CN107909488A - The processing method and processing device of settlement of insurance claim flow - Google Patents
The processing method and processing device of settlement of insurance claim flow Download PDFInfo
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- CN107909488A CN107909488A CN201711110995.7A CN201711110995A CN107909488A CN 107909488 A CN107909488 A CN 107909488A CN 201711110995 A CN201711110995 A CN 201711110995A CN 107909488 A CN107909488 A CN 107909488A
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
- G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
- G06Q40/08—Insurance
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
- G06Q10/00—Administration; Management
- G06Q10/10—Office automation; Time management
- G06Q10/103—Workflow collaboration or project management
Abstract
This application discloses a kind of processing method and processing device of settlement of insurance claim flow, it is related to settlement of insurance claim technical field, the efficiency and accuracy of settlement of insurance claim can be improved, the described method includes：Obtain the current Claims Resolution flow post node where settlement of insurance claim case task, and flow type of settling a claim corresponding with the settlement of insurance claim case task；According to the current Claims Resolution flow post node and the Claims Resolution flow type, the pre-defined Claims Resolution flow dictionary of inquiry, it is included in the Claims Resolution flow dictionary under different Claims Resolution flow types, with Claims Resolution flow post node respectively in requisition for the next Claims Resolution flow post node to circulate；After the relevant Claims Resolution flow processing of the current Claims Resolution flow post node, the settlement of insurance claim case task is pushed to the next Claims Resolution flow post node corresponding with the current Claims Resolution flow post node inquired and is handled.The application is suitable for the processing of settlement of insurance claim flow.
Description
Technical field
This application involves settlement of insurance claim technical field, more particularly to a kind of settlement of insurance claim processing method and processing device.
Background technology
Settlement of insurance claim refers to insurance risk occurs in insurance subject and insurant's property is incurred loss or personal life
When being damaged, or declaration form agreement other insurance risks occur and need pay insurance money when, based on contract insurance company advises
It is fixed, fulfil reparation or pay the behavior of responsibility, be the direct work for embodying insurance function and fulfiling insurance responsibility.Settlement of insurance claim stream
Journey consults to be divided into different Claims Resolution flows from acceptance and hearing of a case, bill typing, Claims Review, Claims Resolution sampling observation, Claims Resolution notice, Claims Resolution
Post node, each flow post node of settling a claim is defined according to the operating right of business personnel.
At present, settlement of insurance claim flow is promoted by manual type.A specifically, reason in settlement of insurance claim flow
Pay on the node of flow post, after business personnel completes the related Claims Resolution flow operations of the Claims Resolution flow post node, can manually select and carry
Next Claims Resolution flow post node is given, continues the settlement of insurance claim process flow of next stage.But this manually side
Formula promotes settlement of insurance claim flow relatively time consuming, and easily malfunctions, and then have impact on the efficiency and accuracy of settlement of insurance claim.
The content of the invention
In view of this, this application provides a kind of processing method and processing device of settlement of insurance claim flow, main purpose to be to solve
Certainly promote settlement of insurance claim flow relatively time consuming by manual type at present, and easily malfunction, and then have impact on settlement of insurance claim
The problem of efficiency and accuracy.
According to the application on one side, there is provided a kind of processing method of settlement of insurance claim flow, this method include：
Obtain the current Claims Resolution flow post node where settlement of insurance claim case task, and with the settlement of insurance claim case
Task is settled a claim flow type accordingly；
According to the current Claims Resolution flow post node and the Claims Resolution flow type, pre-defined Claims Resolution flow is inquired about
Dictionary, is included under different Claims Resolution flow types in the Claims Resolution flow dictionary, corresponding respectively with Claims Resolution flow post node
Need the next Claims Resolution flow post node to circulate；
After the relevant Claims Resolution flow processing of the current Claims Resolution flow post node, by the settlement of insurance claim case
Task is pushed to the next Claims Resolution flow post node corresponding with the current Claims Resolution flow post node inquired and carries out
Processing.
According to the application on the other hand, there is provided a kind of processing unit of settlement of insurance claim flow, the device include：
Acquiring unit, for obtaining the current Claims Resolution flow post node where settlement of insurance claim case task, and with institute
Settlement of insurance claim case task is stated to settle a claim accordingly flow type；
Query unit, for the current Claims Resolution flow post node obtained according to the acquiring unit and the Claims Resolution flow
Type, inquires about pre-defined Claims Resolution flow dictionary, is included in the Claims Resolution flow dictionary under different Claims Resolution flow types,
With Claims Resolution flow post node respectively in requisition for the next Claims Resolution flow post node to circulate；
Push unit, for after the relevant Claims Resolution flow processing of the current Claims Resolution flow post node, by institute
That states that settlement of insurance claim case task is pushed to that the query unit inquires is corresponding with the current Claims Resolution flow post node
Next Claims Resolution flow post node is handled.
According to the application another aspect, there is provided a kind of storage device, is stored thereon with computer program, described program
The processing method of above-mentioned settlement of insurance claim flow is realized when being executed by processor.
According to the application another aspect, there is provided a kind of entity apparatus of settlement of insurance claim flow processing, including storage are set
Standby, processor and storage on a storage device and the computer program that can run on a processor, described in the processor execution
The processing method of above-mentioned settlement of insurance claim flow is realized during program.
By above-mentioned technical proposal, a kind of processing method and processing device for settlement of insurance claim flow that the application provides is and current
Settlement of insurance claim flow is promoted to compare by manual type, the current Claims Resolution that the application can be according to where settlement of insurance claim case task
Flow post node and the task are settled a claim flow type accordingly, are inquired about pre-defined Claims Resolution flow dictionary, are found needs
The next Claims Resolution flow post node to circulate, finishes in the currently relevant Claims Resolution flow processing of Claims Resolution flow post node
Afterwards, next Claims Resolution flow post node which is automatically pushed to inquire is handled, saves settlement of insurance claim stream
The propulsion time of journey, accelerates the processing progress of settlement of insurance claim flow, also saves human resources, and pass through flow word of settling a claim
Allusion quotation can accurately find next Claims Resolution flow post node, and then can improve the efficiency and accuracy of settlement of insurance claim.
Described above is only the general introduction of technical scheme, in order to better understand the technological means of the application,
And can be practiced according to the content of specification, and in order to allow above and other objects, features and advantages of the application can
Become apparent, below especially exemplified by the embodiment of the application.
Brief description of the drawings
By reading the detailed description of hereafter preferred embodiment, it is various other the advantages of and benefit it is common for this area
Technical staff will be clear understanding.Attached drawing is only used for showing the purpose of preferred embodiment, and is not considered as to the application
Limitation.And in whole attached drawing, identical component is denoted by the same reference numerals.In the accompanying drawings：
Fig. 1 shows a kind of process flow schematic diagram of settlement of insurance claim flow provided by the embodiments of the present application；
Fig. 2 shows the process flow schematic diagram of another settlement of insurance claim flow provided by the embodiments of the present application；
Fig. 3 shows a kind of structure diagram of the processing unit of settlement of insurance claim flow provided by the embodiments of the present application；
Fig. 4 shows the structure diagram of the processing unit of another settlement of insurance claim flow provided by the embodiments of the present application.
Embodiment
The exemplary embodiment of the disclosure is more fully described below with reference to accompanying drawings.Although the disclosure is shown in attached drawing
Exemplary embodiment, it being understood, however, that may be realized in various forms the disclosure without should be by embodiments set forth here
Limited.On the contrary, these embodiments are provided to facilitate a more thoroughly understanding of the present invention, and can be by the scope of the present disclosure
Completely it is communicated to those skilled in the art.
The embodiment of the present application provides a kind of processing method of settlement of insurance claim flow, can improve the place of settlement of insurance claim flow
Timeliness and accuracy are managed, as shown in Figure 1, this method includes：
101st, obtain the current Claims Resolution flow post node where settlement of insurance claim case task, and with settlement of insurance claim case
Task is settled a claim flow type accordingly.
Wherein, flow post node of settling a claim can be acceptance and hearing of a case post node, bill typing post node, Claims Review
Post node etc. is consulted in post node, Claims Resolution sampling observation post node, Claims Resolution；Settle a claim flow type can be old process type,
Appeal flow type, member's flow type etc.；The content of Claims Resolution flow post node and flow type of settling a claim specifically can basis
Depending on different settlement of insurance claim operation flows.
Executive agent for the embodiment of the present application can be the processing unit for settlement of insurance claim flow, in settlement of insurance claim
In the processing procedure of flow, the automatic push between the node of settlement of insurance claim flow post are realized.
102nd, according to the current Claims Resolution flow post node and Claims Resolution flow type got, pre-defined Claims Resolution is inquired about
Flow dictionary.
Wherein, it is included under different Claims Resolution flow types in Claims Resolution flow dictionary, distinguishes with Claims Resolution flow post node
To in requisition for the next Claims Resolution flow post node to circulate.
It can inquire about to obtain using flow dictionary of settling a claim and settle a claim accordingly under flow type in settlement of insurance claim case task, with
The settlement of insurance claim case task is currently located Claims Resolution flow post node mutually in requisition for the next Claims Resolution flow post to circulate
Node.
103rd, after the currently relevant Claims Resolution flow processing of Claims Resolution flow post node, by settlement of insurance claim case task
The next Claims Resolution flow post node corresponding with current Claims Resolution flow post node inquired is pushed to be handled.
For example, the current post node where settlement of insurance claim case task is acceptance and hearing of a case post node, corresponding Claims Resolution
Flow type is old process type, and having inquired a unique record, current post node in Claims Resolution flow dictionary needs to flow
The next post node gone to is bill typing post node, and according to query result, the settlement of insurance claim case task is current
After the relevant Claims Resolution flow processing of post node, automatic push to bill typing post node carry out the processing of next stage
Operation.
It should be noted that the processing method of settlement of insurance claim flow provided in this embodiment is except applying in settlement of insurance claim stream
Beyond the scene of journey, its similar approach can be applied in other operation flow scenes, such as operation flow examination ＆ approval, certificate acquiring
Flow, common reserve fund check-in flow etc. be related to different post nodes and need level-one level-one circulation carry out scene, to this
The present embodiment does not limit.
The processing method and processing device of a kind of settlement of insurance claim flow provided by the embodiments of the present application, with passing through manual type at present
Settlement of insurance claim flow is promoted to compare, the embodiment of the present application is finished in the currently relevant Claims Resolution flow processing of Claims Resolution flow post node
Afterwards, the next Claims Resolution flow post node that can be automatically pushed to settlement of insurance claim case task inquire is handled, section
The propulsion time of settlement of insurance claim flow has been saved, the processing progress of settlement of insurance claim flow has been accelerated, also saves human resources, and
Next Claims Resolution flow post node can accurately be found by flow dictionary of settling a claim, and then the effect of settlement of insurance claim can be improved
Rate and accuracy.
Further, the refinement and extension as above-described embodiment embodiment, there is provided another settlement of insurance claim
The processing method of flow, as shown in Fig. 2, this method includes：
201st, under different Claims Resolution flow types, Claims Resolution flow post node is meeting the different circulation condition time-divisions for configuration
It is other in requisition for the next Claims Resolution flow post node to circulate.
In the present embodiment, described in step 201 to 202 be pre-defined Claims Resolution flow dictionary process.With reference first to
Different settlement of insurance claim operation flow structures (such as settle a claim flow chart or table), determine under each Claims Resolution flow type, different reasons
Pay for flow post node.
Under different Claims Resolution flow types, each Claims Resolution flow post node is configured as current Claims Resolution flow post section
, respectively can be with the next Claims Resolution flow post node of automatic flow extremely in the case where meeting which flow path conditions during point, circulate condition
Particular content can according to the actual requirements depending on.
202nd, according to configuration result, by Claims Resolution flow type, Claims Resolution flow post node, circulation condition and need to flow
Mapping relations between the next Claims Resolution flow post node gone to are stored in pre-defined Claims Resolution flow dictionary.
For example, include ' Claims Resolution flow type ', ' current Claims Resolution flow post section in Claims Resolution flow dictionary after pre-defined
Existing mapping relations between next Claims Resolution flow post node ' four of point ', ' circulation condition ', '.
In the present embodiment, Claims Resolution flow dictionary contains Claims Resolution flow type, current Claims Resolution flow post node, circulation
Condition, next Claims Resolution flow post four kinds of elements of node, can accurately find and meet settlement of insurance claim task and currently settle a claim flow
Post node is to that in requisition for the next Claims Resolution flow post node to circulate, by the condition coupling that circulates, can find unique
Next Claims Resolution flow post node, can also meet a variety of business demands.
203rd, in the processing procedure of settlement of insurance claim flow, the current Claims Resolution where settlement of insurance claim case task is obtained in real time
Flow post node, and flow type of settling a claim corresponding with settlement of insurance claim case task.
For example, the current Claims Resolution flow post node where acquiring settlement of insurance claim case task is Claims Review post
Node, the settlement of insurance claim case task settle a claim flow type as complaint flow type accordingly.
204th, the relevant information of settlement of insurance claim case task is obtained.
Wherein, relevant information can include bill information, insurance policy information of user to be settled a claim etc.；Can in bill information
Paid with the userspersonal information (such as age, gender, identification card number, work unit) comprising user to be settled a claim, needs each
The contents such as item cost information (such as expense title, Fee Amount)；Declaration form identification information can be included in insurance policy information (such as
Declaration form numbering, title etc.), declaration form insurance kind information, policy type information (such as personal insurance, group insurance), declaration form insured amount letter
The contents such as breath, declaration form responsibility managing detailed catalogue (Claims Resolution ratio, Claims Resolution scope, Claims Resolution limit, the Claims Resolution condition of such as general expenses).
205th, by inquiring about in flow dictionary of settling a claim the mapping relations preserved, determine in the Claims Resolution flow type got
Under, the current each circulation condition settled a claim corresponding to the node of flow post, and the corresponding next Claims Resolution of each circulation condition
Flow post node.
Further, in order to meet to upgrade demand to Claims Resolution flow dictionary, obtain more accurate or needed closer to business
The query result wanted, in the alternative embodiment of the application, can also include：According to the Claims Resolution flow dictionary received
Fresh information, is updated Claims Resolution flow dictionary, and wherein fresh information can obtain in timing or not timing from cloud server
Take, or since related technical personnel write fresh information manually according to business needs and input；Correspondingly, step 205 is specific
It can include：By inquiring about in the Claims Resolution flow dictionary after updating the mapping relations preserved, determine in the Claims Resolution flow got
Under type, the current each circulation condition settled a claim corresponding to the node of flow post, and each circulation condition are corresponding next
Flow of settling a claim post node.
206th, according to the relevant information got, the stream that settlement of insurance claim case task meets is obtained from each circulation condition
Turn condition.
For the present embodiment, ' the Claims Resolution flow type ' included first in the pre-defined Claims Resolution flow dictionary of basis, ' when
Preceding Claims Resolution flow post node ', ' circulation condition ', ' existing mapping is closed between next Claims Resolution flow post node ' four
System, can inquire about to obtain under the corresponding Claims Resolution flow type of settlement of insurance claim case task, the Claims Resolution flow post being currently located
Each flow path conditions corresponding to node, and the corresponding next Claims Resolution flow post node of each circulation condition；Then root
According to the relevant information of the settlement of insurance claim case task, judgement currently meets which of above-mentioned each circulation condition circulation bar
Part.
For example, according to the relevant information of settlement of insurance claim case task, it is member user to determine user to be settled a claim, and meets member
Circulation condition, you can using the mechanism that redirects, to accelerate Claims Resolution flow processing progress；For another example according to the phase of settlement of insurance claim case task
Information is closed, corresponding insurance products is inquired and supports straight knot service, that is, enjoy insurance company and directly tie Claims Resolution service, meet straight knot stream
Turn condition；Corresponding insurance products are and for example inquired as the collaboration product with other companies, meet collaboration product circulation condition；Again
Such as inquire settlement of insurance claim case task and exception information occur, meet abnormality processing condition.
In order to enable also can when meeting circulation condition there is no settlement of insurance claim case task in flow dictionary of settling a claim
Suitable next Claims Resolution flow post node is found, in the alternative embodiment of the application, before step 206, also
Including：According to the relevant information of settlement of insurance claim case task, detect and whether deposited in each circulation condition in Claims Resolution flow dictionary
In the circulation condition that settlement of insurance claim case task meets；If being not present, classification division is carried out to the settlement of insurance claim case task,
Inquiry is obtained currently on the node of Claims Resolution flow post, being more than predetermined threshold with settlement of insurance claim case similarity and settling a claim
There are the reference settlement of insurance claim case task of circulation condition in flow dictionary；Then settlement of insurance claim will be referred in Claims Resolution flow dictionary
Case task is settled a claim corresponding circulation condition on the node of flow post in this prior, is determined as the settlement of insurance claim case task and is met
Circulation condition, wherein, the predetermined threshold of similarity can be depending on actual conditions.
For example, according to the relevant information of settlement of insurance claim case task, inquiry is less than on current hilllock in flow dictionary of settling a claim
The circulation condition that is met of the task on the node of position, can be with this moment in order to find suitable next Claims Resolution flow post node
Inquiry is also in this prior on the node of post, with the similarity of tasks be more than certain threshold value and in the Claims Resolution flow dictionary
In the presence of the reference settlement of insurance claim case task of circulation condition, this in the flow dictionary that then will settle a claim refers to settlement of insurance claim case task
Corresponding circulation condition is determined as the circulation condition that the task is met on the node of post in this prior；If there is multiple references
Settlement of insurance claim case task, then therefrom take and refer to settlement of insurance claim case as corresponding with a task of similarity of tasks maximum
Part task.
207th, by next Claims Resolution flow post node corresponding with the circulation condition met, it is determined as flowing with currently Claims Resolution
Journey post node is in requisition for the next Claims Resolution flow post node to circulate.
For example, the current post node of settlement of insurance claim case task is acceptance and hearing of a case post node, flow of settling a claim accordingly
Type is complaint flow type, and the task meets normal Claims Resolution appeal, determines to need the next Claims Resolution to circulate
Flow post node audits post node for case.
For another example current post node is acceptance and hearing of a case post node, corresponding flow type of settling a claim is old process
Type, if settlement of insurance claim case task meets straight knot circulation condition, determines to need the next Claims Resolution flow post to circulate
Node is straight knot adjustment examination ＆ verification post node；If settlement of insurance claim case task meets abnormality processing condition, determine to need to circulate
The next Claims Resolution flow post node arrived is abnormal examination post node.
208th, after the currently relevant Claims Resolution flow processing of Claims Resolution flow post node, by settlement of insurance claim case task
The next Claims Resolution flow post node corresponding with current Claims Resolution flow post node inquired is pushed to be handled.
Further, in order to notify on oneself post of staff's timely processing on the node of each Claims Resolution flow post
Settlement of insurance claim case task, accelerates the efficiency of settlement of insurance claim, in the alternative embodiment of the application, after step 208
It can also include：Obtain the communication method information that the next Claims Resolution flow post node inquired corresponds to Service Processing Module；
Using the communication method information got, to the processing prompting message of Service Processing Module transmission settlement of insurance claim case task.Its
In, Service Processing Module can settle a claim the relevant information of case according to, the corresponding industry of the case on this post node where processing
The unit module of business, concrete processing procedure may refer to processing mode of the prior art, and details are not described herein；Communication mode is believed
Breath can include E-mail address (Electronic MAIL, E-mail) address of Service Processing Module, IP address, telephone number,
Account of instant messaging tools etc..
In the present embodiment, can be to the responsible post node when case task of settling a claim reaches a post node
Service Processing Module sends processing prompting message, so that Service Processing Module is handled in time, the processing of guarantee insurance Claims Resolution
Efficiency.
Further, there is abnormal post node to analyze and process, and to occur abnormal post node carry out and
When maintenance handle, in the alternative embodiment of the application, can also include：The each Claims Resolution flow post node of record is to protecting
The processing progress information of danger Claims Resolution case task；According to the processing progress information of record, by comparing average treatment progress msg,
Statistics is in the presence of abnormal Claims Resolution flow post node and there is the abnormal settlement of insurance claim case task of processing, and divides from predetermined reason
Analyse and corresponding doubtful reason and solution information are obtained in storehouse；According to statistical result, the doubtful reason obtained and solution
Scheme information, generates the analysis report of settlement of insurance claim flow processing.Wherein, different exceptions is preserved in predetermined analysis of causes storehouse
The corresponding doubtful reason of situation and corresponding solution information, can be edited, and protect in advance by related technical personnel
There are in predetermined analysis of causes storehouse.
According to the average treatment progress of each post node, the post node that handling duration is more than certain threshold value is counted,
Be determined as in the presence of abnormal Claims Resolution flow post node, and obtain from predetermined analysis of causes storehouse corresponding doubtful reason with
And solution information, exist as statistics obtains work efficiencies of the staff A on post node 1 compared to other staff
Work efficiency on post node 1 is much lower, and it is abnormal to illustrate that staff A exists, can be obtained from predetermined analysis of causes storehouse
Take corresponding doubtful reason and solution information, it is possible to which reason, the solution such as lack experience for being staff A be
Need to strengthen to train accordingly, can generate corresponding analysis report based on these information shows performance personnel or higher level to lead
Lead.
For another example show that the relatively other kinds of case of settlement of insurance claim case of type-A deals with progress by statistics
It is relatively slow, corresponding doubtful reason can be obtained from predetermined analysis of causes storehouse according to the treatment situation of related each post node
And solution information, it is possible to be caused by the settlement of insurance claim case of type-A needs the bill information of typing excessive, solve
Scheme is plus sends staff's number of bill typing node to be generated accordingly based on these information to accelerate processing progress
Analysis report is shown, and this report can be the forms such as figure, table.
The processing method of another kind settlement of insurance claim flow provided by the embodiments of the present application, can accelerate settlement of insurance claim flow
Processing progress, saves human resources, can improve the efficiency and accuracy of settlement of insurance claim；And pass through a condition of circulating
Match somebody with somebody, unique next Claims Resolution flow post node can be found, can also meet a variety of business demands；Flowed in Claims Resolution
Also suitable next Claims Resolution flow can be found when meeting circulation condition there is no settlement of insurance claim case task in journey dictionary
Post node；And it can also notify the insurance on each oneself post of staff's timely processing settled a claim on the node of flow post
Claims Resolution case task, accelerates the efficiency of settlement of insurance claim.
Further, the specific implementation as Fig. 1 and Fig. 2 the methods, the embodiment of the present application provide a kind of insurance reason
The processing unit of flow is paid for, as shown in figure 3, described device includes：Acquiring unit 31, query unit 32, push unit 33.
Acquiring unit 31, can be used for obtaining the current Claims Resolution flow post node where settlement of insurance claim case task, with
And flow type of settling a claim corresponding with the settlement of insurance claim case task；
Query unit 32, can be used for the current Claims Resolution flow post node that is obtained according to the acquiring unit 31 and described
Claims Resolution flow type, inquires about pre-defined Claims Resolution flow dictionary, wherein being included in different reasons in the Claims Resolution flow dictionary
Pay under flow type, with Claims Resolution flow post node respectively in requisition for the next Claims Resolution flow post node to circulate；
Push unit 33, can be used for finishing in the relevant Claims Resolution flow processing of the current Claims Resolution flow post node
Afterwards, the settlement of insurance claim case task is pushed to that the query unit inquires with the current Claims Resolution flow post node
Corresponding next Claims Resolution flow post node is handled.
In specific application scenarios, as shown in figure 4, described device further includes：Dispensing unit 34, storage unit 35；
Dispensing unit 34, can be used for configuration under different Claims Resolution flow types, and Claims Resolution flow post node is meeting
Next Claims Resolution flow post node that corresponding needs circulate respectively during different circulation conditions；
Storage unit 35, can be used for the configuration result according to dispensing unit 34, by Claims Resolution flow type, Claims Resolution flow hilllock
Mapping relations between next Claims Resolution flow post node that position node, circulation condition and needs circulate preserve
In pre-defined Claims Resolution flow dictionary.By the condition coupling that circulates, unique next Claims Resolution flow post can be found
Node, can also meet a variety of business demands.
In specific application scenarios, as shown in figure 4, query unit 32 specifically includes：Acquisition module 321, determining module
322；
Acquisition module 321, can be used for the relevant information for obtaining the settlement of insurance claim case task；
Determining module 322, can be used for, by inquiring about the mapping relations, determining in the Claims Resolution flow class got
Under type, each circulation condition corresponding to the current Claims Resolution flow post node, and each circulation condition are corresponding next
A Claims Resolution flow post node；
Acquisition module 321, can be also used for according to the relevant information, and the guarantor is obtained from each circulation condition
The circulation condition that danger Claims Resolution case task meets；
Determining module 322, can be also used for next Claims Resolution flow post corresponding with the circulation condition met
Node, is determined as with the current Claims Resolution flow post node in requisition for the next Claims Resolution flow post node to circulate.
In specific application scenarios, to be accorded with order to enable there is no settlement of insurance claim case task in flow dictionary of settling a claim
Interflow can also find suitable next Claims Resolution flow post node when turning condition, as shown in figure 4, query unit 32 is specifically gone back
Including：Detection module 323, enquiry module 324；
Detection module 323, can be used for according to the relevant information, detects and whether there is in each circulation condition
The circulation condition that the settlement of insurance claim case task meets；
Enquiry module 324, if can be used for detection module 323 detects that there is no the stream that settlement of insurance claim case task meets
Turn condition, then classification division is carried out to the settlement of insurance claim case task, and inquire about and obtain in the current Claims Resolution flow post
On node, with the settlement of insurance claim case similarity be more than predetermined threshold and it is described Claims Resolution flow dictionary in exist circulation
The reference settlement of insurance claim case task of condition；
Determining module 322, can be also used for described in the Claims Resolution flow dictionary with reference to settlement of insurance claim case task to exist
Corresponding circulation condition on the current Claims Resolution flow post node, is determined as the circulation that the settlement of insurance claim case task meets
Condition；
Acquisition module 321, if specifically can be used in the presence of according to the relevant information, from each circulation condition
The middle circulation condition for obtaining the settlement of insurance claim case task and meeting.
In specific application scenarios, acquiring unit 31, can be also used in the current Claims Resolution flow post node phase
After the Claims Resolution flow processing of pass, the settlement of insurance claim case task is pushed to inquiring with the current Claims Resolution flow
After node corresponding next Claims Resolution flow post node in post is handled, the next Claims Resolution flow hilllock inquired is obtained
Position node corresponds to the communication method information of Service Processing Module；
Push unit 33, can be also used for utilizing the communication method information, to described in Service Processing Module transmission
The processing prompting message of settlement of insurance claim case task.
In specific application scenarios, there is abnormal post node to analyze and process, and to there is abnormal post
Node carries out timely maintenance processing, in the alternative embodiment of the application, as shown in figure 4, described device further includes：Record
Unit 36, statistic unit 37, generation unit 38；
Recording unit 36, can be used for recording processing of each Claims Resolution flow post node to settlement of insurance claim case task into
Spend information；
Statistic unit 37, can be used for according to the processing progress information, by comparing average treatment progress msg, statistics
In the presence of abnormal Claims Resolution flow post node and there is the settlement of insurance claim case task of processing exception, and from predetermined analysis of causes storehouse
It is middle to obtain corresponding doubtful reason and solution information；
Generation unit 38, can be used for according to the statistical result, the doubtful reason and solution information, generation
The analysis report of settlement of insurance claim flow processing.
In specific application scenarios, in order to meet to upgrade demand to Claims Resolution flow dictionary, obtain more accurately or more
The query result needed close to business, as shown in figure 4, described device further includes：Updating block 39；
Updating block 39, can be used for the fresh information according to the Claims Resolution flow dictionary received, to the Claims Resolution
Flow dictionary is updated；
Query unit 32, specifically can be used for according to the current Claims Resolution flow post node and the Claims Resolution flow class
Type, the Claims Resolution flow dictionary after inquiry renewal.
It should be noted that each function involved by a kind of processing unit of settlement of insurance claim flow provided by the embodiments of the present application
Other corresponding descriptions of unit, may be referred to the corresponding description in Fig. 1 and Fig. 2, details are not described herein.
Based on above-mentioned method as depicted in figs. 1 and 2, correspondingly, the embodiment of the present application additionally provides a kind of storage device, its
On be stored with computer program, which realizes above-mentioned settlement of insurance claim flow as depicted in figs. 1 and 2 when being executed by processor
Processing method.
Embodiment based on above-mentioned method as depicted in figs. 1 and 2 and such as Fig. 3 and virtual bench as shown in Figure 4, in order to realize
Above-mentioned purpose, the embodiment of the present application additionally provide a kind of entity apparatus of settlement of insurance claim flow processing, which includes depositing
Store up equipment and processor；The storage device, for storing computer program；The processor, for performing the computer
Program is to realize the processing method of above-mentioned settlement of insurance claim flow as depicted in figs. 1 and 2.
By the technical solution of application the application, the processing progress of settlement of insurance claim flow can be accelerated, save manpower money
Source, can improve the efficiency and accuracy of settlement of insurance claim；And by the condition coupling that circulates, it can find unique next
Flow of settling a claim post node, can also meet a variety of business demands；Settlement of insurance claim is not present in flow dictionary of settling a claim
Also suitable next Claims Resolution flow post node can be found when case task meets circulation condition；And it can also notify every
The settlement of insurance claim case task on oneself post of staff's timely processing on the node of a Claims Resolution flow post, accelerates insurance reason
The efficiency of compensation.
Through the above description of the embodiments, those skilled in the art can be understood that the application can lead to
Hardware realization is crossed, the mode of necessary general hardware platform can also be added by software to realize.Based on such understanding, this Shen
Technical solution please can be embodied in the form of software product, which can be stored in a non-volatile memories
In medium (can be CD-ROM, USB flash disk, mobile hard disk etc.), including some instructions are used so that a computer equipment (can be
Personal computer, server, or network equipment etc.) perform each implement scene of the application described in method.
It will be appreciated by those skilled in the art that attached drawing is a schematic diagram for being preferable to carry out scene, module in attached drawing or
Flow is not necessarily implemented necessary to the application.
It will be appreciated by those skilled in the art that the module in device in implement scene can be described according to implement scene into
Row is distributed in the device of implement scene, can also carry out one or more dresses that respective change is disposed other than this implement scene
In putting.The module of above-mentioned implement scene can be merged into a module, can also be further split into multiple submodule.
Above-mentioned the application sequence number is for illustration only, does not represent the quality of implement scene.
Disclosed above is only several specific implementation scenes of the application, and still, the application is not limited to this, Ren Heben
What the technical staff in field can think change should all fall into the protection domain of the application.
Claims (10)
- A kind of 1. processing method of settlement of insurance claim flow, it is characterised in that including：Obtain the current Claims Resolution flow post node where settlement of insurance claim case task, and with the settlement of insurance claim case task Corresponding Claims Resolution flow type；According to the current Claims Resolution flow post node and the Claims Resolution flow type, pre-defined Claims Resolution flow word is inquired about Allusion quotation, is included under different Claims Resolution flow types in the Claims Resolution flow dictionary, with Claims Resolution flow post node corresponding need respectively The next Claims Resolution flow post node to circulate；After the relevant Claims Resolution flow processing of the current Claims Resolution flow post node, by the settlement of insurance claim case task The next Claims Resolution flow post node corresponding with the current Claims Resolution flow post node inquired is pushed to be handled.
- It is 2. according to the method described in claim 1, it is characterized in that, described according to the current Claims Resolution flow post node and institute Claims Resolution flow type is stated, is inquired about before pre-defined Claims Resolution flow dictionary, the method further includes：Under different Claims Resolution flow types, Claims Resolution flow post node is corresponding respectively when meeting different circulation conditions to be needed for configuration The next Claims Resolution flow post node to circulate；According to configuration result, by Claims Resolution flow type, Claims Resolution flow post node, circulation condition and need to circulate down Mapping relations between one Claims Resolution flow post node are stored in pre-defined Claims Resolution flow dictionary.
- It is 3. according to the method described in claim 2, it is characterized in that, described according to the current Claims Resolution flow post node and institute Claims Resolution flow type is stated, inquires about pre-defined Claims Resolution flow dictionary, including：Obtain the relevant information of the settlement of insurance claim case task；By inquiring about the mapping relations, determine under the Claims Resolution flow type got, the current Claims Resolution flow hilllock Each circulation condition corresponding to the node of position, and the corresponding next Claims Resolution flow post node of each circulation condition；According to the relevant information, the circulation bar that the settlement of insurance claim case task meets is obtained from each circulation condition Part；By next Claims Resolution flow post node corresponding with the circulation condition met, it is determined as flowing with the current Claims Resolution Journey post node is in requisition for the next Claims Resolution flow post node to circulate.
- 4. according to the method described in claim 3, it is characterized in that, described according to the relevant information, from each circulation Before the circulation condition that the settlement of insurance claim case task meets is obtained in condition, the method further includes：According to the relevant information, detect and meet in each circulation condition with the presence or absence of the settlement of insurance claim case task Circulation condition；If being not present, classification division is carried out to the settlement of insurance claim case task, and inquires about and obtains in the current Claims Resolution stream On the node of journey post, with the settlement of insurance claim case similarity be more than predetermined threshold and it is described Claims Resolution flow dictionary in deposit In the reference settlement of insurance claim case task of circulation condition；To currently it settle a claim on the node of flow post described with reference to settlement of insurance claim case task described in the Claims Resolution flow dictionary Corresponding circulation condition, is determined as the circulation condition that the settlement of insurance claim case task meets；It is described according to the relevant information, the stream that the settlement of insurance claim case task meets is obtained from each circulation condition Turn condition, including：If in the presence of according to the relevant information, the settlement of insurance claim case task symbol is obtained from each circulation condition The circulation condition of conjunction.
- 5. according to the method described in claim 1, it is characterized in that, in the current Claims Resolution relevant Claims Resolution of flow post node After flow processing, the settlement of insurance claim case task is pushed to inquiring with the current Claims Resolution flow post node After corresponding next Claims Resolution flow post node is handled, the method further includes：Obtain the communication method information that the next Claims Resolution flow post node inquired corresponds to Service Processing Module；Using the communication method information, the processing that the settlement of insurance claim case task is sent to the Service Processing Module is reminded Information.
- 6. according to the method described in claim 1, it is characterized in that, the method further includes：Processing progress information of each Claims Resolution flow post node of record to settlement of insurance claim case task；According to the processing progress information, by comparing average treatment progress msg, there is abnormal Claims Resolution flow post in statistics Node and there is the abnormal settlement of insurance claim case task of processing, and obtain from predetermined analysis of causes storehouse corresponding doubtful reason with And solution information；According to the statistical result, the doubtful reason and solution information, the analysis of settlement of insurance claim flow processing is generated Report.
- 7. method according to any one of claim 1 to 6, it is characterised in that the method further includes：According to the fresh information of the Claims Resolution flow dictionary received, the Claims Resolution flow dictionary is updated；It is described according to the current Claims Resolution flow post node and the Claims Resolution flow type, inquire about pre-defined Claims Resolution flow Dictionary, including：According to the current Claims Resolution flow post node and the Claims Resolution flow type, the Claims Resolution flow dictionary after inquiry renewal.
- A kind of 8. processing unit of settlement of insurance claim flow, it is characterised in that including：Acquiring unit, for obtaining the current Claims Resolution flow post node where settlement of insurance claim case task, and with the guarantor Danger Claims Resolution case task is settled a claim flow type accordingly；Query unit, for the current Claims Resolution flow post node obtained according to the acquiring unit and the Claims Resolution flow class Type, inquires about pre-defined Claims Resolution flow dictionary, is included in the Claims Resolution flow dictionary under different Claims Resolution flow types, with Flow post node settle a claim respectively in requisition for the next Claims Resolution flow post node to circulate；Push unit, for after the relevant Claims Resolution flow processing of the current Claims Resolution flow post node, by the guarantor It is corresponding next with the current Claims Resolution flow post node to be pushed to that the query unit inquires for danger Claims Resolution case task A Claims Resolution flow post node is handled.
- 9. a kind of storage device, is stored thereon with computer program, it is characterised in that is realized when described program is executed by processor The processing method of settlement of insurance claim flow any one of claim 1 to 7.
- 10. a kind of processing unit of settlement of insurance claim flow, including storage device, processor and storage are on a storage device and can be The computer program run on processor, it is characterised in that the processor realizes claim 1 to 7 when performing described program Any one of settlement of insurance claim flow processing method.
Priority Applications (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201711110995.7A CN107909488A (en) | 2017-11-10 | 2017-11-10 | The processing method and processing device of settlement of insurance claim flow |
| PCT/CN2018/074618 WO2019090982A1 (en) | 2017-11-10 | 2018-01-30 | Method and apparatus for processing insurance claim settlement process |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201711110995.7A CN107909488A (en) | 2017-11-10 | 2017-11-10 | The processing method and processing device of settlement of insurance claim flow |
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| CN107909488A true CN107909488A (en) | 2018-04-13 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN201711110995.7A Pending CN107909488A (en) | 2017-11-10 | 2017-11-10 | The processing method and processing device of settlement of insurance claim flow |
Country Status (2)
| Country | Link |
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| CN (1) | CN107909488A (en) |
| WO (1) | WO2019090982A1 (en) |
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| WO2019090982A1 (en) | 2019-05-16 |
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