WO2018205373A1 - Procédé et appareil d'estimation de dépenses de dommages corporels et de dépenses de règlement de sinistre, serveur et support - Google Patents

Procédé et appareil d'estimation de dépenses de dommages corporels et de dépenses de règlement de sinistre, serveur et support Download PDF

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Publication number
WO2018205373A1
WO2018205373A1 PCT/CN2017/090582 CN2017090582W WO2018205373A1 WO 2018205373 A1 WO2018205373 A1 WO 2018205373A1 CN 2017090582 W CN2017090582 W CN 2017090582W WO 2018205373 A1 WO2018205373 A1 WO 2018205373A1
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WO
WIPO (PCT)
Prior art keywords
loss
injury
human injury
damage
accident
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PCT/CN2017/090582
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English (en)
Chinese (zh)
Inventor
林梓棱
马显芳
蔡智晓
王鸿
范永安
谢洪彬
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平安科技（深圳）有限公司
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Publication of WO2018205373A1 publication Critical patent/WO2018205373A1/fr

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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 computer technology, and in particular, to a method, device, server and medium for measuring a human injury claim loss cost.
  • a method, apparatus, server, and medium for measuring a human injury claim loss cost are provided.
  • a method for calculating a human injury claim loss cost comprising:
  • the fixed loss cost corresponding to the personal injury claim is calculated by using the fixed loss duration corresponding to the plurality of fixed damage items.
  • a device for calculating a human injury claim loss cost comprising:
  • a receiving module configured to receive a human injury and loss request sent by the terminal, where the personal injury and loss request carries the injured person information
  • the measuring module is configured to input the injured person information into the human injury and loss model, and calculate a fixed loss duration corresponding to the plurality of fixed damage items by using the human injury and loss model;
  • the damage duration calculates the fixed loss cost corresponding to the personal injury claim.
  • a server comprising a memory and a processor, the memory storing computer executable instructions, the instructions being executed by the processor, causing the processor to perform the following steps:
  • the fixed loss cost corresponding to the personal injury claim is calculated by using the fixed loss duration corresponding to the plurality of fixed damage items.
  • One or more non-volatile readable storage media storing computer-executable instructions, when executed by one or more processors, cause the one or more processors to perform the following steps:
  • the fixed loss cost corresponding to the personal injury claim is calculated by using the fixed loss duration corresponding to the plurality of fixed damage items.
  • 1 is an application scenario diagram of a method for calculating a human injury claim loss cost in an embodiment
  • FIG. 2 is a flow chart of a method for calculating a human injury claim loss cost in an embodiment
  • FIG. 3 is a block diagram of a device for measuring a human injury claim loss cost in an embodiment
  • FIG. 4 is a block diagram of a device for measuring a human injury claim loss cost in another embodiment
  • Figure 5 is a block diagram of a server in one embodiment.
  • the method for calculating the human injury claim loss cost can be applied to the application scenario shown in FIG. 1 .
  • the claims terminal 102 is connected to the server 104 via a network.
  • the claimant can input the injured person information through the claim terminal 102 when processing the personal injury claim.
  • the claim terminal 102 generates a human injury loss request using the injured person information, and transmits a personal injury loss request to the server 104.
  • a human injury damage model is pre-established on the server 104.
  • the human injury damage model is invoked.
  • the server 104 inputs the injured person information to the human injury and loss model, and calculates the fixed loss duration corresponding to the plurality of fixed damage items by the human injury and loss model.
  • the server 104 obtains a corresponding measurement standard for the fixed loss according to the fixed loss item.
  • the server 104 calculates the fixed loss expenses corresponding to the plurality of fixed damage items by using the measurement standards of the fixed loss duration and the fixed loss cost, and accumulates the fixed loss expenses corresponding to the plurality of fixed damage items to obtain the fixed loss expenses corresponding to the personal injury claims. In the whole process, no manual participation is required, which effectively saves the time of manual measurement and improves the measurement efficiency of the fixed loss cost.
  • a method for calculating a human injury claim loss cost is provided. It should be understood that although the steps in the flowchart of FIG. 2 are sequentially displayed as indicated by the arrows, these steps are performed. It is not necessarily performed in the order indicated by the arrows. Except as explicitly stated herein, the execution of these steps is not strictly limited, and may be performed in other sequences. Moreover, at least some of the steps in FIG.
  • the method is applied to the server as an example, and specifically includes the following steps:
  • Step 202 Receive a human injury determination request sent by the terminal, and carry the injured person information in the personal injury determination request.
  • the terminal can be a claim terminal or a client terminal. Terminals include computers, personal laptops, tablets, smartphones, and personal digital assistants.
  • the server can receive the personal injury request sent by the claimant through the claim terminal when processing the personal injury claim.
  • the server can also receive a personal injury request sent by the client terminal when the client applies for the injury claim.
  • the injured person's information is carried in the personal injury request.
  • the injured information includes the basic information of the injured person and the medical information of the injured person.
  • the basic information of the injured person includes the name, gender, age and location of the injured person.
  • the injured medical information includes the injured part of the injured person, medical items, diagnostic code, name of the operation, and type of surgery.
  • step 204 the human injury damage model is invoked according to the fixed loss request.
  • step 206 the injured person information is input into the human injury damage model, and the fixed damage duration corresponding to the plurality of fixed damage items is calculated by the human injury damage model.
  • a human injury damage model is pre-established on the server.
  • the human injury damage model can be expressed in the form of a multivariate function.
  • the multivariate function of the human injury damage model includes multiple factor variables.
  • a database is deployed on the server.
  • the database of human injury damage data corresponding to the current human injury damage model is stored in the database.
  • the human injury damage data table includes multiple factor fields, including the loss item, the length of the damage, the diagnosis code, the type of surgery, the age range, the region, and the gender. Among them, the damage items include lost work, nursing and nutritional subsidies.
  • the data of the factor field in the human injury timing data table may be calculated based on historical human injury loss data within a preset time period.
  • the server can update the human injury timing data table according to the set frequency to ensure that the content of each factor field is accurate.
  • the server After receiving the loss request, the server will call the human injury damage model.
  • the server obtains the required information from the injured person's information according to the factor variable of the human injury damage model, and inputs the required information into the human injury damage model.
  • the human injury damage model queries the factor field corresponding to each factor variable in the human injury damage data table to obtain the fixed loss duration corresponding to multiple damage items.
  • the human injury damage model can simultaneously output the fixed loss duration corresponding to multiple damage items.
  • the length of the damage can be varied, for example, it can be in days, weeks, or hours.
  • the length of the fixed loss corresponding to multiple damage items is calculated.
  • the code for the Beijing area is 201
  • the code for the comminuted fracture of the left femur is G.42.4.1
  • the code for the surgical treatment is 2
  • the code for the male is M
  • the age range is 36-50 years old.
  • Step 208 Calculate the fixed loss cost corresponding to the personal injury claim using the fixed loss duration corresponding to the plurality of fixed damage items.
  • the server calculates the fixed loss duration corresponding to the plurality of fixed damage items by using the human injury and loss model
  • the corresponding loss calculation standard is obtained according to the fixed damage item.
  • the measurement of the fixed loss cost can correspond to the unit of the fixed loss duration.
  • the measurement standard of the fixed loss cost may be the daily average fixed loss amount measured by the day, or the weekly average fixed loss amount measured by the week, or may be the hourly average fixed loss amount measured by the hour. Due to the different labor costs, nursing expenses and nutritional subsidies in different regions and different industries, the server can further obtain the corresponding measurement cost of the loss according to the injured area and/or industry.
  • the server calculates the fixed loss expenses corresponding to the plurality of fixed damage items by using the measurement criteria of the fixed loss duration and the fixed loss cost.
  • the fixed loss cost the length of the fixed loss * the measurement standard of the fixed loss. For example, the duration of the loss is measured in days, and the measurement standard for the loss is the average daily loss.
  • the server accumulates the fixed loss expenses corresponding to the plurality of fixed damage items to obtain the fixed loss expenses corresponding to the personal injury claims.
  • the human injury damage model when a human injury loss request is received, the human injury damage model is invoked.
  • the information of the injured person carried in the personal injury request is input into the human injury damage model, and the fixed damage duration corresponding to the plurality of fixed damage items is calculated by the human injury damage model. Therefore, the fixed loss time required for the personal injury claim is calculated by using the fixed loss duration corresponding to the plurality of fixed damage items. In the whole process, no human intervention is required at all.
  • the human injury damage model By calling the human injury damage model, the fixed damage cost required for the human injury claim can be automatically calculated, which effectively saves the time of manual measurement and improves the measurement efficiency of the fixed loss cost. .
  • the server may obtain the corresponding fixed loss fee according to the fixed damage item carried in the injured person information.
  • Fixed damage items that do not require a fixed length of time include death compensation, mental comfort and disability compensation.
  • the method further includes: acquiring historical human injury loss data within a preset time period; the historical human injury loss data includes a plurality of factor fields; and the historical human injury loss data corresponding to the factor field is aggregated Class analysis, the clustering results corresponding to multiple factor fields are obtained; the clustering results are used to optimize the human injury damage model.
  • the adjustment includes the injury site, the name of the surgery, age or gender.
  • it is necessary to optimize the human injury damage model.
  • the server may acquire, in the database, historical damage data of a plurality of injured persons within a preset time period.
  • the preset time period can be one year, half a year, or a quarter.
  • Historical human injury damage data includes multiple factor fields, such as damage items, duration of injury, diagnostic code, type of surgery, age range, region, and gender.
  • the server takes the historical damage data of each injured person as a sample, and takes the field name of each factor field as a dimension.
  • the server performs cluster analysis on samples of each dimension.
  • the server adopts a clustering analysis algorithm, for example, a K-means algorithm, and the field names of each factor field are used as data objects to iteratively calculate multiple samples in turn, and the clustering results corresponding to each dimension are calculated.
  • the server obtains the dimensions of gender, age, injury site, and medical item, and performs cluster analysis on multiple samples to obtain the duration of the same gender, the same injury site, and the same medical item in a certain age range.
  • the server updates the human injury damage data table by using the clustering result against the field name of each factor field.
  • the server may perform an average calculation on the length of the lost time within the budget range according to the dimension.
  • the mean calculation includes an average calculation or a square mean calculation, and the like. For example, after cluster analysis, it is obtained that the gender is male, the length of the lost time of the fracture between 30-40 years old is 198 days, and the length of the lost work between 40-50 years old is 199 days, and the age is 40-50 years old. The length of time between work is 200 days, and the average value of several lost time is analyzed, for example, the average value is 199 days.
  • the server can update the length of the lost time of a male with a 30- to 50-year-old fracture to 199 days.
  • the server is updated by the human injury timing data table, so that the human injury damage model can be queried in the human injury timing data table to update the fixed loss duration, thereby realizing the optimization of the human injury damage model. This makes it possible to ensure that an accurate personal injury loss is calculated when a person is injured.
  • the method before the step of receiving the person's injury claim, the method further includes: capturing news content on multiple websites; performing big data analysis on the plurality of news contents to obtain content related to the insurance accident; If the content related to the insurance accident identifies the claim for compensation, the claims task is generated according to the claim compensation event, and the claim task is sent to the claim terminal, so that the claim terminal generates a personal injury claim when processing the personal injury claim.
  • the personal injury claim may be a claim service provided by the claimant when the customer encounters an insured event.
  • the server can use the multiple sites in the crawler technology to collect news content and perform big data analysis on the collected news content. If the claim-to-claims event can be identified in the results of the big data analysis, the server generates a corresponding claim task, sends the claim task to the claim terminal, and the claimant goes to provide the client with the active claim service.
  • the server performs big data analysis on news content collected from a plurality of websites.
  • the server can obtain insurance-related keywords, such as car accidents, plane crashes, earthquakes, and explosions, and use keywords to cluster the collected news content to obtain content related to insurance accidents.
  • the server's big data analysis of the collected news content can be regarded as a primary screening of news content.
  • the server needs to further process the content obtained by the screening, that is, the insurance-related content, to identify whether the insurance-related content involves an insurance accident to be settled.
  • the manner of identifying whether there is an insured event to be settled may include a plurality of types.
  • the server may acquire the basic information of the accident in the content related to the insurance accident, generate an accident investigation task according to the basic information of the accident, and send the inspection task to the inspection terminal corresponding to the surveying personnel.
  • the surveying personnel go to the scene of the accident to conduct a survey. If there is a customer who needs to make a claim, the survey terminal returns the information of the customer to be settled to the server.
  • the server receives the to-be-claimed customer information returned by the inspection terminal, and records the to-be-resolved accident corresponding to the content related to the insurance accident according to the customer information to be claimed.
  • the server may obtain a picture of the content related to the insured event, identify whether there is a face in the picture, and if so, further identify whether the face is an insured customer image. If so, the server records the claims to be settled corresponding to the content related to the insurance accident according to the customer image.
  • the server may obtain the corresponding customer information according to the to-be-resolved accident, and extract the corresponding policy information in the database according to the customer information.
  • the server generates a claims task according to the policy information and the to-be-resolved accident, and sends the claim task to the claim terminal.
  • the claimant provides the client with an active claim service based on the claims task received by the claim terminal. Therefore, the customer can enjoy the claim service in time in the event of an insurance accident.
  • the method further includes: acquiring a picture in the content related to the insurance accident, and identifying the picture; If the face is recognized, it is further recognized whether the face is an insured customer image; if so, the to-be-resolved accident corresponding to the content related to the insurance accident is recorded.
  • the server may acquire the basic information of the accident in the content related to the insurance accident according to the result of the big data analysis.
  • Basic information about the accident includes the time of the accident, the location of the accident, and the type of accident.
  • the server may generate an accident investigation task according to the basic information of the accident, and send the inspection task to the inspection terminal corresponding to the surveying personnel.
  • the server may obtain the identification of the surveying personnel in the corresponding area according to the location of the accident, and query the identification of the surveying personnel familiar with the type of the accident according to the identification of the surveying personnel and the type of the accident.
  • the server sends the survey task to the survey terminal corresponding to the survey person identification.
  • the survey personnel familiar with the type of the accident can make a timely investigation to identify whether there is a customer who needs to claim in the accident. If there is a customer who needs to make a claim, the surveying personnel input the information to be claimed by the surveying terminal, and the surveying terminal uploads the information to be processed to the server. After receiving the customer information to be claimed, the server obtains the corresponding policy information according to the customer information to be claimed.
  • the policy information includes the policy status and the corresponding claims terms. If the policy status is valid and the insured event complies with the terms of the claim, the server records the claims to be settled corresponding to the content related to the insured event. This makes it possible to accurately identify the claims to be settled.
  • the survey personnel can be identified by means of assigning survey tasks, and each customer who needs to claim can be accurately identified. This ensures that every customer experiencing an insured event is provided with timely and effective claims services.
  • the claimant actively provides the claim service, the fixed damage fee corresponding to the personal injury claim can be quickly and accurately calculated in the manner provided in the above embodiment. In turn, it can effectively improve the efficiency of claims.
  • a human injury claim loss cost estimating apparatus including: a receiving module 302, a calling module 304, and a measuring module 306, wherein:
  • the receiving module 302 is configured to receive a human injury and loss request sent by the terminal, and the injured person carries the injured person information.
  • the calling module 304 is configured to invoke the human injury loss model according to the fixed loss request.
  • the measuring module 306 is configured to input the injured person information into the human injury and damage model, and calculate the fixed loss duration corresponding to the plurality of fixed damage items by using the human injury and loss model; and calculate the human injury by using the fixed loss duration corresponding to the plurality of fixed damage items.
  • the apparatus further includes: an optimization module 308, configured to acquire historical human injury loss data within a preset time period; historical human injury loss data includes a plurality of factor fields; and a history corresponding to the factor field
  • the human injury damage data is clustered and analyzed, and the clustering results corresponding to multiple factor fields are obtained.
  • the clustering results are used to optimize the human injury damage model.
  • the apparatus further includes: a content collection module 310, a content analysis module 312, and a claims module 314, wherein:
  • the content collection module 310 is configured to capture news content on multiple websites.
  • the content analysis module 312 is configured to perform big data analysis on various news contents to obtain content related to the insurance accident.
  • the claim module 314 is configured to: if the claim-to-claim event is identified according to the content related to the insurance accident, generate a claim task according to the claim-resolving accident, and send the claim task to the claim terminal, so that the claim terminal generates a personal injury when processing the person's injury claim Fixed loss request.
  • the apparatus further includes: a surveying module 316, configured to generate an accident survey task according to the content related to the insurance accident, send the accident survey task to the survey terminal, and receive the survey information returned by the survey terminal; Including customer information, it records the claims to be settled corresponding to the content related to the insurance accident.
  • a surveying module 316 configured to generate an accident survey task according to the content related to the insurance accident, send the accident survey task to the survey terminal, and receive the survey information returned by the survey terminal; Including customer information, it records the claims to be settled corresponding to the content related to the insurance accident.
  • Each module in the above-mentioned human injury claim loss cost estimating device may be implemented in whole or in part by software, hardware, and combinations thereof.
  • the receiving module 302 is configured to receive a human injury loss request sent by the terminal through a network interface.
  • the network interface may be an Ethernet card or a wireless network card.
  • the above modules may be embedded in the hardware of the base station or may be stored in the memory of the base station in a software form, so that the processor can call the corresponding operations of the above modules.
  • the processor may be a central processing unit (CPU) or a microprocessor.
  • a server is provided, as shown in FIG. 5, which includes a processor coupled through a system bus, memory, a computer program stored on the memory and executable on the processor, a network interface, and the like.
  • the processor is used to provide calculation and control capabilities.
  • the memory provides an environment for the operation of the computer program.
  • the memory includes an internal memory and a non-volatile storage medium.
  • the network interface is used to communicate with an external survey terminal or claim terminal via a network connection. The following steps are implemented when the processor executes a computer program:
  • the fixed loss cost corresponding to the personal injury claim is calculated by using the fixed loss duration corresponding to the plurality of fixed damage items.
  • the server can be implemented as a standalone server or a server cluster consisting of multiple servers. It will be understood by those skilled in the art that the structure shown in FIG. 5 is only a block diagram of a part of the structure related to the solution of the present application, and does not constitute a limitation on the server to which the solution of the present application is applied.
  • the specific server may include More or fewer components are shown in the figures, or some components are combined, or have different component arrangements.
  • the processor further implements the following steps when executing the computer program:
  • historical human injury damage data within a preset time period; historical human injury damage data includes a plurality of factor fields;
  • the clustering results were used to optimize the human injury damage model.
  • the processor further implements the following steps when executing the computer program:
  • the claim task is generated according to the claim-resolving accident, and the claim-receiving task is sent to the claim terminal, so that the claim-making terminal generates a personal injury-determining request when processing the personal injury claim.
  • the processor further implements the following steps when executing the computer program:
  • the survey information includes customer information
  • the incident to be settled corresponding to the content related to the insurance accident is recorded.
  • one or more non-volatile readable storage media storing computer-executable instructions are provided, the computer-executable instructions being executed by one or more processors such that the one or more The processors perform the following steps:
  • the fixed loss cost corresponding to the personal injury claim is calculated by using the fixed loss duration corresponding to the plurality of fixed damage items.
  • historical human injury damage data within a preset time period; historical human injury damage data includes a plurality of factor fields;
  • the clustering results were used to optimize the human injury damage model.
  • the claim task is generated according to the claim-resolving accident, and the claim-receiving task is sent to the claim terminal, so that the claim-making terminal generates a personal injury-determining request when processing the personal injury claim.
  • the survey information includes customer information
  • the incident to be settled corresponding to the content related to the insurance accident is recorded.
  • the storage medium may be a magnetic disk, an optical disk, or a read-only storage memory (Read-Only) Memory, ROM), etc.

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Abstract

L'invention concerne un procédé d'estimation d'une dépense de dommages corporels et de dépenses de règlement de sinistre, le procédé consistant : à recevoir une demande de règlement de dommages corporels envoyée par un terminal, la demande de règlement de dommages corporels transportant des informations concernant une partie blessée; à invoquer un modèle de règlement de dommages corporels en fonction de la demande de règlement de dommages corporels; à entrer les informations concernant la partie blessée dans le modèle règlement de dommages corporels et à calculer une durée règlement de dommages correspondant à une pluralité de projets de règlement de dommages au moyen du modèle de règlement de dommages corporels; et à calculer des dépenses de règlement de sinistre correspondant à des dépenses de dommages corporels à l'aide de la durée de règlement de dommages correspondant à la pluralité de projets de règlement de dommages.
PCT/CN2017/090582 2017-05-10 2017-06-28 Procédé et appareil d'estimation de dépenses de dommages corporels et de dépenses de règlement de sinistre, serveur et support WO2018205373A1 (fr)

Applications Claiming Priority (2)

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CN201710326780.2A CN107180389B (zh) 2017-05-10 2017-05-10 人伤理赔定损费用测算方法、装置、服务器和介质
CN201710326780.2 2017-05-10

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