CN107909232A - Case of settling a claim distribution method, device, storage medium and computer equipment - Google Patents
Case of settling a claim distribution method, device, storage medium and computer equipment Download PDFInfo
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- CN107909232A CN107909232A CN201710751985.5A CN201710751985A CN107909232A CN 107909232 A CN107909232 A CN 107909232A CN 201710751985 A CN201710751985 A CN 201710751985A CN 107909232 A CN107909232 A CN 107909232A
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Abstract
The present invention relates to one kind settle a claim case distribution method, the described method includes：The Claims Resolution case examination ＆ verification request of the first management terminal initiation is received, the Claims Resolution case examination ＆ verification request carries the first user identifier of corresponding first management terminal, and first user identifier is used for the user that unique mark initiates the Claims Resolution case examination ＆ verification request；The the first Claims Resolution case differed with the applying type of head of the queue Claims Resolution case and the people that is in danger mark all same and application time of settling a claim no more than the first preset time threshold is searched in Claims Resolution case queue to be allocated；Described first Claims Resolution case is distributed into corresponding first management terminal of first user identifier.Using the method, the treatment effeciency of Claims Resolution case can be improved.In addition, additionally provide a kind of Claims Resolution case distributor, storage medium and computer equipment.
Description
Technical field
The present invention relates to field of computer technology, more particularly to one kind Claims Resolution case distribution method, device, storage medium
And computer equipment.
Background technology
Same client may relate to polytype declaration form, for example same client have purchased that same company is multiple to accept insurance
The same type insurance of mechanism, as client have purchased the medical insurance and Pingan Insurance's public affairs of Shanghai mechanism of Ping An Insurance Company at the same time
Taking charge of the medical insurance of Shenzhen mechanism, then the client has the personal medical insurance declaration form of Shanghai mechanism and Shenzhen mechanism respectively, or
Enterprise where the person client uniformly have purchased medical insurance to employee, then all employees share group's declaration form, per zooid
Work (including the employee) also corresponds to a sub- declaration form of group.
Because being serviced when self-service Claims Resolution system offer 7*24 is small, client can carry out repeatedly Claims Resolution application in one day.When client exists
When Claims Resolution application is frequently carried out in the short time, Claims Resolution case that traditional Claims Resolution case processing method is received by concurrently distributing
Part, the polytype Claims Resolution case for being easily related to same client are distributed to different auditors and are audited at the same time, and because
The correlation of these Claims Resolution cases, as client's hospitalization takes 2000 yuan, Shanghai mechanism of Ping An Insurance Company has compensated
1000 yuan, then the compensation amount of money of Ping An Insurance Company Shenzhen mechanism must not exceed 1000 yuan, and each mechanism adds up the gold compensated
Volume must not exceed total sum insured etc. so that interdigitated interlock occurs for these Claims Resolution cases, so as to cause the treatment effeciency of Claims Resolution case low.
The content of the invention
, can be with an embodiment of the present invention provides one kind Claims Resolution case distribution method, device, storage medium and computer equipment
Improve Claims Resolution case treatment effeciency.
One kind Claims Resolution case distribution method, the described method includes：
The Claims Resolution case examination ＆ verification request of the first management terminal initiation is received, the Claims Resolution case examination ＆ verification request carries corresponding institute
The first user identifier of the first management terminal is stated, first user identifier is used for unique mark and initiates the Claims Resolution case examination ＆ verification
The user of request；
Searched in Claims Resolution case queue to be allocated and identify all same with the applying type of head of the queue Claims Resolution case and the people that is in danger
And Claims Resolution application time difference is no more than the first Claims Resolution case of the first preset time threshold；
Described first Claims Resolution case is distributed into corresponding first management terminal of first user identifier.
It is in one of the embodiments, described that by the described first Claims Resolution case, to distribute to first user identifier corresponding
First management terminal, including：Judge whether the quantity of the first Claims Resolution case is less than or equal to default case and handles number
Amount；If so, the described first Claims Resolution case is then distributed into corresponding first management terminal of first user identifier.
It is in one of the embodiments, described that by the described first Claims Resolution case, to distribute to first user identifier corresponding
First management terminal, including：Obtain distributed Claims Resolution case in described first Claims Resolution case applying type and be in danger
People identifies the processing state of the second Claims Resolution case of all same；If the processing state of the second Claims Resolution case is to wind up the case, will
The first Claims Resolution case distributes to corresponding first management terminal of first user identifier.
In one of the embodiments, if the processing state of the second Claims Resolution case is not wind up the case, described the is obtained
The corresponding second user mark of two Claims Resolution cases；Described first Claims Resolution case is distributed into corresponding second pipe of second user mark
Manage terminal.
In one of the embodiments, the corresponding policy type of the head of the queue Claims Resolution case is obtained；If the policy type
For the sub- declaration form of group, then it is the sub- declaration form of group to search policy type in the Claims Resolution case queue to be allocated, with the head of the queue
Claims Resolution case has identical group's declaration form, and differs pre- no more than second with the Claims Resolution application time of head of the queue Claims Resolution case
If the 3rd Claims Resolution case of time threshold；It is whole that described 3rd Claims Resolution case is distributed into corresponding first user of the first user identifier
End.
One kind Claims Resolution case distributor, described device include：
Claims Resolution case searching module, for searching the application class with head of the queue Claims Resolution case in Claims Resolution case queue to be allocated
Type and the people that is in danger identify all same and first Claims Resolution case of the application time difference no more than the first preset time threshold of settling a claim；
Claims Resolution case distribution module, it is corresponding described with the described first Claims Resolution case is distributed to first user identifier
First management terminal.
In one of the embodiments, the Claims Resolution case distribution module is used for the quantity for judging the first Claims Resolution case
Whether it is less than or equal to default case and handles quantity；Marked if so, the described first Claims Resolution case then is distributed to first user
Know corresponding first management terminal.
In one of the embodiments, the Claims Resolution case distribution module be used to obtain distributed in Claims Resolution case with it is described
The applying type of first Claims Resolution case and the people that is in danger identify the processing state of the second Claims Resolution case of all same；If second reason
The processing state for paying for case is to wind up the case, then the described first Claims Resolution case is distributed to first user identifier corresponding described the
One management terminal.
A kind of computer-readable recording medium, is stored thereon with computer program, which realizes when being executed by processor
Following steps：
The Claims Resolution case examination ＆ verification request of the first management terminal initiation is received, the Claims Resolution case examination ＆ verification request carries corresponding institute
The first user identifier of the first management terminal is stated, first user identifier is used for unique mark and initiates the Claims Resolution case examination ＆ verification
The user of request；
Searched in Claims Resolution case queue to be allocated and identify all same with the applying type of head of the queue Claims Resolution case and the people that is in danger
And Claims Resolution application time difference is no more than the first Claims Resolution case of the first preset time threshold；
Described first Claims Resolution case is distributed into corresponding first management terminal of first user identifier.
A kind of computer equipment, the computer equipment include memory, processor and are stored on the memory simultaneously
The computer program that can be run on the processor, the processor realize following steps when performing the calculator program：
The Claims Resolution case examination ＆ verification request of the first management terminal initiation is received, the Claims Resolution case examination ＆ verification request carries corresponding institute
The first user identifier of the first management terminal is stated, first user identifier is used for unique mark and initiates the Claims Resolution case examination ＆ verification
The user of request；
Searched in Claims Resolution case queue to be allocated and identify all same with the applying type of head of the queue Claims Resolution case and the people that is in danger
And Claims Resolution application time difference is no more than the first Claims Resolution case of the first preset time threshold；
Described first Claims Resolution case is distributed into corresponding first management terminal of first user identifier.
Above-mentioned Claims Resolution case distribution method, device, storage medium and computer equipment, are sent out by receiving the first management terminal
The Claims Resolution case examination ＆ verification request risen, Claims Resolution case examination ＆ verification request carry the first user identifier of corresponding first management terminal,
First user identifier is used for the user that unique mark initiates Claims Resolution case examination ＆ verification request, is searched in Claims Resolution case queue to be allocated
With head of the queue Claims Resolution case be in danger people's identity and applying type all same and the Claims Resolution application time differ be no more than it is first pre-
If the first Claims Resolution case of time threshold, the find first Claims Resolution case is distributed into corresponding first pipe of the first user identifier
Manage terminal.Since the first Claims Resolution case found is the corresponding same type of the same people that is in danger in preset time range
The Claims Resolution case of insurance kind and different policy type, then these cases are distributed into same auditor and are audited, effectively reduce because
For the concurrently distribution for case of settling a claim so that be mutually related the probability that Claims Resolution case interlocks, so as to improve Claims Resolution case
Treatment effeciency.
Brief description of the drawings
Fig. 1 is the applied environment figure of Claims Resolution case distribution method in one embodiment；
Fig. 2 is the cut-away view of server in one embodiment；
Fig. 3 is the flow chart of Claims Resolution case distribution method in one embodiment；
Fig. 4 is that the first Claims Resolution case is distributed to the first user identifier corresponding described the by Fig. 3 in one embodiment
The method flow diagram of one management terminal；
Fig. 5 be Fig. 3 in another embodiment that the first Claims Resolution case is distributed to the first user identifier is corresponding described
The method flow diagram of first management terminal；
Fig. 6 is the flow chart of Claims Resolution case distribution method in another embodiment；
Fig. 7 is the structure diagram of device in one embodiment.
Embodiment
In order to make the purpose , technical scheme and advantage of the present invention be clearer, with reference to the accompanying drawings and embodiments, it is right
The present invention is further elaborated.It should be appreciated that the specific embodiments described herein are merely illustrative of the present invention, and
It is not used in the restriction present invention.
Transaction rollback method provided in an embodiment of the present invention can be applied in environment as shown in Figure 1.Refering to what is shown in Fig. 1,
The Claims Resolution case examination ＆ verification request that 102 receiving terminal 104 of server is sent, terminal 104 is distributed to by the Claims Resolution case found.Tool
Body, server 102 is communicated by network with terminal 104, and the Claims Resolution case that 102 receiving terminal 104 of server is sent is examined
Core ask, it is to be allocated Claims Resolution case queue in search with head of the queue Claims Resolution case applying type and the people that is in danger mark all same and
Claims Resolution case of the application time difference of settling a claim no more than preset time threshold, terminal 104 is distributed to by the first Claims Resolution case.Eventually
End 104 is operated by auditor, and for being audited to Claims Resolution case, auditor is the use with Claims Resolution case examination ＆ verification authority
The terminal of family here includes but not limited to various personal computers, laptop, smart mobile phone, tablet computer, portable wears
Wear equipment etc..
In one embodiment, as shown in Fig. 2, additionally providing a kind of server, which includes passing through system bus
Processor, non-volatile memory medium, built-in storage, the network connection mouth of connection, are stored with behaviour in non-volatile memory medium
Make system and computer executable instructions, which is used for realization being suitable for of being provided in the embodiment of the present application
The medical services reserving method of server.The processor is used to improve calculating and control ability, supports the operation of whole server.
Built-in storage is used to provide environment for the operating system in non-volatile memory medium and the operation of computer executable instructions.Net
Network interface is used to carry out network service with terminal.It will be understood by those skilled in the art that structure shown in Figure 2, only with
The block diagram of the relevant part-structure of application scheme, does not form the limit for the server being applied thereon to application scheme
Fixed, specifically server can include, than more or fewer components shown in figure, either combining some components or with not
Same component arrangement.
In one embodiment, as shown in Figure 3, there is provided one kind Claims Resolution case distribution method, including：
Step 302, receive the Claims Resolution case that the first management terminal is initiated and audit request, Claims Resolution case examination ＆ verification request carrying pair
The first user identifier of the first management terminal is answered, the first user identifier is used for the use that unique mark initiates Claims Resolution case examination ＆ verification request
Family.
Claims Resolution case is that the insurance of the Claims Resolution material and purchase provided according to client carries out the case of reparation processing；First pipe
Reason terminal is that terminal used in the auditor that the Claims Resolution case stored in examination ＆ verification database is asked is sent to server；First
User identifier is used for the user that unique mark initiates Claims Resolution case examination ＆ verification request.
In the present embodiment, the Claims Resolution case examination ＆ verification request that server receives is that the first management terminal passes through the first user identifier
The Claims Resolution case sent to server audits request.
Step 304, search in Claims Resolution case queue to be allocated and marked with the applying type of head of the queue Claims Resolution case and the people that is in danger
Know all same and the application time of settling a claim differs case of settling a claim no more than the first of the first preset time threshold.
In the present embodiment, it is to be allocated Claims Resolution case be in the Claims Resolution case received be in etc. pending Claims Resolution case
Part；Head of the queue Claims Resolution case is the Claims Resolution case positioned at the Head-of-line of Claims Resolution case queue to be allocated；Applying type, that is, Claims Resolution case
Insurance kind type on the corresponding declaration form of part, the applying type for case of such as settling a claim is property insurance or personal insurance；The people that is in danger identifies
Can be mark or use that customized character string is formed specifically for the people that is in danger of unique mark Claims Resolution case
The ID card No. at family etc.；First preset time threshold is by analyzing the numbers such as a large amount of application times of Claims Resolution case received
According to rear, the same client calculated frequently carries out the time interval of Claims Resolution application, such as 5 it is small when.
Be in danger people's mark and the applying type all same with head of the queue Claims Resolution case are searched in Claims Resolution case queue to be allocated
And Claims Resolution application time difference, no more than in the first Claims Resolution case of the first preset time threshold, the order of lookup is to be allocated
The head of the queue of Claims Resolution case queue starts, and searches backward successively, until the tail of the queue of Claims Resolution case queue to be allocated, that is to say, that look into
The the first Claims Resolution case found includes head of the queue Claims Resolution case.
Step 306, the first Claims Resolution case is distributed into corresponding first management terminal of the first user identifier.
In the present embodiment, after the different Claims Resolution cases that the same people that is in danger is associated are found out, the Claims Resolution case that will find
The management terminal where same user identifier is distributed to, so that the management terminal identifies the Claims Resolution to being assigned to by the user
Case is audited successively.
In the present embodiment, since the Claims Resolution case found is the corresponding phase of the same people that is in danger in preset time range
The Claims Resolution case of the insurance kind of same type and different policy types, then these cases are distributed into same auditor and are audited, effectively
Reduce because the concurrently distribution of Claims Resolution case so that be mutually related the probability that Claims Resolution case interlocks, so as to improve
The treatment effeciency for case of settling a claim.
In one embodiment, step 306 includes：Handled if the quantity of the first Claims Resolution case is less than or equal to default case
Quantity, then distribute to corresponding first management terminal of the first user identifier by the first Claims Resolution case.
Wherein, it is the maximum number that preconfigured auditor handles Claims Resolution case to preset case processing quantity, specifically
Ground, default Claims Resolution case processing quantity can be the same values that all auditors share, such as the first and second the third couples of auditor
The default Claims Resolution caseload answered is 80 or the case according to default case auditor in preset time range
Part averagely audits what quantity etc. was set dynamically, such as the examination ＆ verification quantity that auditor's first is averaged every day in the first quarter
100, second examination ＆ verification quantity of average every day in the first quarter is 90, third in the first quarter average every day examine
Nuclear volume is 80, then it is 100,90 and 80 to set the first and second the third corresponding default Claims Resolution caseloads respectively.
In the present embodiment, by being limited to the Claims Resolution caseload for distributing to auditor, Claims Resolution case is improved
The efficiency of examination ＆ verification.
In one embodiment, as shown in figure 4, step 306 includes：
Step 316, obtain to have distributed in Claims Resolution case and identified homogeneously with the applying type of the first Claims Resolution case and the people that is in danger
The processing state of the second same Claims Resolution case.
In the present embodiment, the processing state for case of settling a claim includes：In pending, examination ＆ verification, wait to adjust, adjust neutralization and wind up the case five
A state.When server receives the Claims Resolution case of user's typing, it is pending nuclear state to mark the Claims Resolution case, and this is managed
Pay for case to be put in task pool, which is put into Claims Resolution case queue to be allocated by server further according to the application time；
Auditor sends the examination ＆ verification request of Claims Resolution case, and server will include the Claims Resolution according to the method for step 304 to step 306
The case set of case distributes to auditor, and auditor sends the Claims Resolution case examination ＆ verification request, then changes the Claims Resolution case
The examination ＆ verification state of part is in examination ＆ verification；The auditing result that the terminal where server receives auditor is sent is (such as examination ＆ verification material
Whether whether complete and effective, the corresponding declaration form of Claims Resolution case also can compensate amount of money etc.), (if auditing the neat group of material and having
Effect, the corresponding declaration form of Claims Resolution case have can compensate the amount of money) then by the processing status modifier of the Claims Resolution case to wait to adjust；Service
Device timing detection is in Claims Resolution case to be adjusted, when detecting the Claims Resolution case, then according to Claims Resolution case applying type pair
The default Claims Resolution rule answered adjusts the Claims Resolution case, and changes the examination ＆ verification state of the Claims Resolution case as in adjustment；Treat as
Work((calculates amount for which loss settled) when calculating adjustment result, and the examination ＆ verification state for changing the Claims Resolution case is to wind up the case.
Step 326, if the processing state of the second Claims Resolution case is to wind up the case, the first Claims Resolution case is distributed into the first user
Identify corresponding first management terminal.
If in Claims Resolution case has been distributed with the applying type of Claims Resolution case found and the people that is in danger mark all same
The processing state for case of settling a claim is to wind up the case, then explanation is being located currently without the related Claims Resolution case of the Claims Resolution case with finding
In reason, then the Claims Resolution found case can will be distributed to the corresponding management terminal of foregoing user identifier.
In the present embodiment, ensure with it is to be allocated Claims Resolution case it is associated distributed Claims Resolution case it is processed before
Put, the Claims Resolution case to be allocated that is mutually related in guarantee preset time range distributes to same person, it is entirely avoided mutually
The interdigitated interlock problem that associated Claims Resolution case occurs, further increases the treatment effeciency of Claims Resolution case.
In one embodiment, after step 326, further include：If the processing state of the second Claims Resolution case is not wind up the case,
Then obtain the corresponding second user mark of the second Claims Resolution case；First Claims Resolution case is distributed into second user mark corresponding the
Two management terminals.
Wherein, second user mark is used for the applying type of unique mark and the Claims Resolution case found and the people that is in danger identifies
The auditor for having distributed Claims Resolution case of all same；Second management terminal be with the applying type of Claims Resolution case that finds and
Terminal used in the Claims Resolution case that the auditor's examination ＆ verification for having distributed Claims Resolution case that the people that is in danger identifies all same is assigned to；Not
Processing state of winding up the case refers in examination ＆ verification, wait to adjust and adjust in any of three kinds of processing states processing state.
In the present embodiment, state of not winding up the case is in the Claims Resolution case of distribution for learning associated with Claims Resolution case to be allocated
(in processing), the Claims Resolution case to be allocated that will be mutually related in preset time range, which is distributed to, foregoing is auditing Claims Resolution case
Auditor, equally completely avoid the interdigitated interlock problem that Claims Resolution case occurs that is mutually related, further increases Claims Resolution
The treatment effeciency of case.
In one embodiment, after step 306, further include：Detect and whether received in the 3rd preset time threshold
The auditing result of first Claims Resolution case；If so, then auditing result is preserved to database, if it is not, then returning the first Claims Resolution case
Receive to task pool and reallocate.
Wherein, the 3rd preset time threshold is will to settle a claim case distributes to examination ＆ verification user to calculate since server, such as
Preset time range is 1 day, then detection service device the Claims Resolution case found is distributed to after auditor 24 it is small when it is interior
Whether auditing result for distributed Claims Resolution case is received, if then preserving auditing result to database, if it is not, then by this
A little Claims Resolution cases are recycled to task pool, these are settled a claim further according to the sequencing of the application time of the Claims Resolution case in task pool
Case is put into Claims Resolution case queue to be allocated, these Claims Resolution cases are distributed then according to the method for abovementioned steps 302 to 306.
In one embodiment, as shown in figure 5, after step 306, further including：
Step 502, the corresponding policy type of head of the queue Claims Resolution case in Claims Resolution case queue to be allocated is obtained.
In the present embodiment, policy type includes personal declaration form, the sub- declaration form of group's declaration form and group.Wherein, personal declaration form is
Client is with the corresponding declaration form of insurance that one's own name is bought, for example Zhang San is to oneself have purchased a medical insurance, then Zhang San
The corresponding declaration form of medical insurance of purchase is personal declaration form；Group's declaration form, that is, client is with the corresponding guarantor of insurance of group's name purchase
List, such as company give each Employee Purchase a business insurance, then all employees of the said firm share one with the public affairs
Take charge of group's declaration form for differentiation；The declaration form that the sub- declaration form of group is possessed for each individual corresponding to group's declaration form, for example, it is public
Each employee of department possesses the corresponding declaration form of a business insurance respectively.
Step 504, if policy type is the sub- declaration form of group, lookup policy type is in Claims Resolution case queue to be allocated
The sub- declaration form of group, has identical group's declaration form with head of the queue Claims Resolution case, and the Claims Resolution application time phase for case of settling a claim with head of the queue
Difference is no more than the 3rd Claims Resolution case of the second preset time threshold.
Wherein, the second preset time threshold be previously according to largely have identical group's declaration form difference be in danger people correspond to
Same type insurance kind different Claims Resolution cases Claims Resolution application time data, the difference under the identical group's declaration form calculated is in danger
People carry out Claims Resolution application time interval, such as 8 it is small when.
Step 506, the 3rd Claims Resolution case is distributed into corresponding first user terminal of the first user identifier.
Other people couple that are in danger on declaration form corresponding with the head of the queue Claims Resolution case in Claims Resolution case queue to be allocated is found out
After the Claims Resolution case answered, by the corresponding Claims Resolution case of these other people that are in danger with finding out before and head of the queue Claims Resolution case phase
Associated Claims Resolution case distributes to same auditor.
In the present embodiment, by the way that the people that is in danger of the difference under same Zhang Tuanti declaration forms in preset time range is corresponding similar
The Claims Resolution case of type insurance kind is distributed to same auditor and is audited, since the difference under same Zhang Tuanti declaration forms is in danger people
The material check method of the Claims Resolution case of corresponding same type insurance kind is identical with Claims Resolution computational methods so that auditor can be quick
The examination ＆ verification of Claims Resolution case is completed, improves the treatment effeciency of Claims Resolution case.
In one embodiment, as shown in fig. 6, additionally providing another Claims Resolution case distribution method, including：
Step 602, receive the Claims Resolution case that the first management terminal is initiated and audit request, Claims Resolution case examination ＆ verification request carrying pair
The first user identifier of the first management terminal is answered, the first user identifier is used for the use that unique mark initiates Claims Resolution case examination ＆ verification request
Family.
Similarly, the first management terminal is that the examination ＆ verification that the Claims Resolution case stored in examination ＆ verification database is asked is sent to server
Terminal used in personnel；First user identifier is used for the user that unique mark initiates Claims Resolution case examination ＆ verification request.
In the present embodiment, the Claims Resolution case examination ＆ verification request that server receives is that the first management terminal passes through the first user identifier
The Claims Resolution case sent to server audits request.
Step 604, search in Claims Resolution case queue to be allocated and marked with the applying type of head of the queue Claims Resolution case and the people that is in danger
Know all same and the application time of settling a claim differs case of settling a claim no more than the first of the first preset time threshold.
Similarly, in the present embodiment, it is to be allocated Claims Resolution case be in the Claims Resolution case received be in etc. it is pending
Claims Resolution case；Head of the queue Claims Resolution case is the Claims Resolution case positioned at the Head-of-line of Claims Resolution case queue to be allocated；Applying type is
Insurance kind type on the corresponding declaration form of case of settling a claim, the applying type for case of such as settling a claim is property insurance or personal insurance；It is in danger
People's mark is used for the people that is in danger of unique mark Claims Resolution case, specifically, can be the mark that customized character string is formed, also may be used
To be ID card No. of user etc.；When first preset time threshold is the application by analyzing a large amount of Claims Resolution cases received
Between etc. after data, the same client calculated frequently carries out the time interval of Claims Resolution application.
Step 606, obtain to have distributed in Claims Resolution case and identified homogeneously with the applying type of the first Claims Resolution case and the people that is in danger
The processing state of the second same Claims Resolution case,
Similarly, the processing state for case of settling a claim includes：In pending, examination ＆ verification, wait to adjust, adjust neutralization and wind up the case five shapes
State.
Step 608, whether the processing state for judging the second Claims Resolution case is to wind up the case, if then entering step 610, if otherwise
Enter step 611.
In the present embodiment, the processing state for case of settling a claim refers to that the current processing state of Claims Resolution case is not wind up the case
In examination ＆ verification, any of wait to adjust, adjust Claims Resolution state.
Step 610, if the quantity of the first Claims Resolution case, which is less than default case, handles quantity, head of the queue Claims Resolution case pair is obtained
The policy type answered.
Similarly, in the present embodiment, policy type includes personal declaration form, the sub- declaration form of group's declaration form and group.Wherein, it is personal
Declaration form, that is, client is with the corresponding declaration form of insurance that one's own name is bought, for example Zhang San is to oneself have purchased a medical insurance,
Then the corresponding declaration form of medical insurance of Zhang San's purchase is personal declaration form；Group's declaration form, that is, client is with the insurance pair of group's name purchase
The declaration form answered, such as company give each Employee Purchase a business insurance, then all employees of the said firm share one
Using the said firm as the group's declaration form distinguished；The declaration form that the sub- declaration form of group is possessed for each individual corresponding to group's declaration form,
For example each employee of company possesses the corresponding declaration form of a business insurance respectively.
Step 611, the corresponding second user mark of the second Claims Resolution case is obtained, and the first Claims Resolution case is distributed to second
Corresponding second management terminal of user identifier.
Similarly, second user mark is used for the applying type of unique mark and the Claims Resolution case found and the people that is in danger marks
Know the auditor for having distributed Claims Resolution case of all same；Second management terminal is the applying type of the Claims Resolution case with finding
Terminal used in the Claims Resolution case that the auditor's examination ＆ verification for having distributed Claims Resolution case with people's mark all same of being in danger is assigned to.
Step 612, if policy type is the sub- declaration form of group, lookup policy type is in Claims Resolution case queue to be allocated
The sub- declaration form of group, has identical group's declaration form with head of the queue Claims Resolution case, and the Claims Resolution application time phase for case of settling a claim with head of the queue
Difference is no more than the 3rd Claims Resolution case of the second preset time threshold.
Wherein, the second preset time threshold be previously according to largely have identical group's declaration form difference be in danger people correspond to
Same type insurance kind different Claims Resolution cases Claims Resolution application time data, the difference under the identical group's declaration form calculated is in danger
People carries out the time interval of Claims Resolution application.
Step 614, handled if the sum of quantity of the first Claims Resolution case and the 3rd Claims Resolution case is less than or equal to default case
Quantity, then distribute to corresponding first user terminal of the first user identifier by the first Claims Resolution case and the 3rd Claims Resolution case.
Other people couple that are in danger on declaration form corresponding with the head of the queue Claims Resolution case in Claims Resolution case queue to be allocated is found out
After the Claims Resolution case answered, by the corresponding Claims Resolution case of these other people that are in danger with finding out before and head of the queue Claims Resolution case phase
Associated Claims Resolution case distributes to same auditor.
Step 616, if the quantity of the first Claims Resolution case, which is equal to default case, handles quantity, by the first Claims Resolution case distribution
Give the first user identifier corresponding first management terminal.
If the number of the Claims Resolution case associated with the head of the queue Claims Resolution case in Claims Resolution case queue to be allocated found
Amount has reached default case processing quantity, then the Claims Resolution case found is directly distributed to the management for initiating case examination ＆ verification request
Terminal.
In the present embodiment, ensure with it is to be allocated Claims Resolution case it is associated distributed Claims Resolution case it is processed before
Put, the Claims Resolution case to be allocated that is mutually related in guarantee preset time range distributes to same auditor, avoids completely
Be mutually related the interdigitated interlock problem that Claims Resolution case occurs, and effectively increases the treatment effeciency of Claims Resolution case；And to distribution
Claims Resolution caseload to auditor is limited, and further increases the treatment effeciency of Claims Resolution case；At the same time again true
The Claims Resolution caseload for distributing to auditor is protected within its examination ＆ verification ability to bear, will be had with the Claims Resolution case that is mutually related
The corresponding Claims Resolution case of the sub- declaration form of other groups (and other people that are in danger) and the foregoing Claims Resolution that is mutually related of identical group's declaration form
Case distributes to same auditor, because both material checking methods are identical with Claims Resolution operation rule, further improves
There is the treatment effeciency of Claims Resolution case.
In one embodiment, as shown in Figure 7, there is provided one kind Claims Resolution case distributor, including：
Case of settling a claim examination ＆ verification request receiving module 702, receives the Claims Resolution case examination ＆ verification request that the first management terminal is initiated, reason
The first user identifier that case examination ＆ verification request carries corresponding first management terminal is paid for, the first user identifier is initiated for unique mark
The user of case of settling a claim examination ＆ verification request；
Case of settling a claim searching module 704, for searching the Shen with head of the queue Claims Resolution case in Claims Resolution case queue to be allocated
Please type and be in danger people's mark all same and first Claims Resolution case of the application time difference no more than the first preset time threshold of settling a claim
Part；
Case of settling a claim distribution module 706, corresponding first management of the first user identifier is distributed to by the first Claims Resolution case
Terminal.
In one embodiment, case distribution module 706 of settling a claim is used to judge whether the quantity of the first Claims Resolution case is less than
Or handle quantity equal to default case；If so, the first Claims Resolution case is then distributed into corresponding first management of the first user identifier
Terminal.
In one embodiment, case distribution module 706 of settling a claim is used to obtain to have distributed in Claims Resolution case settles a claim with first
The applying type of case and the people that is in danger identify the processing state of the second Claims Resolution case of all same；If the processing of the second Claims Resolution case
State is to wind up the case, then the first Claims Resolution case is distributed to corresponding first management terminal of the first user identifier.
In one embodiment, if the processing state that Claims Resolution case distribution module 706 is used for the second Claims Resolution case is not tie
Case, then obtain the corresponding second user mark of the second Claims Resolution case；First Claims Resolution case is distributed to second user mark to correspond to
The second management terminal.
In one embodiment, case distribution module 706 of settling a claim is used to obtain the corresponding policy type of head of the queue Claims Resolution case；
If policy type is the sub- declaration form of group, it is the sub- declaration form of group to search policy type in Claims Resolution case queue to be allocated, with team
Head Claims Resolutions case has identical group's declaration form, and differs default no more than second with the Claims Resolution application time of head of the queue Claims Resolution case
3rd Claims Resolution case of time threshold；
3rd Claims Resolution case is distributed into corresponding first user terminal of the first user identifier.
In one embodiment, there is provided a kind of computer-readable recording medium, is stored thereon with computer program, the journey
Following steps are realized when sequence is executed by processor：
The Claims Resolution case examination ＆ verification request of the first management terminal initiation is received, Claims Resolution case examination ＆ verification request carries corresponding first pipe
The first user identifier of terminal is managed, the first user identifier is used for the user that unique mark initiates Claims Resolution case examination ＆ verification request；
Searched in Claims Resolution case queue to be allocated and identify all same with the applying type of head of the queue Claims Resolution case and the people that is in danger
And Claims Resolution application time difference is no more than the first Claims Resolution case of the first preset time threshold；
First Claims Resolution case is distributed into corresponding first management terminal of the first user identifier.
In one embodiment, the first Claims Resolution case is distributed into the first user identifier corresponding the performed by processor
One management terminal, including：Judge whether the quantity of the first Claims Resolution case is less than or equal to default case and handles quantity；If so, then
First Claims Resolution case is distributed into corresponding first management terminal of the first user identifier.
In one embodiment, the first Claims Resolution case is distributed into the first user identifier corresponding the performed by processor
One management terminal, including：Obtain to have distributed in Claims Resolution case and identified homogeneously with the applying type of the first Claims Resolution case and the people that is in danger
The processing state of the second same Claims Resolution case；If the processing state of the second Claims Resolution case is to wind up the case, by the first Claims Resolution case point
Corresponding first management terminal of the first user identifier of dispensing.
In one embodiment, if the processing state of the second Claims Resolution case performed by processor is not wind up the case, obtain
The corresponding second user mark of second Claims Resolution case；First Claims Resolution case is distributed into corresponding second management of second user mark
Terminal.
In one embodiment, the corresponding policy type of acquisition head of the queue Claims Resolution case performed by processor；If declaration form class
Type is the sub- declaration form of group, then it is the sub- declaration form of group to search policy type in Claims Resolution case queue to be allocated, with head of the queue Claims Resolution case
Part has identical group's declaration form, and is differed with the Claims Resolution application time of head of the queue Claims Resolution case and be no more than the second preset time threshold
The 3rd Claims Resolution case；3rd Claims Resolution case is distributed into corresponding first user terminal of the first user identifier
In one embodiment, there is provided a kind of computer equipment, computer equipment include memory, processor and storage
On a memory and the computer program that can run on a processor, processor realize following steps when performing calculator program：
The Claims Resolution case examination ＆ verification request of the first management terminal initiation is received, Claims Resolution case examination ＆ verification request carries corresponding first pipe
The first user identifier of terminal is managed, the first user identifier is used for the user that unique mark initiates Claims Resolution case examination ＆ verification request；
Searched in Claims Resolution case queue to be allocated and identify all same with the applying type of head of the queue Claims Resolution case and the people that is in danger
And Claims Resolution application time difference is no more than the first Claims Resolution case of the first preset time threshold；
First Claims Resolution case is distributed into corresponding first management terminal of the first user identifier.
In one embodiment, the first Claims Resolution case is distributed into the first user identifier corresponding the performed by processor
One management terminal, including：Judge whether the quantity of the first Claims Resolution case is less than or equal to default case and handles quantity；If so, then
First Claims Resolution case is distributed into corresponding first management terminal of the first user identifier.
In one embodiment, the first Claims Resolution case is distributed into the first user identifier corresponding the performed by processor
One management terminal, including：Obtain to have distributed in Claims Resolution case and identified homogeneously with the applying type of the first Claims Resolution case and the people that is in danger
The processing state of the second same Claims Resolution case；If the processing state of the second Claims Resolution case is to wind up the case, by the first Claims Resolution case point
Corresponding first management terminal of the first user identifier of dispensing.
In one embodiment, if the processing state of the second Claims Resolution case performed by processor is not wind up the case, obtain
The corresponding second user mark of second Claims Resolution case；First Claims Resolution case is distributed into corresponding second management of second user mark
Terminal.
In one embodiment, the corresponding policy type of acquisition head of the queue Claims Resolution case performed by processor；If declaration form class
Type is the sub- declaration form of group, then it is the sub- declaration form of group to search policy type in Claims Resolution case queue to be allocated, with head of the queue Claims Resolution case
Part has identical group's declaration form, and is differed with the Claims Resolution application time of head of the queue Claims Resolution case and be no more than the second preset time threshold
The 3rd Claims Resolution case；3rd Claims Resolution case is distributed into corresponding first user terminal of the first user identifier.
It should be noted that " first ", " second " and " the 3rd " in each embodiment of the present invention etc. is used only as distinguishing, and
It is not used as the restriction to size, subordinate, sequencing etc..For example, the first management terminal and the second management terminal are only
For distinguishing different management terminals, without departing from the scope of the invention, the first management end can be known as second
Management terminal, it is similar, the second management terminal can be known as to the first management terminal, the first management terminal and the second management terminal two
Person is management terminal, but is not same management terminal.
Each technical characteristic of embodiment described above can be combined arbitrarily, to make description succinct, not to above-mentioned reality
Apply all possible combination of each technical characteristic in example to be all described, as long as however, the combination of these technical characteristics is not deposited
In contradiction, the scope that this specification is recorded all is considered to be.
Embodiment described above only expresses the several embodiments of the present invention, its description is more specific and detailed, but simultaneously
Cannot therefore it be construed as limiting the scope of the patent.It should be pointed out that come for those of ordinary skill in the art
Say, without departing from the inventive concept of the premise, various modifications and improvements can be made, these belong to the protection of the present invention
Scope.Therefore, the protection domain of patent of the present invention should be determined by the appended claims.
Claims (10)
1. one kind Claims Resolution case distribution method, the described method includes：
Receive the Claims Resolution case examination ＆ verification request of the first management terminal initiation, the Claims Resolution case examination ＆ verification request carries corresponding described the
First user identifier of one management terminal, first user identifier are used for unique mark and initiate the Claims Resolution case examination ＆ verification request
User；
Searched in Claims Resolution case queue to be allocated and identify all same and reason with the applying type of head of the queue Claims Resolution case and the people that is in danger
Pay for first Claims Resolution case of the application time difference no more than the first preset time threshold；
Described first Claims Resolution case is distributed into corresponding first management terminal of first user identifier.
2. according to the method described in claim 1, it is characterized in that, described distribute to described first by the described first Claims Resolution case
Corresponding first management terminal of user identifier, including：
Judge whether the quantity of the first Claims Resolution case is less than or equal to default case and handles quantity；
If so, the described first Claims Resolution case is then distributed into corresponding first management terminal of first user identifier.
3. according to the method described in claim 1, it is characterized in that, described distribute to described first by the described first Claims Resolution case
Corresponding first management terminal of user identifier, including：
Obtain to have distributed in Claims Resolution case and identify the second of all same with the applying type of the described first Claims Resolution case and the people that is in danger
The processing state for case of settling a claim；
If the processing state of the second Claims Resolution case is to wind up the case, the described first Claims Resolution case is distributed into first user
Identify corresponding first management terminal.
4. according to the method described in claim 3, it is characterized in that, the method further includes：
If the processing state of the second Claims Resolution case is not wind up the case, the corresponding second user of the second Claims Resolution case is obtained
Mark；
Described first Claims Resolution case is distributed into second user and identifies corresponding second management terminal.
5. according to the method described in claim 1, it is characterized in that, the method further includes：
Obtain the corresponding policy type of the head of the queue Claims Resolution case；
If the policy type is the sub- declaration form of group, it is group to search policy type in the Claims Resolution case queue to be allocated
Sub- declaration form, has identical group's declaration form with head of the queue Claims Resolution case, and with the head of the queue settle a claim the Claims Resolution application of case when
Between difference no more than the second preset time threshold the 3rd Claims Resolution case；
Described 3rd Claims Resolution case is distributed into corresponding first user terminal of the first user identifier.
6. one kind Claims Resolution case distributor, it is characterised in that described device includes：
Case of settling a claim examination ＆ verification request receiving module, receives the Claims Resolution case examination ＆ verification request that the first management terminal is initiated, the Claims Resolution
Case examination ＆ verification request carries the first user identifier of corresponding first management terminal, and first user identifier is used to uniquely mark
Know the user for initiating the Claims Resolution case examination ＆ verification request；
Settle a claim case searching module, for it is to be allocated Claims Resolution case queue in search with head of the queue Claims Resolution case applying type and
The people that is in danger identifies all same and first Claims Resolution case of the application time difference no more than the first preset time threshold of settling a claim；
Claims Resolution case distribution module, first user identifier corresponding described first is distributed to by the described first Claims Resolution case
Management terminal.
7. device according to claim 6, it is characterised in that the Claims Resolution case distribution module is used to judge described first
Whether the quantity for case of settling a claim, which is less than or equal to default case, handles quantity；If so, then the described first Claims Resolution case is distributed to
Corresponding first management terminal of first user identifier.
8. device according to claim 6, it is characterised in that the Claims Resolution case distribution module, which is used to obtain, has distributed reason
Pay for the processing shape for the second Claims Resolution case for identifying all same in case with the applying type of the described first Claims Resolution case and the people that is in danger
State；If the processing state of the second Claims Resolution case is to wind up the case, the described first Claims Resolution case is distributed into first user
Identify corresponding first management terminal.
9. a kind of computer-readable recording medium, is stored thereon with computer program, it is characterised in that the program is held by processor
Realized during row as any one of claim 1 to 5 the step of method.
10. a kind of computer equipment, the computer equipment includes memory, processor and is stored on the memory and can
The computer program run on the processor, the processor realize such as claim 1 when performing the calculator program
To any one of 5 the step of method.
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710751985.5A CN107909232B (en) | 2017-08-28 | 2017-08-28 | Claims case distribution method and device, storage medium and computer equipment |
| PCT/CN2018/088567 WO2019041912A1 (en) | 2017-08-28 | 2018-05-27 | Method and apparatus for assigning claim settlement case, computer device, and storage medium |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201710751985.5A CN107909232B (en) | 2017-08-28 | 2017-08-28 | Claims case distribution method and device, storage medium and computer equipment |
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| Publication Number | Publication Date |
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| CN107909232A true CN107909232A (en) | 2018-04-13 |
| CN107909232B CN107909232B (en) | 2021-05-04 |
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| WO (1) | WO2019041912A1 (en) |
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| CN109658223A (en) * | 2018-11-12 | 2019-04-19 | 平安科技（深圳）有限公司 | Collection case distribution method, device, equipment and medium based on data processing |
| CN109767070A (en) * | 2018-12-14 | 2019-05-17 | 深圳壹账通智能科技有限公司 | Case distribution method, device, computer equipment and storage medium |
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| CN111445261A (en) * | 2018-12-29 | 2020-07-24 | 达丰(上海)电脑有限公司 | Processing method, system, electronic terminal and storage medium of customer claims case |
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Also Published As
| Publication number | Publication date |
|---|---|
| CN107909232B (en) | 2021-05-04 |
| WO2019041912A1 (en) | 2019-03-07 |
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