WO2018184550A1 - 理赔金的计算方法、装置、终端设备及介质 - Google Patents

理赔金的计算方法、装置、终端设备及介质 Download PDF

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Publication number
WO2018184550A1
WO2018184550A1 PCT/CN2018/081824 CN2018081824W WO2018184550A1 WO 2018184550 A1 WO2018184550 A1 WO 2018184550A1 CN 2018081824 W CN2018081824 W CN 2018081824W WO 2018184550 A1 WO2018184550 A1 WO 2018184550A1
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paid
sub
case
target case
amount
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PCT/CN2018/081824
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English (en)
French (fr)
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梁效栋
朱瑾
周鹏
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平安科技（深圳）有限公司
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Publication of WO2018184550A1 publication Critical patent/WO2018184550A1/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 belongs to the field of information processing technologies, and in particular, to a method, device, terminal device and medium for calculating a claim payment.
  • the embodiment of the present application provides a method, a device, a terminal device, and a medium for calculating a claim fund, so as to solve the problem that the calculation efficiency of the claim money in the prior art is relatively low.
  • a first aspect of the embodiments of the present application provides a method for calculating a claim payment, including:
  • the compensation amount of each of the to-be-paid scenes is separately calculated according to a preset adjustment rule
  • a second aspect of the embodiments of the present application provides a computing claim calculation apparatus, including:
  • a case determination module for determining a target case for which a claim is to be calculated
  • a case bill obtaining module configured to obtain each bill of the target case through a back-end database of the insurance company
  • a payout scenario determining module configured to determine, according to the case information of the target case and the billing information of the respective bills, each to-be-paid scene of the target case;
  • the claim amount calculation module is configured to calculate, according to the policy information of each of the policies for accepting the policy and the bill information of the respective bills, the compensation amount of each of the to-be-paid scenes according to a preset adjustment rule;
  • the case claim calculation module is configured to calculate a sum of the claims amount of each of the to-be-paid scenarios, and obtain a claim for the target case.
  • a third aspect of the embodiments of the present application provides a terminal device, including a memory and a processor, where the computer stores computer readable instructions executable on the processor, the processor executing the computer
  • the step of calculating the method of claim payment as described in the first aspect is implemented when the instruction is read.
  • a fourth aspect of the embodiments of the present application provides a computer readable storage medium storing computer readable instructions, the computer readable instructions being executed by a processor to implement the first aspect as described in the first aspect The steps of the calculation method of the claim.
  • each payment scenario of the target case is determined according to each bill of the target case, and then the compensation amount of each to-be-paid scenario is calculated by using the to-be-paid scenario as a dimension, and finally the sum of the claims is obtained to obtain the target.
  • the claim of the case not only realized the automatic calculation of the case claim, but also greatly improved the calculation efficiency of the claim, thereby improving the settlement efficiency of the claim case, and refined the calculation process of the claim with the scene as the dimension.
  • the calculation of the claims is more accurate.
  • 1 is a flow chart of an embodiment of a method for calculating a claim payment according to an embodiment of the present application
  • step 103 is a schematic flowchart of step 103 of a method for calculating a claim payment in an application scenario according to an embodiment of the present application;
  • FIG. 3 is a schematic flowchart of step 104 of a method for calculating a claim payment in an application scenario according to an embodiment of the present application;
  • FIG. 4 is a schematic flowchart of step 305 of a method for calculating a claim payment in an application scenario in FIG. 3;
  • FIG. 5 is a structural block diagram of a computing device for calculating a claim payment according to an embodiment of the present application
  • FIG. 6 is a schematic diagram of a terminal device according to an embodiment of the present application.
  • an embodiment of a method for calculating a claim payment in an embodiment of the present application includes:
  • target cases can be selected from cases in which claim claims have been initiated. It can be understood that when the requester initiates the claim request, it is generally required to report the case, that is, the relevant case information, such as the bill, the personal information of the requester, the policy information, etc., are reported to the insurance company's system, and the system is accepted by the insurance company. Generate corresponding claims cases.
  • the bills for these cases can be kept in the back-end database of the insurance company. Therefore, each bill of the target case can be obtained through the back-end database of the insurance company.
  • the liability liability generally agreed in the policy of the case is differentiated according to different scenarios.
  • the insured vehicle is also damaged.
  • the responsibility for the auto insurance policy is different in different scenarios.
  • the damage event is the responsibility of the auto insurance policy; if the vehicle is damaged under the scene of force majeure (such as flood or typhoon), this time The damage event is not the responsibility of the auto insurance policy. Therefore, before calculating the claim, it is necessary to determine the respective payout scenarios of the target case, and then subdivide and calculate the respective claims amount according to different scenarios.
  • the scene to be paid is the scene within the scope of responsibility of the corresponding policy corresponding to the target case.
  • the foregoing step 103 may include:
  • 201 Grouping the respective bills according to a preset grouping rule, and each obtained billing group is respectively used as each sub-case of the target case; 202, generating, according to the case information and the billing information, each of the sub-cases Presetting the attribute value of the first attribute type; 203, generating an attribute value of the preset second attribute type of each of the bills according to the case information and the billing information; 204, extracting each policy acceptance policy under the target case Attribute value of the preset core attribute of all claims liability; 205, matching the attribute value of the preset core attribute of all claim liabilities with the attribute value of the preset core attribute of the target case, and obtaining each claim with successful matching Responsibility as the claim liability of the target case; 206, matching the attribute value of each claim liability of the target case with the attribute value of the bill under each of the sub-cases, and obtaining the claims liability corresponding to each of the sub-cases 207, respectively extracting each of the predefined scenarios under the claims liability corresponding to each of the sub-cases; 208
  • a target case mostly has multiple bills, which may have different billing dates, types, consumption areas, etc., therefore, these billing rules can be grouped and grouped according to these billing attribute setting grouping rules. , thereby dividing multiple bills into more than one billing group.
  • the corresponding bill is a medical bill, and the same day group visit, the same type of treatment, the same disease type, and the same hospital can be used as the same billing group.
  • Each billing team is a sub-case of the target case. Sub-cases are used as calculation dimensions in subsequent steps.
  • the first attribute type may be set according to different sub-cases, for example, may include an accident nature, a refinement governance type, a risk location, etc., and the attribute values of the first attribute types may pass case information of the target case. And billing information is obtained or generated.
  • the second attribute type may be set according to different bill types, for example, may include a fee item, a consumption date, a billing unit name, etc., and the attribute values of the second attribute types may pass the case information of the target case. And billing information is obtained or generated.
  • the core attribute is the main attribute of the claims liability for accepting the policy, and these core attributes can be set according to the needs of different insurance companies.
  • the acceptance policy refers to the valid policy in the corresponding policy of the target case. It can be understood that the insured person corresponding to the target case may have multiple policies corresponding to the purchase, but considering that different policies have different expiration dates and other agreements, only some of the policies purchased by the insured may be valid. Warranty.
  • the claims liability agreed in the acceptance policy can be determined, and then the attribute values of the core attributes of all these claims liabilities are extracted.
  • step 205 after obtaining the attribute value of the preset core attribute of all claim liabilities of each of the accepted policies under the target case, and obtaining the attribute value of the preset core attribute of the target case, the attribute values of the two may be obtained. Matching and matching the successful claim liability is the claim liability of the target case.
  • the attribute value of the preset core attribute of the target case may be obtained or generated according to the case information of the target case.
  • the attribute value of the claim liability matches the attribute value of the target case successfully, it indicates that the claim liability is considered to meet the requirements or the situation of the target case from the core attribute, so that the matching claimability can be determined as Claim liability for the target case.
  • Claim liability for example, in the case of accidental medical liability, the nature of the accident is accident, the type of refinement treatment is outpatient and hospitalization, and the cost items include medical expenses, medical expenses, bed fees, and medicines.
  • the target case can be considered to be in contact with the accidental medical liability.
  • step 206 after determining the respective claims liability of the target case, the attribute value of each claim liability and the attribute value of the bill under each of the above sub-cases may be matched, and each claim liability of the target case is subdivided into sub-cases. Corresponding claims liability.
  • each scenario pre-defined under the claims liability corresponding to each of the sub-cases may be separately extracted.
  • the scenarios in which claims should be made under each claim liability are pre-agreed, defined, and recorded. For example, for medical claims liability, it will pre-agreed which scenes belong to the scope of claims for medical claims, and which scenes are not covered by the claims for medical claims.
  • the attribute value of the sub-case needs to be matched with the attribute value of the scene. If the matching is successful, the matching successful scene may be determined as the to-be-paid scene of the sub-case. That is the applicable scenario. Further, in order to improve the scenario matching success rate, when the attribute values of the respective scenarios of the sub-case are sequentially matched with the attribute values of the sub-cases according to a preset scene sequence, if each scenario of the sub-case is If the unmatching is successful, the last scene located in the scene sequence may be determined as the to-be-paid scene of the sub-case. Thereby improving the matching efficiency of the scene, and indirectly improving the determining efficiency of the target to be compensated scene.
  • the sub-cases to be compensated for each sub-case can be determined by step 208, and one sub-case can determine more than one pay-to-pay scenario. After determining the sub-cases to be compensated, all of the sub-cases are to be treated.
  • the payout scenario can be used to determine the individual payout scenarios for the target case.
  • the scene is calculated as the minimum dimension, that is, the compensation amount of each scene to be paid is calculated.
  • the foregoing step 104 may include:
  • 301 Obtain a remaining insured amount of each of the accepted policies in the to-be-paid scenario; 302, calculate a payable payment for each bill in the to-be-paid scenario; 303, determine whether the payable is greater than Determining the payout limit of the payout scenario, if yes, executing step 304, if not, executing step 305; 304, updating the value of the payable payment to the value of the payout limit; 305, according to the response
  • the claim payment amount, the remaining deductibles in the to-be-paid scenario and the corresponding claims ratio are calculated, and the claim amount of each of the accepted policies in the to-be-paid scenario is calculated; 306, the claim amount is taken The smaller of the remaining insured amount is used as the payout amount of the to-be-paid scenario.
  • the remaining insured amount of the policy in the to-be-paid scenario is accepted, that is, the maximum indemnity amount in the to-be-paid scenario.
  • the remaining insured amount may include three parts: the remaining insured amount of the policy, the remaining insured amount of the responsibility, and the remaining insured amount of the scene, and the minimum amount of the insured amount of the above three parts is obtained by the remaining claims in the scene to be compensated Insurance amount.
  • the payout limit of the to-be-paid scenario refers to the maximum payable amount under the pay-to-pay scenario. It can be understood that, when the payable fee is greater than the payout limit of the pay-as-you-go scenario, step 304 should be performed to adjust the value of the payable payout to the payout limit of the pay-to-pay scenario.
  • the remaining deductible refers to the amount of the deductible of the insurance policy in the scene to be compensated, and the specific amount of the deductible is agreed by the insurer and the insured in advance, and the amount of the loss is within the prescribed amount.
  • the insured shall bear the losses on its own and the insurer shall not be responsible for the amount of compensation. If there is no deductible amount in the to-be-paid scenario, the remaining deductible may be considered to be zero.
  • the foregoing step 305 may specifically include:
  • the remaining deductible should be subtracted from the compensable payment, thereby obtaining a reasonable compensation.
  • step 403 in this embodiment, different payout ratios are set in advance for different fee intervals.
  • there may be two cost intervals: when 0 ⁇ reasonable compensation for ⁇ 999, the compensation ratio is 0.9; when the reasonable compensation is for > 1000, the compensation ratio is 0.8.
  • step 306 since the remaining insured amount in the to-be-paid scene is obtained in step 301, and the claim amount cannot be greater than the remaining insured amount, the smaller value of the claim amount and the remaining insured amount may be taken as The amount of the payment to be paid for the scene to be paid.
  • the payment amount of each to-be-paid scene can be calculated, and since the target case may have one or more to-be-paid scenarios, the claim amount of the target case is equal to the corresponding payment amount of all the corresponding payment scenarios. Sum.
  • each payable scene of the target case is determined according to each bill of the target case, and then the payout amount of each payable scene is calculated by using the payable scene as a dimension, and finally the sum of the payout amounts is obtained to obtain the target case.
  • the claim compensation not only realizes the automatic calculation of the case claims, but also greatly improves the calculation efficiency of the claims, thereby improving the settlement efficiency of the claims case, and refining the calculation process of the claims in the dimension of the scene, so that the claims are made.
  • the calculation of gold is more accurate.
  • FIG. 5 is a structural block diagram of the calculation device of the claim compensation provided by the embodiment of the present application. For the convenience of description, only the embodiment related to the embodiment of the present application is shown. section.
  • a computing device for claim compensation includes:
  • a case determination module 501 configured to determine a target case for which the claim is to be calculated
  • the case bill obtaining module 502 is configured to obtain each bill of the target case through a back-end database of the insurance company;
  • the payout scenario determining module 503 is configured to determine, according to the case information of the target case and the billing information of the respective bills, each to-be-paid scene of the target case;
  • the claim amount calculation module 504 is configured to separately calculate the payout amount of each of the to-be-paid scenarios according to the policy information of each of the policies for accepting the policy and the billing information of the respective bills according to a preset adjustment rule;
  • the case claim calculation module 505 is configured to calculate a sum of the claims amount of each of the to-be-paid scenarios, and obtain a claim for the target case.
  • the claim scenario determining module 503 can include:
  • a billing grouping unit configured to group the respective bills according to a preset grouping rule, and each obtained billing group is respectively used as a sub-case of the target case;
  • a first attribute value generating unit configured to generate, according to the case information and the bill information, an attribute value of a preset first attribute type of each of the sub-cases;
  • a second attribute value generating unit configured to generate, according to the case information and the billing information, an attribute value of a preset second attribute type of each of the bills;
  • a core attribute value extracting unit configured to extract an attribute value of a preset core attribute of all claim liabilities of each of the accepted policies under the target case
  • a case responsibility matching unit configured to match an attribute value of the preset core attribute of the all claims liability with an attribute value of the preset core attribute of the target case, to obtain each claim liability of the matching success as the target case Claim liability
  • a sub-case responsibility matching unit configured to match an attribute value of each claim liability of the target case with an attribute value of the bill under each of the sub-cases, to obtain a claim liability corresponding to each of the sub-cases;
  • a scene extracting unit configured to separately extract each of the predefined scenarios under the claims responsibility corresponding to each of the sub-cases
  • the sub-case scene matching unit is configured to match the attribute values of the scenes of the sub-cases with the attribute values of the sub-cases according to a preset scene sequence. If the matching is successful, the scenes with successful matching are determined as The scene to be paid for the case;
  • the to-be-paid scene determination unit is configured to determine the determined to-be-paid scenes of the respective sub-cases as the respective to-be-paid scenes of the target case.
  • the calculating device of the claim money may further include: a scene matching module, configured to sequentially, in the sub-case scene matching unit, attribute values of respective scenes of the sub-case to the child according to a preset scene sequence When the attribute values of the case are matched, if the scenes of the sub-cases are not successfully matched, the last scene located in the scene sequence is determined as the to-be-paid scene of the sub-case.
  • a scene matching module configured to sequentially, in the sub-case scene matching unit, attribute values of respective scenes of the sub-case to the child according to a preset scene sequence When the attribute values of the case are matched, if the scenes of the sub-cases are not successfully matched, the last scene located in the scene sequence is determined as the to-be-paid scene of the sub-case.
  • the payout amount calculation module 504 may include: a remaining insured amount obtaining unit, configured to acquire a remaining insured amount of each of the received insurance policies in the to-be-paid scene; and a compensable payment unit for calculating each of the a billing fee for the payable in the scenario to be compensated; a fee value updating unit, configured to update the value of the compensable payment to the value if the payable fee is greater than the payout limit of the payable scenario a value of the payout limit; the claim amount calculation unit is configured to calculate, according to the payable payable, the remaining deductibles in the to-be-paid scenario and the corresponding payout ratio, The claim amount in the to-be-paid scenario; the payout amount value unit is configured to take the smaller of the claim amount and the remaining insured amount as the payout amount of the to-be-paid scenario.
  • the claim amount calculation unit may include: a deductible amount acquisition sub-unit, configured to acquire a remaining deductible of the respective acceptance policies under the to-be-paid scenario; a reasonable cost calculation sub-unit, for calculating the Determining the difference between the payable and the remaining deductible, and obtaining a reasonable payout; the claim ratio determining subunit is configured to determine, according to the fee interval for the reasonable payout, the respective accepted policies in the to-be-paid scenario a payout ratio, the cost interval has a corresponding relationship with the payout ratio; the amount calculation subunit is configured to calculate, according to the payout ratio and the reasonable payout, the respective accepted policies in the to-be-paid scenario The amount of the claim.
  • FIG. 6 is a schematic diagram of a terminal device according to an embodiment of the present application.
  • the terminal device 6 of this embodiment includes a processor 60 and a memory 61 in which computer readable instructions 62 operable on the processor 60, such as calculation of a claim payment, are stored. program.
  • the processor 60 executes the computer readable instructions 62, the steps in the embodiment of the method for calculating the various claims are implemented, such as steps 101 to 105 shown in FIG.
  • the processor 60 when executing the computer readable instructions 62, implements the functions of the various modules/units in the various apparatus embodiments described above, such as the functions of the modules 501 through 505 shown in FIG.
  • the computer readable instructions 62 may be partitioned into one or more modules/units that are stored in the memory 61 and executed by the processor 60, To complete this application.
  • the one or more modules/units may be a series of computer readable instruction segments capable of performing a particular function, the instruction segments being used to describe the execution of the computer readable instructions 62 in the terminal device 6.
  • the terminal device 6 may be a computing device such as a desktop computer, a notebook, a palmtop computer, and a cloud server.
  • the terminal device may include, but is not limited to, the processor 60 and the memory 61. It will be understood by those skilled in the art that FIG. 6 is only an example of the terminal device 6, and does not constitute a limitation of the terminal device 6, and may include more or less components than those illustrated, or combine some components or different components.
  • the terminal device may further include an input/output device, a network access device, a bus, and the like.
  • the so-called processor 60 can be a central processing unit (Central Processing Unit, CPU), can also be other general-purpose processors, digital signal processors (DSP), application specific integrated circuits (Application Specific Integrated Circuit (ASIC), Field-Programmable Gate Array (FPGA) or other programmable logic device, discrete gate or transistor logic device, discrete hardware components, etc.
  • the general purpose processor may be a microprocessor or the processor or any conventional processor or the like.
  • the memory 61 may be an internal storage unit of the terminal device 6, such as a hard disk or a memory of the terminal device 6.
  • the memory 61 may also be an external storage device of the terminal device 6, for example, a plug-in hard disk equipped on the terminal device 6, a smart memory card (SMC), and a secure digital (SD). Card, flash card, etc. Further, the memory 61 may also include both an internal storage unit of the terminal device 6 and an external storage device.
  • the memory 61 is configured to store the computer readable instructions and other programs and data required by the terminal device.
  • the memory 61 can also be used to temporarily store data that has been output or is about to be output.
  • each functional unit in each embodiment of the present application may be integrated into one processing unit, or each unit may exist physically separately, or two or more units may be integrated into one unit.
  • the above integrated unit can be implemented in the form of hardware or in the form of a software functional unit.
  • the integrated unit if implemented in the form of a software functional unit and sold or used as a standalone product, may be stored in a computer readable storage medium.
  • a computer readable storage medium A number of instructions are included to cause a computer device (which may be a personal computer, server, or network device, etc.) to perform all or part of the steps of the methods described in various embodiments of the present application.
  • the foregoing storage medium includes: a U disk, a mobile hard disk, a read-only memory (ROM), a random access memory (RAM), a magnetic disk, or an optical disk, and the like, which can store program codes. .

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Abstract

本方案提供了一种理赔金的计算方法、装置、终端设备及介质，适用于信息处理技术领域，该方法包括：确定待计算理赔金的目标案件；通过保险公司的后台数据库获取所述目标案件的各个账单；根据所述目标案件的案件信息和所述各个账单的账单信息确定所述目标案件的各个待赔付场景；根据所述目标案件下各个受理保单的保单信息和所述各个账单的账单信息按照预设的理算规则分别计算各个所述待赔付场景的赔付金额；计算各个所述待赔付场景的赔付金额之和，得到所述目标案件的理赔金。本方案解决了现有理赔金的计算效率低下的问题。

Description

理赔金的计算方法、装置、终端设备及介质
本申请要求于2017年04月07日提交中国专利局、申请号为201710223859.2 、发明名称为“一种理赔金的计算方法和装置”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
本申请属于信息处理技术领域，尤其涉及一种理赔金的计算方法、装置、终端设备及介质。
 背景技术
在保险行业中，现有理赔案件需要通过报案、受理、录入、审核等环节操作，才能完成理赔完整的流程，并给付给客户赔付理赔金。在此过程中，涉及理赔金的计算。
现有理赔金的计算一般由专门的工作人员进行人工核算，不仅容易导致理赔金的计算效率低下，而且在面对大量理赔案件时，往往造成大量理赔案件延期，大大降低理赔案件的结案效率。
 技术问题
有鉴于此，本申请实施例提供了一种理赔金的计算方法、装置、终端设备及介质，以解决现有技术中理赔金的计算效率较为低下的问题。
 技术解决方案
本申请实施例的第一方面提供了一种理赔金的计算方法，包括：
确定待计算理赔金的目标案件；
通过保险公司的后台数据库获取所述目标案件的各个账单；
根据所述目标案件的案件信息和所述各个账单的账单信息确定所述目标案件的各个待赔付场景；
根据所述目标案件下各个受理保单的保单信息和所述各个账单的账单信息按照预设的理算规则分别计算各个所述待赔付场景的赔付金额；
计算各个所述待赔付场景的赔付金额之和，得到所述目标案件的理赔金。
本申请实施例的第二方面提供了一种理赔金的计算装置，包括：
案件确定模块，用于确定待计算理赔金的目标案件；
案件账单获取模块，用于通过保险公司的后台数据库获取所述目标案件的各个账单；
赔付场景确定模块，用于根据所述目标案件的案件信息和所述各个账单的账单信息确定所述目标案件的各个待赔付场景；
赔付金额计算模块，用于根据所述目标案件下各个受理保单的保单信息和所述各个账单的账单信息按照预设的理算规则分别计算各个所述待赔付场景的赔付金额；
案件理赔金计算模块，用于计算各个所述待赔付场景的赔付金额之和，得到所述目标案件的理赔金。
本申请实施例的第三方面提供了一种终端设备，包括存储器以及处理器，所述存储器中存储有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第一方面所述的理赔金的计算方法的步骤。
本申请实施例的第四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第一方面所述的理赔金的计算方法的步骤。
 有益效果
在本申请实施例中，根据目标案件的各个账单确定出目标案件的各个待赔付场景，然后以这些待赔付场景作为维度分别计算各个待赔付场景的赔付金额，最后计算这些赔付金额之和得到目标案件的理赔金，不仅实现了案件理赔金的自动化计算，大大提高了理赔金的计算效率，从而提高了理赔案件的结案效率，而且以场景为维度对理赔金的计算过程进行了精细化，使得理赔金的计算更加准确。
 附图说明
图1为本申请实施例中一种理赔金的计算方法一个实施例流程图；
图2为本申请实施例中一种理赔金的计算方法步骤103在一个应用场景下的流程示意图；
图3为本申请实施例中一种理赔金的计算方法步骤104在一个应用场景下的流程示意图；
图4为图3对应实施例中一种理赔金的计算方法步骤305在一个应用场景下的流程示意图；
图5为本申请实施例中一种理赔金的计算装置的结构框图；
图6为本申请实施例提供的终端设备的示意图。
 本发明的实施方式
为了说明本申请所述的技术方案，下面通过具体实施例来进行说明。
请参阅图1，本申请实施例中一种理赔金的计算方法一个实施例包括：
101、确定待计算理赔金的目标案件；
本实施例中，在进行理赔金计算之前，首先需要确定需要计算理赔金的目标案件。这些目标案件可以从已经发起了理赔请求的案件中选取。可以理解的是，在请求人发起理赔请求时，一般需要进行报案处理，即将相关的案件信息，例如账单、请求人相关个人信息、保单信息等上报至保险公司的***，由保险公司***受理后生成对应的理赔案件。
102、通过保险公司的后台数据库获取所述目标案件的各个账单；
在保险公司***受理并生成相关理赔案件之后，这些案件的账单可以保存在保险公司的后台数据库中。因此，可以通过保险公司的后台数据库获取所述目标案件的各个账单。
103、根据所述目标案件的案件信息和所述各个账单的账单信息确定所述目标案件的各个待赔付场景；
在本实施例中，为了精确计算目标案件的理赔金，由于案件的保单中一般约定的理赔责任是根据不同的场景进行区分的。例如，对于同一个车险保单，同样是被保车辆损坏，在不同的场景下车险保单承担的责任并不相同。比如，若车辆是在人为的场景下受损，则本次受损事件属于车险保单的责任范围；而若该车辆是在不可抗力下的场景（如洪水、台风）下受损，则本次受损事件不属于车险保单的责任范围。因此，在计算理赔金之前需要确定该目标案件的各个待赔付场景，然后在根据不同的场景细分并计算出各自的赔付金额。其中，待赔付场景即为属于目标案件对应保单的责任范围内的场景。
进一步地，如图2所示，上述步骤103可以包括：
201、按照预设分组规则对所述各个账单进行分组，得到的各个账单小组分别作为所述目标案件的各个子案件；202、根据所述案件信息和所述账单信息生成各个所述子案件的预设第一属性类型的属性值；203、根据所述案件信息和所述账单信息生成各个所述账单的预设第二属性类型的属性值；204、提取所述目标案件下各个受理保单的所有理赔责任的预设核心属性的属性值；205、将所述所有理赔责任的预设核心属性的属性值与所述目标案件的预设核心属性的属性值进行匹配，得到匹配成功的各个理赔责任作为所述目标案件的理赔责任；206、将所述目标案件的各个理赔责任的属性值与各个所述子案件下所述账单的属性值进行匹配，得到各个所述子案件对应的理赔责任；207、分别提取各个所述子案件对应的理赔责任下预定义的各个场景；208、将所述子案件的各个场景的属性值按照预设的场景顺序依次与所述子案件的属性值进行匹配，若匹配成功，则将匹配成功的场景确定为所述子案件的待赔付场景；209、将确定出的各个所述子案件的待赔付场景确定为所述目标案件的各个待赔付场景。
对于步骤201，一般来说，一个目标案件大多具有多个账单，这些账单可能具有不同的账单日期、类型、消费区域等，因此，可以根据这些账单属性设置分组规则对这些账单进行归类、分组，从而将多个账单分成一个以上的账单小组。例如，对于医疗理赔案件，对应的账单为医疗账单，可以将同一天就诊、同一就诊类型、同一疾病类型、且同一家医院作为同一账单小组。每一个账单小组即为目标案件的一个子案件。在后续的步骤中均以子案件作为计算维度。
对于步骤202，所述第一属性类型可以根据不同的子案件进行设定，例如可以包括事故性质、细化治理类型、出险地等，这些第一属性类型的属性值可以通过目标案件的案件信息和账单信息获取或生成得到。
对于步骤203，所述第二属性类型可以根据不同的账单类型进行设定，例如可以包括费用项目、消费日期、出账单位名称等，这些第二属性类型的属性值可以通过目标案件的案件信息和账单信息获取或生成得到。
对于步骤204，所述核心属性为受理保单的理赔责任的主要属性，这些核心属性可以根据不同保险公司的需要进行设定。所述受理保单是指该目标案件对应保单中的有效保单。可以理解的是，目标案件对应的被保人可能对应购买有多个保单，但考虑到不同保单具有不一样的有效期以及其它约定，因此，被保人购买的这些保单中可能只有一部分保单为有效保单。
在确定出目标案件下的各个受理保单之后，可以确定这些受理保单中约定的理赔责任，然后提取所有这些理赔责任的核心属性的属性值。
需要说明的是，上述步骤202、203和204之间不限定先后执行顺序。
对于步骤205，在得到目标案件下的各个受理保单的所有理赔责任的预设核心属性的属性值，以及得到所述目标案件的预设核心属性的属性值之后，可以将这两者的属性值进行匹配，匹配成功的理赔责任即为目标案件的理赔责任。其中，目标案件的预设核心属性的属性值可以根据目标案件的案件信息获取或生成得到。
可以理解的是，当理赔责任的属性值与目标案件的属性值匹配成功时，表明该理赔责任从核心属性方面考虑是满足目标案件的要求或情况的，因此可以将匹配成功的理赔责任确定为目标案件的理赔责任。例如，若意外医疗责任，其事故性质为意外，细化治疗类型为门诊和住院，费用项目包含医疗费，诊疗费，床位费，药品费等。当某一目标案件的事故性质、案件账单的治疗类型，费用项目与意外医疗责任的属性值均相同，则可以认为该目标案件匹配上了意外医疗责任。
对于步骤206，在确定出目标案件的各个理赔责任之后，可以根据各个理赔责任的属性值和上述各个子案件下账单的属性值进行匹配，将该目标案件的各个理赔责任细分为各个子案件对应的理赔责任。
对于步骤207，在得到各个子案件对应的理赔责任之后，可以分别提取各个所述子案件对应的理赔责任下预定义的各个场景。本实施例中，对每个理赔责任下应当进行理赔的场景均预先约定、定义并记录。例如，对于医疗理赔责任，其会预先约定哪些场景属于医疗理赔责任的理赔范围，哪场场景则不属于医疗理赔责任的理赔范围。
对于步骤208，对于一个子案件来说，需要将该子案件的属性值与这些场景的属性值进行匹配，若匹配成功，则可以将匹配成功的场景确定为该子案件的待赔付场景，也即适用场景。进一步地，为了提高场景匹配成功率，在将所述子案件的各个场景的属性值按照预设的场景顺序依次与所述子案件的属性值进行匹配时，若所述子案件的各个场景均未匹配成功，则可以将位于所述场景顺序中最后一个场景确定为所述子案件的待赔付场景。从而提高场景的匹配效率，也间接提高了目标案件的待赔付场景的确定效率。
对于步骤209，通过步骤208可以分别确定出各个子案件的待赔付场景，一个子案件可以确定出一个以上的待赔付场景，在确定出各个子案件的待赔付场景之后，所有这些子案件的待赔付场景即可以确定为该目标案件的各个待赔付场景。
104、根据所述目标案件下各个受理保单的保单信息和所述各个账单的账单信息按照预设的理算规则分别计算各个所述待赔付场景的赔付金额；
本实施例中，在该计算各个待赔付场景的赔付金额的过程中，是以场景作为最小维度计算的，即计算每个待赔付场景的赔付金额。
进一步地，如图3所示，上述步骤104可以包括：
301、获取所述各个受理保单在所述待赔付场景下的剩余保额；302、计算所述各个账单在所述待赔付场景下的应赔付费用；303、判断所述应赔付费用是否大于所述待赔付场景的赔付费用限额，若是，则执行步骤304，若否，则执行步骤305；304、将所述应赔付费用的值更新为所述赔付费用限额的值；305、根据所述应赔付费用、所述各个受理保单在所述待赔付场景下的剩余免赔额以及对应的赔付比例计算得到所述各个受理保单在所述待赔付场景下的理赔金额；306、取所述理赔金额与所述剩余保额中的较小值作为所述待赔付场景的赔付金额。
对于步骤301，受理保单在待赔付场景下的剩余保额，也即该待赔付场景下的最大可赔付金额。该剩余保额可以包括三部分：保单的剩余保额、责任的剩余保额、场景的剩余保额，对以上三部分的保额取最小值则得到这些受理保单在该待赔付场景下的剩余保额。
对于步骤302，根据各个账单的账单信息，可以计算这些账单在该待赔付场景下的应赔付费用。具体地，该应赔付费用=账单金额-不合理医疗费用-自费金额-医保给付金额。
对于步骤303，所述待赔付场景的赔付费用限额是指该待赔付场景下的最大可赔付的金额。可以理解的是，当该应赔付费用大于该待赔付场景的赔付费用限额时，应该执行步骤304，将该应赔付费用的值调整为该待赔付场景的赔付费用限额。
对于步骤305，该剩余免赔额是指这些受理保单在该待赔付场景下的免赔的额度，具体的免赔的额度是由保险人和被保险人事先约定，损失额在规定数额之内，被保险人自行承担损失，保险人不负责赔偿的额度。若该待赔付场景下没有免赔的额度，则可以认为该剩余免赔额为0。
具体地，如图4所示，上述步骤305具体可以包括：
401、获取所述各个受理保单在所述待赔付场景下的剩余免赔额；
402、计算所述应赔付费用与所述剩余免赔额之差，得到合理赔付费用；
403、根据所述合理赔付费用落入的费用区间确定所述各个受理保单在所述待赔付场景下赔付比例，所述费用区间与所述赔付比例存在对应关系；
404、根据所述赔付比例和所述合理赔付费用计算得到所述各个受理保单在所述待赔付场景下的理赔金额。
对于上述步骤401和402，考虑到该待赔付场景下的剩余免赔额，在计算理赔金额之前，应当从应赔付费用中减去这部分剩余免赔额，从而得到合理赔付费用。
对于步骤403，本实施例中，预先对不同的费用区间设置有不同的赔付比例。例如，在场景A中，费用区间可能有两个：当0<合理赔付费用<999时，赔付比例为0.9；当合理赔付费用>=1000,赔付比例则为0.8。
对于步骤404，在计算得到合理赔付费用以及确定出对应的赔付比例之后，可以根据该合理赔付费用和对应的赔付比例计算得到该待赔付场景下的理赔金额。具体地，该待赔付场景下的理赔金额=合理赔付费用*赔付比例。从而计算出各个受理保单在该待赔付场景下的理赔金额。
对于上述步骤306，由于步骤301获取到该待赔付场景下的剩余保额，而理赔金额不能大于该剩余保额，因此，可以取所述理赔金额与所述剩余保额中的较小值作为所述待赔付场景的赔付金额。
105、计算各个所述待赔付场景的赔付金额之和，得到所述目标案件的理赔金。
通过上述步骤104，可以计算出各个待赔付场景的赔付金额，而由于该目标案件可能存在一个或多个待赔付场景，因此，该目标案件的理赔金等于其对应的所有待赔付场景的赔付金额之和。
在本实施例中，根据目标案件的各个账单确定出目标案件的各个待赔付场景，然后以这些待赔付场景作为维度分别计算各个待赔付场景的赔付金额，最后计算这些赔付金额之和得到目标案件的理赔金，不仅实现了案件理赔金的自动化计算，大大提高了理赔金的计算效率，从而提高了理赔案件的结案效率，而且以场景为维度对理赔金的计算过程进行了精细化，使得理赔金的计算更加准确。
对应于上文实施例所述的理赔金的计算方法，图5示出了本申请实施例提供的理赔金的计算装置的结构框图，为了便于说明，仅示出了与本申请实施例相关的部分。
如图5所示，一种理赔金的计算装置，包括：
案件确定模块501，用于确定待计算理赔金的目标案件；
案件账单获取模块502，用于通过保险公司的后台数据库获取所述目标案件的各个账单；
赔付场景确定模块503，用于根据所述目标案件的案件信息和所述各个账单的账单信息确定所述目标案件的各个待赔付场景；
赔付金额计算模块504，用于根据所述目标案件下各个受理保单的保单信息和所述各个账单的账单信息按照预设的理算规则分别计算各个所述待赔付场景的赔付金额；
案件理赔金计算模块505，用于计算各个所述待赔付场景的赔付金额之和，得到所述目标案件的理赔金。
进一步地，所述赔付场景确定模块503可以包括：
账单分组单元，用于按照预设分组规则对所述各个账单进行分组，得到的各个账单小组分别作为所述目标案件的各个子案件；
第一属性值生成单元，用于根据所述案件信息和所述账单信息生成各个所述子案件的预设第一属性类型的属性值；
第二属性值生成单元，用于根据所述案件信息和所述账单信息生成各个所述账单的预设第二属性类型的属性值；
核心属性值提取单元，用于提取所述目标案件下各个受理保单的所有理赔责任的预设核心属性的属性值；
案件责任匹配单元，用于将所述所有理赔责任的预设核心属性的属性值与所述目标案件的预设核心属性的属性值进行匹配，得到匹配成功的各个理赔责任作为所述目标案件的理赔责任；
子案件责任匹配单元，用于将所述目标案件的各个理赔责任的属性值与各个所述子案件下所述账单的属性值进行匹配，得到各个所述子案件对应的理赔责任；
场景提取单元，用于分别提取各个所述子案件对应的理赔责任下预定义的各个场景；
子案件场景匹配单元，用于将所述子案件的各个场景的属性值按照预设的场景顺序依次与所述子案件的属性值进行匹配，若匹配成功，则将匹配成功的场景确定为所述子案件的待赔付场景；
待赔付场景确定单元，用于将确定出的各个所述子案件的待赔付场景确定为所述目标案件的各个待赔付场景。
进一步地，所述理赔金的计算装置还可以包括：场景匹配模块，用于在所述子案件场景匹配单元将所述子案件的各个场景的属性值按照预设的场景顺序依次与所述子案件的属性值进行匹配时，若所述子案件的各个场景均未匹配成功，则将位于所述场景顺序中最后一个场景确定为所述子案件的待赔付场景。
进一步地，所述赔付金额计算模块504可以包括：剩余保额获取单元，用于获取所述各个受理保单在所述待赔付场景下的剩余保额；应赔付费用单元，用于计算所述各个账单在所述待赔付场景下的应赔付费用；费用值更新单元，用于若所述应赔付费用大于所述待赔付场景的赔付费用限额，则将所述应赔付费用的值更新为所述赔付费用限额的值；理赔金额计算单元，用于根据所述应赔付费用、所述各个受理保单在所述待赔付场景下的剩余免赔额以及对应的赔付比例计算得到所述各个受理保单在所述待赔付场景下的理赔金额；赔付金额取值单元，用于取所述理赔金额与所述剩余保额中的较小值作为所述待赔付场景的赔付金额。
进一步地，所述理赔金额计算单元可以包括：免赔额获取子单元，用于获取所述各个受理保单在所述待赔付场景下的剩余免赔额；合理费用计算子单元，用于计算所述应赔付费用与所述剩余免赔额之差，得到合理赔付费用；赔付比例确定子单元，用于根据所述合理赔付费用落入的费用区间确定所述各个受理保单在所述待赔付场景下赔付比例，所述费用区间与所述赔付比例存在对应关系；金额计算子单元，用于根据所述赔付比例和所述合理赔付费用计算得到所述各个受理保单在所述待赔付场景下的理赔金额。
图6是本申请一实施例提供的终端设备的示意图。如图6所示，该实施例的终端设备6包括：处理器60以及存储器61，所述存储器61中存储有可在所述处理器60上运行的计算机可读指令62，例如理赔金的计算程序。所述处理器60执行所述计算机可读指令62时实现上述各个理赔金的计算方法实施例中的步骤，例如图1所示的步骤101至105。或者，所述处理器60执行所述计算机可读指令62时实现上述各装置实施例中各模块/单元的功能，例如图5所示模块501至505的功能。
示例性的，所述计算机可读指令62可以被分割成一个或多个模块/单元，所述一个或者多个模块/单元被存储在所述存储器61中，并由所述处理器60执行，以完成本申请。所述一个或多个模块/单元可以是能够完成特定功能的一系列计算机可读指令段，该指令段用于描述所述计算机可读指令62在所述终端设备6中的执行过程。
所述终端设备6可以是桌上型计算机、笔记本、掌上电脑及云端服务器等计算设备。所述终端设备可包括，但不仅限于处理器60和存储器61。本领域技术人员可以理解，图6仅仅是终端设备6的示例，并不构成对终端设备6的限定，可以包括比图示更多或更少的部件，或者组合某些部件，或者不同的部件，例如所述终端设备还可以包括输入输出设备、网络接入设备、总线等。
所称处理器60可以是中央处理单元(Central Processing Unit，CPU)，还可以是其他通用处理器、数字信号处理器 (Digital Signal Processor，DSP)、专用集成电路 (Application Specific Integrated Circuit，ASIC)、现成可编程门阵列 (Field-Programmable Gate Array，FPGA) 或者其他可编程逻辑器件、分立门或者晶体管逻辑器件、分立硬件组件等。通用处理器可以是微处理器或者该处理器也可以是任何常规的处理器等。
所述存储器61可以是所述终端设备6的内部存储单元，例如终端设备6的硬盘或内存。所述存储器61也可以是所述终端设备6的外部存储设备，例如所述终端设备6上配备的插接式硬盘，智能存储卡（Smart Media Card，SMC），安全数字（Secure Digital，SD）卡，闪存卡（Flash Card）等。进一步地，所述存储器61还可以既包括所述终端设备6的内部存储单元也包括外部存储设备。所述存储器61用于存储所述计算机可读指令以及所述终端设备所需的其他程序和数据。所述存储器61还可以用于暂时地存储已经输出或者将要输出的数据。
另外，在本申请各个实施例中的各功能单元可以集成在一个处理单元中，也可以是各个单元单独物理存在，也可以两个或两个以上单元集成在一个单元中。上述集成的单元既可以采用硬件的形式实现，也可以采用软件功能单元的形式实现。
所述集成的单元如果以软件功能单元的形式实现并作为独立的产品销售或使用时，可以存储在一个计算机可读取存储介质中。基于这样的理解，本申请的技术方案本质上或者说对现有技术做出贡献的部分或者该技术方案的全部或部分可以以软件产品的形式体现出来，该计算机软件产品存储在一个存储介质中，包括若干指令用以使得一台计算机设备（可以是个人计算机，服务器，或者网络设备等）执行本申请各个实施例所述方法的全部或部分步骤。而前述的存储介质包括：U盘、移动硬盘、只读存储器（Read-Only Memory，ROM）、随机存取存储器（Random Access Memory，RAM）、磁碟或者光盘等各种可以存储程序代码的介质。
以上所述，以上实施例仅用以说明本申请的技术方案，而非对其限制；尽管参照前述实施例对本申请进行了详细的说明，本领域的普通技术人员应当理解：其依然可以对前述各实施例所记载的技术方案进行修改，或者对其中部分技术特征进行等同替换；而这些修改或者替换，并不使相应技术方案的本质脱离本申请各实施例技术方案的精神和范围。

Claims (20)

  1. 一种理赔金的计算方法，其特征在于，包括：
    确定待计算理赔金的目标案件；
    通过保险公司的后台数据库获取所述目标案件的各个账单；
    根据所述目标案件的案件信息和所述各个账单的账单信息确定所述目标案件的各个待赔付场景；
    根据所述目标案件下各个受理保单的保单信息和所述各个账单的账单信息按照预设的理算规则分别计算各个所述待赔付场景的赔付金额；
    计算各个所述待赔付场景的赔付金额之和，得到所述目标案件的理赔金。
  2. 如权利要求1所述的理赔金的计算方法，其特征在于，所述根据所述目标案件的案件信息和所述各个账单的账单信息确定所述目标案件的各个待赔付场景包括：
    按照预设分组规则对所述各个账单进行分组，得到的各个账单小组分别作为所述目标案件的各个子案件；
    根据所述案件信息和所述账单信息生成各个所述子案件的预设第一属性类型的属性值；
    根据所述案件信息和所述账单信息生成各个所述账单的预设第二属性类型的属性值；
    提取所述目标案件下各个受理保单的所有理赔责任的预设核心属性的属性值；
    将所述所有理赔责任的预设核心属性的属性值与所述目标案件的预设核心属性的属性值进行匹配，得到匹配成功的各个理赔责任作为所述目标案件的理赔责任；
    将所述目标案件的各个理赔责任的属性值与各个所述子案件下所述账单的属性值进行匹配，得到各个所述子案件对应的理赔责任；
    分别提取各个所述子案件对应的理赔责任下预定义的各个场景；
    将所述子案件的各个场景的属性值按照预设的场景顺序依次与所述子案件的属性值进行匹配，若匹配成功，则将匹配成功的场景确定为所述子案件的待赔付场景；
    将确定出的各个所述子案件的待赔付场景确定为所述目标案件的各个待赔付场景。
  3. 如权利要求2所述的理赔金的计算方法，其特征在于，在将所述子案件的各个场景的属性值按照预设的场景顺序依次与所述子案件的属性值进行匹配时，若所述子案件的各个场景均未匹配成功，则将位于所述场景顺序中最后一个场景确定为所述子案件的待赔付场景。
  4. 如权利要求1至3任一项所述的理赔金的计算方法，其特征在于，所述根据所述目标案件下各个受理保单的保单信息和所述各个账单的账单信息按照预设的理算规则分别计算各个所述待赔付场景的赔付金额包括：
    获取所述各个受理保单在所述待赔付场景下的剩余保额；
    计算所述各个账单在所述待赔付场景下的应赔付费用；
    若所述应赔付费用大于所述待赔付场景的赔付费用限额，则将所述应赔付费用的值更新为所述赔付费用限额的值；
    根据所述应赔付费用、所述各个受理保单在所述待赔付场景下的剩余免赔额以及对应的赔付比例计算得到所述各个受理保单在所述待赔付场景下的理赔金额；
    取所述理赔金额与所述剩余保额中的较小值作为所述待赔付场景的赔付金额。
  5. 如权利要求4所述的理赔金的计算方法，其特征在于，所述根据所述应赔付费用、所述各个受理保单在所述待赔付场景下的剩余免赔额以及对应的赔付比例计算得到所述各个受理保单在所述待赔付场景下的理赔金额包括：
    获取所述各个受理保单在所述待赔付场景下的剩余免赔额；
    计算所述应赔付费用与所述剩余免赔额之差，得到合理赔付费用；
    根据所述合理赔付费用落入的费用区间确定所述各个受理保单在所述待赔付场景下赔付比例，所述费用区间与所述赔付比例存在对应关系；
    根据所述赔付比例和所述合理赔付费用计算得到所述各个受理保单在所述待赔付场景下的理赔金额。
  6. 一种理赔金的计算装置，其特征在于，包括：
    案件确定模块，用于确定待计算理赔金的目标案件；
    案件账单获取模块，用于通过保险公司的后台数据库获取所述目标案件的各个账单；
    赔付场景确定模块，用于根据所述目标案件的案件信息和所述各个账单的账单信息确定所述目标案件的各个待赔付场景；
    赔付金额计算模块，用于根据所述目标案件下各个受理保单的保单信息和所述各个账单的账单信息按照预设的理算规则分别计算各个所述待赔付场景的赔付金额；
    案件理赔金计算模块，用于计算各个所述待赔付场景的赔付金额之和，得到所述目标案件的理赔金。
  7. 根据权利要求6所述的理赔金的计算装置，其特征在于，所述赔付场景确定模块包括：
    账单分组单元，用于按照预设分组规则对所述各个账单进行分组，得到的各个账单小组分别作为所述目标案件的各个子案件；
    第一属性值生成单元，用于根据所述案件信息和所述账单信息生成各个所述子案件的预设第一属性类型的属性值；
    第二属性值生成单元，用于根据所述案件信息和所述账单信息生成各个所述账单的预设第二属性类型的属性值；
    核心属性值提取单元，用于提取所述目标案件下各个受理保单的所有理赔责任的预设核心属性的属性值；
    案件责任匹配单元，用于将所述所有理赔责任的预设核心属性的属性值与所述目标案件的预设核心属性的属性值进行匹配，得到匹配成功的各个理赔责任作为所述目标案件的理赔责任；
    子案件责任匹配单元，用于将所述目标案件的各个理赔责任的属性值与各个所述子案件下所述账单的属性值进行匹配，得到各个所述子案件对应的理赔责任；
    场景提取单元，用于分别提取各个所述子案件对应的理赔责任下预定义的各个场景；
    子案件场景匹配单元，用于将所述子案件的各个场景的属性值按照预设的场景顺序依次与所述子案件的属性值进行匹配，若匹配成功，则将匹配成功的场景确定为所述子案件的待赔付场景；
    待赔付场景确定单元，用于将确定出的各个所述子案件的待赔付场景确定为所述目标案件的各个待赔付场景。
  8. 根据权利要求7所述的理赔金的计算装置，其特征在于，所述理赔金的计算装置还包括：
    场景匹配模块，用于在所述子案件场景匹配单元将所述子案件的各个场景的属性值按照预设的场景顺序依次与所述子案件的属性值进行匹配时，若所述子案件的各个场景均未匹配成功，则将位于所述场景顺序中最后一个场景确定为所述子案件的待赔付场景。
  9. 根据权利要求6至8中任一项所述的理赔金的计算装置，其特征在于，所述赔付金额计算模块包括：
    剩余保额获取单元，用于获取所述各个受理保单在所述待赔付场景下的剩余保额；
    应赔付费用单元，用于计算所述各个账单在所述待赔付场景下的应赔付费用；
    费用值更新单元，用于若所述应赔付费用大于所述待赔付场景的赔付费用限额，则将所述应赔付费用的值更新为所述赔付费用限额的值；
    理赔金额计算单元，用于根据所述应赔付费用、所述各个受理保单在所述待赔付场景下的剩余免赔额以及对应的赔付比例计算得到所述各个受理保单在所述待赔付场景下的理赔金额；
    赔付金额取值单元，用于取所述理赔金额与所述剩余保额中的较小值作为所述待赔付场景的赔付金额。
  10. 根据权利要求9所述的理赔金的计算装置，其特征在于，所述理赔金额计算单元包括：
    免赔额获取子单元，用于获取所述各个受理保单在所述待赔付场景下的剩余免赔额；
    合理费用计算子单元，用于计算所述应赔付费用与所述剩余免赔额之差，得到合理赔付费用；
    赔付比例确定子单元，用于根据所述合理赔付费用落入的费用区间确定所述各个受理保单在所述待赔付场景下赔付比例，所述费用区间与所述赔付比例存在对应关系；
    金额计算子单元，用于根据所述赔付比例和所述合理赔付费用计算得到所述各个受理保单在所述待赔付场景下的理赔金额。
  11. 一种终端设备，其特征在于，包括存储器以及处理器，所述存储器中存储有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下步骤：
    确定待计算理赔金的目标案件；
    通过保险公司的后台数据库获取所述目标案件的各个账单；
    根据所述目标案件的案件信息和所述各个账单的账单信息确定所述目标案件的各个待赔付场景；
    根据所述目标案件下各个受理保单的保单信息和所述各个账单的账单信息按照预设的理算规则分别计算各个所述待赔付场景的赔付金额；
    计算各个所述待赔付场景的赔付金额之和，得到所述目标案件的理赔金。
  12. 根据权利要求11所述的终端设备，其特征在于，所述根据所述目标案件的案件信息和所述各个账单的账单信息确定所述目标案件的各个待赔付场景包括：
    按照预设分组规则对所述各个账单进行分组，得到的各个账单小组分别作为所述目标案件的各个子案件；
    根据所述案件信息和所述账单信息生成各个所述子案件的预设第一属性类型的属性值；
    根据所述案件信息和所述账单信息生成各个所述账单的预设第二属性类型的属性值；
    提取所述目标案件下各个受理保单的所有理赔责任的预设核心属性的属性值；
    将所述所有理赔责任的预设核心属性的属性值与所述目标案件的预设核心属性的属性值进行匹配，得到匹配成功的各个理赔责任作为所述目标案件的理赔责任；
    将所述目标案件的各个理赔责任的属性值与各个所述子案件下所述账单的属性值进行匹配，得到各个所述子案件对应的理赔责任；
    分别提取各个所述子案件对应的理赔责任下预定义的各个场景；
    将所述子案件的各个场景的属性值按照预设的场景顺序依次与所述子案件的属性值进行匹配，若匹配成功，则将匹配成功的场景确定为所述子案件的待赔付场景；
    将确定出的各个所述子案件的待赔付场景确定为所述目标案件的各个待赔付场景。
  13. 根据权利要求12所述的终端设备，其特征在于，在将所述子案件的各个场景的属性值按照预设的场景顺序依次与所述子案件的属性值进行匹配时，若所述子案件的各个场景均未匹配成功，则将位于所述场景顺序中最后一个场景确定为所述子案件的待赔付场景。
  14. 根据权利要求11至13任一项所述的终端设备，其特征在于，所述根据所述目标案件下各个受理保单的保单信息和所述各个账单的账单信息按照预设的理算规则分别计算各个所述待赔付场景的赔付金额包括：
    获取所述各个受理保单在所述待赔付场景下的剩余保额；
    计算所述各个账单在所述待赔付场景下的应赔付费用；
    若所述应赔付费用大于所述待赔付场景的赔付费用限额，则将所述应赔付费用的值更新为所述赔付费用限额的值；
    根据所述应赔付费用、所述各个受理保单在所述待赔付场景下的剩余免赔额以及对应的赔付比例计算得到所述各个受理保单在所述待赔付场景下的理赔金额；
    取所述理赔金额与所述剩余保额中的较小值作为所述待赔付场景的赔付金额。
  15. 根据权利要求14所述的终端设备，其特征在于，所述根据所述应赔付费用、所述各个受理保单在所述待赔付场景下的剩余免赔额以及对应的赔付比例计算得到所述各个受理保单在所述待赔付场景下的理赔金额包括：
    获取所述各个受理保单在所述待赔付场景下的剩余免赔额；
    计算所述应赔付费用与所述剩余免赔额之差，得到合理赔付费用；
    根据所述合理赔付费用落入的费用区间确定所述各个受理保单在所述待赔付场景下赔付比例，所述费用区间与所述赔付比例存在对应关系；
    根据所述赔付比例和所述合理赔付费用计算得到所述各个受理保单在所述待赔付场景下的理赔金额。
  16. 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至少一个处理器执行时实现如下步骤：
    确定待计算理赔金的目标案件；
    通过保险公司的后台数据库获取所述目标案件的各个账单；
    根据所述目标案件的案件信息和所述各个账单的账单信息确定所述目标案件的各个待赔付场景；
    根据所述目标案件下各个受理保单的保单信息和所述各个账单的账单信息按照预设的理算规则分别计算各个所述待赔付场景的赔付金额；
    计算各个所述待赔付场景的赔付金额之和，得到所述目标案件的理赔金。
  17. 根据权利要求16所述的计算机可读存储介质，其特征在于，所述根据所述目标案件的案件信息和所述各个账单的账单信息确定所述目标案件的各个待赔付场景包括：
    按照预设分组规则对所述各个账单进行分组，得到的各个账单小组分别作为所述目标案件的各个子案件；
    根据所述案件信息和所述账单信息生成各个所述子案件的预设第一属性类型的属性值；
    根据所述案件信息和所述账单信息生成各个所述账单的预设第二属性类型的属性值；
    提取所述目标案件下各个受理保单的所有理赔责任的预设核心属性的属性值；
    将所述所有理赔责任的预设核心属性的属性值与所述目标案件的预设核心属性的属性值进行匹配，得到匹配成功的各个理赔责任作为所述目标案件的理赔责任；
    将所述目标案件的各个理赔责任的属性值与各个所述子案件下所述账单的属性值进行匹配，得到各个所述子案件对应的理赔责任；
    分别提取各个所述子案件对应的理赔责任下预定义的各个场景；
    将所述子案件的各个场景的属性值按照预设的场景顺序依次与所述子案件的属性值进行匹配，若匹配成功，则将匹配成功的场景确定为所述子案件的待赔付场景；
    将确定出的各个所述子案件的待赔付场景确定为所述目标案件的各个待赔付场景。
  18. 根据权利要求17所述的计算机可读存储介质，其特征在于，在将所述子案件的各个场景的属性值按照预设的场景顺序依次与所述子案件的属性值进行匹配时，若所述子案件的各个场景均未匹配成功，则将位于所述场景顺序中最后一个场景确定为所述子案件的待赔付场景。
  19. 根据权利要求16至18任一项所述的计算机可读存储介质，其特征在于，所述根据所述目标案件下各个受理保单的保单信息和所述各个账单的账单信息按照预设的理算规则分别计算各个所述待赔付场景的赔付金额包括：
    获取所述各个受理保单在所述待赔付场景下的剩余保额；
    计算所述各个账单在所述待赔付场景下的应赔付费用；
    若所述应赔付费用大于所述待赔付场景的赔付费用限额，则将所述应赔付费用的值更新为所述赔付费用限额的值；
    根据所述应赔付费用、所述各个受理保单在所述待赔付场景下的剩余免赔额以及对应的赔付比例计算得到所述各个受理保单在所述待赔付场景下的理赔金额；
    取所述理赔金额与所述剩余保额中的较小值作为所述待赔付场景的赔付金额。
  20. 根据权利要求19所述的计算机可读存储介质，其特征在于，所述根据所述应赔付费用、所述各个受理保单在所述待赔付场景下的剩余免赔额以及对应的赔付比例计算得到所述各个受理保单在所述待赔付场景下的理赔金额包括：
    获取所述各个受理保单在所述待赔付场景下的剩余免赔额；
    计算所述应赔付费用与所述剩余免赔额之差，得到合理赔付费用；
    根据所述合理赔付费用落入的费用区间确定所述各个受理保单在所述待赔付场景下赔付比例，所述费用区间与所述赔付比例存在对应关系；
    根据所述赔付比例和所述合理赔付费用计算得到所述各个受理保单在所述待赔付场景下的理赔金额。
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