KR20230046821A - Insurance requesting method and system that can be claimed only with consent to use insurance claim data - Google Patents

Abstract

The present invention relates to a cloud-based insurance claim method. The cloud-based insurance claim method includes: a step in which when receiving an insurance company access token issue request from an insurance company server, a cloud server generates an insurance company access token to issue the generated access token to an insurance company server; a step in which when requested for an insurance claim by a user, a user terminal transmits user information to the cloud server, and the cloud server performs user authentication, and, when the authentication is successful, requests a hospital server for user treatment data; a step in which the hospital server checks the user authentication and the treatment data about the user, and transmits proof information of the user in accordance with the checked result; a step in which the cloud server receives the proof information of the user and registers an insurance claim document, and, when the registration of the insurance claim document is completed, transmits a notification to the user terminal; and a step in which the cloud server generates an access token for the insurance claim document, and transmits an invoice including the access token for the insurance claim document to the insurance company server. In accordance with the present invention, unlike a method in which a patient needs to file an insurance claim by sending a prescription, a receipt, and the like to an insurance company, an approved insurance company accesses the cloud server storing documents necessary for insurance claims and pulls the documents to handle the claims, thereby enabling a more convenient insurance claim without causing an omission.

Description

Insurance requesting method and system that can be claimed only with consent to use insurance claim data}

The present invention relates to a cloud-based indemnity insurance claim method and system in which claims can be made only by consent to use insurance claim data. It relates to a cloud-based loss insurance claim method and system that allows users to easily claim loss insurance simply by agreeing to use insurance claim data without submitting documents to the insurance company server.

Indemnity medical insurance is a health insurance that guarantees the amount actually borne by the insured person for medical expenses in case of hospitalization or outpatient treatment due to illness or injury. In general, in order for an insurance subscriber to claim insurance money, the insurance subscriber visits hospitals, clinics, and pharmacies, receives various evidentiary documents such as medical bills, medical certificates, prescriptions, and prescription drug charge receipts, and then faxes or mails them to the insurance company.

As of 2015, there are 230,000 overlapping subscribers who subscribed to two or more indemnity insurance, and each indemnity insurance subscribed has different guaranteed items, so it is cumbersome for patients to check each one individually, so many insurers can receive insurance money. However, insurance claims are not being made.

As for the prior patent, there is Registered Patent No. 10-2139180 (Cloud-based Actual Loss Medical Expense Insurance Claim System and Method), but through standardized API, EDI data for insurance claim regardless of the type of development language and heterogeneous DBMS of the medical institution server. It only discloses the technology for generating .

The problem to be solved by the present invention is a cloud-based loss insurance claim that allows only the approved insurance company server to access the document for loss insurance claim stored in the cloud server, so that the patient can easily claim loss insurance without the need to directly submit documents to the insurance company server. It is to provide an insurance claim method and system.

A cloud-based indemnity insurance claim method according to an embodiment of the present invention includes, when a cloud server receives a request for issuing an insurance company access token from an insurance company server, generating an insurance company access token and issuing the generated access token to the insurance company server; When the user terminal receives a real-life insurance claim request from the user, the user information is transmitted to the cloud server, and when the cloud server performs user authentication and the authentication is successful, the step of requesting the user's medical treatment data to the hospital server; Verifying authentication and medical treatment data for the user, and transmitting the user's proof information according to the confirmation result to the cloud server, the cloud server receiving the user's proof information, registering the real-life insurance claim document, and real-life insurance Sending a notification to the user terminal when the claim document registration is complete, generating an access token for the loss insurance claim document by the cloud server, and transmitting the bill including the access token for the loss insurance claim document to the insurance company server. includes

The cloud-based indemnity insurance claim system according to an embodiment of the present invention, when receiving a request for indemnity insurance from a user, a user terminal that transmits user information to a cloud server, and a request for issuance of an insurance company access token from an insurance company server, an insurer Generates an access token, issues the generated access token to the insurance company server, receives the user's proof information from the hospital server, registers the indemnity insurance claim document, and sends a notification to the user terminal when the indemnity insurance claim document registration is completed , A cloud server that generates an access token for a real-life insurance claim document and transmits a bill including an access token for a real-life insurance claim document to an insurance company server, and upon receiving a request for user medical data from the cloud server, user authentication and user The hospital server that checks the medical treatment data for and transmits the user's proof information to the cloud server according to the confirmation result, and the cloud server with approval using the insurance company access token and the actual loss insurance claim document access token issued from the cloud server and an insurance company server that receives a loss insurance claim document from

According to the present invention, rather than a method in which the patient sends a prescription, receipt, etc. to the insurance company to claim loss insurance, the approved insurance company accesses the cloud server where the documents necessary for claiming loss insurance are stored and takes the documents necessary for claiming loss insurance ( By processing pull), it is possible to file a loss insurance claim more conveniently and without omission.

In addition, patients and insurers can use cloud-based insurance claim data anytime, anywhere.

In addition, it is not necessary for the patient to check whether the actual loss insurance he or she subscribes to can be claimed, and it is not necessary to separately prepare necessary documents for each insurance company, so it is possible to make a claim easily.

1 is a flowchart illustrating a cloud-based real-life insurance claim method according to an embodiment of the present invention.
2 is a block diagram illustrating a cloud-based indemnity insurance claim system according to an embodiment of the present invention.

Specific structural or functional descriptions of the embodiments according to the concept of the present invention disclosed in this specification are only illustrated for the purpose of explaining the embodiments according to the concept of the present invention, and the embodiments according to the concept of the present invention may be embodied in many forms and are not limited to the embodiments described herein.

Embodiments according to the concept of the present invention can apply various changes and can have various forms, so the embodiments are illustrated in the drawings and described in detail in this specification. However, this is not intended to limit the embodiments according to the concept of the present invention to specific disclosed forms, and includes all modifications, equivalents or substitutes included in the spirit and scope of the present invention.

Terms used in this specification are only used to describe specific embodiments, and are not intended to limit the present invention. Singular expressions include plural expressions unless the context clearly dictates otherwise. In this specification, terms such as "comprise" or "having" are intended to indicate that there is a feature, number, step, operation, component, part, or combination thereof described in this specification, but one or more other features It should be understood that it does not preclude the possibility of the presence or addition of numbers, steps, operations, components, parts, or combinations thereof.

Hereinafter, embodiments of the present invention will be described in detail with reference to the accompanying drawings.

1 is a flowchart illustrating a cloud-based real-life insurance claim method according to an embodiment of the present invention.

Referring to FIG. 1, in the cloud-based indemnity insurance claim method, when the cloud server 100 first receives a request for issuing an insurance company access token from the insurance company server 400 (S101), the cloud server 100 checks whether the insurance company is accessible Afterwards, an insurance company access token (IT) is generated (S103), and the insurance company access token generated is issued to the insurance company server (S105). The insurance company access token is a token for identifying whether the insurance company server 400 is an accessible insurance company so as to be able to bring documents necessary for an actual loss insurance claim from the cloud server 100 .

When the user terminal 200 receives a request for an actual loss insurance claim from the user (S107), the user terminal 200 transmits user information to the cloud server 100 (S109). At this time, the user information includes not only the unique ID of the patient, but also content agreeing to use of insurance claim data.

The cloud server 100 performs user authentication (S111), and if the authentication is successful, requests the user's medical treatment data to the hospital server 300 (S113).

The hospital server 300 verifies user authentication and medical treatment data for the user (S115), and transmits the user's proof information according to the confirmation result to the cloud server (S117). The user's proof information may be one of various certification information related to medical treatment, such as a bill, a receipt for medical expenses, a detailed statement of medical expenses, a prescription, and a medical certificate.

The cloud server 100 receives the user's proof information and registers a loss insurance claim document (S119). The cloud server 100 may register original authentication information for the user's authentication information. The cloud server 100 transmits a notification to the user terminal when the actual loss insurance claim document registration is completed (S121).

The cloud server 100 generates an access token (DT) for the real-life insurance claim document (S123) and transmits the bill including the access token (DT) for the real-life insurance claim document to the insurance company server (S125).

The insurance company server 400 requests an actual loss insurance claim document to the cloud server through the insurance company access token (IT) and the indemnity insurance claim document access token (DT) issued from the cloud server 100 (S127).

The cloud server 100 identifies the insurance company access token (IT) and loss insurance claim document access token (DT) received from the insurance company server, and determines whether or not the insurance company is approved and whether the document is accessible (S129). ).

The cloud server transmits the indemnity insurance claim document to the approved insurance company server (S131).

That is, the present invention is not a method in which the patient transmits a prescription, receipt, etc. to the insurance company to claim loss insurance, but the approved insurance company accesses the cloud server where the documents necessary for the loss insurance claim are stored and takes the documents necessary for the loss insurance claim By processing, it may be possible to file a loss insurance claim more conveniently and without omission.

2 is a block diagram illustrating a cloud-based indemnity insurance claim system according to an embodiment of the present invention.

Referring to FIG. 2 , the indemnity insurance claim system 10 is composed of a cloud server 100 , a user terminal 200 , a hospital server 300 , and a plurality of insurance company servers 400 .

The cloud server 100 issues an insurance company access token and an access token for an actual loss insurance claim document to the insurance company server 400, and when the insurance company server 400 requests access to the actual loss insurance claim document, the corresponding token is identified and approved. can do.

When the user terminal 200 receives an actual loss insurance claim request from the user, it may transmit user information to the cloud server. When the insurance company server 400 requests execution of a loss insurance claim, it may determine whether or not to proceed with a loss insurance claim by confirming the request of the corresponding insurance company.

Upon receiving a request for user medical treatment data from the cloud server, the hospital server 300 may verify user authentication and medical treatment data for the user, and transmit user identification information to the cloud server according to the verification result.

The insurance company server 400 may use the insurance company access token and the loss insurance claim document access token issued from the cloud server to receive approval and receive the loss insurance claim document from the cloud server. Inability to access billing documents.

The cloud server 100 includes a token generation unit 110, a user authentication unit 120, an authentication information receiving unit 130, a document registration unit 140, a notification unit 150, a token authentication unit 160, a storage unit ( 170), a communication unit 180, and a control unit 190.

The token generation unit 110 may generate and issue an insurance company access token (IT) when receiving a request for issuance of an access token from the insurance company server 400 for authentication of the insurance company's access. When the actual loss insurance claim document is registered in the document register, the token generation unit 110 may generate an access token DT for the actual loss insurance claim document. The generated loss insurance claim document access token may be included in the claim form and transmitted to the insurance company server 400 .

When a loss insurance claim is requested from the user terminal and user information is received, the user authentication unit 120 may check the user information and perform authentication whether the user is capable of making a loss insurance claim.

The proof information receiver 130 may receive user proof information including at least one of a bill, a receipt for medical expenses, a detailed statement of medical expenses, a prescription, and a medical certificate from the hospital server 300 .

The document registration unit 140 may receive user verification information received from the hospital server 300 and register it as a document for an actual loss insurance claim. The document registration unit 140 may register patient user's subscribed insurance company information and actual loss insurance claim data.

The notification unit 150 may send a notification to the user terminal when the registration of the actual loss insurance claim document is completed.

The token authentication unit 160 receives an insurance company access token (IT) and an actual loss insurance claim document access token (DT) from the insurance company server 400 and performs authentication. Document access is allowed only when both the insurance company access token (IT) and the loss insurance claim document access token (DT) match.

The storage unit 170 stores the user authentication information received from the hospital server and registers original authentication. The storage unit 170 may store EDI including the digital signature of each hospital of the user and store user information received from the user terminal.

The communication unit 180 may transmit and receive data with the user terminal 200, the hospital server 300, and the insurance company server 400 through wired and wireless communication modules.

The controller 190 is equipped with operating software to control each configuration of the cloud server.

Although the present invention has been described with reference to the embodiments shown in the drawings, this is only exemplary, and those skilled in the art will understand that various modifications and equivalent other embodiments are possible therefrom. Therefore, the true technical protection scope of the present invention should be determined by the technical spirit of the attached claims.

10; Loss Insurance Claim System
100; cloud server 110; token generation unit
120; User authentication unit 130; Evidence Information Receiving Unit
140; document register 150; notification
160; Token authentication unit 170; storage
180; communication unit 190; control unit
200; User terminal 300; hospital server
400; Insurance company server

Claims (5)

In the cloud-based indemnity insurance claim method,
(a) generating an insurance company access token and issuing the generated access token to the insurance company server when the cloud server receives a request for issuing an insurance company access token from the insurance company server;
(b) when the user terminal receives a real-life insurance claim request from the user, transmitting user information to the cloud server, and when the cloud server performs user authentication and authentication is successful, requesting user medical data from the hospital server;
(c) the hospital server confirming the user authentication and medical treatment data for the user, and transmitting the user's authentication information according to the confirmation result to the cloud server;
(d) the cloud server receiving the user's proof information, registering the real-life insurance claim document, and sending a notification to the user terminal when the real-life insurance claim document registration is complete;
(e) A cloud-based real-life insurance claim method comprising the steps of a cloud server generating an access token for a real-life insurance claim document and transmitting a bill including the access token for a real-life insurance claim document to an insurance company server.
According to claim 1,
(f) A cloud-based real-life insurance claim method further comprising the step of the insurance company server requesting a real-life insurance claim document to the cloud server through the insurance company access token and the real-life insurance claim document access token issued from the cloud server.
According to claim 2,
(g) A cloud-based real-life insurance claim method further comprising the cloud server identifying the insurance company access token and the real-life insurance claim document access token received from the insurance company server and determining whether to approve it.
According to claim 3,
(h) A cloud-based real-life insurance claim method, further comprising the step of the cloud server transmitting the indemnity insurance claim document to the approved insurance company server, and the unauthorized insurer server is inaccessible.
In the cloud-based real-life insurance claim system,
When receiving a request for an actual loss insurance claim from the user, the user terminal for transmitting user information to the cloud server;
Upon receipt of a request for issuance of an insurance company access token from the insurance company server, an insurance company access token is generated and the generated access token is issued to the insurance company server, the user's proof information is received from the hospital server, a loss insurance claim document is registered, and a loss insurance claim document is registered. A cloud server that sends a notification to the user terminal when the claim document registration is complete, generates an access token for the real-life insurance claim document, and transmits the bill including the access token for the real-life insurance claim document to the insurance company server;
a hospital server that, upon receiving a request for user medical treatment data from the cloud server, verifies user authentication and medical treatment data for the user, and transmits user identification information according to the verification result to the cloud server; and
A cloud-based real-life insurance claim system that includes an insurance company server that receives a real-life insurance claim document from the cloud server after receiving approval using the insurance company access token and the real-life insurance claim document access token issued from the cloud server.

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