CN113506181A

CN113506181A - Insurance claim settlement information processing method and device based on block chain

Info

Publication number: CN113506181A
Application number: CN202110854686.0A
Authority: CN
Inventors: 关舒; 刘路; 张湘; 安赟
Original assignee: Industrial and Commercial Bank of China Ltd ICBC
Current assignee: Industrial and Commercial Bank of China Ltd ICBC
Priority date: 2021-07-28
Filing date: 2021-07-28
Publication date: 2021-10-15

Abstract

The application provides an insurance claim settlement information processing method and device based on a block chain, which relate to the field of the block chain and can also be used in the financial field, wherein the method comprises the following steps: generating basic account opening information according to client insurance information acquired from a commercial bank node or an insurance company node in a block chain and an intelligent account opening contract which is previously achieved with the commercial bank node and the insurance company node; carrying out insurance claim settlement judgment according to the basic account opening information, the insurance transaction records obtained from the commercial bank nodes and claim settlement intelligent contracts which are previously achieved with the commercial bank nodes and the insurance company nodes; and sending the insurance claim settlement judgment result to the commercial bank node so as to enable the commercial bank node to carry out insurance claim settlement processing. The method and the system can process insurance claim settlement information by using the intelligent account opening contract and the intelligent claim settlement contract which are pre-achieved with the commercial bank node and the insurance company node.

Description

Insurance claim settlement information processing method and device based on block chain

Technical Field

The application relates to the field of block chains, can be used in the financial field, and particularly relates to an insurance claim settlement information processing method and device based on the block chains.

Background

With the development of times, the medical insurance of Chinese people is more and more important. The insuring amount and the insuring scale of the medical insurance show a trend of increasing year by year, which causes the insurance claim settlement flow to be more complicated and more difficult to examine, and is shown in the following steps: the insurance company has long check process before insurance, low claim settlement efficiency and opaque claim settlement process; the commercial bank has low participation degree and high replaceability in the process of medical treatment of the policyholder; the fund payment pressure of the applicant is high, and more submitted materials are filled; the pressure of doctors and patients in medical institutions is high, and the provision of documents is complicated.

Specifically, currently, offline manual methods are commonly used in the industry to submit account opening information and claim settlement application information of claim settlement accounts. In this case, the insurance company has difficulty in acquiring, acquiring and auditing the account opening information and the claim application information of the claim account. Meanwhile, the applicant is unfamiliar with the claim settlement process, so that the submitted materials are not standard and incomplete, the claim settlement process is repeated, and the consumption of manpower and material resources is huge. In addition, the current claim settlement process is completed in a mode that an applicant independently settles a claim, an insurance company assists in auditing, and a commercial bank executes public-private transfer, so that the commercial bank cannot completely master the insurance transaction information of the applicant and cannot comprehensively and stereoscopically evaluate the credit rating of a client. The above problems lead to poor insurance claim settlement timeliness.

Disclosure of Invention

Aiming at the problems in the prior art, the application provides an insurance claim settlement information processing method and device based on a block chain, which can process the insurance claim settlement information by utilizing an intelligent account opening contract and an intelligent claim settlement contract which are previously achieved with a commercial bank node and an insurance company node.

In order to solve the technical problem, the application provides the following technical scheme:

in a first aspect, the present application provides a block chain-based insurance claim settlement information processing method, including:

generating basic account opening information according to client insurance information acquired from a commercial bank node or an insurance company node in a block chain and an intelligent account opening contract which is previously achieved with the commercial bank node and the insurance company node;

carrying out insurance claim settlement judgment according to the basic account opening information, the insurance transaction records obtained from the commercial bank nodes and claim settlement intelligent contracts which are previously achieved with the commercial bank nodes and the insurance company nodes;

and sending the insurance claim settlement judgment result to the commercial bank node so as to enable the commercial bank node to carry out insurance claim settlement processing.

Further, the block chain-based insurance claim settlement information processing method further includes:

if the insurance claim settlement judgment result is passed, carrying out secondary insurance claim settlement judgment according to the basic account opening information, medical payment certificates acquired from medical institution nodes in the block chain and the claim settlement intelligent contract;

and sending the judgment result of the reinsurance claim to the commercial bank node so as to enable the commercial bank node to carry out insurance claim processing.

Further, the generating basic account opening information according to the customer insurance information acquired from the commercial bank node or the insurance company node in the blockchain and the intelligent account opening contract agreed with the commercial bank node and the insurance company node in advance comprises:

judging the client application condition according to the client application information and the account opening intelligent contract;

and if the client application insurance information meets the application insurance condition, generating the basic account opening information according to the client application insurance information and the intelligent account opening contract.

Further, the judging the client application condition according to the client application information and the account opening intelligent contract comprises:

judging the legality of the client certificate according to the client application information and the account opening intelligent contract;

if the client certificate is legal, judging the credit level of the client according to the client insurance information and the account opening intelligent contract;

and if the client credit level exceeds a preset credit level, judging the legality of the client application behavior according to the client application information and the account opening intelligent contract.

Further, the judging of insurance claims according to the basic account opening information, the insurance transaction record obtained from the commercial bank node and the intelligent claim settlement contract which is achieved with the commercial bank node and the insurance company node in advance comprises:

judging whether a trade account corresponding to the insurance transaction record has a joint insurance policy or not by using the claim settlement intelligent contract;

if so, judging whether the transaction place corresponding to the insurance transaction record is a medical institution or not by using the claim settlement intelligent contract;

if so, judging whether the transaction mechanism corresponding to the insurance claim settlement record belongs to the first insurance claim settlement category by using the claim settlement intelligent contract to obtain the insurance claim settlement judgment result.

Further, the performing reinsurance claim judgment according to the basic account opening information, the medical payment voucher acquired from the medical institution node in the block chain, and the claim settlement intelligent contract includes:

and judging whether the medical behavior corresponding to the basic account opening information belongs to a second insurance claim settlement category or not according to the medical payment voucher and the claim settlement intelligent contract.

and sending the result of the insurance claim settlement processing of the commercial bank node to a supervision agency node in the block chain, so that the supervision agency node supervises the insurance claim settlement processing process.

and encrypting and transmitting the insurance claim settlement judgment result, the reinsurance claim settlement judgment result and the result of the insurance claim settlement processing.

In a second aspect, the present application provides a block chain-based insurance claim settlement information processing method, including:

the basic account opening information generating unit is used for generating basic account opening information according to client insurance information acquired from a commercial bank node or an insurance company node in a block chain and an intelligent account opening contract which is previously achieved with the commercial bank node and the insurance company node;

the insurance claim settlement judging unit is used for judging insurance claim settlement according to the basic account opening information, the insurance transaction records acquired from the commercial bank nodes and claim settlement intelligent contracts which are previously communicated with the commercial bank nodes and the insurance company nodes;

and the claim settlement judgment result sending unit is used for sending the insurance claim settlement judgment result to the commercial bank node so as to enable the commercial bank node to carry out insurance claim settlement processing.

the secondary insurance claim settlement judging unit is used for judging secondary insurance claim settlement according to the basic account opening information, the medical payment voucher acquired from the medical institution node in the block chain and the claim settlement intelligent contract when the insurance claim settlement judging result is passed;

and the reissue claim settlement judgment result sending unit is used for sending the reissue claim settlement judgment result to the commercial bank node so as to enable the commercial bank node to carry out insurance claim settlement processing.

Further, the account opening basic information generating unit includes:

the client application condition judgment module is used for judging the client application condition according to the client application information and the account opening intelligent contract;

and the account opening basic information generating module is used for generating the account opening basic information according to the client application information and the account opening intelligent contract when the application condition is met.

Further, the client application condition judgment module comprises:

the certificate validity judging module is used for judging the validity of the client certificate according to the client insurance information and the account opening intelligent contract;

the credit rating judging module is used for judging the credit rating of the client according to the client insurance information and the account opening intelligent contract when the client certificate is legal;

and the insurance application behavior validity judging module is used for judging the validity of the insurance application behavior of the client according to the insurance application information of the client and the account opening intelligent contract when the credit level of the client exceeds a preset credit level.

Further, the insurance claim settlement judging unit includes:

the joint insurance policy judging module is used for judging whether a trade account corresponding to the insurance transaction record has a joint insurance policy by using the claim settlement intelligent contract;

the medical institution judgment module is used for judging whether the transaction place corresponding to the insurance transaction record is a medical institution or not by utilizing the claim settlement intelligent contract when the joint insurance policy exists;

and the first insurance claim settlement category judgment module is used for judging whether the transaction mechanism corresponding to the insurance transaction record belongs to a first insurance claim settlement category or not by using the claim settlement intelligent contract when the transaction mechanism is a medical mechanism, so as to obtain the insurance claim settlement judgment result.

Further, the reinsurance claim settlement judging unit is specifically configured to:

and the insurance claim settlement monitoring unit is used for sending the result of the insurance claim settlement processing performed by the commercial bank node to the monitoring mechanism node in the block chain so as to enable the monitoring mechanism node to monitor the insurance claim settlement processing process.

and the insurance claim settlement encryption unit is used for encrypting and transmitting the insurance claim settlement judgment result, the reinsurance claim settlement judgment result and the result of performing insurance claim settlement processing.

In a third aspect, the present application provides an electronic device including a memory, a processor, and a computer program stored on the memory and executable on the processor, wherein the processor implements the steps of the block chain-based insurance claim information processing method when executing the program.

In a fourth aspect, the present application provides a computer-readable storage medium, on which a computer program is stored, which, when being executed by a processor, implements the steps of the block chain-based insurance claim information processing method.

Aiming at the problems in the prior art, the insurance claim information processing method and device based on the block chain can process the insurance claim information by using the intelligent account opening contract and the intelligent claim settlement contract which are pre-achieved by the block chain information management node, the commercial bank node and the insurance company node, realize the high efficiency and the transparency of the insurance claim flow through the block chain technology, improve the efficiency of the insured to receive the insurance claim, enhance the participation degree of the commercial bank, the medical institution and the supervision institution in the insurance claim settlement process, and reduce the insurance claim information processing pressure.

Drawings

In order to more clearly illustrate the embodiments of the present invention or the technical solutions in the prior art, the drawings used in the description of the embodiments or the prior art will be briefly described below, it is obvious that the drawings in the following description are only some embodiments of the present invention, and for those skilled in the art, other drawings can be obtained according to the drawings without creative efforts.

FIG. 1 is a flowchart of a block chain-based insurance claim information processing method according to an embodiment of the present application;

FIG. 2 is a diagram of a block chain-based method for processing insurance claim information in an embodiment of the present application;

FIG. 3 is a second flowchart of a block chain-based insurance claim information processing method according to an embodiment of the present application;

FIG. 4 is a second scenario of the method for processing insurance claim settlement information based on block chains according to the embodiment of the present application;

FIG. 5 is a flowchart illustrating generating basic account opening information according to an embodiment of the present application;

FIG. 6 is a flowchart illustrating a process of determining a client application condition according to an embodiment of the present application;

FIG. 7 is a flowchart illustrating an embodiment of the present application for making insurance claim settlement decisions;

fig. 8 is one of the configuration diagrams of the block chain-based insurance claim information processing apparatus in the embodiment of the present application;

FIG. 9 is a second block diagram of an embodiment of the present application, illustrating an embodiment of an insurance claim information processing apparatus based on a block chain;

fig. 10 is a structural diagram of an account opening basic information generating unit in the embodiment of the present application;

FIG. 11 is a block diagram of a client application condition determining module according to an embodiment of the present disclosure;

FIG. 12 is a block diagram of an insurance claim settlement judging unit according to an embodiment of the present application;

fig. 13 is a schematic structural diagram of an electronic device in an embodiment of the present application;

fig. 14 is an entity scene diagram of the insurance claim settlement information processing method based on the block chain in the embodiment of the present application.

Detailed Description

The technical solutions in the embodiments of the present application will be clearly and completely described below with reference to the drawings in the embodiments of the present application, and it is obvious that the described embodiments are only a part of the embodiments of the present application, and not all of the embodiments. All other embodiments, which can be derived by a person skilled in the art from the embodiments given herein without making any creative effort, shall fall within the protection scope of the present application.

It should be noted that the method and apparatus for processing insurance claim settlement information based on a block chain provided in the present application can be used in the financial field, and can also be used in any field other than the financial field.

Fig. 14 is an entity scene diagram corresponding to the embodiment of the present application. As shown, the customer may apply insurance directly to the insurer or indirectly through a commercial bank. The insurance application can be life insurance, medical health insurance and the like, and the application is not limited to the above.

In the prior art, insurance claims are usually initiated by a customer, and the customer submits account opening information and claim application information of a claim account in an offline manual mode. Insurance companies need to collect account opening information and claim application information of claim accounts and check the information. If the audit is passed, an insurance company sends a claim settlement processing request to the commercial bank, namely, the reimbursement and payment operation is carried out. Finally, the commercial bank sends the claim money to the client to complete the claim.

But the unfamiliarity of the client to the claim settlement flow can cause the submitted materials to be irregular and incomplete, the claim settlement flow is repeated, and manpower and material resources are consumed; after the insurance company finishes auditing, the insurance company also needs to contact commercial banks to execute public-private transfer, the commercial banks do not completely master the conditions of clients, and the participation degree is low; more importantly, the process lacks a high-efficiency tamper-resistant uniform supervision mechanism, so that loopholes of the claim settlement process are frequent.

In order to solve the problems in the prior art, the application provides an insurance claim settlement information processing method based on a block chain. Its participants still include the customers, commercial banks, insurance companies, medical institutions, and regulatory agencies as shown in fig. 14. Data interaction among all the parties is carried out in the blockchain, and the property of the blockchain can be used to ensure that the insurance claim settlement processing is efficiently and safely completed, which is described in detail below.

Referring to fig. 1, in order to perform insurance claim settlement information processing by using an intelligent account opening contract and an intelligent claim settlement contract which are previously agreed with a commercial bank node and an insurance company node, the block chain-based insurance claim settlement information processing method provided by the present application includes:

s101: generating basic account opening information according to client insurance information acquired from a commercial bank node or an insurance company node in a block chain and an intelligent account opening contract which is previously achieved with the commercial bank node and the insurance company node;

s102: carrying out insurance claim settlement judgment according to the basic account opening information, the insurance transaction records obtained from the commercial bank nodes and claim settlement intelligent contracts which are previously achieved with the commercial bank nodes and the insurance company nodes;

s103: and sending the insurance claim settlement judgment result to the commercial bank node so that the commercial bank node carries out insurance claim settlement processing.

It can be understood that, referring to fig. 2, the present application constructs a blockchain insurance claim information processing platform including commercial banks and insurance companies by using blockchain technology, and deploys blockchain nodes according to each participant in the blockchain insurance claim information processing platform. The nodes include but are not limited to commercial bank nodes and insurance company nodes, and the number of the nodes is not limited in the application, and the number can be flexibly set according to actual business needs. Each node can access the block chain insurance claim settlement information processing platform through a plurality of channels such as a mobile terminal or an internal business system.

In the application scenario of the embodiment of the present application, the customer may purchase insurance through a commercial bank or an insurance company, that is, the commercial bank or the insurance company may grasp the insurance information of the customer. Such insurance information includes, but is not limited to, customer personal information profiles, customer insurance types and customer insurance contracts. In the block chain insurance claim settlement information processing platform, the commercial bank node can also master the historical transaction records of the customers, the historical transaction records comprise the insurance transaction records, and the insurance transaction records refer to the fund traffic condition of the customers in the accident occurrence/process in the insurance guarantee category.

When a customer initiates an insurance claim settlement request through a commercial bank node, the block chain insurance claim settlement information processing platform can acquire the customer insurance information and the insurance transaction record from the corresponding node, and then completes the insurance claim settlement and insurance claim settlement judgment by using an intelligent account settlement contract and an intelligent claim settlement contract which are achieved with the commercial bank node and an insurance company node, and finally sends an insurance claim settlement judgment result to the commercial bank node so as to enable the commercial bank node to carry out insurance claim settlement processing.

It should be noted that the intelligent account opening contract and the intelligent claim settlement contract are pre-agreed with the business bank node and the insurance company node on the blockchain insurance claim information processing platform, and the practical meaning of the intelligent account opening contract and the intelligent claim settlement contract is understood to be an insurance claim information processing scheme (including but not limited to generating an insurance claim information template) pre-negotiated for completing the insurance claim information processing by the three nodes. The intelligent account opening contracts and the intelligent claim settlement contracts have the general characteristic of block chain intelligent contracts.

In conclusion, the establishment of the block chain insurance claim settlement information processing platform realizes the information security sharing among the clients, the commercial bank nodes and the insurance company nodes, realizes the automatic audit operation of the insurance claim settlement, can efficiently update the client insurance information, the client medical files and the like, enhances the participation of the commercial banks in the insurance claim settlement service, improves the claim settlement efficiency and realizes the traceability of the insurance claim in the whole life cycle range.

As can be seen from the above description, the insurance claim information processing method based on the block chain according to the present application can perform insurance claim information processing by using the intelligent account opening contract and the intelligent claim settlement contract pre-established by the block chain information management node, the commercial bank node and the insurance company node, and realize high efficiency and transparency of the insurance claim process through the block chain technology, thereby improving the efficiency of the insured to receive the insurance claim, enhancing the participation of the commercial bank in the insurance claim settlement process, and reducing the processing pressure of the insurance claim information.

Referring to fig. 3, the method for processing insurance claim settlement information based on a block chain further includes:

s201: if the insurance claim settlement judgment result is passed, carrying out secondary insurance claim settlement judgment according to the basic account opening information, the medical payment voucher acquired from the medical institution node in the block chain and the claim settlement intelligent contract;

s202: and sending the judgment result of the reinsurance claim to the commercial bank node so that the commercial bank node carries out insurance claim processing.

It is to be appreciated that, referring to fig. 4, in one embodiment, the blockchain insurance claim information processing platform may further include a medical facility node. The medical institution node may master customer medical profiles including, but not limited to, medical payment vouchers. The medical payment voucher can prove the medical expense generation condition of the client at the time/in the process of the insurance. In some business scenarios, the insurance company only undertakes part of the medical expenses generated by the client during the insurance process; insurance claim settlement judgment can be carried out according to the medical payment voucher so as to determine which medical expenses can participate in claim settlement and which medical expenses cannot participate in claim settlement. However, the above examples are for illustrative purposes only, and the role of the medical payment voucher is not limited thereto, and the role thereof can be expanded according to actual business needs.

It should be noted that the insurance claim judgment in step S201 is made on the basis of the first insurance claim judgment in step S102. If the insurance claim settlement result in step S102 is a pass, in step S201, a second insurance claim settlement determination may be performed according to the basic account opening information, the medical payment voucher acquired from the medical institution node in the block chain, and the claim settlement intelligent contract. For example, when making a reinsurance claim judgment, it can be judged whether the medical expenses incurred by the customer during the treatment period are legally compliant, whether there is out-of-range abuse; alternatively, the medical expenses belong to which medical insurance categories, which can participate in insurance claims, and the like. In one embodiment, claim intelligence contracts also allow healthcare facility nodes to participate in a co-agreement.

In one embodiment, the medical facility node may also upload medical treatment processes to trigger insurance claims. After the block chain insurance claim settlement information processing platform automatically finishes auditing, the commercial bank node can provide claim settlement reimbursement service, reimbursement money is sent into a reimbursement special account opened by a customer in a commercial bank through the insurance company credit, and credit records and payment records are uploaded to the block chain insurance claim settlement information processing platform.

As can be seen from the above description, the insurance claim settlement information processing method based on the block chain provided in the present application can perform a re-insurance claim settlement judgment according to the basic account opening information, the medical payment voucher, and the claim settlement intelligent contract, and send the re-insurance claim settlement judgment result to the commercial bank node, so that the commercial bank node performs the insurance claim settlement processing.

Referring to fig. 5, generating basic account opening information according to the customer insurance information obtained from the commercial bank node or the insurance company node in the blockchain and the intelligent account opening contract previously agreed with the commercial bank node and the insurance company node, includes:

s501: judging the client application condition according to the client application information and the account opening intelligent contract;

s502: and if the client application insurance information meets the application insurance conditions, generating basic account opening information according to the client application insurance information and the intelligent account opening contract.

It is to be understood that the blockchain insurance claim information processing platform can obtain the customer insurance application information from the commercial bank node or the insurance company node.

In other words, if a customer purchases insurance through a commercial bank node, the commercial bank node may prepare and upload customer insurance application information to the blockchain insurance claim information processing platform. If the customer purchases insurance through the insurance company node, the insurance company node can prepare and upload customer insurance application information to the blockchain insurance claim information processing platform. Such customer insurance information includes, but is not limited to, customer license number, customer asset identification, customer insurance product number, and other information about the customer.

In an embodiment, the commercial bank node may further notify the insurance company node to apply for auditing of the client insurance claim, and after the insurance company node completes auditing, the commercial bank node may upload client insurance information to the block chain insurance claim information processing platform, so that the block chain insurance claim information processing platform generates basic account opening information according to the client insurance information and the account opening contract, and sends a notification to each node in the platform. The notification content includes but is not limited to a customer examination result, customer account opening information, a customer insurance product number, a customer joint name card number, a customer account opening account number and the like.

In one embodiment, the customer insurance information uploaded by the insurance company node may further include insurance claim terms, insurance purchase contracts, and the like.

The specific operation of the block chain insurance claim settlement information processing platform for generating the basic information for opening an account according to the client application information and the intelligent contract for opening an account may be that each data item in the client application information is read, and the data item required to be filled in the intelligent contract for opening an account is extracted from the client application information, so that the basic information for opening an account is generated. For example, the name, certificate number, policy number, and number of the product to be insured in the information of the client application are all filled in the corresponding data items (name, certificate number, policy number, and number of the product to be insured) in the intelligent contract for opening an account.

It should be noted that, before generating the basic information for opening an account according to the client application information and the intelligent contract for opening an account, the block chain insurance claim information processing platform needs to determine the client application condition according to the client application information and the intelligent contract for opening an account, and the specific determination logic may refer to the descriptions in steps S601 to S602. If the condition is not met, the customer can be informed of the failure of claim settlement through the commercial bank node and/or the insurance company node.

As can be seen from the above description, the insurance claim settlement information processing method based on the blockchain provided by the present application can generate basic account opening information according to the customer insurance information acquired from the commercial bank node or the insurance company node in the blockchain and the intelligent account opening contract previously agreed with the commercial bank node and the insurance company node.

Referring to fig. 6, the judgment of the client application condition according to the client application information and the account opening intelligent contract comprises:

s601: judging the legality of the client certificate according to the client application information and the account opening intelligent contract;

s602: if the client certificate is legal, judging the credit level of the client according to the client insurance information and the account opening intelligent contract;

s603: and if the credit level of the client exceeds the preset credit level, judging the legality of the client application behavior according to the client application information and the account opening intelligent contract.

It is understood that, in one embodiment, the intelligent contract for opening an account may be provided by the commercial bank node and agreed with the blockchain insurance claim information processing platform and the insurance company node in advance. The block chain insurance claim settlement information processing platform can be combined with client information acquired by a legal channel to judge the legality of the client certificate according to the client insurance information and an account opening intelligent contract. The credit condition of the client can be known by the commercial bank node and also can be known by the insurance company node. For example, a customer can always pay a premium on schedule, the fund situation is sufficient, and at the same time, there is no illegal violation record, and the credit rating of the customer is relatively high. The block chain insurance claim settlement information processing platform can preset a client credit rating threshold, and if the client credit rating exceeds the preset credit rating threshold, the next judgment can be carried out, namely the legality of the client application behavior is judged according to the client application information and the account opening intelligent contract. For example, the validity of the customer insurance application behavior may be understood as whether the customer hides from the personal medical history when purchasing insurance, and of course, the validity of the customer insurance application behavior is determined not only by this, which is merely an example, and the specific determination rule may be flexibly set according to the actual business scenario.

From the above description, the insurance claim settlement information processing method based on the block chain can judge the client insurance application condition according to the client insurance application information and the account opening intelligent contract.

Referring to fig. 7, the insurance claim settlement judgment is performed according to the basic account opening information, the insurance transaction record obtained from the commercial bank node and the intelligent claim settlement contract which is previously agreed with the commercial bank node and the insurance company node, and includes:

s701: judging whether a trade account corresponding to the insurance trade record has a joint insurance policy or not by using the claim settlement intelligent contract;

s702: if so, judging whether the transaction place corresponding to the insurance transaction record is a medical institution or not by using the claim settlement intelligent contract;

s703: if so, judging whether the transaction mechanism corresponding to the insurance transaction record belongs to the first insurance claim category by using the claim settlement intelligent contract to obtain an insurance claim settlement judgment result.

It is understood that in one embodiment, the claim intelligence contract may be provided by an insurance company node and agreed with the blockchain insurance claim information processing platform and the commercial bank node in advance. The claim settlement intelligent contract can include, but is not limited to, a customer insurance product number, a customer insurance period, a customer insurance cool period, a claim range (including which), a claim range (not including which), a customer violation term, an insurance claim scheme, and an insurance claim applicable condition.

In one embodiment, after the commercial bank node uploads the insurance transaction record, an intelligent contract for claim settlement can be triggered to perform insurance claim settlement judgment. The block chain insurance claim settlement information processing platform can compare the actual medical payment behaviors according to the customer co-branded card number, the customer insurance product number, the transaction place, the transaction MCC, the insurance product type, the insurance period, the exception terms and the like contained in the claim settlement intelligent contract, and automatically settle the claim.

The specific judgment logic may be that whether the trade account corresponding to the insurance trade record has the joint insurance policy is judged first. The application scenario corresponding to this step may be that the customer uses a certain joint-name bank card corresponding to the policy to perform medical payment in the medical institution. That is, the bank card for medical payment in the medical institution has a joint insurance policy. If the joint insurance policy exists, judging whether the transaction place corresponding to the insurance transaction record is a medical institution or not by using the claim settlement intelligent contract. The application scenario corresponding to this step may be that although the customer uses the bank card, the transaction place may be a supermarket rather than a medical institution, which may cause a claim settlement failure. If the transaction record is the medical institution, whether the transaction institution corresponding to the insurance transaction record is the medical institution specified in the insurance purchase contract or not can be judged, namely whether the transaction institution belongs to the first insurance claim settlement category or not. In the above judgment logic, if any judgment result is "no", the judgment result of the insurance claim may be "deny the claim". Of course, the specific judgment condition can be flexibly set according to the actual service scene.

As can be seen from the above description, the insurance claim settlement information processing method based on the block chain according to the present application can determine insurance claims according to the basic account opening information, the insurance transaction record obtained from the commercial bank node, and the claim settlement intelligent contract previously reached by the commercial bank node and the insurance company node.

In one embodiment, the re-insurance claim settlement judgment is performed according to the basic account opening information, the medical payment voucher acquired from the medical institution node in the block chain and the claim settlement intelligent contract, and includes: and judging whether the medical behavior corresponding to the basic information for opening an account belongs to the second insurance claim category or not according to the medical payment voucher and the claim settlement intelligent contract.

It is understood that the understanding of the second insurance claim category can be exemplified with reference to the explanations in steps S201 to S202.

As can be seen from the above description, the insurance claim settlement information processing method based on the block chain provided by the application can perform the second insurance claim settlement judgment according to the basic account opening information, the medical payment voucher acquired from the medical institution node in the block chain, and the claim settlement intelligent contract.

In one embodiment, the insurance claim settlement information processing method based on the block chain further includes:

It is to be understood that the blockchain insurance claim information processing platform may also include a regulatory agency node. The supervision organization node can acquire process data and result data of each claim settlement processing of the block chain insurance claim settlement information processing platform, and stores the data by utilizing the non-tampering characteristic of the block chain technology so as to supervise the insurance claim settlement processing process, thereby ensuring the disclosure and transparency of the insurance claim settlement process.

As can be seen from the above description, the block chain-based insurance claim information processing method provided in the present application can send the result of the insurance claim processing performed by the commercial bank node to the administrative department node in the block chain, so that the administrative department node supervises the insurance claim processing process.

It is understood that, in an embodiment, the data such as the basic information of the account opening and the judgment result of the insurance claim need to be notified to each node related party (including the business bank node, the insurance company node, the medical institution node and the monitoring institution node) in the blockchain insurance claim information processing platform through the message notification module. Sometimes, the insurance company node also needs to upload the client insurance information to the block chain insurance claim settlement information processing platform or feed back the account opening result (client review result, account opening information, insurance application number and joint number information) to the commercial bank node and the client.

When data security transmission needs exist, the embodiment of the application can utilize the security characteristic of the block chain technology to realize data encryption transmission and access the data with limited authority. The permissions can be flexibly set according to actual service scenes. The execution subject of the data encryption transmission can be an information encryption module in the blockchain insurance claim settlement information processing platform.

As can be seen from the above description, the insurance claim information processing method based on the block chain according to the present application can encrypt and transmit the insurance claim judgment result, the reinsurance claim judgment result, and the result of performing the insurance claim processing.

Based on the same inventive concept, the embodiment of the present application further provides an insurance claim settlement information processing apparatus based on a block chain, which can be used to implement the method described in the foregoing embodiment, as described in the following embodiment. Because the principle of solving the problem of the block chain-based insurance claim information processing device is similar to the block chain-based insurance claim information processing method, the implementation of the block chain-based insurance claim information processing device can refer to the implementation of the software performance standard determination method, and repeated details are omitted. As used hereinafter, the term "unit" or "module" may be a combination of software and/or hardware that implements a predetermined function. While the system described in the embodiments below is preferably implemented in software, implementations in hardware, or a combination of software and hardware are also possible and contemplated.

In an embodiment, referring to fig. 8, in order to perform insurance claim information processing by using an intelligent account opening contract and an intelligent claim settlement contract which are pre-agreed with a commercial bank node and an insurance company node, the present application provides a block chain-based insurance claim information processing method, including: an account opening basic information generating unit 801, an insurance claim settlement judging unit 802, and a claim settlement judging result transmitting unit 803.

An account opening basic information generating unit 801, configured to generate account opening basic information according to customer insurance information acquired from a commercial bank node or an insurance company node in a block chain and an account opening intelligent contract which is achieved with the commercial bank node and the insurance company node in advance;

an insurance claim settlement judging unit 802, configured to judge an insurance claim settlement according to the basic account opening information, the insurance transaction record obtained from the commercial bank node, and a claim settlement intelligent contract which is pre-agreed with the commercial bank node and the insurance company node;

the claim settlement result sending unit 803 is configured to send the insurance claim settlement result to the commercial bank node, so that the commercial bank node performs insurance claim settlement processing.

In an embodiment, referring to fig. 9, the method for processing insurance claim settlement information based on a block chain further includes: a reinsurance claim settlement judging unit 901 and a reimbursement claim settlement judging result transmitting unit 902.

A reinsurance claim settlement unit 901, configured to, when the insurance claim settlement result is passed, perform a reinsurance claim settlement judgment according to the basic account opening information, the medical payment credentials obtained from the medical institution nodes in the block chain, and the claim settlement intelligent contract;

a reissue claim settlement judgment result sending unit 902, configured to send the reissue claim settlement judgment result to the commercial bank node, so that the commercial bank node performs claim settlement processing.

In an embodiment, referring to fig. 10, the basic account opening information generating unit 801 includes: a client insurance application condition judging module 1001 and an account opening basic information generating module 1002.

A client application condition judgment module 1001, configured to judge a client application condition according to the client application information and the account opening intelligent contract;

and an account opening basic information generating module 1002, configured to generate the account opening basic information according to the client application information and the account opening intelligent contract when the application condition is met.

In an embodiment, referring to fig. 11, the client application condition determining module 1001 includes: a certificate validity judging module 1101, a credit level judging module 1102 and an insurance application validity judging module 1103.

The certificate validity judging module 1101 is used for judging the validity of the client certificate according to the client insurance information and the account opening intelligent contract;

the credit rating judgment module 1102 is used for judging the credit rating of the client according to the client insurance information and the account opening intelligent contract when the client certificate is legal;

and the insurance application behavior validity judging module 1103 is used for judging the validity of the insurance application behavior of the client according to the insurance application information of the client and the account opening intelligent contract when the credit level of the client exceeds the preset credit level.

In an embodiment, referring to fig. 12, the insurance claim settlement unit 802 includes: a joint insurance policy judging module 1201, a medical institution judging module 1202 and a first insurance claim category judging module 1203.

A joint insurance policy judging module 1201, configured to judge whether a trade account corresponding to the insurance transaction record has a joint insurance policy by using the claim settlement intelligent contract;

the medical institution judgment module 1202 is configured to judge whether the transaction place corresponding to the insurance issue transaction record is a medical institution by using the claim settlement intelligent contract when a joint insurance policy exists;

the first insurance claim settlement category determining module 1203 is configured to, when the medical institution is the insurance institution, determine, by using the claim settlement intelligent contract, whether the transaction institution corresponding to the insurance claim settlement record belongs to a first insurance claim settlement category, and obtain the insurance claim settlement determination result.

In an embodiment, the reinsurance claim determining unit 901 is specifically configured to:

In an embodiment, the method for processing insurance claim settlement information based on a block chain further includes:

In terms of hardware, in order to process insurance claim information by using an intelligent account opening contract and an intelligent claim settlement contract which are pre-agreed with a commercial bank node and an insurance company node, the present application provides a block chain-based insurance claim information processing method, and the present application provides an embodiment of an electronic device for implementing all or part of the contents of the block chain-based insurance claim information processing method, where the electronic device specifically includes the following contents:

a Processor (Processor), a Memory (Memory), a communication Interface (Communications Interface) and a bus; the processor, the memory and the communication interface complete mutual communication through the bus; the communication interface is used for realizing information transmission between the block chain-based insurance claim settlement information processing device and relevant equipment such as a core service system, a user terminal and a relevant database; the logic controller may be a desktop computer, a tablet computer, a mobile terminal, and the like, but the embodiment is not limited thereto. In this embodiment, the logic controller may refer to the embodiment of the method for processing insurance claim information based on a block chain and the embodiment of the apparatus for processing insurance claim information based on a block chain in the embodiment, and the contents thereof are incorporated herein, and repeated details are not repeated.

It is understood that the user terminal may include a smart phone, a tablet electronic device, a network set-top box, a portable computer, a desktop computer, a Personal Digital Assistant (PDA), an in-vehicle device, a smart wearable device, and the like. Wherein, intelligence wearing equipment can include intelligent glasses, intelligent wrist-watch, intelligent bracelet etc..

In practical applications, part of the insurance claim settlement information processing method based on the block chain may be executed on the electronic device side as described above, or all operations may be completed in the client device. The selection may be specifically performed according to the processing capability of the client device, the limitation of the user usage scenario, and the like. This is not a limitation of the present application. The client device may further include a processor if all operations are performed in the client device.

The client device may have a communication module (i.e., a communication unit), and may be in communication connection with a remote server to implement data transmission with the server. The server may include a server on the side of the task scheduling center, and in other implementation scenarios, the server may also include a server on an intermediate platform, for example, a server on a third-party server platform that is communicatively linked to the task scheduling center server. The server may include a single computer device, or may include a server cluster formed by a plurality of servers, or a server structure of a distributed apparatus.

Fig. 13 is a schematic block diagram of a system configuration of an electronic device 9600 according to an embodiment of the present application. As shown in fig. 13, the electronic device 9600 can include a central processor 9100 and a memory 9140; the memory 9140 is coupled to the central processor 9100. Notably, this fig. 13 is exemplary; other types of structures may also be used in addition to or in place of the structure to implement telecommunications or other functions.

In one embodiment, the block chain based insurance claim information processing method functions may be integrated into the central processor 9100. The central processor 9100 may be configured to control as follows:

s103: and sending the insurance claim settlement judgment result to the commercial bank node so as to enable the commercial bank node to carry out insurance claim settlement processing.

As can be seen from the above description, the insurance claim information processing method based on the block chain according to the present application can perform insurance claim information processing by using the intelligent account opening contract and the intelligent claim settlement contract pre-established by the block chain information management node, the commercial bank node and the insurance company node, and realize high efficiency and transparency of the insurance claim process through the block chain technology, thereby improving the efficiency of the insured to receive the insurance claim, enhancing the participation of the commercial bank, the medical institution and the monitoring institution in the insurance claim settlement process, and reducing the processing pressure of the insurance claim information.

In another embodiment, the insurance claim information processing apparatus based on the block chain may be configured separately from the central processor 9100, for example, the insurance claim information processing apparatus based on the block chain of the data composite transmission apparatus may be configured as a chip connected to the central processor 9100, and the functions of the insurance claim information processing method based on the block chain may be implemented by the control of the central processor.

As shown in fig. 13, the electronic device 9600 may further include: a communication module 9110, an input unit 9120, an audio processor 9130, a display 9160, and a power supply 9170. It is noted that the electronic device 9600 also does not necessarily include all of the components shown in fig. 13; in addition, the electronic device 9600 may further include components not shown in fig. 13, which can be referred to in the prior art.

As shown in fig. 13, a central processor 9100, sometimes referred to as a controller or operational control, can include a microprocessor or other processor device and/or logic device, which central processor 9100 receives input and controls the operation of the various components of the electronic device 9600.

The memory 9140 can be, for example, one or more of a buffer, a flash memory, a hard drive, a removable media, a volatile memory, a non-volatile memory, or other suitable device. The information relating to the failure may be stored, and a program for executing the information may be stored. And the central processing unit 9100 can execute the program stored in the memory 9140 to realize information storage or processing, or the like.

The input unit 9120 provides input to the central processor 9100. The input unit 9120 is, for example, a key or a touch input device. Power supply 9170 is used to provide power to electronic device 9600. The display 9160 is used for displaying display objects such as images and characters. The display may be, for example, an LCD display, but is not limited thereto.

The memory 9140 can be a solid state memory, e.g., Read Only Memory (ROM), Random Access Memory (RAM), a SIM card, or the like. There may also be a memory that holds information even when power is off, can be selectively erased, and is provided with more data, an example of which is sometimes called an EPROM or the like. The memory 9140 could also be some other type of device. Memory 9140 includes a buffer memory 9141 (sometimes referred to as a buffer). The memory 9140 may include an application/function storage portion 9142, the application/function storage portion 9142 being used for storing application programs and function programs or for executing a flow of operations of the electronic device 9600 by the central processor 9100.

The memory 9140 can also include a data store 9143, the data store 9143 being used to store data, such as contacts, digital data, pictures, sounds, and/or any other data used by an electronic device. The driver storage portion 9144 of the memory 9140 may include various drivers for the electronic device for communication functions and/or for performing other functions of the electronic device (e.g., messaging applications, contact book applications, etc.).

The communication module 9110 is a transmitter/receiver 9110 that transmits and receives signals via an antenna 9111. The communication module (transmitter/receiver) 9110 is coupled to the central processor 9100 to provide input signals and receive output signals, which may be the same as in the case of a conventional mobile communication terminal.

Based on different communication technologies, a plurality of communication modules 9110, such as a cellular network module, a bluetooth module, and/or a wireless lan module, may be disposed in the same electronic device. The communication module (transmitter/receiver) 9110 is also coupled to a speaker 9131 and a microphone 9132 via an audio processor 9130 to provide audio output via the speaker 9131 and receive audio input from the microphone 9132, thereby implementing ordinary telecommunications functions. The audio processor 9130 may include any suitable buffers, decoders, amplifiers and so forth. In addition, the audio processor 9130 is also coupled to the central processor 9100, thereby enabling recording locally through the microphone 9132 and enabling locally stored sounds to be played through the speaker 9131.

An embodiment of the present application further provides a computer-readable storage medium capable of implementing all the steps in the block chain based insurance claim information processing method of which the execution subject is the server or the client in the above embodiments, where the computer-readable storage medium stores a computer program, and when the computer program is executed by a processor, the computer program implements all the steps in the block chain based insurance claim information processing method of which the execution subject is the server or the client in the above embodiments, for example, when the processor executes the computer program, the processor implements the following steps:

As will be appreciated by one skilled in the art, embodiments of the present invention may be provided as a method, apparatus, or computer program product. Accordingly, the present invention may take the form of an entirely hardware embodiment, an entirely software embodiment or an embodiment combining software and hardware aspects. Furthermore, the present invention may take the form of a computer program product embodied on one or more computer-usable storage media (including, but not limited to, disk storage, CD-ROM, optical storage, and the like) having computer-usable program code embodied therein.

The present invention is described with reference to flowchart illustrations and/or block diagrams of methods, apparatus (devices), and computer program products according to embodiments of the invention. It will be understood that each flow and/or block of the flow diagrams and/or block diagrams, and combinations of flows and/or blocks in the flow diagrams and/or block diagrams, can be implemented by computer program instructions. These computer program instructions may be provided to a processor of a general purpose computer, special purpose computer, embedded processor, or other programmable data processing apparatus to produce a machine, such that the instructions, which execute via the processor of the computer or other programmable data processing apparatus, create means for implementing the functions specified in the flowchart flow or flows and/or block diagram block or blocks.

These computer program instructions may also be stored in a computer-readable memory that can direct a computer or other programmable data processing apparatus to function in a particular manner, such that the instructions stored in the computer-readable memory produce an article of manufacture including instruction means which implement the function specified in the flowchart flow or flows and/or block diagram block or blocks.

These computer program instructions may also be loaded onto a computer or other programmable data processing apparatus to cause a series of operational steps to be performed on the computer or other programmable apparatus to produce a computer implemented process such that the instructions which execute on the computer or other programmable apparatus provide steps for implementing the functions specified in the flowchart flow or flows and/or block diagram block or blocks.

The principle and the implementation mode of the invention are explained by applying specific embodiments in the invention, and the description of the embodiments is only used for helping to understand the method and the core idea of the invention; meanwhile, for a person skilled in the art, according to the idea of the present invention, there may be variations in the specific embodiments and the application scope, and in summary, the content of the present specification should not be construed as a limitation to the present invention.

Claims

1. An insurance claim settlement information processing method based on a block chain is characterized by comprising the following steps:

2. The block chain-based insurance claim information processing method according to claim 1, further comprising:

3. The method for processing insurance claim settlement information based on a blockchain according to claim 1, wherein the generating of basic information for making an account according to customer insurance information acquired from a commercial bank node or an insurance company node in the blockchain and an intelligent contract for making an account previously agreed with the commercial bank node and the insurance company node comprises:

4. The block chain-based insurance claim settlement information processing method according to claim 3, wherein the judgment of the client application condition according to the client application information and the account opening intelligent contract comprises:

5. The block chain-based insurance claim information processing method according to claim 1, wherein the insurance claim judgment according to the basic account opening information, the insurance transaction record obtained from the commercial bank node and the intelligent claim settlement contract agreed with the commercial bank node and the insurance company node in advance comprises:

6. The insurance claim settlement information processing method based on the block chain according to claim 2, wherein the judgment of re-insurance claim settlement according to the basic account opening information, the medical payment voucher acquired from the medical institution node in the block chain and the claim settlement intelligent contract comprises:

7. The block chain-based insurance claim information processing method according to claim 1, further comprising:

8. The block chain-based insurance claim information processing method according to claim 7, further comprising:

9. An insurance claim settlement information processing apparatus based on a block chain, comprising:

10. The block chain-based insurance claim information processing apparatus according to claim 9, further comprising:

11. The block chain-based insurance claim information processing apparatus according to claim 9, wherein the account opening basic information generating unit includes:

12. The block chain-based insurance claim information processing apparatus according to claim 9, wherein the insurance claim judgment unit includes:

13. An electronic device comprising a memory, a processor and a computer program stored on the memory and executable on the processor, wherein the processor when executing the program implements the steps of the block chain based insurance claim information processing method of any one of claims 1 to 8.

14. A computer-readable storage medium, on which a computer program is stored, which, when being executed by a processor, implements the steps of the block chain-based insurance claim information processing method according to any one of claims 1 to 8.