TWM574294U - Intelligent claim system based on mobile carrier - Google Patents

Intelligent claim system based on mobile carrier Download PDF

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Publication number
TWM574294U
TWM574294U TW107213789U TW107213789U TWM574294U TW M574294 U TWM574294 U TW M574294U TW 107213789 U TW107213789 U TW 107213789U TW 107213789 U TW107213789 U TW 107213789U TW M574294 U TWM574294 U TW M574294U
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cloud
module
communication unit
server
data
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TW107213789U
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Chinese (zh)
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林修德
劉順鐘
蔡秉翰
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南山人壽保險股份有限公司
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Publication of TWM574294U publication Critical patent/TWM574294U/en

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Abstract

本創作係關於一種基於行動載具之智能理賠系統,其包括行動終端設備、雲端解析伺服器及保險理賠伺服器,其中行動終端設備包括影像擷取模組、印信處理模組、字元辨識模組以及行動通訊模組;而雲端解析伺服器包括雲端通訊單元、雲端儲存單元以及雲端處理單元;以及保險理賠伺服器包括理賠通訊單元、理賠儲存單元及理賠處理單元用以產生關於保單之應理賠結果及應理賠金額。 The present invention relates to an intelligent claim system based on a mobile vehicle, which includes a mobile terminal device, a cloud parsing server, and an insurance claim server. The mobile terminal device includes an image capturing module, a printing processing module, and a character recognition module. a group and a mobile communication module; and the cloud parsing server includes a cloud communication unit, a cloud storage unit, and a cloud processing unit; and the insurance claim server includes a claims communication unit, a claim storage unit, and a claims processing unit for generating a claim for the policy The result and the amount of the claim.

Description

一種基於行動載具之智能理賠系統 An intelligent claim system based on mobile vehicles

本創作係關於一種自助式智能保險理賠系統,保戶可透過行動裝置自動辨識紙本文件之文字內容,同時鑑識其真偽,並由雲端解析伺服器解析出紙本文件中傷病名稱所對應之國際疾病分類碼,再透過保險理賠伺服器及銀行伺服器的運作將應理賠金額匯入保戶之帳戶,以提高保險理賠之效率,同時降低理賠審核作業中人為判斷的出錯風險。 This creation is about a self-service intelligent insurance claims system. The policy holder can automatically identify the text content of the paper document through the mobile device, and at the same time identify the authenticity, and the cloud analysis server parses out the name of the injured file in the paper file. The International Disease Classification Code, through the operation of the insurance claims server and the banking server, will remit the amount of the claims to the account of the policyholder to improve the efficiency of the insurance claims and reduce the risk of human error in the claims review operation.

以往,保戶若要向保險公司申請理賠時,必須備齊相關紙本文件(例如理賠申請資料及診斷證明書)並送至保險公司,由保險公司以人工方式來鑑識紙本文件的真偽後,並以人工判斷紙本文件中傷病名稱所對應之國際疾病分類碼,再輸入相關資料以完成保險理賠之作業程序,但這些人工作業既耗時又費力,有著效率不彰的問題。 In the past, if a policyholder wants to apply for a claim from an insurance company, he must prepare relevant paper documents (such as claims application materials and diagnostic certificates) and send them to the insurance company. The insurance company will manually identify the authenticity of the paper documents. After that, the international disease classification code corresponding to the name of the injury in the paper document is manually determined, and then the relevant information is input to complete the operation procedure of the insurance claim, but these manual operations are time consuming and laborious, and have inefficiency problems.

此外,保險公司產品類型眾多,各式各樣的理賠條款及大量的理賠案件量,難保前述以傳統人工方式來鑑識、判斷及輸入相關資料等等的理賠作業程序不會發生錯誤,進而造成保戶或保險公司的損失。隨著科技的演進,如何透過新技術來完成保險理賠程序,並兼顧效率及可靠性,乃是目前保險產業所欲積極尋求的目標。 In addition, there are many types of insurance company products, various claims terms and a large number of claims cases. It is difficult to ensure that the above-mentioned claims operation procedures for identifying, judging and inputting relevant materials in the traditional manual manner will not cause errors, thereby causing insurance. Loss of the household or insurance company. With the evolution of technology, how to complete the insurance claims process through new technologies, taking into account efficiency and reliability, is the current objective of the insurance industry.

為了達成上述目標,本創作人乃積極苦思研究,以期可解決上述保險理賠的相關問題,經過不斷的努力及研究,終於研發出本創作。 In order to achieve the above objectives, the creator is actively studying and researching in order to solve the problems related to the above insurance claims. After continuous efforts and research, the author has finally developed this creation.

因此,本創作之目的,即在提供一種基於行動載具之智能理賠系統,此系統包括行動終端設備、雲端解析伺服器及保險理賠伺服器,其中行動終端設備(例如筆記型電腦、智慧型手機、平板電腦或智慧型穿戴裝置)包括影像擷取模組、印信處理模組、字元辨識模組及行動通訊模組,其中影像擷取模組用以擷取理賠申請資料、診斷證明書及收據等紙本文件,並 轉成影像檔案;印信處理模組係連接影像擷取模組,用以針對影像檔案進行背景色預處理,並根據影像檔案鑑識紙本文件之真偽;字元辨識模組係連接該印信處理模組,用以辨識擷取自紙本文件的影像檔案,並產生經辨識之資料,其中可包含文字資料及防偽圖像資料;以及行動通訊模組係連接字元辨識模組,用以傳送經辨識之資料;而雲端解析伺服器係連接行動終端設備,用於處理經辨識之資料,其中雲端解析伺服器包括雲端通訊單元、雲端儲存單元及雲端處理單元,其中雲端通訊單元用於接收該經辨識之資料;而雲端儲存單元係連接雲端通訊單元,並預先儲存國際疾病分類碼(International Classification of Disease,ICD);以及雲端處理單元分別連接雲端通訊單元及雲端儲存單元,用以解析紙本文件中之至少一傷病名稱及對應之國際疾病分類碼;而保險理賠伺服器係連接雲端解析伺服器,用於處理保戶對於保單之理賠需求,其中保險理賠伺服器包括理賠通訊單元、理賠儲存單元及理賠處理單元,其中理賠通訊單元係用於接收及傳送與保單之理賠需求相關之資料;而理賠儲存單元係連接理賠通訊單元,用於儲存與保單之理賠需求相關之資料;而理賠處理單元係分別連接理賠通訊單元及理賠儲存單元,用以產生關於保單之應理賠結果及應理賠金額,並由理賠通訊單元傳送應理賠金額至銀行伺服器,再將應理賠金額匯入至保戶之帳戶,並向保險理賠伺服器回傳理賠結果,並由理賠儲存單元儲存理賠結果,理賠通訊單元傳送理賠結果至行動終端設備。 Therefore, the purpose of this creation is to provide an intelligent claim system based on mobile vehicles, which includes mobile terminal devices, cloud parsing servers and insurance claims servers, among which mobile terminal devices (such as notebook computers and smart phones) The image capture module, the print processing module, the character recognition module and the mobile communication module, wherein the image capture module is used to retrieve the claim application data and the diagnostic certificate. Receipts and other paper documents, and Converting into an image file; the printing processing module is connected to the image capturing module for performing background color preprocessing on the image file, and authenticating the authenticity of the paper document according to the image file; the character recognition module is connected to the printing letter processing a module for identifying an image file taken from a paper document and generating the identified data, which may include text data and anti-counterfeit image data; and a mobile communication module is connected to the character recognition module for transmitting The cloud computing server is connected to the mobile terminal device for processing the identified data, wherein the cloud resolution server comprises a cloud communication unit, a cloud storage unit and a cloud processing unit, wherein the cloud communication unit is configured to receive the data. The identified data; the cloud storage unit is connected to the cloud communication unit, and pre-stores the International Classification of Disease (ICD); and the cloud processing unit is connected to the cloud communication unit and the cloud storage unit respectively for parsing the paper At least one name of the injury and the corresponding international disease classification code in the document; and insurance The server is connected to the cloud parsing server for processing the claim of the policy for the policy, wherein the insurance claim server includes a claim communication unit, a claim storage unit and a claim processing unit, wherein the claim communication unit is used for receiving and transmitting the policy. The claim storage unit is connected to the claim communication unit for storing the information related to the claim claim of the policy; and the claim processing unit is connected to the claim communication unit and the claim storage unit respectively for generating the policy. The result of the claim and the amount of the claim should be settled, and the claim settlement unit should transmit the amount of the claim to the bank server, and then transfer the amount of the claim to the account of the policyholder, and return the claim result to the insurance claim server, and store the claim result. The unit stores the claim result, and the claim communication unit transmits the claim result to the mobile terminal device.

依據本創作之另一實施例,紙本文件可為理賠申請資料、診斷證明書及收據之一或多者。 According to another embodiment of the present invention, the paper document may be one or more of a claim application document, a diagnostic certificate, and a receipt.

依據本創作之另一實施例,雲端通訊單元進一步用以傳送雲端儲存單元所儲存之資料。 According to another embodiment of the present invention, the cloud communication unit is further configured to transmit the data stored by the cloud storage unit.

依據本創作之另一實施例,字元辨識模組為光學字元辨識模組。 According to another embodiment of the present invention, the character recognition module is an optical character recognition module.

依據本創作之另一實施例,經辨識之資料包含文字資料及防偽圖像資料(印信圖像資料),其中文字資料可包含申請人姓名、日期、診斷之病理說明及名稱、保單各項資料等。醫療院所常會將關防章及/或醫師章等蓋在診斷證明書的文字資料上,造成上述部分文字資料被印信所遮蔽,此現象並不利於診斷證明書的字元辨識。為解決此一問題,印信處理模組可對於 影像檔案在進入字元辨識模組之前,先進行背景色預處理,尤其是當文字資料被印信所遮蔽而難以直接辨識時,針對影像檔案先進行背景預處理。由於一般印信所使用之墨水或印泥大多為單一顏色(例如藍色或紅色),本創作可選擇接近影像檔案中印信的原色(如藍色、紅色、綠色之一者),套入影像檔案的背景色,以淡化文字資料被印信遮蔽之影響,用以增進字元識別模組對於影像檔案之文字資料的辨識範圍。 According to another embodiment of the present invention, the identified data includes text data and anti-counterfeit image data (printed image data), wherein the text data may include the applicant's name, date, pathological description and name of the diagnosis, and policy information. Wait. Medical institutions often cover the prevention and control chapters and/or doctor's chapters on the text of the diagnostic certificate, causing some of the above-mentioned texts to be obscured by the printed letter. This phenomenon is not conducive to the character identification of the diagnostic certificate. In order to solve this problem, the printing processing module can Before the image file enters the character recognition module, the background color pre-processing is performed first, especially when the text data is obscured by the printing and is difficult to be directly recognized, and the image file is first subjected to background pre-processing. Since the ink or ink used in general printing is mostly in a single color (such as blue or red), this creation can choose to close the original color of the printed image in the image file (such as one of blue, red, and green), and fit into the image file. The background color is used to reduce the influence of the text data on the text data of the image file.

此外,為避免有心人士利用掃瞄或複印其它蓋有真正關防章及/或醫師章之文件,將其關防章及/或醫師章之影像檔案擷取出來,並透過修圖或列印等方式添加或黏貼至欲偽造之診斷證明書上。本創作之另一實施例,係利用印信處理模組中的邊緣檢測演算法來定義印信圖像資料之檢測邊緣,做為判定診斷證明書之真偽的基礎。若是利用掃瞄或複印所擷取之印信圖像資料,其印信圖像容易會有去背不全、邊緣仍帶有殘色或鋸齒紋狀等問題。本創作之印信處理模組可使用Sobel算子、Roberts Cross算子、Prewitt算子、Canny算子、羅盤算子、Marr-Hildreth算子、Laplacian算子及小波轉換等邊緣檢測演算法來進行邊緣檢測,先定義出印信圖像的檢測邊緣,再於印信圖像之檢測邊緣外設定鑑識邊界,並於檢測邊緣及鑑識邊界之間的區域計算計算色碼數值的變異程度,並判斷其是否高於一閥限值,用以鑑識具有印信圖像資料之影像檔案之真偽。如果高於前述閥限值,代表印信圖像資料極可能是利用掃描擷取而得,因此可判定屬偽造者,反之則判定非屬偽造者。 In addition, in order to avoid the use of scanning or copying other documents with genuine seals and/or doctor's seals, the image files of the chapters and/or doctor's chapters may be taken out and processed through retouching or printing. Add or paste on the diagnostic certificate you want to falsify. Another embodiment of the present invention uses the edge detection algorithm in the print processing module to define the detection edge of the printed image data as the basis for determining the authenticity of the diagnostic certificate. If the image of the printed image captured by scanning or copying is used, the printed image may have problems such as incomplete backing and residual color or jaggedness on the edge. The creative processing module of this creation can use the edge detection algorithm such as Sobel operator, Roberts Cross operator, Prewitt operator, Canny operator, compass operator, Marr-Hildreth operator, Laplacian operator and wavelet transform to perform edge detection. Detection, first define the detection edge of the printed image, then set the identification boundary outside the detection edge of the printed image, and calculate the degree of variation of the color code value in the area between the detection edge and the identification boundary, and determine whether it is high. The threshold value is used to identify the authenticity of the image file with the printed image data. If it is higher than the aforementioned threshold value, it is very likely that the representative image data is obtained by scanning, so that it can be judged to be a counterfeiter, and vice versa to determine that it is not a counterfeit.

依據本創作之另一實施例,印信處理模組更包含人工智慧子模組,其可通過機器學習模型及大量訓練數據,來達到學習更多的印信特徵,例如調整前述閥限值或鑑識邊界的設定,從而提升防偽鑑識的準確性。 According to another embodiment of the present invention, the printing processing module further comprises an artificial intelligence sub-module, which can learn more printing features, such as adjusting the aforementioned threshold value or the identification boundary, through a machine learning model and a large amount of training data. The setting to improve the accuracy of anti-counterfeiting.

依據本創作之另一實施例,雲端解析伺服器之雲端處理單元更包含人工智慧子單元,其可通過機器學習模型及雲端儲存單元內的大量訓練數據,從而提升解析傷病名稱所對應之國際疾病分類碼的準確性。 According to another embodiment of the present invention, the cloud processing unit of the cloud parsing server further includes an artificial intelligence subunit, which can improve the international disease corresponding to the name of the injured disease through the machine learning model and a large amount of training data in the cloud storage unit. The accuracy of the classification code.

依據本創作之另一實施例,該系統在使用者利用行動終端設備提出保單之理賠需求時,該系統進行下述步驟:步驟S101,使用者於行動終端設備之應用程式中啟動理賠申請程序;步驟S102,行動終端設備透過影像擷 取模組擷取包含印信圖像資料之診斷證明書,並轉成影像檔案;步驟S103,印信處理模組先針對影像檔案進行背景色預處理,再使用邊緣檢測鑑識印信圖像資料,並產生防偽鑑識結果;步驟S104,若防偽鑑識結果為真,則由字元辨識模組辨識影像檔案,並產生文字資料及印信圖像資料;步驟S105,行動通訊模組傳送文字資料及印信圖像資料至雲端解析伺服器之雲端通訊單元;步驟S106,雲端通訊單元接收文字資料及印信圖像資料,並儲存至雲端儲存單元;步驟S107,雲端處理單元解析文字資料中之至少一傷病名稱,由雲端儲存單元預先儲存之國際疾病分類碼中尋找所對應之國際疾病分類碼,再儲存至雲端儲存單元,並由雲端通訊單元傳送至保險理賠伺服器之理賠通訊單元;步驟S108,保險理賠伺服器之理賠處理單元根據保單及至少一傷病名稱所對應之國際疾病分類碼,產生應理賠結果及應理賠金額,並由理賠通訊單元傳送應理賠金額至銀行伺服器;步驟S109,銀行伺服器將應理賠金額匯入至保戶之帳戶,並向保險理賠伺服器回傳理賠結果,由理賠儲存單元儲存理賠結果;步驟S110,理賠通訊單元傳送理賠結果至行動終端設備之該行動通訊模組,使行動終端設備之應用程式結束理賠申請程序。 According to another embodiment of the present invention, the system performs the following steps when the user makes a claim for the policy by using the mobile terminal device: in step S101, the user initiates the claim application procedure in the application of the mobile terminal device; Step S102, the mobile terminal device transmits the image撷 Taking the module to retrieve the diagnostic certificate containing the printed image data, and converting it into an image file; in step S103, the printing processing module first performs background color pre-processing on the image file, and then uses the edge detection to identify the printed image data, and generates The anti-counterfeiting identification result; in step S104, if the anti-counterfeiting authentication result is true, the character recognition module recognizes the image file, and generates the text data and the printed image data; in step S105, the mobile communication module transmits the text data and the printed image data. Go to the cloud communication unit of the cloud resolution server; in step S106, the cloud communication unit receives the text data and the printed image data, and stores the data in the cloud storage unit; in step S107, the cloud processing unit parses at least one injury name in the text data, by the cloud The international disease classification code stored in the pre-stored international disease classification code is stored in the cloud storage unit, and transmitted by the cloud communication unit to the claim communication unit of the insurance claim server; step S108, the insurance claim server The claims processing unit is based on the policy and the international name corresponding to at least one injury name. The disease classification code generates the result of the claim and the amount of the claim, and the claim communication unit transmits the claim amount to the bank server; in step S109, the bank server remits the claim amount to the account of the policy holder, and provides the claim to the insurance claim server. Returning the claim result, the claim storage unit stores the claim result; in step S110, the claim communication unit transmits the claim result to the mobile communication module of the mobile terminal device, so that the application of the mobile terminal device ends the claim application procedure.

10‧‧‧基於行動載具之智能理賠系統 10‧‧‧Intelligent claims system based on mobile vehicles

11‧‧‧行動終端設備 11‧‧‧Mobile terminal equipment

12‧‧‧雲端解析伺服器 12‧‧‧Cloud parsing server

13‧‧‧保險理賠伺服器 13‧‧‧Insurance claims server

14‧‧‧銀行伺服器 14‧‧‧Bank server

111‧‧‧影像擷取模組 111‧‧‧Image capture module

112‧‧‧印信處理模組 112‧‧‧Print processing module

113‧‧‧字元辨識模組 113‧‧‧ character recognition module

114‧‧‧行動通訊模組 114‧‧‧Mobile communication module

121‧‧‧雲端通訊單元 121‧‧‧Cloud Communication Unit

122‧‧‧雲端儲存單元 122‧‧‧Cloud storage unit

123‧‧‧雲端處理單元 123‧‧‧Cloud Processing Unit

131‧‧‧理賠通訊單元 131‧‧‧ Claims Communication Unit

132‧‧‧理賠儲存單元 132‧‧‧ Claims Storage Unit

133‧‧‧理賠處理單元 133‧‧‧ Claims Processing Unit

1121‧‧‧人工智慧子模組 1121‧‧‧Artificial Wisdom Module

1231‧‧‧人工智慧子單元 1231‧‧‧Artificial Subunit

21‧‧‧影像檔案 21‧‧‧Image files

22‧‧‧印信圖像資料 22‧‧‧Printed image data

31‧‧‧印信圖像資料 31‧‧‧Printed image data

311‧‧‧檢測邊緣 311‧‧‧Detection edge

32‧‧‧鑑識邊界 32‧‧‧ Forensic boundaries

S101-S110‧‧‧步驟 S101-S110‧‧‧Steps

圖1係顯示本創作之基於行動載具之智能理賠系統的概略結構方塊圖。 1 is a block diagram showing the schematic structure of an intelligent claim system based on a mobile vehicle of the present invention.

圖2(A)係顯示本創作之影像檔案進行背景色預處理前之示意圖。 Fig. 2(A) is a schematic view showing the background image before the background color preprocessing of the created image file.

圖2(B)係顯示本創作之影像檔案進行背景色預處理後之示意圖。 Fig. 2(B) is a schematic diagram showing the background color preprocessing of the created image file.

圖3係顯示本創作對於印信圖像資料鑑識其真偽之示意圖。 FIG. 3 is a schematic diagram showing the authenticity of the present invention for the identification of the printed image data.

圖4係顯示本創作之智能理賠程序的實施範例流程圖。 FIG. 4 is a flow chart showing an example of implementation of the intelligent claims program of the present creation.

參看所附之圖式,就本創作之具體形態來加以說明。 Referring to the attached drawings, the specific form of the creation will be explained.

如圖1所示,本創作係一種基於行動載具之智能理賠系統,其應用於保險公司理賠,本實施例之智能理賠系統10包括:具有裝載一應用程式之一行動終端設備11(例如筆記型電腦、智慧型手機、平板電腦或智慧型手錶),其包括:一影像擷取模組111,其用以擷取紙本文件以轉成影像檔案,該影像擷取模組111可以是該行動終端設備11上的相機;一印信處理模組112, 其連接該影像擷取模組111,用以針對該影像檔案進行背景色預處理,並根據該影像檔案鑑識該紙本文件之真偽;一字元辨識模組113,其連接該印信處理模組112,用以辨識該影像檔案,例如由光學字元辨識(Optical Character Recognition,OCR)技術來辨識該影像檔案中的文字,以產生一經辨識之資料;以及一行動通訊模組114,其連接該字元辨識模組113,用以傳送該經辨識之資料,其可採用GSM、3G、4G、Wi-Fi等通訊介面,惟類別不在此限;一雲端解析伺服器12,其連接該行動終端設備11,該雲端解析伺服器12用於處理該經辨識之資料,其包括:一雲端通訊單元121,其可採用GSM、3G、4G、Wi-Fi、Ethernet等通訊介面(不以此為限),用於接收該經辨識之資料,其中該雲端解析伺服器12係藉由該雲端通訊單元121連接該行動終端設備11之該行動通訊模組114;一雲端儲存單元122,其連接該雲端通訊單元121,並預先儲存國際疾病分類碼,而該雲端通訊單元121用以傳送該雲端儲存單元122所儲存之資料;以及一雲端處理單元123,其分別連接該雲端通訊單元121及該雲端儲存單元122,用以解析該紙本文件中之至少一傷病名稱及對應之國際疾病分類碼;及一保險理賠伺服器13,其連接該雲端解析伺服器12,用於處理一保戶對於一保單之理賠需求,其包括:一理賠通訊單元131,其可採用GSM、3G、4G、Wi-Fi、Ethernet等通訊介面(不以此為限),用於接收及傳送與該保單之理賠需求相關之資料,其中該保險理賠伺服器13係藉由該理賠通訊單元131連接該雲端解析伺服器12之該雲端通訊單元121;一理賠儲存單元132,其連接該理賠通訊單元131,用於儲存與該保單之理賠需求相關之資料;及一理賠處理單元133,其分別連接該理賠通訊單元131及該理賠儲存單元132,用以產生關於該保單之一應理賠結果及一應理賠金額,並由該理賠通訊單元131傳送該應理賠金額至一銀行伺服器14,再由該銀行伺服器14將該應理賠金額匯入至保戶之帳戶,並向該保險理賠伺服器13回傳一理賠結果,由該理賠儲存單元132儲存理賠結果,並由該理賠通訊單元131傳送該理賠結果至該行動終端設備11。 As shown in FIG. 1 , the present invention is an intelligent claim system based on a mobile vehicle, which is applied to an insurance company claim. The smart claim system 10 of the present embodiment includes: a mobile terminal device 11 having one application loaded (for example, a note) The image capturing module 111 is configured to capture a paper file to be converted into an image file, and the image capturing module 111 can be the image computer, the smart phone, the tablet computer, or the smart watch. a camera on the mobile terminal device 11; a print processing module 112, The image capture module 111 is configured to perform background color pre-processing on the image file, and to identify the authenticity of the paper file according to the image file; a character recognition module 113 connected to the print processing module The group 112 is configured to identify the image file, for example, the optical character recognition (OCR) technology is used to identify the text in the image file to generate a recognized data; and a mobile communication module 114 is connected. The character recognition module 113 is configured to transmit the identified data, and may use a communication interface such as GSM, 3G, 4G, Wi-Fi, etc., but the category is not limited thereto; a cloud parsing server 12 connected to the action The terminal device 11 is configured to process the identified data, and includes: a cloud communication unit 121, which can adopt a communication interface such as GSM, 3G, 4G, Wi-Fi, Ethernet, etc. The cloud computing server 12 is connected to the mobile communication module 114 of the mobile terminal device 11 by the cloud communication unit 121; a cloud storage unit 122 The cloud communication unit 121 is configured to pre-store the international disease classification code, and the cloud communication unit 121 is configured to transmit the data stored by the cloud storage unit 122; and a cloud processing unit 123 is connected to the cloud communication unit 121 and the cloud communication unit 121. The cloud storage unit 122 is configured to parse at least one injury name and the corresponding international disease classification code in the paper file, and an insurance claim server 13 connected to the cloud resolution server 12 for processing a policy holder The claim claim of a policy includes: a claim communication unit 131, which can adopt a communication interface of GSM, 3G, 4G, Wi-Fi, Ethernet, etc. (not limited thereto), for receiving and transmitting claims with the policy. The demand related information, wherein the insurance claim server 13 is connected to the cloud communication unit 121 of the cloud parsing server 12 by the claim communication unit 131; a claim storage unit 132 is connected to the claim communication unit 131 for Storing information related to the claim claim of the policy; and a claim processing unit 133 connected to the claim communication unit 131 and the claim storage unit 132, respectively To generate a claim result and a claim amount for the policy, and send the claim amount to the bank server 14 by the claim communication unit 131, and then the bank server 14 transfers the claim amount to the bank account 14 The account of the policy holder returns a claim result to the insurance claim server 13, and the claim storage unit 132 stores the claim result, and the claim result is transmitted by the claim communication unit 131 to the mobile terminal device 11.

另外,該紙本文件可為理賠申請資料、診斷證明書及收據之一或多者。 In addition, the paper document may be one or more of claims application materials, diagnostic certificates and receipts.

另外,該字元辨識模組113為一光學字元辨識模組,其中該經辨識之資料包含一文字資料及一防偽圖像資料,該行動終端設備11可利用該光學字 元辨識模組辨識該文字資料,其中該文字資料可包含申請人姓名、日期、診斷之病理說明及名稱、保單各項資料等。 In addition, the character recognition module 113 is an optical character recognition module, wherein the recognized data includes a text data and an anti-counterfeit image data, and the mobile terminal device 11 can utilize the optical word. The meta-identification module recognizes the text data, wherein the text data may include the applicant's name, date, pathological description and name of the diagnosis, and various information of the policy.

如圖2(A)所示,根據該影像檔案21所產生之該防偽圖像資料為一印信圖像資料22。由於該字元辨識模組113產生該經辨識之資料時,該影像檔案21中的文字可能會被該印信圖像資料22所遮蔽,而不利於該字元識別模組113之運作。為解決此一問題,印信處理模組112可在該影像檔案20進入該字元辨識模組113之前,先進行背景色預處理。如圖2(B)所示,背景色預處理係選擇接近該影像檔案21中該印信圖像資料22的原色(如圖2(B)中的紅色),套入該影像檔案21的背景色,以淡化該影像檔案21中的文字被該印信圖像資料22遮蔽之影響。 As shown in FIG. 2(A), the anti-counterfeit image data generated according to the image file 21 is a printed image data 22. When the character recognition module 113 generates the identified data, the text in the image file 21 may be obscured by the printed image data 22, which is unfavorable for the operation of the character recognition module 113. To solve this problem, the print processing module 112 can perform background color pre-processing before the image file 20 enters the character recognition module 113. As shown in FIG. 2(B), the background color preprocessing selects the primary color of the printed image data 22 in the image file 21 (as shown in red in FIG. 2(B)), and fits the background color of the image file 21. To weaken the influence of the text in the image file 21 by the printed image data 22.

該印信處理模組112係除了對該影像檔案21進行背景色預處理,還透過邊緣檢測以鑑識該印信圖像資料22,其中該印信處理模組112可使用Sobel算子、Roberts Cross算子、Prewitt算子、Canny算子、羅盤算子、Marr-Hildreth算子、Laplacian算子及小波轉換等邊緣檢測演算法來進行邊緣檢測,用以鑑識具有該印信圖像資料22之該影像檔案21之真偽。如圖3所示,前述邊緣檢測演算法係用以定義出該印信圖像資料31的一檢測邊緣311,再於該檢測邊緣311外設定一鑑識邊界32,並於該檢測邊緣311至該鑑識邊界32之間計算色碼數值的變異程度,並判斷其是否高於一閥限值。如果高於該閥限值,代表該檢測邊緣311仍帶有殘色或鋸齒狀紋等問題,有極高的可能是利用掃描擷取而得,因此可判定該印信圖像資料31屬偽造者,反之則判定非屬偽造者。 The print processing module 112 is configured to perform background color preprocessing on the image file 21, and to identify the printed image data 22 through edge detection. The print processing module 112 can use a Sobel operator, a Roberts Cross operator, An edge detection algorithm such as a Prewitt operator, a Canny operator, a compass operator, a Marr-Hildreth operator, a Laplacian operator, and a wavelet transform is used for edge detection to identify the image file 21 having the printed image data 22. True or false. As shown in FIG. 3, the edge detection algorithm is used to define a detection edge 311 of the printed image data 31, and an identification boundary 32 is set outside the detection edge 311, and the detection edge 311 is to the identification edge. The degree of variation of the color code value is calculated between the boundaries 32 and judged whether it is above a threshold value. If it is higher than the threshold value, it means that the detection edge 311 still has problems such as residual color or zigzag pattern, and there is a high possibility that it is obtained by scanning, so that the printed image data 31 can be determined to be a counterfeiter. On the contrary, it is determined that it is not a counterfeiter.

另外,該印信處理模組112更包含一人工智慧子模組1121,其可由機器學習提升鑑識該印信圖像資料之準確性,例如根據機器學習模型及大量訓練數據,調整該閥限值或該鑑識邊界的設定。 In addition, the print processing module 112 further includes an artificial intelligence sub-module 1121, which can improve the accuracy of identifying the printed image data by machine learning, for example, adjusting the threshold value according to a machine learning model and a large amount of training data. Forensic boundary settings.

另外,該雲端解析伺服器12之該雲端處理單元123更包含一人工智慧子單元1231,其可由機器學習解析該至少一傷病名稱所對應之國際疾病分類碼,以提升解析之準確性。 In addition, the cloud processing unit 123 of the cloud parsing server 12 further includes an artificial intelligence sub-unit 1231, which can analyze the international disease classification code corresponding to the at least one injury name by machine learning to improve the accuracy of the parsing.

參看圖4所示,以下便針對本創作之使用方式的實施範例流程來加以說明。 Referring to Figure 4, the following is a description of the implementation flow of the use of the present creation.

如圖4所示,該系統10在一使用者利用該行動終端設備11提出保單之理賠需求時,該智能理賠系統10進行下述步驟:步驟S101,該使用者於該行動終端設備11之一應用程式中啟動一理賠申請程序;步驟S102,該行動終端設備11透過該影像擷取模組111擷取包含該印信圖像資料之該診斷證明書,並轉成該影像檔案;步驟S103,該印信處理模組112先針對該影像檔案進行背景色預處理,再使用邊緣檢測鑑識該印信圖像資料,並產生一防偽鑑識結果;步驟S104,若該防偽鑑識結果為真,則由該字元辨識模組113辨識該影像檔案,並產生該文字資料及該印信圖像資料;步驟S105,該行動通訊模組114傳送該文字資料及該印信圖像資料至該雲端解析伺服器12之該雲端通訊單元121;步驟S106,該雲端通訊單元121接收該文字資料及該印信圖像資料,並儲存至該雲端儲存單元122;步驟S107,該雲端處理單元123解析該文字資料中之該至少一傷病名稱,由該雲端儲存單元122預先儲存之國際疾病分類碼中尋找所對應之國際疾病分類碼,再儲存至該雲端儲存單元123,並由該雲端通訊單元121傳送至該保險理賠伺服器13之該理賠通訊單元131;步驟S108,該保險理賠伺服器13之該理賠處理單元133根據該保單及該至少一傷病名稱所對應之國際疾病分類碼,產生一應理賠結果及一應理賠金額,並由該理賠通訊單元131傳送該應理賠金額至一銀行伺服器14;步驟S109,該銀行伺服器14將該應理賠金額匯入至該保戶之帳戶,並向該保險理賠伺服器13回傳一理賠結果(若該保戶之帳戶正確,則為匯款成功之訊息;反之,則為匯款失敗之訊息),由該理賠儲存單元132儲存該理賠結果;步驟S110,該理賠通訊單元131傳送該理賠結果至該行動終端設備11之該行動通訊模組114,使該行動終端設備11之該應用程式結束該理賠申請程序。 As shown in FIG. 4, when the user uses the mobile terminal device 11 to make a claim for a policy, the smart claim system 10 performs the following steps: Step S101, the user is in the mobile terminal device 11 In the application, a claim application process is started in the application; in step S102, the mobile terminal device 11 retrieves the diagnostic certificate including the printed image data through the image capturing module 111, and converts the diagnostic certificate into the image file; The print processing module 112 first performs background color pre-processing on the image file, and then uses the edge detection to identify the printed image data, and generates an anti-counterfeiting identification result; in step S104, if the anti-counterfeiting identification result is true, the character is The identification module 113 recognizes the image file and generates the text data and the printed image data. In step S105, the mobile communication module 114 transmits the text data and the printed image data to the cloud of the cloud analysis server 12 The communication unit 121; the step S106, the cloud communication unit 121 receives the text data and the printed image data, and stores the data in the cloud storage unit 122; Step S107 The cloud processing unit 123 parses the at least one injury name in the text data, searches for the corresponding international disease classification code in the international disease classification code pre-stored by the cloud storage unit 122, and stores the corresponding international disease classification code in the cloud storage unit 123. The cloud communication unit 121 transmits the claim communication unit 131 to the insurance claim server 13; in step S108, the claim processing unit 133 of the insurance claim server 13 is based on the policy and the international disease corresponding to the at least one injury name. The classification code generates a claim result and a claim amount, and the claim payment unit 131 transmits the claim amount to a bank server 14; in step S109, the bank server 14 remits the claim amount to the The account of the policy holder, and returning a claim result to the insurance claim server 13 (if the account of the policy holder is correct, the message is successful for remittance; otherwise, the message is that the remittance failed), by the claim storage unit 132 The claim result is stored; in step S110, the claim communication unit 131 transmits the claim result to the mobile communication module 114 of the mobile terminal device 11, so that 11 of the mobile terminal device application claims the end of the application process.

以上所述僅為本創作的較佳具體實施例,其並不用以限制本創作,凡在本創作的精神和原則之內,所作的任何修改、等同拆換、改進等,均應包含在本創作的保護範圍之內。 The above description is only a preferred embodiment of the present invention, and is not intended to limit the present invention. Any modifications, equivalents, improvements, etc., which are made within the spirit and principles of the present invention, should be included in the present disclosure. Within the scope of creation protection.

Claims (10)

一種基於行動載具之智能理賠系統,其包括:一行動終端設備,其包括:一影像擷取模組,其用以擷取一紙本文件以轉成一影像檔案;一印信處理模組,其連接影像擷取模組,用以針對該影像檔案進行背景色預處理,並根據該影像檔案鑑識該紙本文件之真偽;一字元辨識模組,其連接該印信處理模組,用以辨識該影像檔案,並產生一經辨識之資料;以及一行動通訊模組,其連接該字元辨識模組,用以傳送該經辨識之資料;一雲端解析伺服器,其連接該行動終端設備,用於處理該經辨識之資料,其包括:一雲端通訊單元,其用於接收該經辨識之資料;一雲端儲存單元,其連接該雲端通訊單元,並預先儲存國際疾病分類碼;以及一雲端處理單元,其分別連接該雲端通訊單元及該雲端儲存單元,用以解析該紙本文件中之至少一傷病名稱及對應之國際疾病分類碼;及一保險理賠伺服器,其連接該雲端解析伺服器,用於處理一保戶對於一保單之理賠需求,其包括:一理賠通訊單元,其用於接收及傳送與該保單之理賠需求相關之資料;一理賠儲存單元,其連接該理賠通訊單元,用於儲存與該保單之理賠需求相關之資料;及一理賠處理單元,其分別連接該理賠通訊單元及該理賠儲存單元,用以產生關於該保單之一應理賠結果及一應理賠金額。 An intelligent claim system based on a mobile vehicle includes: a mobile terminal device, comprising: an image capture module for capturing a paper document for conversion into an image file; a print processing module, The image capturing module is configured to perform background color pre-processing on the image file, and to identify the authenticity of the paper file according to the image file; a character recognition module connected to the printing processing module, Identifying the image file and generating a recognized data; and a mobile communication module connected to the character recognition module for transmitting the identified data; a cloud resolution server connected to the mobile terminal device For processing the identified data, comprising: a cloud communication unit for receiving the identified data; a cloud storage unit connected to the cloud communication unit, and pre-storing the international disease classification code; a cloud processing unit, which is respectively connected to the cloud communication unit and the cloud storage unit, for parsing at least one injury name and corresponding international disease in the paper file And an insurance claim server connected to the cloud parsing server for processing a policyholder's claim for a policy, comprising: a claim communication unit for receiving and transmitting claims with the policy Demand related information; a claim storage unit connected to the claim communication unit for storing information related to the claim claim of the policy; and a claim processing unit respectively connected to the claim communication unit and the claim storage unit In order to generate a claim for the policy and the amount of the claim. 如申請專利範圍第1項之系統,其中該紙本文件可為一理賠申請資料、一診斷證明書或一收據。 For example, the system of claim 1 of the patent scope, wherein the paper document can be a claim application document, a diagnostic certificate or a receipt. 如申請專利範圍第1項之系統,其中該雲端通訊單元更進一步用以傳送該雲端儲存單元所儲存之資料。 The system of claim 1, wherein the cloud communication unit is further configured to transmit the data stored by the cloud storage unit. 如申請專利範圍第2或3項之系統,其中該字元辨識模組為一光學字元辨識模組。 For example, the system of claim 2 or 3, wherein the character recognition module is an optical character recognition module. 如申請專利範圍第4項之系統,其中該經辨識之資料包含一文字資料及一防偽圖像資料。 For example, the system of claim 4, wherein the identified data includes a text material and an anti-counterfeit image data. 如申請專利範圍第5項之系統,其中該防偽圖像資料為一印信圖像資料。 For example, the system of claim 5, wherein the anti-counterfeit image data is a printed image data. 如申請專利範圍第6項之系統,其中該印信處理模組係使用邊緣檢測以鑑識該印信圖像資料。 The system of claim 6, wherein the printing processing module uses edge detection to identify the printed image data. 如申請專利範圍第7項之系統,其中該印信處理模組更包含一人工智慧子模組,其可由機器學習鑑識該印信圖像資料。 The system of claim 7, wherein the printing processing module further comprises an artificial intelligence sub-module, which can be used by the machine to learn the printed image data. 如申請專利範圍第8項之系統,其中該雲端解析伺服器之該雲端處理單元更包含一人工智慧子單元,其可由機器學習解析該至少一傷病名稱所對應之國際疾病分類碼。 The system of claim 8 , wherein the cloud processing unit of the cloud parsing server further comprises an artificial intelligence subunit, wherein the international disease classification code corresponding to the at least one injury name is parsed by the machine learning. 如申請專利範圍第9項之系統,其中一使用者利用該行動終端設備提出該保單之理賠需求時,該系統進行下述步驟:步驟S101,該使用者於該行動終端設備之一應用程式中啟動一理賠申請程序;步驟S102,該行動終端設備透過該影像擷取模組擷取包含該印信圖像資料之該診斷證明書,並轉成該影像檔案; 步驟S103,該印信處理模組先針對該影像檔案進行背景色預處理,再使用邊緣檢測鑑識該印信圖像資料,並產生一防偽鑑識結果;步驟S104,若該防偽鑑識結果為真,則由該字元辨識模組辨識該影像檔案,並產生該文字資料及該印信圖像資料;步驟S105,該行動通訊模組傳送該文字資料及該印信圖像資料至該雲端解析伺服器之該雲端通訊單元;步驟S106,該雲端通訊單元接收該文字資料及該印信圖像資料,並儲存至該雲端儲存單元;步驟S107,該雲端處理單元解析該文字資料中之該至少一傷病名稱,由該雲端儲存單元預先儲存之國際疾病分類碼中尋找所對應之國際疾病分類碼,再儲存至該雲端儲存單元,並由該雲端通訊單元傳送至該保險理賠伺服器之該理賠通訊單元;步驟S108,該保險理賠伺服器之該理賠處理單元根據該保單及該至少一傷病名稱所對應之國際疾病分類碼,產生一應理賠結果及一應理賠金額,並由該理賠通訊單元傳送該應理賠金額至一銀行伺服器;步驟S109,該銀行伺服器將該應理賠金額匯入至該保戶之帳戶,並向該保險理賠伺服器回傳一理賠結果,由該理賠儲存單元儲存該理賠結果;步驟S110,該理賠通訊單元傳送該理賠結果至該行動終端設備之該行動通訊模組,使該行動終端設備之該應用程式結束該理賠申請程序。 For example, in the system of claim 9, wherein a user uses the mobile terminal device to make a claim for the policy, the system performs the following steps: Step S101, the user is in an application of the mobile terminal device Starting a claim application process; in step S102, the mobile terminal device retrieves the diagnostic certificate including the printed image data through the image capturing module, and converts the diagnostic certificate into the image file; Step S103, the printing processing module performs background color pre-processing on the image file, and then uses the edge detection to identify the printed image data, and generates an anti-counterfeiting identification result; in step S104, if the anti-counterfeiting identification result is true, The character recognition module identifies the image file and generates the text data and the printed image data. In step S105, the mobile communication module transmits the text data and the printed image data to the cloud of the cloud analysis server. a communication unit; in step S106, the cloud communication unit receives the text data and the printed image data, and stores the data in the cloud storage unit; in step S107, the cloud processing unit parses the at least one injury name in the text data, Searching for the corresponding international disease classification code in the international disease classification code pre-stored by the cloud storage unit, and storing the corresponding international disease classification code to the cloud storage unit, and transmitting the cloud communication unit to the claim communication unit of the insurance claim server; step S108, The claim processing unit of the insurance claim server corresponds to the policy and the at least one injury name The disease classification code generates a claim result and a claim amount, and the claim payment unit transmits the claim amount to a bank server; in step S109, the bank server remits the claim amount to the policy The account of the household, and returning a claim result to the insurance claim server, the claim settlement unit stores the claim result; in step S110, the claim communication unit transmits the claim result to the mobile communication module of the mobile terminal device, The application of the mobile terminal device is caused to end the claim application process.
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Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
TWI684157B (en) * 2018-10-12 2020-02-01 南山人壽保險股份有限公司 A Smart Claims System Based on Action Vehicle
TWI712979B (en) * 2019-04-16 2020-12-11 富邦人壽保險股份有限公司 System and method for processing insurance claims using long short-term memory model of deep learning
US11972489B1 (en) 2020-04-24 2024-04-30 State Farm Mutual Automobile Insurance Company Claims process assistance using models

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
TWI684157B (en) * 2018-10-12 2020-02-01 南山人壽保險股份有限公司 A Smart Claims System Based on Action Vehicle
TWI712979B (en) * 2019-04-16 2020-12-11 富邦人壽保險股份有限公司 System and method for processing insurance claims using long short-term memory model of deep learning
US11972489B1 (en) 2020-04-24 2024-04-30 State Farm Mutual Automobile Insurance Company Claims process assistance using models

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