific website after no, continuing waiting for interval time
Or server scans for and repeats such scheme.
Can also be insurance company's system according to being actually needed irregularly to predetermined from examining eligibility criteria and predetermined priority
Configuration rule is updated.The renewal can be updated manually by staff, or renewal button corresponding to triggering is certainly
The specific website of trend or server search are predetermined accordingly from the renewal for examining eligibility criteria and predetermined priority configuration rule
Content, automatically updated.
As the specific implementation of Fig. 1 methods, the declaration form that the embodiment of the present application provides a kind of settlement of insurance claim case determines dress
Put, as shown in figure 3, the device includes：Acquiring unit 21, verification unit 22, priority dispensing unit 23 and determining unit 24.
Acquiring unit 21, for obtaining multiple declaration form data of settlement of insurance claim case；
Verification unit 22, for, from eligibility criteria is examined, carrying out examining qualification school certainly respectively to multiple declaration form data according to predetermined
Test；
Priority dispensing unit 23, for reference to predetermined priority configuration rule, making a reservation for meet from careful eligibility criteria
The corresponding priority of declaration form data configuration；
Determining unit 24, for according to configuration result, the declaration form data of highest priority to be defined as into target declaration form data.
In a particular embodiment, verification unit 22, specifically include：
Judge module, for judging whether corresponding declaration form classification is predetermined white list classification to multiple declaration form data respectively；
Or judge whether multiple declaration form data meet rejecting standard, wherein reject standard include but is not limited to it is at least one following：
Time of policy purchase in declaration form data reject in the time, the warrantee in declaration form data in big customer's list, protect
The content of personal verification declaration form is included in remark information of the insurer in blacklist, in declaration form data in forms data；
Determining module, for not being predetermined white list classification or the declaration form data for meeting rejecting standard by declaration form classification,
It is defined as not meeting the predetermined declaration form data from careful eligibility criteria.
In a particular embodiment, priority dispensing unit 23, is specifically included：
Acquisition module, it is predetermined from the declaration form data for examining eligibility criteria from meeting for the effective time according to declaration form data
It is middle to obtain non-failed declaration form data；
Enquiry module, for inquiring about the declaration form amount of money and/or day of due date in non-failed declaration form data；
Priority configuration module, for according to the bigger priority of declaration form amount of money numerical value is higher, and/or day of due date is more early preferential
The higher principle of level, is the non-failed corresponding priority of declaration form data configuration.
In a particular embodiment, priority configuration module, it is additionally operable to be that declaration form money item and day of due date item are matched somebody with somebody respectively in advance
Put each self-corresponding weighted value；By presetting calculation formula, and weighted value is combined, be that non-failed declaration form data configuration is excellent accordingly
First level.
In a particular embodiment, priority configuration module, specifically include：
Time computing module, day is handled apart from current settlement of insurance claim case for calculating day of due date in non-failed declaration form data
Remaining time；
Weight value calculation module, for inverted to remaining time and be multiplied by weighted value corresponding to day of due date, along with non-
Declaration form amount of money numerical value is multiplied by the product value of weighted value corresponding to the declaration form amount of money in lapsed policy data；
Priority computation module, for determining the non-failed corresponding priority of declaration form data according to result of calculation.
In a particular embodiment, device also includes：
Exploitation and encapsulation unit, for being developed predetermined and being sealed from careful eligibility criteria and predetermined priority configuration rule
Dress processing, obtain examining eligibility criteria and predetermined priority configuration rule corresponding application programming interface respectively certainly with predetermined
API；
Verification unit 22, it is additionally operable to carry out multiple declaration form data respectively conversion process, generates multiple pending declaration forms pair
As；Api interface corresponding to transferring predetermined certainly careful eligibility criteria, realize using predetermined certainly careful eligibility criteria, to multiple pending guarantors
Single object carries out verifying from careful qualification respectively；
Priority dispensing unit 23, it is additionally operable to transfer api interface corresponding to predetermined priority configuration rule, realizes using pre-
Determine priority configuration guideline, it is predetermined from the corresponding priority of pending declaration form object configuration for examining eligibility criteria to meet.
In a particular embodiment, device also includes：
Push unit, for, from eligibility criteria is examined, carrying out examining qualification school certainly respectively to multiple declaration form data according to predetermined
After testing, by by being shown from declaration form data-pushing to the front end page for examining qualification verification；
Unit is changed, for the modification instruction received according to front end page, to the declaration form number by being verified from careful qualification
According to modifying；Amended declaration form data are defined as to meet the predetermined declaration form data from careful eligibility criteria.
As shown in figure 4, in a particular embodiment, the device also includes：
Updating block 2a, for predetermined from examining eligibility criteria and/or predetermined priority configuration rule is not carried out periodically or not
Regularly update, wherein, updating block 2a is respectively connected with verification unit 22 and priority dispensing unit 23；
Verification unit 22, it is additionally operable to, according to the predetermined certainly careful eligibility criteria after renewal, carry out multiple declaration form data respectively
Verified from careful qualification；
Priority dispensing unit 23, it is additionally operable to reference to the predetermined priority configuration rule after renewal, it is predetermined from careful to meet
The corresponding priority of declaration form data configuration of eligibility criteria.
Based on method shown in above-mentioned Fig. 1,2, accordingly, the embodiment of the present application additionally provides a kind of storage device, deposits thereon
Computer program is contained, step corresponding to Fig. 1, method shown in 2 is realized when program is executed by processor.
Based on method shown in above-mentioned Fig. 1,2 and Fig. 3, the embodiment of 4 shown devices, the embodiment of the present application additionally provides one kind
The entity apparatus that the declaration form of settlement of insurance claim case confirms, as shown in figure 5, including storage device 32 and processor 31, wherein storing
Equipment 32 and processor 31 are arranged in bus 33.
Storage device 32, for storing computer program；
Processor 31, for performing computer program to realize step corresponding to Fig. 1, method shown in 2.
, being capable of the automatic checking verification multiple declaration forms related to settlement of insurance claim case by the above-mentioned technical proposal of the application
Data, and therefrom select with the most suitable declaration form data of settlement of insurance claim case, as target declaration form data.For the later stage
It is that the amount of money is compensated in the adjustment of settlement of insurance claim case according to the target declaration form data.The selection process of whole target declaration form data is all certainly
Dynamic completion, human resources can be saved, reduce error rate, effectively improve the timeliness and accuracy of settlement of insurance claim.
Through the above description of the embodiments, those skilled in the art can be understood that the application can lead to
Hardware realization is crossed, the mode of necessary general hardware platform can also be added by software to realize.Based on such understanding, this Shen
Technical scheme please can be embodied in the form of software product, and the software product can be stored in a non-volatile memories
In medium (can be CD-ROM, USB flash disk, mobile hard disk etc.), including some instructions are causing a computer equipment (can be
Personal computer, server, or network equipment etc.) perform each implement scene of the application described in method.
It will be appreciated by those skilled in the art that accompanying drawing is a schematic diagram for being preferable to carry out scene, module in accompanying drawing or
Flow is not necessarily implemented necessary to the application.
It will be appreciated by those skilled in the art that the module in device in implement scene can be described according to implement scene into
Row is distributed in the device of implement scene, can also carry out one or more dresses that respective change is disposed other than this implement scene
In putting.The module of above-mentioned implement scene can be merged into a module, can also be further split into multiple submodule.
Above-mentioned the application sequence number is for illustration only, does not represent the quality of implement scene.
Disclosed above is only several specific implementation scenes of the application, and still, the application is not limited to this, Ren Heben
What the technical staff in field can think change should all fall into the protection domain of the application.
Claims (10)
1. a kind of declaration form of settlement of insurance claim case determines method, it is characterised in that methods described includes：
Obtain multiple declaration form data of settlement of insurance claim case；
According to predetermined from eligibility criteria is examined, the multiple declaration form data are carried out respectively to verify from careful qualification；
It is described predetermined preferential accordingly from the declaration form data configuration for examining eligibility criteria to meet with reference to predetermined priority configuration rule
Level；
According to configuration result, the declaration form data of highest priority are defined as target declaration form data.
2. according to the method for claim 1, it is characterised in that the basis is predetermined from eligibility criteria is examined, to the multiple
Declaration form data carry out, from qualification verification is examined, specifically including respectively：
Judge whether corresponding declaration form classification is predetermined white list classification to the multiple declaration form data respectively；Or
Judge whether the multiple declaration form data meet rejecting standard, wherein the rejecting standard include but is not limited to it is following at least
One of：
Time of policy purchase in the declaration form data reject in the time, the warrantee in the declaration form data is in big customer's list
Protected in remark information of the insurer in blacklist, in the declaration form data in interior, described declaration form data comprising personal verification
Single content；
It is not the predetermined white list classification or the declaration form data for meeting the rejecting standard by the declaration form classification, it is determined that
It is described predetermined from the declaration form data for examining eligibility criteria not meet.
3. according to the method for claim 1, it is characterised in that it is described with reference to predetermined priority configuration rule, to meet
The predetermined corresponding priority of declaration form data configuration from careful eligibility criteria is stated, is specifically included：
According to the effective time of declaration form data, non-failed guarantor is obtained from meeting in the predetermined declaration form data for examining eligibility criteria certainly
Forms data；
The declaration form amount of money and/or day of due date inquired about in the non-failed declaration form data；
According to the principle that the bigger priority of declaration form amount of money numerical value is higher, and/or the more early priority of day of due date is higher, it is
The non-failed corresponding priority of declaration form data configuration.
4. according to the method for claim 3, it is characterised in that be described according to the declaration form amount of money and the day of due date
The non-failed corresponding priority of declaration form data configuration, is specifically included：
Each self-corresponding weighted value is respectively configured for declaration form money item and day of due date item in advance；
By presetting calculation formula, and it is the non-failed corresponding priority of declaration form data configuration with reference to the weighted value.
5. according to the method for claim 4, it is characterised in that it is described by presetting calculation formula, and with reference to the weight
Value, is the non-failed corresponding priority of declaration form data configuration, specifically includes：
Calculate the remaining time that day of due date in non-failed declaration form data handles day apart from current settlement of insurance claim case；
It is inverted to the remaining time and be multiplied by weighted value corresponding to the day of due date, along with the non-failed declaration form data
Middle declaration form amount of money numerical value is multiplied by the product value of weighted value corresponding to the declaration form amount of money；
The non-failed corresponding priority of declaration form data is determined according to result of calculation.
6. according to the method for claim 1, it is characterised in that the basis is predetermined from eligibility criteria is examined, to the multiple
Declaration form data are carried out from before examining qualification verification respectively, and methods described also includes：
Will be described predetermined from eligibility criteria is examined and predetermined priority configuration rule is developed and encapsulation process, obtain with it is predetermined from
Examine application programming interface API corresponding to eligibility criteria and predetermined priority configuration rule difference；
The basis is predetermined from eligibility criteria is examined, and the multiple declaration form data are carried out respectively to verify from careful qualification, specifically included：
The multiple declaration form data are carried out with conversion process respectively, generates multiple pending declaration form objects；
Api interface corresponding to transferring the predetermined certainly careful eligibility criteria, realize using the predetermined certainly careful eligibility criteria, to described
Multiple pending declaration form objects carry out verifying from careful qualification respectively；
The reference predetermined priority configuration rule, it is described predetermined corresponding from the declaration form data configuration for examining eligibility criteria to meet
Priority, specifically include：
Api interface corresponding to the predetermined priority configuration rule is transferred, realizes and utilizes the predetermined priority configuration rule, be
Meet described predetermined from the corresponding priority of pending declaration form object configuration for examining eligibility criteria.
7. according to the method for claim 1, it is characterised in that the basis is predetermined from eligibility criteria is examined, to the multiple
Declaration form data are carried out from after examining qualification verification respectively, and methods described also includes：
By by being shown from declaration form data-pushing to the front end page for examining qualification verification；
The modification received according to the front end page instructs, to described by being repaiied from the declaration form data for examining qualification verification
Change；
Amended declaration form data are defined as to meet the predetermined declaration form data from careful eligibility criteria.
8. method according to any one of claim 1 to 7, it is characterised in that methods described also includes：
The predetermined certainly careful eligibility criteria and/or the predetermined priority configuration rule are periodically or non-periodically updated；
The basis is predetermined from eligibility criteria is examined, and the multiple declaration form data are carried out respectively to verify from careful qualification, specifically included：
According to the predetermined certainly careful eligibility criteria after renewal, the multiple declaration form data are carried out respectively to verify from careful qualification；
The reference predetermined priority configuration rule, it is described predetermined corresponding from the declaration form data configuration for examining eligibility criteria to meet
Priority, specifically include：
It is described predetermined from the declaration form data configuration phase for examining eligibility criteria to meet with reference to the predetermined priority configuration rule after renewal
The priority answered.
9. a kind of storage device, is stored thereon with computer program, it is characterised in that is realized when described program is executed by processor
The declaration form of settlement of insurance claim case described in any one of claim 1 to 8 determines method.
10. a kind of declaration form determining device of settlement of insurance claim case, it is characterised in that described device includes storage device and processing
Device,
The storage device, for storing computer program；
The processor, for performing the computer program to realize the settlement of insurance claim case described in any one of claim 1 to 8
The declaration form of part determines method.
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201711113078.4A CN107784117A (en) | 2017-11-10 | 2017-11-10 | The declaration form of settlement of insurance claim case determines method and apparatus |
| PCT/CN2018/074621 WO2019090985A2 (en) | 2017-11-10 | 2018-01-30 | Insurance claim case policy determination method and apparatus |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201711113078.4A CN107784117A (en) | 2017-11-10 | 2017-11-10 | The declaration form of settlement of insurance claim case determines method and apparatus |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| CN107784117A true CN107784117A (en) | 2018-03-09 |
Family
ID=61432738
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| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CN201711113078.4A Pending CN107784117A (en) | 2017-11-10 | 2017-11-10 | The declaration form of settlement of insurance claim case determines method and apparatus |
Country Status (2)
| Country | Link |
|---|---|
| CN (1) | CN107784117A (en) |
| WO (1) | WO2019090985A2 (en) |
Cited By (7)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109409817A (en) * | 2018-09-03 | 2019-03-01 | 中国平安人寿保险股份有限公司 | Insurance data checking method, device, computer equipment and storage medium |
| CN109658258A (en) * | 2018-11-07 | 2019-04-19 | 中国平安财产保险股份有限公司 | Amount for which loss settled based on big data adjusts method, apparatus, computer equipment automatically |
| CN109727145A (en) * | 2018-06-01 | 2019-05-07 | 中国平安人寿保险股份有限公司 | Declaration form Claims Resolution judgment method, equipment, storage medium and device |
| CN109785165A (en) * | 2018-12-14 | 2019-05-21 | 中国平安财产保险股份有限公司 | Declaration form reparation method, apparatus and computer equipment based on data processing |
| CN111652581A (en) * | 2020-05-29 | 2020-09-11 | 泰康保险集团股份有限公司 | Method and device for processing arithmetic data, storage medium and electronic equipment |
| CN111932196A (en) * | 2020-07-08 | 2020-11-13 | 泰康保险集团股份有限公司 | Case processing method, device and equipment and readable storage medium |
| CN113537774A (en) * | 2021-07-16 | 2021-10-22 | 精英数智科技股份有限公司 | Method and system for detecting whether coal mine enterprise policy is valid |
Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20020116228A1 (en) * | 1999-07-30 | 2002-08-22 | Alan R. Bauer | Method and apparatus for internet on-line insurance policy service |
| CN102542337A (en) * | 2010-12-13 | 2012-07-04 | 金蝶软件（中国）有限公司 | Service logic processing method for information system and device |
| CN105469310A (en) * | 2014-09-12 | 2016-04-06 | 易保网络技术(上海)有限公司 | Calculation method and system for insurance related cost of insurance product |
| CN106530092A (en) * | 2015-09-15 | 2017-03-22 | 平安科技（深圳）有限公司 | Automatic matching system of medical insurance responsibilities and method |
-
2017
- 2017-11-10 CN CN201711113078.4A patent/CN107784117A/en active Pending
-
2018
- 2018-01-30 WO PCT/CN2018/074621 patent/WO2019090985A2/en active Application Filing
Patent Citations (4)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20020116228A1 (en) * | 1999-07-30 | 2002-08-22 | Alan R. Bauer | Method and apparatus for internet on-line insurance policy service |
| CN102542337A (en) * | 2010-12-13 | 2012-07-04 | 金蝶软件（中国）有限公司 | Service logic processing method for information system and device |
| CN105469310A (en) * | 2014-09-12 | 2016-04-06 | 易保网络技术(上海)有限公司 | Calculation method and system for insurance related cost of insurance product |
| CN106530092A (en) * | 2015-09-15 | 2017-03-22 | 平安科技（深圳）有限公司 | Automatic matching system of medical insurance responsibilities and method |
Cited By (10)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN109727145A (en) * | 2018-06-01 | 2019-05-07 | 中国平安人寿保险股份有限公司 | Declaration form Claims Resolution judgment method, equipment, storage medium and device |
| CN109727145B (en) * | 2018-06-01 | 2023-11-10 | 中国平安人寿保险股份有限公司 | Method, device, storage medium and apparatus for judging warranty claim |
| CN109409817A (en) * | 2018-09-03 | 2019-03-01 | 中国平安人寿保险股份有限公司 | Insurance data checking method, device, computer equipment and storage medium |
| CN109658258A (en) * | 2018-11-07 | 2019-04-19 | 中国平安财产保险股份有限公司 | Amount for which loss settled based on big data adjusts method, apparatus, computer equipment automatically |
| CN109785165A (en) * | 2018-12-14 | 2019-05-21 | 中国平安财产保险股份有限公司 | Declaration form reparation method, apparatus and computer equipment based on data processing |
| CN111652581A (en) * | 2020-05-29 | 2020-09-11 | 泰康保险集团股份有限公司 | Method and device for processing arithmetic data, storage medium and electronic equipment |
| CN111652581B (en) * | 2020-05-29 | 2023-06-13 | 泰康保险集团股份有限公司 | Method and device for processing calculated data, storage medium and electronic equipment |
| CN111932196A (en) * | 2020-07-08 | 2020-11-13 | 泰康保险集团股份有限公司 | Case processing method, device and equipment and readable storage medium |
| CN113537774A (en) * | 2021-07-16 | 2021-10-22 | 精英数智科技股份有限公司 | Method and system for detecting whether coal mine enterprise policy is valid |
| CN113537774B (en) * | 2021-07-16 | 2023-04-07 | 精英数智科技股份有限公司 | Method and system for detecting whether policy of coal mine enterprise is effective or not |
Also Published As
| Publication number | Publication date |
|---|---|
| WO2019090985A2 (en) | 2019-05-16 |
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Application publication date: 20180309 |