WO2018149397A1 - 一种理赔准备金的评估方法、存储介质、终端设备及装置 - Google Patents

一种理赔准备金的评估方法、存储介质、终端设备及装置 Download PDF

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Publication number
WO2018149397A1
WO2018149397A1 PCT/CN2018/076663 CN2018076663W WO2018149397A1 WO 2018149397 A1 WO2018149397 A1 WO 2018149397A1 CN 2018076663 W CN2018076663 W CN 2018076663W WO 2018149397 A1 WO2018149397 A1 WO 2018149397A1
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insurance
case
evaluated
policy
amount
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PCT/CN2018/076663
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English (en)
French (fr)
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戴建云
朱瑾
周鹏
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平安科技（深圳）有限公司
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Publication of WO2018149397A1 publication Critical patent/WO2018149397A1/zh

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    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
    • G06Q40/08—Insurance

Definitions

  • the present application relates to the field of financial services, and in particular, to a method for evaluating claims reserves, a computer readable storage medium, a terminal device, and a device.
  • the application provides an evaluation method for a claim reserve, a computer readable storage medium, a terminal device and a device, which can automatically calculate the claim reserve of the case to be evaluated, and improve the evaluation accuracy and the evaluation efficiency.
  • a first aspect of the embodiments of the present application provides a method for evaluating a claim reserve, including:
  • the claim insurance type belongs to a medical insurance type
  • the preset amount of the claim insurance is obtained, and the number of the insurance policy items of the for-assessed case is determined according to the risk information, and the claim is based on the piece of the claim. Calculating the claim reserve for the case to be assessed based on the amount of the policy and the number of the policy insurance;
  • the claim insurance type does not belong to the medical insurance category, calculating the insurance amount of the policy under the claim insurance type, and calculating the to-be-evaluated case according to the calculated insurance amount and the preset compensation ratio of the claim insurance type Claims reserve.
  • a second aspect of the embodiments of the present application provides a computer readable storage medium storing computer readable instructions that are implemented by a processor to implement an embodiment of the present application.
  • a third aspect of an embodiment of the present application provides a terminal device including a memory, a processor, and computer readable instructions stored in the memory and executable on the processor, the processor executing the computer
  • the steps of the method for evaluating the claims reserve as set forth in the first aspect of the embodiments of the present application are implemented when the instructions are readable.
  • a fourth aspect of the embodiments of the present application provides an apparatus for evaluating a claim reserve, including:
  • a case acquisition module for obtaining a case to be evaluated
  • the insurance information obtaining module is configured to obtain the insurance information of the case to be evaluated
  • a claim insurance type determining module configured to determine, according to the risk information, a claim insurance type corresponding to the policy of the case to be evaluated;
  • a judging module configured to determine whether the claim insurance type belongs to a medical insurance type
  • a first reserve calculation module configured to acquire a preset amount of the claim for the claim insurance type if the claim type belongs to the medical insurance type, and determine the riskable policy of the case to be evaluated according to the risk information
  • the number of insurance types, the claim reserve for the case to be evaluated is calculated according to the amount of the claim and the number of the policy insurance;
  • a second reserve calculation module configured to calculate a policy amount of the policy under the claim insurance type if the claim insurance type does not belong to a medical insurance type, and calculate the insurance amount and the precautionary insurance type according to the calculation Set the compensation ratio to calculate the claim reserve for the case to be evaluated.
  • This application can realize the automatic calculation of the claims reserve of the case to be evaluated, avoiding the evaluation result of the claim reserve from being affected by the professional level and experience of the assessor, improving the accuracy of the assessment; and greatly improving the evaluation efficiency of the claim reserve. In the face of a large number of cases to be assessed, the cost of the claims reserve assessment is reduced.
  • FIG. 1 is a flow chart of a first embodiment of a method for evaluating a claim reserve in the present application
  • FIG. 2 is a schematic flow chart of a calculation step of an average compensation amount for a method for evaluating a claim reserve in the present application
  • FIG. 3 is a schematic flow chart of a calculation step of a preset payout ratio of a method for evaluating a claim reserve in the present application
  • FIG. 4 is a flow chart of a second embodiment of a method for evaluating claim reserves in the present application.
  • Fig. 5 is a structural diagram showing a first embodiment of an apparatus for evaluating claim reserves in the present application.
  • the present application provides a method and apparatus for evaluating claim reserves, which are used to solve the problem that the evaluation result of the claim reserve is easily influenced by the professional level and experience of the assessor, and the problem of inefficiency is evaluated.
  • a first embodiment of a method for evaluating a claim reserve in the present application includes:
  • the case to be evaluated can be obtained.
  • the case to be evaluated may be an insurance product to be evaluated, or may be a claim for evaluation.
  • the risk information refers to information for recording the risk situation of the case to be evaluated, which may be entered by the applicant who filed the claim, or may be submitted or entered by the staff of the insurance company.
  • the claim insurance type corresponding to the policy of the case to be evaluated may be determined according to the risk information.
  • case to be evaluated can correspond to multiple policies, and there may be multiple types of insurance policies on each policy, such as disability insurance, critical illness insurance, personal injury insurance, medical insurance, and the like. Therefore, a case to be evaluated can determine one, two or more claims insurance based on the risk information.
  • each type of insurance can be ordered according to the degree of importance: death insurance, critical illness insurance, disability insurance and medical insurance.
  • death insurance critical illness insurance
  • disability insurance disability insurance
  • medical insurance medical insurance
  • the specific steps of determining the claim insurance type of the policy to be evaluated according to the risk information may include:
  • the policy to be evaluated corresponds to the death insurance corresponding to the risk information, and the date of the insurance of the case to be evaluated satisfies the time limit for the death insurance in the policy, and if so, the The claim insurance type is a death insurance, and the claims reserve is evaluated according to the case of personal injury insurance. If not, the next step is performed;
  • the to-be-evaluated case corresponding policy includes a critical illness insurance corresponding to the risk information, and the date of the insurance of the case to be evaluated satisfies the time limit condition for the critical illness insurance in the policy, and if yes, the The claim insurance type is a critical illness insurance, and the claim reserve assessment is carried out according to the case of the critical illness insurance. If not, the next step is performed;
  • the claim reserve assessment is conducted in accordance with the disability insurance case, and if not, the next step is performed;
  • the claim reserve assessment is carried out according to the case of medical insurance. If not, it can be determined that the corresponding policy is not included in the corresponding policy of the case to be evaluated. Therefore, if the claim is unqualified, the case to be evaluated can be directly determined.
  • the claim reserve is 0.
  • step 104 determining whether the claims insurance belongs to the medical insurance, if yes, proceed to step 105, if not, proceed to step 108;
  • step 105 After determining the claims insurance of the policy to be evaluated according to the risk information, it may be determined whether the claim insurance belongs to the medical insurance, and if yes, step 105 is performed; if not, step 108 is performed.
  • the above medical insurance types may be medical insurance, and the above non-medical insurance types may include death insurance, heavy illness insurance and disability insurance.
  • the preset amount of the claim for the claim insurance type may be obtained. Understandably, because the claims for medical insurance need to be based on specific medical expenses, even if the same policy is under the same risk information, the medical expenses that need to be paid are likely to be different. Therefore, it is suitable to use the average amount of compensation to evaluate the claims reserve for medical insurance.
  • the amount of the claim can be obtained by the following steps:
  • each month in the past year may be a time period.
  • the total number of historical cases and the corresponding historical total amount of medical insurance for each month in the past year can be separately counted.
  • the total number of historical cases in the month of July last year was B
  • the total amount of historical claims was A
  • the average amount of compensation in July last year was A/B.
  • the relevant data details may be submitted to the staff for verification, and if the verification is correct, the intervention is not performed; if the verification is incorrect, the abnormality may be manually corrected.
  • the data is used to ensure the accuracy of the claim compensation and the accuracy of the claim reserve assessment.
  • the number of the policy insurance items of the case to be evaluated may be determined according to the risk information. It can be seen from the content described in the above step 103 that one case to be evaluated can determine one, two or more types of claims insurance according to the risk information, so that the number of policy types that can be out of danger can also have one, two or more.
  • the claim reserve of the case to be evaluated may be calculated according to the amount of the claim and the number of the policy insurance.
  • the claim reserve may be equal to the product of the average amount of the claim and the number of the policy insurance.
  • the same medical liability is generally only paid once for the same insurance company, and if there are multiple insurance policies in the case to be evaluated that contain the same medical liability, a double counting portion may occur. Therefore, the number of liability claims cnt_liab under each policy insurance type of the case to be evaluated can also be obtained.
  • the different policy types include the quantity cnt_liab_sub of the same liability, assuming that the average amount of compensation in the area is medi_r, and the number of policy insurance items is cnt_pol, then The reserve for each liability for each policy type is medi_r/(cnt_pol*cnt_liab*cnt_liab_sub).
  • the claim reserve for the case to be evaluated is sum(medi_r/(cnt_pol*cnt_liab*cnt_liab_sub)), and sum is the summation function, that is, the reserve for all liabilities after calculating the reserve for each responsibility. The sum is equal to the claim reserve for the case to be assessed.
  • the insurance amount of the policy under the claim insurance type may be calculated. It can be understood that the insured amount of the claim insurance can be calculated according to the agreement of the policy. For example, the type of claims insurance is death insurance, the premium is 10,000 per year. If the insured person dies within 20 years, he can pay 500,000 in one lump sum. The 500,000 is the insured amount of the deceased insurance. The calculation of the specific insurance amount can be found in the contractual agreement of the policy, and will not be repeated here.
  • the claim reserve of the case to be evaluated may be calculated according to the calculated insurance amount and the preset payout ratio of the claim insurance type.
  • the preset payout ratio can be calculated or counted according to historical data in advance. It can be understood that the payout ratios of different claims insurance types are generally different, for example, the personal injury insurance, the critical illness insurance, and the disability insurance have respective preset payout ratios.
  • the claim reserve of the case to be evaluated may be equal to the product of the insurance amount and the preset payout ratio.
  • the preset payout ratio can be calculated by the following steps:
  • each month in the past year may be a time period.
  • the historical total amount of insurance for non-medical insurance for each month in the past year, the total amount of the historical claims, the total number of applications for the case, and the total number of claims for the case may be separately counted.
  • the above-mentioned historical total insurance amount refers to the total insured amount of the claim insurance case, which is set to A; the above historical total compensation refers to the total payment of the final payment of the claim type under the claim insurance type, and is set as B; the total number of applications for the above-mentioned cases refers to the total number of cases in which claims are applied under the claims insurance, or may be considered as the total number of cases to be assessed, set to C; and the total number of claims in the above cases refers to the application in the case Based on the total number of cases that were finally paid out, set to D.
  • the total number of insured persons refers to the total number of insured persons corresponding to the policy to be evaluated in this embodiment, and is set to E.
  • the total number of people in the above-mentioned insurance refers to the total number of people who are insured in the case to be evaluated in this embodiment, and is set to F.
  • the preset payout ratio calculation model may specifically include:
  • the preset payout ratio (B/A)*(D/C-( D/C-F/E)/2);
  • the relevant data details may be submitted to the staff for verification, and if the verification is correct, the intervention is not performed; if the verification is incorrect, the abnormality may be manually corrected.
  • the data is used to ensure that the preset payout ratio is accurate and effective, thereby improving the accuracy of the claims reserve assessment.
  • the preset payout ratio of one year may take the average of the preset payout ratios of the plurality of months.
  • the preset payout ratio corresponds to the preset payout ratio.
  • the preset chargeback ratio is 1 - the preset payout ratio, so the preset payout ratio used above may also be used in the system.
  • the above steps 301 ⁇ 307 are applicable to the calculation of the preset payout ratio of the death insurance, the critical illness insurance and the disability insurance. Further, when calculating the preset payout ratio of the disability insurance, the historical total compensation B may be specifically subdivided into the historical total compensation B1 including the disability ratio and the historical total compensation B2 not including the disability ratio.
  • the above “contains disability ratio” refers to whether the statistics of the total historical compensation amount takes into account the disability ratio as a factor.
  • the estimated proportion of the disability that is estimated to have a disability ratio includes:
  • the preset payout ratio (B1/A)*(D/C+(F/E-D/C)/2);
  • the preset payout ratio (B1/A)*(D/C-( D/C-F/E)/2);
  • the estimated proportion of the disability insurance that is estimated to have no disability ratio includes:
  • the preset payout ratio (B2/A)*(D/C+(F/E-D/C)/2);
  • the preset payout ratio (B2/A)*(D/C-( D/C-F/E)/2);
  • the automatic calculation of the claim reserve for the case to be evaluated can be realized, and the evaluation result of the claim reserve is prevented from being affected by the professional level and experience of the assessor, and the evaluation accuracy is improved; and the claim reserve is greatly improved.
  • the efficiency of the assessment reduces the cost of the claims reserve assessment in the face of a large number of cases to be assessed.
  • a second embodiment of the method for evaluating claim reserves in the embodiment of the present application includes:
  • the method further includes: determining, according to the risk information, whether the policy corresponding to the case to be evaluated includes a claim insurance type corresponding to the risk information, and The expiration date of the case to be evaluated satisfies the time limit condition of the policy, and if yes, the step of determining the claim type of the policy corresponding to the case to be evaluated according to the risk information, and if not, determining the claim of the case to be evaluated The reserve is 0.
  • step 404 determining whether the claims insurance belongs to the medical insurance, if yes, proceed to step 405, if not, proceed to step 408;
  • Steps 401-409 are the same as steps 101-109. For details, refer to the related description of steps 101-109.
  • the current claim phase of the case to be evaluated may be obtained. It can be understood that the current claim phase refers to the current stage of the application for claim settlement of the case to be evaluated, for example, the stage in which the case to be evaluated has been entered into the claim information but the amount of the claim is not paid, and the case to be evaluated has been given. The amount of the audit but not the stage of the payment of the audit amount, and so on.
  • the predicted claim amount of the claim insurance type may be calculated according to the claim information and the claim calculation rule of the policy.
  • the above-mentioned “received claim information” means that the claim information has been entered, that is, the claim for the case to be evaluated can be calculated according to the specific claim information; and the above-mentioned “unpaid amount” refers to the fact that although the claim can be calculated, However, the claims paid by the insurance company have not been finalized and reviewed. Therefore, the predicted claims of the claim insurance can be calculated according to the claim calculation rule of the policy.
  • the claim calculation rule is generally pre-agreed in the policy.
  • the final claim reserve is obtained by adjusting the forecasting claims, making the assessment of the claims reserve more accurate.
  • the audit amount may be directly determined as the claim reserve of the case to be evaluated.
  • the claim amount (equal to the audit amount) of the case to be evaluated has been determined, and only the payment of the claim amount is still not paid at this stage, so the audit amount can be directly determined.
  • the accuracy of the claims reserve of each product may be verified.
  • the accuracy check can be performed in three dimensions, namely the total evaluation amount, the evaluation amount of each product category, and the total throughput of the evaluation case. The steps to verify the accuracy of the three dimensions are briefly described below:
  • the monthly evaluation case amount allCnt the total evaluation amount of the month allAmt, the last month evaluation case amount allCntOld, the last month total evaluation amount allAmtOld, the last month evaluation case amount allCntLast, last year's total evaluation amount allAmtLast, last year
  • Cnt_new_reck Cnt_old-cnt_old_end+cnt_new-cnt_new_end
  • the equation should be identical. If the equation is found to be unsuccessful, the difference detail data is extracted and submitted to each region for analysis.
  • Fig. 5 is a block diagram showing the first embodiment of an evaluation apparatus for claim settlement in the present application.
  • an evaluation device for claim settlement includes:
  • a case obtaining module 501 configured to obtain a case to be evaluated
  • the risk information obtaining module 502 is configured to obtain the risk information of the case to be evaluated
  • the claim insurance type determining module 503 is configured to determine, according to the risk information, a claim insurance type corresponding to the policy of the case to be evaluated;
  • the determining module 504 is configured to determine whether the claim insurance type belongs to a medical insurance type
  • the first reserve calculation module 505 is configured to: if the claim insurance belongs to the medical insurance, acquire the preset amount of the claim for the claim insurance, and determine, according to the insurance information, the risk of the case to be evaluated.
  • the number of insurance policy types, the claim reserve for the case to be evaluated is calculated according to the average amount of the claim and the number of the policy insurance;
  • a second reserve calculation module 506 configured to calculate a policy amount of the policy under the claim insurance type if the claim insurance type does not belong to a medical insurance type, and calculate the insurance amount and the claim insurance type according to the calculation
  • the claim compensation ratio is calculated by the preset payout ratio.
  • the preset payout ratio can be calculated by the following modules:
  • the historical total insurance amount acquisition module is configured to obtain the historical total insurance amount of the claim insurance type within the preset time period
  • a historical compensation total acquisition module configured to obtain a historical total payment amount of the claim insurance type in the preset time period
  • a total number of cases for obtaining a case application module configured to obtain a total number of case applications for the claims insurance type in the preset time period
  • a case payment total item obtaining module configured to obtain a total number of case claims for the claim insurance type in the preset time period
  • the total number of people in the insurance acquisition module is used to obtain the total number of persons who have taken out the insurance policy
  • the input module is configured to input the historical total amount of the insurance, the total amount of the historical claims, the total number of the case applications, the total number of the claims, the total number of the insured persons, and the total number of the insured persons into a preset payment
  • the proportional calculation model obtains the preset payout ratio of the claim insurance type.
  • evaluation device of the claim reserve may further include:
  • a claim phase acquisition module configured to obtain a current claim phase of the case to be evaluated
  • a predictive claims calculation module configured to calculate, according to the claim information and the claim calculation rule of the policy, if the current claim phase is a stage in which the claim information has been entered but the amount of the claim is not paid Predicted claims for claims insurance;
  • a comparison module configured to compare the claim reserve with the predicted claims to obtain a comparison result
  • an adjustment module configured to adjust the predicted claims according to the comparison result, and determine the adjusted claims to be the claim reserve of the case to be evaluated.
  • evaluation device of the claim reserve may further include:
  • a first determining module configured to determine that the audit amount is the case to be evaluated if the current claim phase is a stage in which the audit amount of the case to be evaluated has been given but the payment amount of the audit amount is not initiated Claims reserve.
  • evaluation device of the claim reserve may further include:
  • condition judging module configured to determine, according to the risk information, whether the policy to be evaluated corresponds to a claim insurance policy corresponding to the risk information, and the date of the insurance of the case to be evaluated satisfies the time limit of the policy;
  • a triggering module configured to trigger the claim insurance type determining module if the determination result of the condition determining module 519 is YES;
  • the second determining module is configured to determine, if the determination result of the condition determining module 519 is negative, that the claim reserve of the case to be evaluated is 0.
  • the embodiment of the present application further provides a computer readable storage medium storing computer readable instructions, which are executed by a processor to implement any one as shown in FIG. 1 or FIG. The steps of the method of evaluating the claims reserve.
  • the embodiment of the present application further provides a terminal device, including a memory, a processor, and computer readable instructions stored in the memory and executable on the processor, when the processor executes the computer readable instruction.
  • a terminal device including a memory, a processor, and computer readable instructions stored in the memory and executable on the processor, when the processor executes the computer readable instruction.

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Abstract

本申请公开了一种理赔准备金的评估方法、计算机可读存储介质、终端设备及装置，用于解决理赔准备金的评估结果容易受到评估人员的专业水平和从业经验的影响，并且评估效率低下的问题。该评估方法包括：获取待评估案件；获取所述待评估案件的出险信息；根据所述出险信息确定所述待评估案件对应保单的理赔险种；判断所述理赔险种是否属于医疗类险种；若所述理赔险种属于医疗类险种，则根据所述件均赔款额和所述保单险种件数计算所述待评估案件的理赔准备金；若所述理赔险种不属于医疗类险种，则计算所述保单在所述理赔险种下的保额，根据计算得到的所述保额和所述理赔险种的预设赔付比例计算所述待评估案件的理赔准备金。

Description

一种理赔准备金的评估方法、存储介质、终端设备及装置
本申请要求于2017年2月16日提交中国专利局、申请号为201710083376.7、发明名称为“一种理赔准备金的评估方法和装置”的中国专利申请的优先权，其全部内容通过引用结合在本申请中。
技术领域
本申请涉及金融服务领域，尤其涉及一种理赔准备金的评估方法、计算机可读存储介质、终端设备及装置。
 背景技术
目前，保险公司一般通过专业的评估人员进行理赔准备金的评估。这使得理赔准备金评估的准确性往往与评估人员的专业水平以及从业经验密切相关，不同的评估人员对同一案件可能得出不同的理赔准备金评估结果，导致理赔准备金的评估准确性受到影响；另外，随着保险公司的业务发展，越来越多的案件需要进行理赔准备金的评估，而通过评估人员进行评估，在保证理赔准备金评估准确率的前提下往往难以提高评估效率，在面对大量的待评估案件时，大大增加了理赔准备金评估的成本。
 技术问题
本申请提供了一种理赔准备金的评估方法、计算机可读存储介质、终端设备及装置，能够实现待评估案件的理赔准备金的自动计算，提高评估准确率和评估效率。
 技术解决方案
本申请实施例的第一方面提供了一种理赔准备金的评估方法，包括：
获取待评估案件；
获取所述待评估案件的出险信息；
根据所述出险信息确定所述待评估案件对应保单的理赔险种；
判断所述理赔险种是否属于医疗类险种；
若所述理赔险种属于医疗类险种，则获取所述理赔险种的预设的件均赔款额，根据所述出险信息确定所述待评估案件的可出险的保单险种件数，根据所述件均赔款额和所述保单险种件数计算所述待评估案件的理赔准备金；
若所述理赔险种不属于医疗类险种，则计算所述保单在所述理赔险种下的保额，根据计算得到的所述保额和所述理赔险种的预设赔付比例计算所述待评估案件的理赔准备金。
本申请实施例的第二方面，提供了一种计算机可读存储介质，所述计算机可读存储介质存储有计算机可读指令，所述计算机可读指令被处理器执行时实现如本申请实施例的第一方面提出的理赔准备金的评估方法的步骤。
本申请实施例的第三方面提供了一种终端设备，包括存储器、处理器以及存储在所述存储器中并可在所述处理器上运行的计算机可读指令，所述处理器执行所述计算机可读指令时实现如本申请实施例的第一方面提出的理赔准备金的评估方法的步骤。
本申请实施例的第四方面提供了一种理赔准备金的评估装置，包括：
案件获取模块，用于获取待评估案件；
出险信息获取模块，用于获取所述待评估案件的出险信息；
理赔险种确定模块，用于根据所述出险信息确定所述待评估案件对应保单的理赔险种；
判断模块，用于判断所述理赔险种是否属于医疗类险种；
第一准备金计算模块，用于若所述理赔险种属于医疗类险种，则获取所述理赔险种的预设的件均赔款额，根据所述出险信息确定所述待评估案件的可出险的保单险种件数，根据所述件均赔款额和所述保单险种件数计算所述待评估案件的理赔准备金；
第二准备金计算模块，用于若所述理赔险种不属于医疗类险种，则计算所述保单在所述理赔险种下的保额，根据计算得到的所述保额和所述理赔险种的预设赔付比例计算所述待评估案件的理赔准备金。
 有益效果
本申请可以实现待评估案件的理赔准备金的自动计算，避免了理赔准备金的评估结果受到评估人员的专业水平和从业经验的影响，提高评估准确率；并且大大提高理赔准备金的评估效率，在面对大量的待评估案件时，减少了理赔准备金评估的成本。
 附图说明
图1为本申请中一种理赔准备金的评估方法第一个实施例流程图；
图2为本申请中一种理赔准备金的评估方法的件均赔款额的计算步骤流程示意图；
图3为本申请中一种理赔准备金的评估方法的预设赔付比例的计算步骤流程示意图；
图4为本申请中一种理赔准备金的评估方法第二个实施例流程图；
图5为本申请中一种理赔准备金的评估装置第一个实施例结构图。
 本发明的实施方式
本申请提供了一种理赔准备金的评估方法和装置，用于解决理赔准备金的评估结果容易受到评估人员的专业水平和从业经验的影响，并且评估效率低下的问题。
请参阅图1，本申请中一种理赔准备金的评估方法第一个实施例包括：
101、获取待评估案件；
本实施例中，首先，可以获取待评估案件。所述待评估案件可以是待评估的保险产品，也可以是待评估的理赔申请。
102、获取所述待评估案件的出险信息；
在获取待评估案件之后，可以获取所述待评估案件的出险信息。所述出险信息是指记录该待评估案件的出险情况的信息，其可以由提出理赔申请的申请人录入，也可以由保险公司的工作人员提交或录入。
103、根据所述出险信息确定所述待评估案件对应保单的理赔险种；
在获取所述待评估案件的出险信息之后，可以根据所述出险信息确定所述待评估案件对应保单的理赔险种。
可以理解的是，待评估案件可以对应多份保单，而每份保单上可能有多个险种，例如残疾险、重疾险、身故险、医疗险等。因此，一个待评估案件可以根据出险信息确定出一个、两个或多个理赔险种。
一般来说，在同一份保单下，各险种根据重要程度可以依次排序为：身故险、重疾险、残疾险和医疗险。在根据出险信息确定理赔险种时，应当优先选择一份保单约定下重要程度较高的理赔险种。例如，假设该出险信息可以匹配身故险，则不会选择同一份保单下的重疾险、残疾险或医疗险。
因此，根据所述出险信息确定所述待评估案件对应保单的理赔险种的具体步骤可以包括：
先判断是否所述待评估案件对应保单包含与所述出险信息对应的身故险，且所述待评估案件的出险日期满足所述保单中关于身故险的时效条件，若是，则可以确定该理赔险种为身故险，按照身故险的案件进行理赔准备金评估，若否，则执行下一步；
再判断是否所述待评估案件对应保单包含与所述出险信息对应的重疾险，且所述待评估案件的出险日期满足所述保单中关于重疾险的时效条件，若是，则可以确定该理赔险种为重疾险，按照重疾险的案件进行理赔准备金评估，若否，则执行下一步；
再判断是否所述待评估案件对应保单包含与所述出险信息对应的残疾险，且所述待评估案件的出险日期满足所述保单中关于残疾险的时效条件，若是，则可以确定该理赔险种为残疾险，按照残疾险的案件进行理赔准备金评估，若否，则执行下一步；
再判断是否所述待评估案件对应保单包含与所述出险信息对应的医疗险，且所述待评估案件的出险日期满足所述保单中关于医疗险的时效条件，若是，则可以确定该理赔险种为医疗险，按照医疗险的案件进行理赔准备金评估，若否，则可以确定所述待评估案件对应保单中没有包含合适的理赔险种，因此理赔申请不合格，可以直接确定该待评估案件的理赔准备金为0。
104、判断所述理赔险种是否属于医疗类险种，若是，则执行步骤105，若否，则执行步骤108；
在根据所述出险信息确定所述待评估案件对应保单的理赔险种之后，可以判断所述理赔险种是否属于医疗类险种，若是，则执行步骤105，若否，则执行步骤108。
可以理解的是，在本实施例中，由于医疗类险种和非医疗类险种的理赔准备金评估方法不相同，因此需要先判断确定出的理赔险种属于医疗类险种还是非医疗类险种。
上述医疗类险种可以是医疗险，上述非医疗类险种可以包括身故险、重疾险和残疾险。
105、获取所述理赔险种的预设的件均赔款额；
若所述理赔险种属于医疗类险种，则可以获取所述理赔险种的预设的件均赔款额。可以理解的是，由于医疗类险种的理赔款需要根据具体的医疗费用而定，即便是相同的保单在相同的出险信息下，其需要赔付的医疗费用也很可能不同。因此适合采用件均赔款额对医疗类险种的理赔准备金进行评估。
进一步地，如图2所示，所述件均赔款额可以通过以下步骤得到：
201、获取预设第一时间段内所述理赔险种的历史案件总数；
202、获取所述预设第一时间段内所述理赔险种的历史赔付总金额；
203、根据所述历史案件总数和所述历史赔付总金额计算所述理赔险种的件均赔款额。
上述的预设第一时间段内，可以是近一年内每个月份作为一个时间段。例如，可以分别统计近一年内每个月份医疗类险种的历史案件总数和对应的历史赔付总金额。例如，统计去年7月份一个月中的历史案件总数为B，历史赔付总金额为A，则去年7月份的件均赔款额为A/B。
本实施例中，对于件均赔款额过高或者过低的数据，还可以将相关的数据明细提交给工作人员进行核实，若核实无误则不干预；若核实有误，则可以通过人工纠正异常数据，以保证件均赔款额的准确、有效，从而提高理赔准备金评估的准确性。
106、根据所述出险信息确定所述待评估案件的可出险的保单险种件数；
在获取所述理赔险种的预设的件均赔款额之后，可以根据所述出险信息确定所述待评估案件的可出险的保单险种件数。由上述步骤103中描述的内容可知，一件待评估案件可以根据出险信息确定出一个、两个或多个理赔险种，因此其可出险的保单险种件数也可以有一个、两个或多个。
107、根据所述件均赔款额和所述保单险种件数计算所述待评估案件的理赔准备金；
在得到所述件均赔款额和所述保单险种件数之后，可以根据所述件均赔款额和所述保单险种件数计算所述待评估案件的理赔准备金。该理赔准备金可以等于所述件均赔款额和所述保单险种件数之积。
进一步地，由于对于同一保险公司来说，相同的医疗责任一般只进行一次赔付，而若该待评估案件中存在多个保单险种包含同一医疗责任时，则可能出现重复计算部分。因此，还可以获取该待评估案件的每个保单险种下的可赔付责任数cnt_liab，不同保单险种包含同一责任的数量cnt_liab_sub，假设该地区的件均赔款额为medi_r，保单险种件数为cnt_pol，则每个保单险种每个责任的准备金为medi_r/(cnt_pol*cnt_liab*cnt_liab_sub)。最后，可得该待评估案件的理赔准备金为sum(medi_r/(cnt_pol*cnt_liab*cnt_liab_sub))，sum为求和函数，也即在计算得到每个责任的准备金后，所有责任的准备金之和等于该待评估案件的理赔准备金。
108、计算所述保单在所述理赔险种下的保额；
若所述理赔险种不属于医疗类险种，则可以计算所述保单在所述理赔险种下的保额。可以理解的是，可以根据所述保单的约定来计算该理赔险种的保额。例如，理赔险种为身故险，保费为每年1万，在20年内被保险人身故的，可以一次性赔付50万，这50万则为该身故险的保额。具体保额的计算可以从保单的合同约定中找到，此处不再赘述。
109、根据计算得到的所述保额和所述理赔险种的预设赔付比例计算所述待评估案件的理赔准备金。
在计算所述保单在所述理赔险种下的保额之后，可以根据计算得到的所述保额和所述理赔险种的预设赔付比例计算所述待评估案件的理赔准备金。该预设赔付比例可以预先根据历史数据计算或统计得到，可以理解的是，不同理赔险种的赔付比例一般不相同，例如身故险、重疾险和残疾险均有各自的预设赔付比例。
本实施例中，若该理赔险种为非医疗类险种，则该待评估案件的理赔准备金可以等于保额与该预设赔付比例之积。
进一步地，如图3所示，所述预设赔付比例可以通过以下步骤计算得到：
301、获取预设时间段内所述理赔险种的历史涉案总保额；
302、获取所述预设时间段内所述理赔险种的历史赔付总额；
303、获取所述预设时间段内所述理赔险种的案件申请总件数；
304、获取所述预设时间段内所述理赔险种的案件赔付总件数；
305、获取所述保单的投保总人数；
306、获取所述保单的出险总人数；
307、将所述历史涉案总保额、所述历史赔付总额、所述案件申请总件数、所述案件赔付总件数、所述投保总人数和所述出险总人数输入预设的赔付比例计算模型，得到所述理赔险种的预设赔付比例。
对于上述步骤301~304，上述的预设时间段内，可以是近一年内每个月份作为一个时间段。例如，可以分别统计近一年内每个月份非医疗类险种的历史涉案总保额、所述历史赔付总额、所述案件申请总件数和所述案件赔付总件数。其中，上述历史涉案总保额是指该理赔险种下涉及赔付案件的总保额，设为A；上述的历史赔付总额是指该理赔险种下涉及赔付案件的最终赔付的总赔付款，设为B；上述案件申请总件数是指该理赔险种下进行了理赔申请的案件总件数，或者可以认为是确定为待评估案件的总件数，设为C；而上述案件赔付总件数是指在案件申请的基础上最终进行了赔付的总的案件数量，设为D。
对于上述步骤305，上述投保总人数是指本实施例中该待评估案件对应保单的总的投保人数，设为E。
对于上述步骤306，上述出险总人数是指本实施例中该待评估案件对应保单的总的出险人数，设为F。
对于上述步骤307，该预设的赔付比例计算模型具体可以包括：
若满足F/E>2*D/C，则该预设赔付比例=(B/A)*(D/C+(F/E-D/C)/2)；
若满足D/C>2F/E，则该预设赔付比例= (B/A)*(D/C-( D/C-F/E)/2)；
若上述情况均不满足，则该预设赔付比例=(B/A)*(D/C)。
本实施例中，对于预设赔付比例过高或者过低的数据，还可以将相关的数据明细提交给工作人员进行核实，若核实无误则不干预；若核实有误，则可以通过人工纠正异常数据，以保证预设赔付比例的准确、有效，从而提高理赔准备金评估的准确性。
另外，对于计算出多个月份的该理赔险种的预设赔付比例，则一年的预设赔付比例可以取多个月份的预设赔付比例的均值。
本实施例中，与预设赔付比例相对应的是预设拒付比例，一般来说，预设拒付比例=1-预设赔付比例，因此上述使用的预设赔付比例在***中也可以以预设拒付比例的形式存储记录。
需要说明的是，上述步骤301~307适用于身故险、重疾险和残疾险的预设赔付比例的计算。其中，进一步地，在计算残疾险的预设赔付比例时，还可以具体将历史赔付总额B细分为包含残疾比例的历史赔付总额B1和不包含残疾比例的历史赔付总额B2。上述的“包含残疾比例”是指该历史赔付总额的统计是否考虑了残疾比例作为因素。
因此，类似地，预估有残疾比例的该残疾险的预设赔付比例包括：
若满足F/E>2*D/C，则该预设赔付比例=(B1/A)*(D/C+(F/E-D/C)/2)；
若满足D/C>2F/E，则该预设赔付比例= (B1/A)*(D/C-( D/C-F/E)/2)；
若上述情况均不满足，则该预设赔付比例=(B1/A)*(D/C)。
而预估没有残疾比例的该残疾险的预设赔付比例包括：
若满足F/E>2*D/C，则该预设赔付比例=(B2/A)*(D/C+(F/E-D/C)/2)；
若满足D/C>2F/E，则该预设赔付比例= (B2/A)*(D/C-( D/C-F/E)/2)；
若上述情况均不满足，则该预设赔付比例=(B2/A)*(D/C)。
在本实施例中，可以实现待评估案件的理赔准备金的自动计算，避免了理赔准备金的评估结果受到评估人员的专业水平和从业经验的影响，提高评估准确率；并且大大提高理赔准备金的评估效率，在面对大量的待评估案件时，减少了理赔准备金评估的成本。
请参阅图4，本申请实施例中一种理赔准备金的评估方法第二个实施例包括：
401、获取待评估案件；
402、获取所述待评估案件的出险信息；
403、根据所述出险信息确定所述待评估案件对应保单的理赔险种；
在根据所述出险信息确定所述待评估案件对应保单的理赔险种之前，还可以包括：根据所述出险信息判断是否所述待评估案件对应保单包含与所述出险信息对应的理赔险种，且所述待评估案件的出险日期满足所述保单的时效条件，若是，则执行根据所述出险信息确定所述待评估案件对应保单的理赔险种的步骤，若否，则确定所述待评估案件的理赔准备金为0。
404、判断所述理赔险种是否属于医疗类险种，若是，则执行步骤405，若否，则执行步骤408；
405、获取所述理赔险种的预设的件均赔款额；
406、根据所述出险信息确定所述待评估案件的可出险的保单险种件数；
407、根据所述件均赔款额和所述保单险种件数计算所述待评估案件的理赔准备金；
408、计算所述保单在所述理赔险种下的保额；
409、根据计算得到的所述保额和所述理赔险种的预设赔付比例计算所述待评估案件的理赔准备金；
步骤401-409与步骤101-109相同，具体可参照步骤101-109的相关说明。
410、获取所述待评估案件的当前理赔阶段；
在获取所述待评估案件之后，可以获取所述待评估案件的当前理赔阶段。可以理解的是，当前理赔阶段是指该待评估案件申请理赔的当前所处阶段，例如可以包括所述待评估案件已录入理赔信息但未给付赔付金额的阶段、已给出所述待评估案件的审核金额但未发起所述审核金额的给付的阶段，等等。
411、若所述当前理赔阶段为所述待评估案件已录入理赔信息但未给付赔付金额的阶段，则根据所述理赔信息和所述保单的理赔计算规则计算出所述理赔险种的预测理赔款；
若所述当前理赔阶段为所述待评估案件已录入理赔信息但未给付赔付金额的阶段，则可以根据所述理赔信息和所述保单的理赔计算规则计算出所述理赔险种的预测理赔款。
上述的“已录入理赔信息”是指理赔信息已录入，即可以根据具体的理赔信息计算该待评估案件的理赔款；而上述的“未给付赔付金额”指的是虽然理赔款可以计算出来，但未最终确定并审核得出保险公司赔付的赔付款。因此，根据所述保单的理赔计算规则可以计算出该理赔险种的预测理赔款。该理赔计算规则一般在保单中预先约定。
412、将所述理赔准备金与所述预测理赔款进行对比，得到对比结果；
413、根据所述对比结果对所述预测理赔款进行调整，并将调整后得到的所述预测理赔款确定为所述待评估案件的理赔准备金；
对于上述步骤412和413，由于计算得到的理赔准备金和所述预测理赔款对该待评估案件的理赔准备金的评估均具有参考价值，因此可以先将两者进行对比，然后根据对比结果进行调整，以提高理赔准备金的评估准确性。
设理赔准备金为unset_amt，预测理赔款为do_amt，具体的对比和调整步骤可以如下：
若满足do_amt>2*unset_amt，则最后调整得到的理赔准备金final_amt=do_amt –(do_amt-unset_amt)/2；
若满足unset_amt >2*do_amt，则最后调整得到的理赔准备金final_amt=do_amt +( unset_amt- do_amt)/2；
若上述情况均不满足，则最后调整得到的理赔准备金final_amt=do_amt。
通过对预测理赔款的调整得到最终的理赔准备金，使得理赔准备金的评估结果更准确。
414、若所述当前理赔阶段为已给出所述待评估案件的审核金额但未发起所述审核金额的给付的阶段，则确定所述审核金额为所述待评估案件的理赔准备金。
若所述当前理赔阶段为已给出所述待评估案件的审核金额但未发起所述审核金额的给付的阶段，则可以直接确定所述审核金额为所述待评估案件的理赔准备金。
可以理解的是，在审核金额已给出的情况下，说明该待评估案件的理赔金额（等于审核金额）已确定，该阶段下只是仍未进行理赔金额的给付，因此可以直接确定该审核金额为待评估案件的理赔准备金。
进一步地，在本实施例中，在确定出或计算出待评估案件的理赔准备金之后，还可以对各类产品的理赔准备金进行准确性的校验。该准确性校验可以从三个维度进行，分别为总评估量、各产品大类的评估量以及评估案件的总吞吐量。下面将简单介绍三个维度的准确性校验的步骤：
总评估量：
首先从数据库中获取以下数据：当月评估案件量allCnt、当月总评估金额allAmt、上月评估案件量allCntOld、上月总评估金额allAmtOld、去年当月评估案件量allCntLast、去年当月总评估金额allAmtLast、去年上月评估案件量allCntOldLast以及去年上月总评估金额allAmtOldLast。
然后，根据获取到的上述数据，判断总评估量是否存在激增的情况，若存在，针对具体激增的数据进行核实，具体包括：
若（allAmtall-allAmtOld）>设定的增长阀值*（allAmtallLast-allAmtOldLast），则判断allCnt-allCntOld是否大于案件增长阀值*（allCntLast-allCntOldLast），如果大于，则分析激增案件所处的环节。若分析发现某个环节某个地区存在可疑暴增的情况，则需转相关地区核实。若核实发现存在问题，则需进行相关处理调整，调整完成后再重新进行校验。其中，在分析过程中，可以抓取较大准备金额度的案件保单险种的准备金（具体抓取的数据量受配置的较大案件量和较大准备金值控制），然后检验导致超大值的计算过程因子。在整个校验过程中，如果涉及保额问题则需转保险公司负责核保的人员进行调整处理，调整完再重新进行校验；如果涉及加减保问题，则需转保险公司负责保全的人员进行调整处理，调整完再重新进行校验；如果涉及理赔录入受理问题，则需转保险公司负责理赔的人员进行调整处理，调整完再重新进行校验。
另外，若抓取多次被评估准备金的案件，且当月的增长值大于设定的增长阀值，则需分析此次导致变更发生的因素，然后再分析“核保、保全、理赔”的原因，分析完再进行相关处理，后续再重新进行校验。
另一方面，根据获取到的上述数据，还可以判断总评估量是否存在突降的情况，若存在，针对具体突降的数据进行核实，具体包括：
如果（allAmtall-allAmtOld）<设定的增长阀值*（allAmtallLast-allAmtOldLast），则判断allCnt-allCntOld是否小于案件增长阀值*（allCntLast-allCntOldLast），如果小于，则分析突降案件所处的环节，若分析发现某个环节某个地区存在可疑突降的情况，则需转相关地区核实。若核实发现存在问题，则需进行相关处理调整，调整完成后再重新进行校验。
另外，若抓取多次被评估准备金的案件，且当月的减少值大于设定的减少阀值，则需分析此次导致变更发生的因素，然后再分析“核保、保全、理赔”的原因，分析完再进行相关处理，后续再重新进行校验。
各产品大类的评估量：
按照不同产品大类分别计算本月的评估案件量和理赔准备金的值，上月的评估案件量和理赔准备金的值，对比后把差异较大的产品大类提取出来进行分析，分析其中哪些产品大类发生突变、在哪些机构突变、是否集中某些保单等情况，然后再将分析结果数据发送给指定地区和/或总部的指定岗位进行核实，如核实后发现需要调整，则在调整完成后再重新进行校验。
评估案件的总吞吐量：
首先从数据库中获取以下数据：上月评估案件量 cnt_old、上月评估当月结案cnt_old_end、当月进量cnt_new、当月进量且评估cnt_new_reck、当月结案量cnt_new_end。然后将获取到的数据投入下述等式进行验证：
cnt_new_reck= cnt_old-cnt_old_end+cnt_new-cnt_new_end
一般情况下，该等式应该是恒等的，若发现等式不成立，则将差异明细数据提取出来，交给各个地区进行分析处理。
另外，还可以针对案件的明细进行校验，具体包括如下情况：
若案件同时进行上月和当月的评估，且案件过程未发生变化，但是当月的评估金额与上月的评估金额不一致，则需将明细数据挑出来，交给各个地区进行分析处理；
若案件进行上月的评估，且案件过程未发生变化，但是进行当月的评估，则需将明细数据挑出来，交给到各个地区进行分析处理；
若案件同时进行上月和当月的评估，且案件过程未发生变化，但是当月的评估产品类别与上月的评估产品类别不一致，则需将明细数据挑出来，交给到各个地区进行分析处理。
图5示出了本申请中一种理赔准备金的评估装置第一个实施例结构图。
本实施例中，一种理赔准备金的评估装置包括：
案件获取模块501，用于获取待评估案件；
出险信息获取模块502，用于获取所述待评估案件的出险信息；
理赔险种确定模块503，用于根据所述出险信息确定所述待评估案件对应保单的理赔险种；
判断模块504，用于判断所述理赔险种是否属于医疗类险种；
第一准备金计算模块505，用于若所述理赔险种属于医疗类险种，则获取所述理赔险种的预设的件均赔款额，根据所述出险信息确定所述待评估案件的可出险的保单险种件数，根据所述件均赔款额和所述保单险种件数计算所述待评估案件的理赔准备金；
第二准备金计算模块506，用于若所述理赔险种不属于医疗类险种，则计算所述保单在所述理赔险种下的保额，根据计算得到的所述保额和所述理赔险种的预设赔付比例计算所述待评估案件的理赔准备金。
进一步地，所述预设赔付比例可以通过以下模块计算得到：
历史涉案总保额获取模块，用于获取预设时间段内所述理赔险种的历史涉案总保额；
历史赔付总额获取模块，用于获取所述预设时间段内所述理赔险种的历史赔付总额；
案件申请总件数获取模块，用于获取所述预设时间段内所述理赔险种的案件申请总件数；
案件赔付总件数获取模块，用于获取所述预设时间段内所述理赔险种的案件赔付总件数；
投保总人数获取模块，用于获取所述保单的投保总人数；
出险总人数获取模块，用于获取所述保单的出险总人数；
输入模块，用于将所述历史涉案总保额、所述历史赔付总额、所述案件申请总件数、所述案件赔付总件数、所述投保总人数和所述出险总人数输入预设的赔付比例计算模型，得到所述理赔险种的预设赔付比例。
进一步地，所述理赔准备金的评估装置还可以包括：
理赔阶段获取模块，用于获取所述待评估案件的当前理赔阶段；
预测理赔款计算模块，用于若所述当前理赔阶段为所述待评估案件已录入理赔信息但未给付赔付金额的阶段，则根据所述理赔信息和所述保单的理赔计算规则计算出所述理赔险种的预测理赔款；
对比模块，用于将所述理赔准备金与所述预测理赔款进行对比，得到对比结果；
调整模块，用于根据所述对比结果对所述预测理赔款进行调整，并将调整后得到的所述预测理赔款确定为所述待评估案件的理赔准备金。
进一步地，所述理赔准备金的评估装置还可以包括：
第一确定模块，用于若所述当前理赔阶段为已给出所述待评估案件的审核金额但未发起所述审核金额的给付的阶段，则确定所述审核金额为所述待评估案件的理赔准备金。
进一步地，所述理赔准备金的评估装置还可以包括：
条件判断模块，用于根据所述出险信息判断是否所述待评估案件对应保单包含与所述出险信息对应的理赔险种，且所述待评估案件的出险日期满足所述保单的时效条件；
触发模块，用于若所述条件判断模块519的判断结果为是，则触发所述理赔险种确定模块；
第二确定模块，用于若所述条件判断模块519的判断结果为否，则确定所述待评估案件的理赔准备金为0。
所属领域的技术人员可以清楚地了解到，上述描述的***，装置和单元的具体工作过程，可以参考前述方法实施例中的对应过程，在此不再赘述。
本申请实施例还提供一种计算机可读存储介质，所述计算机可读存储介质存储有计算机可读指令，所述计算机可读指令被处理器执行时实现如图1或图4表示的任意一种理赔准备金的评估方法的步骤。
本申请实施例还提供一种终端设备，包括存储器、处理器以及存储在所述存储器中并可在所述处理器上运行的计算机可读指令，所述处理器执行所述计算机可读指令时实现如图1或图4表示的任意一种理赔准备金的评估方法的步骤。

Claims (20)

  1. 一种理赔准备金的评估方法，其特征在于，包括：
    获取待评估案件；
    获取所述待评估案件的出险信息；
    根据所述出险信息确定所述待评估案件对应保单的理赔险种；
    判断所述理赔险种是否属于医疗类险种；
    若所述理赔险种属于医疗类险种，则获取所述理赔险种的预设的件均赔款额，根据所述出险信息确定所述待评估案件的可出险的保单险种件数，根据所述件均赔款额和所述保单险种件数计算所述待评估案件的理赔准备金；
    若所述理赔险种不属于医疗类险种，则计算所述保单在所述理赔险种下的保额，根据计算得到的所述保额和所述理赔险种的预设赔付比例计算所述待评估案件的理赔准备金。
  2. 根据权利要求1所述的理赔准备金的评估方法，其特征在于，所述预设赔付比例通过以下步骤计算得到：
    获取预设时间段内所述理赔险种的历史涉案总保额；
    获取所述预设时间段内所述理赔险种的历史赔付总额；
    获取所述预设时间段内所述理赔险种的案件申请总件数；
    获取所述预设时间段内所述理赔险种的案件赔付总件数；
    获取所述保单的投保总人数；
    获取所述保单的出险总人数；
    将所述历史涉案总保额、所述历史赔付总额、所述案件申请总件数、所述案件赔付总件数、所述投保总人数和所述出险总人数输入预设的赔付比例计算模型，得到所述理赔险种的预设赔付比例。
  3. 根据权利要求1所述的理赔准备金的评估方法，其特征在于，在获取待评估案件之后，还包括：
    获取所述待评估案件的当前理赔阶段；
    在计算得到所述待评估案件的理赔准备金之后，所述理赔准备金的评估方法还包括：
    若所述当前理赔阶段为所述待评估案件已录入理赔信息但未给付赔付金额的阶段，则根据所述理赔信息和所述保单的理赔计算规则计算出所述理赔险种的预测理赔款；
    将所述理赔准备金与所述预测理赔款进行对比，得到对比结果；
    根据所述对比结果对所述预测理赔款进行调整，并将调整后得到的所述预测理赔款确定为所述待评估案件的理赔准备金。
  4. 根据权利要求3所述的理赔准备金的评估方法，其特征在于，所述理赔准备金的评估方法还包括：
    若所述当前理赔阶段为已给出所述待评估案件的审核金额但未发起所述审核金额的给付的阶段，则确定所述审核金额为所述待评估案件的理赔准备金。
  5. 根据权利要求1至4中任一项所述的理赔准备金的评估方法，其特征在于，在根据所述出险信息确定所述待评估案件对应保单的理赔险种之前，还包括：
    根据所述出险信息判断是否所述待评估案件对应保单包含与所述出险信息对应的理赔险种，且所述待评估案件的出险日期满足所述保单的时效条件；
    若是，则执行根据所述出险信息确定所述待评估案件对应保单的理赔险种的步骤；
    若否，则确定所述待评估案件的理赔准备金为0。
  6. 一种计算机可读存储介质，所述计算机可读存储介质存储有计算机可读指令，其特征在于，所述计算机可读指令被处理器执行时实现如下步骤：
    获取待评估案件；
    获取所述待评估案件的出险信息；
    根据所述出险信息确定所述待评估案件对应保单的理赔险种；
    判断所述理赔险种是否属于医疗类险种；
    若所述理赔险种属于医疗类险种，则获取所述理赔险种的预设的件均赔款额，根据所述出险信息确定所述待评估案件的可出险的保单险种件数，根据所述件均赔款额和所述保单险种件数计算所述待评估案件的理赔准备金；
    若所述理赔险种不属于医疗类险种，则计算所述保单在所述理赔险种下的保额，根据计算得到的所述保额和所述理赔险种的预设赔付比例计算所述待评估案件的理赔准备金。
  7. 根据权利要求6所述的计算机可读存储介质，其特征在于，所述预设赔付比例通过以下步骤计算得到：
    获取预设时间段内所述理赔险种的历史涉案总保额；
    获取所述预设时间段内所述理赔险种的历史赔付总额；
    获取所述预设时间段内所述理赔险种的案件申请总件数；
    获取所述预设时间段内所述理赔险种的案件赔付总件数；
    获取所述保单的投保总人数；
    获取所述保单的出险总人数；
    将所述历史涉案总保额、所述历史赔付总额、所述案件申请总件数、所述案件赔付总件数、所述投保总人数和所述出险总人数输入预设的赔付比例计算模型，得到所述理赔险种的预设赔付比例。
  8. 根据权利要求6所述的计算机可读存储介质，其特征在于，在获取待评估案件之后，还包括：
    获取所述待评估案件的当前理赔阶段；
    在计算得到所述待评估案件的理赔准备金之后，所述理赔准备金的评估方法还包括：
    若所述当前理赔阶段为所述待评估案件已录入理赔信息但未给付赔付金额的阶段，则根据所述理赔信息和所述保单的理赔计算规则计算出所述理赔险种的预测理赔款；
    将所述理赔准备金与所述预测理赔款进行对比，得到对比结果；
    根据所述对比结果对所述预测理赔款进行调整，并将调整后得到的所述预测理赔款确定为所述待评估案件的理赔准备金。
  9. 根据权利要求8所述的计算机可读存储介质，其特征在于，所述计算机可读指令被处理器执行时实现的步骤还包括：
    若所述当前理赔阶段为已给出所述待评估案件的审核金额但未发起所述审核金额的给付的阶段，则确定所述审核金额为所述待评估案件的理赔准备金。
  10. 根据权利要求6至9中任一项所述的计算机可读存储介质，其特征在于，在根据所述出险信息确定所述待评估案件对应保单的理赔险种之前，还包括：
    根据所述出险信息判断是否所述待评估案件对应保单包含与所述出险信息对应的理赔险种，且所述待评估案件的出险日期满足所述保单的时效条件；
    若是，则执行根据所述出险信息确定所述待评估案件对应保单的理赔险种的步骤；
    若否，则确定所述待评估案件的理赔准备金为0。
  11. 一种终端设备，包括存储器、处理器以及存储在所述存储器中并可在所述处理器上运行的计算机可读指令，其特征在于，所述处理器执行所述计算机可读指令时实现如下步骤：
    获取待评估案件；
    获取所述待评估案件的出险信息；
    根据所述出险信息确定所述待评估案件对应保单的理赔险种；
    判断所述理赔险种是否属于医疗类险种；
    若所述理赔险种属于医疗类险种，则获取所述理赔险种的预设的件均赔款额，根据所述出险信息确定所述待评估案件的可出险的保单险种件数，根据所述件均赔款额和所述保单险种件数计算所述待评估案件的理赔准备金；
    若所述理赔险种不属于医疗类险种，则计算所述保单在所述理赔险种下的保额，根据计算得到的所述保额和所述理赔险种的预设赔付比例计算所述待评估案件的理赔准备金。
  12. 根据权利要求11所述的终端设备，其特征在于，所述预设赔付比例通过以下步骤计算得到：
    获取预设时间段内所述理赔险种的历史涉案总保额；
    获取所述预设时间段内所述理赔险种的历史赔付总额；
    获取所述预设时间段内所述理赔险种的案件申请总件数；
    获取所述预设时间段内所述理赔险种的案件赔付总件数；
    获取所述保单的投保总人数；
    获取所述保单的出险总人数；
    将所述历史涉案总保额、所述历史赔付总额、所述案件申请总件数、所述案件赔付总件数、所述投保总人数和所述出险总人数输入预设的赔付比例计算模型，得到所述理赔险种的预设赔付比例。
  13. 根据权利要求11所述的终端设备，其特征在于，在获取待评估案件之后，还包括：
    获取所述待评估案件的当前理赔阶段；
    在计算得到所述待评估案件的理赔准备金之后，所述理赔准备金的评估方法还包括：
    若所述当前理赔阶段为所述待评估案件已录入理赔信息但未给付赔付金额的阶段，则根据所述理赔信息和所述保单的理赔计算规则计算出所述理赔险种的预测理赔款；
    将所述理赔准备金与所述预测理赔款进行对比，得到对比结果；
    根据所述对比结果对所述预测理赔款进行调整，并将调整后得到的所述预测理赔款确定为所述待评估案件的理赔准备金。
  14. 根据权利要求13所述的终端设备，其特征在于，所述处理器执行所述计算机可读指令时实现的步骤还包括：
    若所述当前理赔阶段为已给出所述待评估案件的审核金额但未发起所述审核金额的给付的阶段，则确定所述审核金额为所述待评估案件的理赔准备金。
  15. 根据权利要求11至14中任一项所述的终端设备，其特征在于，在根据所述出险信息确定所述待评估案件对应保单的理赔险种之前，还包括：
    根据所述出险信息判断是否所述待评估案件对应保单包含与所述出险信息对应的理赔险种，且所述待评估案件的出险日期满足所述保单的时效条件；
    若是，则执行根据所述出险信息确定所述待评估案件对应保单的理赔险种的步骤；
    若否，则确定所述待评估案件的理赔准备金为0。
  16. 一种理赔准备金的评估装置，其特征在于，包括：
    案件获取模块，用于获取待评估案件；
    出险信息获取模块，用于获取所述待评估案件的出险信息；
    理赔险种确定模块，用于根据所述出险信息确定所述待评估案件对应保单的理赔险种；
    判断模块，用于判断所述理赔险种是否属于医疗类险种；
    第一准备金计算模块，用于若所述理赔险种属于医疗类险种，则获取所述理赔险种的预设的件均赔款额，根据所述出险信息确定所述待评估案件的可出险的保单险种件数，根据所述件均赔款额和所述保单险种件数计算所述待评估案件的理赔准备金；
    第二准备金计算模块，用于若所述理赔险种不属于医疗类险种，则计算所述保单在所述理赔险种下的保额，根据计算得到的所述保额和所述理赔险种的预设赔付比例计算所述待评估案件的理赔准备金。
  17. 根据权利要求16所述的理赔准备金的评估装置，其特征在于，所述预设赔付比例通过以下模块计算得到：
    历史涉案总保额获取模块，用于获取预设时间段内所述理赔险种的历史涉案总保额；
    历史赔付总额获取模块，用于获取所述预设时间段内所述理赔险种的历史赔付总额；
    案件申请总件数获取模块，用于获取所述预设时间段内所述理赔险种的案件申请总件数；
    案件赔付总件数获取模块，用于获取所述预设时间段内所述理赔险种的案件赔付总件数；
    投保总人数获取模块，用于获取所述保单的投保总人数；
    出险总人数获取模块，用于获取所述保单的出险总人数；
    输入模块，用于将所述历史涉案总保额、所述历史赔付总额、所述案件申请总件数、所述案件赔付总件数、所述投保总人数和所述出险总人数输入预设的赔付比例计算模型，得到所述理赔险种的预设赔付比例。
  18. 根据权利要求16所述的理赔准备金的评估装置，其特征在于，所述理赔准备金的评估装置还包括：
    理赔阶段获取模块，用于获取所述待评估案件的当前理赔阶段；
    预测理赔款计算模块，用于若所述当前理赔阶段为所述待评估案件已录入理赔信息但未给付赔付金额的阶段，则根据所述理赔信息和所述保单的理赔计算规则计算出所述理赔险种的预测理赔款；
    对比模块，用于将所述理赔准备金与所述预测理赔款进行对比，得到对比结果；
    调整模块，用于根据所述对比结果对所述预测理赔款进行调整，并将调整后得到的所述预测理赔款确定为所述待评估案件的理赔准备金。
  19. 根据权利要求18所述的理赔准备金的评估装置，其特征在于，所述理赔准备金的评估装置还包括：
    第一确定模块，用于若所述当前理赔阶段为已给出所述待评估案件的审核金额但未发起所述审核金额的给付的阶段，则确定所述审核金额为所述待评估案件的理赔准备金。
  20. 根据权利要求16至19中任一项所述的理赔准备金的评估装置，其特征在于，所述理赔准备金的评估装置还包括：
    条件判断模块，用于根据所述出险信息判断是否所述待评估案件对应保单包含与所述出险信息对应的理赔险种，且所述待评估案件的出险日期满足所述保单的时效条件；
    触发模块，用于若所述条件判断模块的判断结果为是，则触发所述理赔险种确定模块；
    第二确定模块，用于若所述条件判断模块的判断结果为否，则确定所述待评估案件的理赔准备金为0。
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