CN108257028A - Processing method, device, computer equipment and the storage medium of settlement of insurance claim - Google Patents
Processing method, device, computer equipment and the storage medium of settlement of insurance claim Download PDFInfo
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- CN108257028A CN108257028A CN201710612992.7A CN201710612992A CN108257028A CN 108257028 A CN108257028 A CN 108257028A CN 201710612992 A CN201710612992 A CN 201710612992A CN 108257028 A CN108257028 A CN 108257028A
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- 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
Abstract
The present invention proposes a kind of processing method of settlement of insurance claim, receive the Claims Resolution request that user terminal is sent, the number of policy included in extraction Claims Resolution request and corresponding Claims Resolution information, number of policy to be settled a claim and corresponding Claims Resolution information are respectively stored into database, the number of policy of declaration form to be settled a claim is obtained from database, product information of insuring corresponding with number of policy is obtained according to number of policy, corresponding insurance responsibility information is determined according to product information of insuring, obtain quantitative attributes corresponding with insurance responsibility information, quantitative attributes information corresponding with quantitative attributes is captured from database according to number of policy, determine quantitative attributes value corresponding with each quantitative attributes information, amount for which loss settled corresponding with declaration form to be settled a claim is determined according to each quantitative attributes value.The processing method of the settlement of insurance claim is performed fully automatic, time saving and energy saving, and the calculating standard of amount for which loss settled is unified, and accuracy rate is high.In addition, it is also proposed that a kind of processing unit of settlement of insurance claim, computer equipment and storage medium.
Description
Technical field
The present invention relates to computer disposal field, more particularly to a kind of processing method of settlement of insurance claim, device, computer
Equipment and storage medium.
Background technology
With the development of insurance industry, proceeding by for more and more people is insured.After user insures, if in the time limit of insuring
Accident inside has occurred, can propose to settle a claim to insurance company, and insurance company needs to determine to manage accordingly according to corresponding information
The amount of money is paid for, traditional Claims Resolution processing is by the way that corresponding amount for which loss settled is manually calculated, takes time and effort, and is easily malfunctioned.
Invention content
Based on this, it is necessary in view of the above-mentioned problems, proposing the processing of a kind of time saving and energy saving and high accuracy rate settlement of insurance claim
Method, apparatus, computer equipment and storage medium.
A kind of processing method of settlement of insurance claim, the method includes：The Claims Resolution request that user terminal is sent is received, extracts institute
The number of policy included in Claims Resolution request and corresponding Claims Resolution information are stated, by number of policy to be settled a claim and corresponding Claims Resolution information difference
It stores in database, the number of policy of declaration form to be settled a claim is obtained from database；It is obtained and the declaration form according to the number of policy
Number corresponding product information of insuring；Insurance responsibility corresponding with the product information of insuring is determined according to the product information of insuring
Information；Obtain quantitative attributes corresponding with the insurance responsibility information；According to the number of policy from the Claims Resolution information in database
It is middle to capture quantitative attributes information corresponding with the quantitative attributes；It is determined according to the corresponding mapping ruler of each quantitative attributes information
Quantitative attributes value corresponding with each quantitative attributes information；According to the corresponding quantitative attributes value of each quantitative attributes information determine with
The corresponding amount for which loss settled of the declaration form to be settled a claim.
In one of the embodiments, it is described captured from the Claims Resolution information in database according to the number of policy with it is described
The corresponding quantitative attributes information of quantitative attributes includes：It is searched from database according to the number of policy corresponding with the number of policy
Claims Resolution information；Extraction quantitative attributes corresponding with the quantitative attributes are believed from the Claims Resolution information by the way of fields match
Breath.
In one of the embodiments, the corresponding quantitative attributes value of each quantitative attributes information of the basis determine with it is described
The corresponding amount for which loss settled of declaration form to be settled a claim includes：Claims Resolution corresponding with the declaration form to be settled a claim is determined according to each quantitative attributes value
Scene；Corresponding amount for which loss settled is determined according to the Claims Resolution scene.
It is described in one of the embodiments, that reason corresponding with the declaration form to be settled a claim is determined according to each quantitative attributes value
The step of paying for scene includes：It is searched and the declaration form to be settled a claim in the tree pre-established according to each quantitative attributes value
Matched destination path, wherein, each node layer in the tree represents a quantitative attributes, the quantitative attributes pair
The different quantitative attributes values answered correspond to the different branches under each node layer respectively；It is determined according to the destination path and institute
State the corresponding Claims Resolution scene of destination path.
In one of the embodiments, the corresponding quantitative attributes value of each quantitative attributes information of the basis determine with it is described
The step of declaration form to be settled a claim corresponding amount for which loss settled, includes：Calculate the corresponding Claims Resolution coefficient of each quantitative attributes value；According to each
The corresponding Claims Resolution coefficient of quantitative attributes value determines total Claims Resolution coefficient corresponding with the declaration form to be settled a claim；According to total reason
It pays for coefficient and determines corresponding amount for which loss settled.
A kind of processing unit of settlement of insurance claim, described device include：Memory module, for receiving the reason of user terminal transmission
Request is paid for, the number of policy included during the Claims Resolution is asked and corresponding Claims Resolution information are extracted, by number of policy to be settled a claim and accordingly
Claims Resolution information be respectively stored into database；Number of policy acquisition module, for obtaining the guarantor of declaration form to be settled a claim from database
Odd numbers；Obtaining product information module, for obtaining product information of insuring corresponding with the number of policy according to the number of policy；Duty
Appoint information determination module, insurance responsibility letter corresponding with the product information of insuring is determined for product information of insuring according to
Breath；Quantitative attributes determining module, for obtaining quantitative attributes corresponding with the insurance responsibility information；Handling module, for root
Quantitative attributes information corresponding with the quantitative attributes is captured from the Claims Resolution information in database according to the number of policy；Qualitative category
Property value determining module, it is corresponding with each quantitative attributes information for being determined according to the corresponding mapping ruler of each quantitative attributes information
Quantitative attributes value；Amount of money determining module, for according to the corresponding quantitative attributes value of each quantitative attributes information determine with it is described
The corresponding amount for which loss settled of declaration form to be settled a claim.
The handling module includes in one of the embodiments,：Searching module, for according to the number of policy from data
Claims Resolution information corresponding with the number of policy is searched in library；Extraction module, for by the way of fields match from the Claims Resolution
Quantitative attributes information corresponding with the quantitative attributes is extracted in information.
The amount of money determining module includes in one of the embodiments,：Claims Resolution scene determining module, for according to each
Quantitative attributes value determines Claims Resolution scene corresponding with the declaration form to be settled a claim；Amount for which loss settled determining module, for according to the reason
It pays for scene and determines corresponding amount for which loss settled.
The Claims Resolution scene determining module is additionally operable to according to each quantitative attributes value advance in one of the embodiments,
Lookup and the matched destination path of declaration form to be settled a claim in the tree of foundation, wherein, it is each in the tree
Node layer represents a quantitative attributes, and the corresponding different quantitative attributes values of the quantitative attributes correspond to each node layer respectively
Under different branches, Claims Resolution scene corresponding with the destination path is determined according to the destination path.
The amount of money determining module is additionally operable to calculate the corresponding Claims Resolution of each quantitative attributes value in one of the embodiments,
Coefficient；Total Claims Resolution coefficient corresponding with the declaration form to be settled a claim is determined according to the corresponding Claims Resolution coefficient of each quantitative attributes value；
Corresponding amount for which loss settled is determined according to total Claims Resolution coefficient.
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 computer program：
The Claims Resolution request that user terminal is sent is received, extracts the number of policy included in the Claims Resolution request and corresponding Claims Resolution information, it will
Number of policy to be settled a claim and corresponding Claims Resolution information are respectively stored into database；The guarantor of declaration form to be settled a claim is obtained from database
Odd numbers；Product information of insuring corresponding with the number of policy is obtained according to the number of policy；It is true according to the product information of insuring
Fixed insurance responsibility information corresponding with the product information of insuring；Obtain quantitative attributes corresponding with the insurance responsibility information；
Quantitative attributes information corresponding with the quantitative attributes is captured from the Claims Resolution information in database according to the number of policy；It determines
Quantitative attributes value corresponding with each quantitative attributes information；According to the corresponding quantitative attributes value of each quantitative attributes information determine with
The corresponding amount for which loss settled of the declaration form to be settled a claim.
A kind of computer readable storage medium, is stored thereon with computer instruction, which realizes when being executed by processor
Following steps：The Claims Resolution request that user terminal is sent is received, extracts the number of policy included in the Claims Resolution request and corresponding reason
Information is paid for, number of policy to be settled a claim and corresponding Claims Resolution information are respectively stored into database；It is obtained from database and waits to manage
Pay for the number of policy of declaration form；Product information of insuring corresponding with the number of policy is obtained according to the number of policy；It is insured according to described
Product information determines insurance responsibility information corresponding with the product information of insuring；It obtains corresponding with the insurance responsibility information
Quantitative attributes；Quantitative attributes corresponding with the quantitative attributes are captured from the Claims Resolution information in database according to the number of policy
Information；Determine quantitative attributes value corresponding with each quantitative attributes information；According to the corresponding qualitative category of each quantitative attributes information
Property value determines amount for which loss settled corresponding with the declaration form to be settled a claim.
Processing method, device, computer equipment and the storage medium of above-mentioned settlement of insurance claim are sent by receiving user terminal
Claims Resolution request, the number of policy that includes and corresponding Claims Resolution information in extraction Claims Resolution request, by number of policy to be settled a claim and corresponding
Claims Resolution information be respectively stored into database, number of policy to be settled a claim is obtained from database, is determined and protected according to number of policy
The corresponding product information of insuring of odd numbers determines corresponding with product information of insuring according to the corresponding insurance kind type of product information of insuring
Insurance responsibility information determines corresponding quantitative attributes according to insurance responsibility information, is believed according to number of policy from the Claims Resolution in database
Quantitative attributes information corresponding with quantitative attributes is captured in breath, determines the corresponding quantitative attributes value of each quantitative attributes information, root
Corresponding amount for which loss settled is determined according to the corresponding quantitative attributes value of each quantitative attributes information.The processing method of the settlement of insurance claim is complete certainly
It is dynamic to carry out, it is time saving and energy saving, and also the calculating standard of amount for which loss settled is unified, and accuracy rate is high.
Description of the drawings
Fig. 1 is the internal structure schematic diagram of one embodiment Computer equipment；
Fig. 2 is the flow chart of the processing method of settlement of insurance claim in one embodiment；
Fig. 3 be captured from the Claims Resolution information in database according to number of policy in one embodiment it is corresponding with quantitative attributes
The method flow diagram of quantitative attributes information；
Fig. 4 is to determine gold of settling a claim accordingly according to the corresponding quantitative attributes value of each quantitative attributes information in one embodiment
The method flow diagram of volume；
Fig. 5 is to determine to settle a claim accordingly according to the corresponding quantitative attributes value of each quantitative attributes information in another embodiment
The method flow diagram of the amount of money；
Fig. 6 is the structure diagram of the processing unit of settlement of insurance claim in one embodiment；
Fig. 7 is the structure diagram of handling module in one embodiment；
Fig. 8 is the structure diagram of amount of money determining module in one embodiment.
Specific 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.
Fig. 1 is the internal structure schematic diagram of one embodiment Computer equipment, which can be terminal,
Can be server, wherein, terminal can be personal computer or mobile electronic device, mobile electronic device include mobile phone,
At least one of tablet computer, personal digital assistant or Wearable etc., server can be independent server,
It can be server cluster.With reference to Fig. 1, which includes the processor connected by system bus, non-volatile deposits
Storage media, built-in storage and network interface.Wherein, the non-volatile memory medium of the computer equipment can storage program area,
Database and computer-readable instruction, the computer-readable instruction are performed, and may be such that processor performs a kind of settlement of insurance claim
Processing method.The processor of the computer equipment supports the fortune of entire computer equipment for providing calculating and control ability
Row.Computer-readable instruction can be stored in the built-in storage, when which is executed by processor, may be such that place
It manages device and performs a kind of processing method of settlement of insurance claim.Database is for storing data, for example, storage Claims Resolution information and number of policy.
The network interface of computer equipment is used to carry out network communication.It will be understood by those skilled in the art that the structure shown in Fig. 1,
Only with the block diagram of the relevant part-structure of application scheme, the calculating being applied thereon to application scheme is not formed
The restriction of machine equipment, specific computer equipment can include more certain than components more or fewer shown in figure or combination
Component is arranged with different components.
As shown in Figure 2, it is proposed that a kind of processing method of settlement of insurance claim, this method both can be applied to server can also
Applied to terminal, following steps are specifically included：
Step 201, the Claims Resolution request that user terminal is sent is received, the number of policy that includes and corresponding in extraction Claims Resolution request
Number of policy to be settled a claim and corresponding Claims Resolution information are respectively stored into database by Claims Resolution information.
In the present embodiment, user sends Claims Resolution request by terminal, and number of policy and corresponding is carried in Claims Resolution request
Claims Resolution information, so after receiving Claims Resolution request, it is possible to which the number of policy and corresponding Claims Resolution that extraction Claims Resolution includes in asking are believed
Breath.Wherein, number of policy is used for one declaration form of unique mark, and the relevant information that amount for which loss settled needs is determined described in information of settling a claim.
The number of policy to be settled a claim got and corresponding Claims Resolution information are respectively stored into database, convenient for subsequently from database
It extracts corresponding information and carries out asynchronous process.
Step 202, the number of policy of declaration form to be settled a claim is obtained from database.
In the present embodiment, number of policy is used for one declaration form of unique mark, and declaration form is the abbreviation of insurance policy, be the insurer with
A kind of utmost good faith insurance contract that insurer signs.Title, the insurance of the insurer and insurant are mainly recorded on declaration form
Target, insured amount, insurance period, compensation or the Limitation on Liability of payment and miscellaneous stipulations item.Declaration form is also user Xiang Bao
Dangerous company proposes the foundation of Claims Resolution.For user after insurance company proposes Claims Resolution request, insurance company handles the process of settlement of insurance claim
Actually determine the process of the compensation amount of money.Specifically, for user after insurance company proposes corresponding Claims Resolution request, insurance is public
The Claims Resolution acquisition request that department needs to be directed to user's proposition is settled a claim information accordingly, and information of settling a claim accordingly is checked and approved,
Then the Claims Resolution information after approval is deposited into database, convenient for subsequently determining corresponding amount for which loss settled according to Claims Resolution information,
Number of policy to be settled a claim is unifiedly stored in a table simultaneously, and by table storage to database, is started when follow-up to protecting
When danger Claims Resolution is handled, the declaration form of declaration form to be settled a claim is obtained from the table where the number of policy for storing declaration form to be settled a claim first
Number, convenient for subsequently carrying out the operations such as corresponding lookup according to number of policy.
Step 204, product information of insuring corresponding with number of policy is determined according to number of policy.
In the present embodiment, product information of insuring includes the information such as title, product identification, the insurance kind type of product.It insures
It is to be directed to insuring for one or more products progress of insuring, so a declaration form can correspond to one or more and insure product letter
Breath.Therefore it can be one according to the product information of insuring that number of policy determines, or multiple.In fact, product of each insuring
For an insurance kind, a declaration form corresponds to one or more insurance kinds.It for example, may if user is intended for vehicle purchase insurance
Compulsory insurance for traffic accident of motor-drivenvehicle (full name " compulsory insurance for traffic accident of motor-drivenvehicle ") and vehicle business danger can be bought simultaneously.Here compulsory insurance for traffic accident of motor-drivenvehicle is
One insurance kind, vehicle business danger are also an insurance kind.Specifically, it prestores corresponding between number of policy and product information of insuring
Relationship is assured that product information of insuring corresponding with number of policy after getting number of policy.Product in product information of insuring
Number is for one product of unique mark.
Step 206, insurance responsibility information corresponding with product information of insuring is determined according to product information of insuring.
In the present embodiment, an insurance kind (product of insuring) can correspond to one or more insurance responsibilities, determine with
The corresponding one or more of number of policy is insured after product, it is also necessary to be obtained insurance responsibility corresponding with each product information of insuring and be believed
Breath.Insurance responsibility refers to the responsibility that the economic loss that the insurer undertakes compensates or death benefits pay.Different insurance kinds have not
Same insurance responsibility, prestores each correspondence insured between product information and insurance responsibility information, according to each throwing
It protects product information and determines corresponding insurance responsibility information.
Step 208, quantitative attributes corresponding with insurance responsibility information are obtained.
In the present embodiment, the quantitative attributes of different insurance responsibility maintenances of information are different, and quantitative attributes refer to determine duty
The every terms of information for statistics required for event of having a job.Quantitative attributes corresponding to one insurance responsibility information have many, for example, unexpected
The corresponding quantitative attributes of responsibility of dieing include:Whether occupational group work accident, time of casualty, goes out strategical vantage point, traffic responsibility, goes out
Whether identity when dangerous goes on business, many quantitative attributes of nature of occurence etc..In order to subsequently according to the corresponding qualitative category of quantitative attributes
Property value determine corresponding amount for which loss settled, it is necessary first to obtain corresponding with each insurance responsibility information quantitative attributes, one is protected
The corresponding quantitative attributes of dangerous responsibility generally have many or even thousands of.Specifically, pre-set insurance responsibility information with
Correspondence between quantitative attributes can obtain and the insurance responsibility information pair in this way according to determining insurance responsibility information
The quantitative attributes answered.
Step 210, quantitative attributes corresponding with quantitative attributes are captured from the Claims Resolution information in database according to number of policy
Information.
In the present embodiment, after the corresponding quantitative attributes of each insurance responsibility information are determined, according to the quantitative attributes
It goes to capture quantitative attributes information corresponding with quantitative attributes in database.Quantitative attributes information is corresponding with quantitative attributes specific
Information.For example, occupation is a quantitative attributes, then the corresponding specifying information of occupation is then quantitative attributes information, than
Such as, if occupation it is corresponding be teacher, teacher is corresponding quantitative attributes information.In advance by approval and Claims Resolution request pair
The Claims Resolution information storage answered in the database, can thus capture and quantitative attributes pair from the Claims Resolution information in the database
The quantitative attributes information answered.Specifically, Claims Resolution information can be recorded in advance in Claims Resolution information table in the database, each single item letter
Breath is all corresponding with corresponding field information, and field refers to include the content of a certain thematic information.For example, " the surname in a table
Name ", " gender ", " occupation " these be exactly so-called " field ".Quantitative attributes are related to the field in Claims Resolution information table, so
The mode of fields match may be used to obtain when quantitative attributes information corresponding with quantitative attributes is captured from database.
Step 212, determine that each quantitative attributes information is corresponding according to the corresponding mapping ruler of each quantitative attributes information
Quantitative attributes value.
In the present embodiment, quantitative attributes value refers to and the corresponding quantifiable value of quantitative attributes.Get with each
After the corresponding quantitative attributes information of quantitative attributes, it is also necessary to obtain mapping ruler corresponding with each quantitative attributes, mapping rule
Then refer to the mapping ruler between quantitative attributes information and quantitative attributes value.Each quantitative attributes information is determined according to mapping ruler
Corresponding quantitative attributes value.For example, if quantitative attributes are occupation, corresponding quantitative attributes information is：Teacher.And quantitative attributes pair
The value answered is respectively：One kind, two classes, three classes, four classes, five classes and other.So it also needs to determine qualitative category according to mapping ruler
Property the corresponding quantitative attributes value of information, for example, the occupation of teacher be two classes, i.e., the corresponding quantitative attributes value of teacher be two classes.
Step 214, corresponding amount for which loss settled is determined according to the corresponding quantitative attributes value of each quantitative attributes information.
In the present embodiment, after quantitative attributes value corresponding with each quantitative attributes information is determined, it is possible to according to
Each quantitative attributes value determines corresponding amount for which loss settled.In one embodiment, different Claims Resolution scenes is pre-set, it is different
Claims Resolution scene correspond to different amount for which loss settled, and the corresponding each quantitative attributes values of different Claims Resolution scenes are set.So first
Corresponding Claims Resolution scene is matched according to the corresponding quantitative attributes value of determining each quantitative attributes, then according to corresponding Claims Resolution
Scene determines corresponding amount for which loss settled.In another embodiment, it is corresponding that different quantitative attributes values can also be pre-set
Claims Resolution coefficient, and the computation rule between total Claims Resolution coefficient and amount for which loss settled is set.Specifically, each qualitative category is calculated
Property the corresponding Claims Resolution coefficient of value after, corresponding Claims Resolution coefficient is added up, total Claims Resolution coefficient is obtained, then according to total reason
It pays for coefficient and corresponding amount for which loss settled is calculated.
The processing method of above-mentioned settlement of insurance claim, the Claims Resolution sent by receiving user terminal are asked, in extraction Claims Resolution request
Comprising number of policy and corresponding Claims Resolution information, number of policy to be settled a claim and corresponding Claims Resolution information are respectively stored into database
In, number of policy to be settled a claim is obtained from database, product information of insuring corresponding with number of policy is determined according to number of policy, according to
The corresponding insurance kind type of product information of insuring determines insurance responsibility information corresponding with product information of insuring, and is believed according to insurance responsibility
Breath determines corresponding quantitative attributes, captures quantitative attributes information corresponding with quantitative attributes from database according to number of policy, really
Determine the corresponding quantitative attributes value of each quantitative attributes information, phase is determined according to the corresponding quantitative attributes value of each quantitative attributes information
The amount for which loss settled answered.The processing method of the settlement of insurance claim is performed fully automatic, time saving and energy saving, and the calculating standard system of amount for which loss settled
One, accuracy rate is high.
As shown in figure 3, it in one embodiment, is captured and qualitative category from the Claims Resolution information in database according to number of policy
The step 210 of the corresponding quantitative attributes information of property includes：
Step 210A searches Claims Resolution information corresponding with number of policy according to number of policy from database.
In the present embodiment, in advance will with user settle a claim request it is relevant Claims Resolution information be deposited into database, and with reason
It pays for the corresponding number of policy of declaration form and carries out corresponding storage.It can be searched from database according to number of policy so corresponding with number of policy
Claims Resolution information.Claims Resolution information is the reason that insurance responsibility corresponding with the quantitative attributes that insurance responsibility is safeguarded, different is stored
It is different to pay for information, for example, the unexpected Claims Resolution information for dieing responsibility storage include accident spot, time of casualty, nature of occurence,
Whether occupation goes on business.Claims Resolution information can be understood as relevant information corresponding with quantitative attributes.
Step 210B, extraction quantitative attributes corresponding with quantitative attributes are believed from Claims Resolution information by the way of fields match
Breath.
In the present embodiment, Claims Resolution information refers to the information for determining that amount for which loss settled needs count, opposite with quantitative attributes
It should.Since the every terms of information settled a claim in Claims Resolution table is all corresponding with corresponding field information, and quantitative attributes are equivalent in itself
Field information, it is possible to which extraction quantitative attributes corresponding with quantitative attributes are believed from Claims Resolution information by way of fields match
Breath.For example, it is assumed that quantitative attributes include：Occupation, age, accident spot, time of casualty etc., and include in information of settling a claim
The field informations such as occupation, age, accident spot, time of casualty and specifying information corresponding with field information, thus in order to from
Extraction quantitative attributes information corresponding with quantitative attributes also may be used certainly directly using the matched mode of field name in information of settling a claim
By using with field number it is matched in a manner of, field number be used for one field of unique mark.Specifically, qualitative category is pre-set
Correspondence between property and field number, can extract and the corresponding quantitative attributes of respective field number according to quantitative attributes
Information.
As shown in figure 4, it in one embodiment, is determined accordingly according to the corresponding quantitative attributes value of each quantitative attributes information
The step 214 of amount for which loss settled include：
Step 214a determines Claims Resolution scene corresponding with declaration form to be settled a claim according to each quantitative attributes value；
In the present embodiment, the correspondence between each quantitative attributes value and scene of settling a claim is pre-set, according to determining
Each quantitative attributes value match Claims Resolution scene corresponding with each quantitative attributes value, that is, determine corresponding with declaration form to be settled a claim
Claims Resolution scene.Determine that the process of Claims Resolution scene is equivalent to for the secondary Claims Resolution event qualitatively process, that is, determine it is which belongs to
A kind of Claims Resolution scene, convenient for subsequently determining corresponding amount for which loss settled.Specifically, Claims Resolution scene is and each quantitative attributes value pair
It answers, so the number of the number quantitative attributes value corresponding with the number of quantitative attributes and each quantitative attributes of Claims Resolution scene
It is corresponding, such as, it is assumed that there are 5 quantitative attributes altogether, wherein, the corresponding quantitative attributes value of A quantitative attributes is divided into 2 classes, and B is qualitative
The corresponding quantitative attributes value of attribute falls into 5 types, and the corresponding quantitative attributes value of C quantitative attributes is divided into 3 classes, and D quantitative attributes are corresponding
Quantitative attributes value is divided into 2 classes, and the corresponding quantitative attributes value of E quantitative attributes is divided into 4 classes, then and the number of corresponding Claims Resolution scene=
2*5*3*2*4=240 kinds.
Step 214b determines corresponding amount for which loss settled according to Claims Resolution scene.
In the present embodiment, the correspondence of Claims Resolution scene and amount for which loss settled has been prestored, wherein, Claims Resolution scene and reason
The correspondence for paying for the amount of money can be one-to-one relationship or many-to-one relationship.That is, it can set respectively
The correspondence of each Claims Resolution scene and amount for which loss settled can also set multiple Claims Resolution scenes corresponding with amount for which loss settled
Relationship, this can be adjusted according to actual conditions.After Claims Resolution scene is determined, it is possible to directly true according to Claims Resolution scene
Fixed corresponding amount for which loss settled.The determining method of the amount for which loss settled is time saving and energy saving, and can neatly be adjusted, and is calculated
Amount for which loss settled standard it is unified, accuracy rate is high.
In one embodiment, it is described that Claims Resolution field corresponding with the declaration form to be settled a claim is determined according to each quantitative attributes value
The step 214a of scape includes：It is searched and the declaration form to be settled a claim in the tree pre-established according to each quantitative attributes value
Matched destination path, wherein, each node layer in the tree represents a quantitative attributes, the quantitative attributes pair
The different quantitative attributes values answered correspond to the different branches under each node layer respectively；It is determined according to the destination path and institute
State the corresponding Claims Resolution scene of destination path.
In the present embodiment, since quantitative attributes often have many, even thousands of, corresponding guarantor to be settled a claim
Single corresponding quantitative attributes value also just has thousands of, in order to rapidly be matched according to so multiple quantitative attributes values
Corresponding Claims Resolution scene.Tree model is established previously according to quantitative attributes, the node in each layer of tree model
A quantitative attributes are represented, according to the corresponding different quantitative attributes values of quantitative attributes, are accordingly divided into several below each node
Branch.When subsequently being matched according to each quantitative attributes value, according to corresponding quantitative attributes value in each node layer
Specific branch is fitted on, by being matched layer by layer until having matched last node, matched process is just to determine destination path
Process.For example, it is assumed that the first node layer is " whether using medical insurance " this quantitative attributes, then corresponding there are two be worth
"Yes" and "No" Liang Ge branches, then the second node layer is occupational group, corresponding there are five being worth, respectively one kind, two classes, three
Class, four classes, five classes, just there are five branches below each node of such second layer, are matched according to specific quantitative attributes value
Some specific branch, and so on, until having matched the corresponding quantitative attributes value of the last one node, just determine corresponding
Destination path.The correspondence that routing information is prestored between scene of settling a claim, after matching obtains destination path,
Directly to determine information of settling a claim accordingly according to destination path.Matched layer by layer by above-mentioned, can quickly determine with it is each qualitative
The corresponding destination path of property value, so as to quickly determine corresponding Claims Resolution scene.Phase subsequently can be determined according to Claims Resolution scene
The amount for which loss settled answered is automatically performed the calculating of corresponding amount for which loss settled, time saving and energy saving, and accuracy rate is high.
As shown in figure 5, it in one embodiment, is determined accordingly according to the corresponding quantitative attributes value of each quantitative attributes information
The step 214 of amount for which loss settled include：
Step 214A calculates the corresponding Claims Resolution coefficient of each quantitative attributes value.
In the present embodiment, computation rule corresponding with quantitative attributes value is pre-set, is got corresponding with quantitative attributes
Quantitative attributes value after, coefficient of settling a claim accordingly, the calculating corresponding to different quantitative attributes are determined according to the quantitative attributes rule
Method is different, needs to set the corresponding computation rule of each quantitative attributes respectively.For example, professional quantitative attributes value point
For one kind, two classes, three classes, four classes and five classes, it is directed to each quantitative attributes value and determines a Claims Resolution coefficient, for example, a kind of
Corresponding Claims Resolution coefficient is 0.01, and two classes coefficient of settling a claim accordingly is 0.02, and three classes coefficient of settling a claim accordingly is 0.03 etc., due to
The probability of different occupation Claims Resolution is different, and the Claims Resolution coefficients comparison set for the big occupation of Claims Resolution probability is small, for example, a kind of duty
Industry.For example, for unexpected danger of dieing, the probability that certain dangerous occupations are in danger is bigger, such as working at height personnel, institute
It is relatively low with the ratio that coefficient of settling a claim accordingly can be set.The quantitative attributes value whether gone on business be divided into be with it is no, it is corresponding to be directed to "Yes"
The Claims Resolution coefficient of setting one be 0.2, it is 0.1 to be directed to one Claims Resolution coefficient of "No" setting accordingly.Mode in this way,
The corresponding Claims Resolution coefficient of each quantitative attributes value is calculated respectively.
Step 214B is determined corresponding with the declaration form to be settled a claim total according to the corresponding Claims Resolution coefficient of each quantitative attributes value
Claims Resolution coefficient.
In the present embodiment, after the corresponding Claims Resolution coefficient of each quantitative attributes value is determined, it is possible to according to each fixed
Property property value calculates total Claims Resolution coefficient corresponding with declaration form to be settled a claim.Determine that total Claims Resolution coefficient can be directly using cumulative
Method, i.e., by each quantitative attributes value it is corresponding Claims Resolution coefficient be added, obtain a total Claims Resolution coefficient.In another implementation
In example, it is also necessary to the corresponding weight of each quantitative attributes be set, total Claims Resolution coefficient is calculated by weighted sum.
Step 214C determines corresponding amount for which loss settled according to total Claims Resolution coefficient.
In the present embodiment, it is determined that with after the corresponding total Claims Resolution coefficient of Claims Resolution declaration form, it is possible to according to total reason
Coefficient is paid for corresponding amount for which loss settled is calculated.Specifically, the corresponding protection amount of declaration form to be settled a claim is obtained, passes through total Claims Resolution system
Number is multiplied by corresponding protection amount and obtains the corresponding amount for which loss settled of declaration form to be settled a claim.
As shown in fig. 6, in one embodiment it is proposed that a kind of processing unit of settlement of insurance claim, the device include：
Memory module 601 for receiving the Claims Resolution request of user terminal transmission, extracts the guarantor included in the Claims Resolution request
Odd numbers and corresponding Claims Resolution information, number of policy to be settled a claim and corresponding Claims Resolution information are respectively stored into database.
Number of policy acquisition module 602, for obtaining the number of policy of declaration form to be settled a claim from database.
Obtaining product information module 604, for obtaining product of insuring corresponding with the number of policy according to the number of policy
Information.
Information responsible determining module 606 determines and the product information pair of insuring for product information of insuring according to
The insurance responsibility information answered.
Quantitative attributes determining module 608, for obtaining quantitative attributes corresponding with the insurance responsibility information.
Handling module 610, for being captured from the Claims Resolution information in database according to the number of policy and the qualitative category
The corresponding quantitative attributes information of property.
Quantitative attributes value determining module 612, for according to the corresponding mapping ruler of each quantitative attributes information determine with often
The corresponding quantitative attributes value of a quantitative attributes information.
Amount of money determining module 614, for determining to treat with described according to the corresponding quantitative attributes value of each quantitative attributes information
The corresponding amount for which loss settled of Claims Resolution declaration form.
As shown in fig. 7, in one embodiment, handling module 610 includes：
Searching module 610A, for searching Claims Resolution letter corresponding with the number of policy from database according to the number of policy
Breath.
Extraction module 610B, for being extracted and the quantitative attributes from the Claims Resolution information by the way of fields match
Corresponding quantitative attributes information.
As shown in figure 8, in one embodiment, the amount of money determining module 614 includes：
Settle a claim scene determining module 614A, corresponding with the declaration form to be settled a claim for being determined according to each quantitative attributes value
Claims Resolution scene；
Amount for which loss settled determining module 614B, for determining corresponding amount for which loss settled according to the Claims Resolution scene.
In one embodiment, the Claims Resolution scene determining module 614A is additionally operable to according to each quantitative attributes value advance
Lookup and the matched destination path of declaration form to be settled a claim in the tree of foundation, wherein, it is each in the tree
Node layer represents a quantitative attributes, and the corresponding different quantitative attributes values of the quantitative attributes correspond to each node layer respectively
Under different branches, Claims Resolution scene corresponding with the destination path is determined according to the destination path.
In one embodiment, the amount of money determining module 614 is additionally operable to calculate the corresponding Claims Resolution of each quantitative attributes value
Coefficient；Total Claims Resolution coefficient corresponding with the declaration form to be settled a claim is determined according to the corresponding Claims Resolution coefficient of each quantitative attributes value；
Corresponding amount for which loss settled is determined according to total Claims Resolution coefficient.
In one embodiment it is proposed that a kind of computer equipment, the computer equipment include memory, processor and
The computer program that can be run on the memory and on the processor is stored in, the processor performs the computer
Following steps are realized during program：The Claims Resolution request that user terminal is sent is received, extracts the number of policy included in the Claims Resolution request
With corresponding Claims Resolution information, number of policy to be settled a claim and corresponding Claims Resolution information are respectively stored into database；From database
The middle number of policy for obtaining declaration form to be settled a claim；Product information of insuring corresponding with the number of policy is obtained according to the number of policy；Root
Insurance responsibility information corresponding with the product information of insuring is determined according to the product information of insuring；It obtains and the insurance responsibility
The corresponding quantitative attributes of information；It is captured from the Claims Resolution information in database according to the number of policy corresponding with the quantitative attributes
Quantitative attributes information；Determine quantitative attributes value corresponding with each quantitative attributes information；According to each quantitative attributes information pair
The quantitative attributes value answered determines amount for which loss settled corresponding with the declaration form to be settled a claim.
In one embodiment, performed by the processor captured from database according to the number of policy with it is described fixed
The step of property attribute corresponding quantitative attributes information, includes：It is searched and the number of policy pair from database according to the number of policy
The Claims Resolution information answered；By the way of fields match qualitative category corresponding with the quantitative attributes is extracted from the Claims Resolution information
Property information.
In one embodiment, the corresponding quantitative attributes value of each quantitative attributes information of basis performed by the processor
The step of determining amount for which loss settled corresponding with the declaration form to be settled a claim includes：It determines to wait to manage with described according to each quantitative attributes value
Pay for the corresponding Claims Resolution scene of declaration form；Corresponding amount for which loss settled is determined according to the Claims Resolution scene.
In one embodiment, performed by the processor according to each quantitative attributes value determine with it is described treat Claims Resolution protect
Single corresponding Claims Resolution scene includes：It is searched in the tree pre-established according to each quantitative attributes value and waits to settle a claim with described
The matched destination path of declaration form, wherein, each node layer in the tree represents a quantitative attributes, the qualitative category
Property corresponding different quantitative attributes values correspond to different branches under each node layer respectively；It is determined according to the destination path
Claims Resolution scene corresponding with the destination path.
In one embodiment, the corresponding quantitative attributes value of each quantitative attributes information of basis performed by the processor
Determine that amount for which loss settled corresponding with the declaration form to be settled a claim includes：Calculate the corresponding Claims Resolution coefficient of each quantitative attributes value；According to
The corresponding Claims Resolution coefficient of each quantitative attributes value determines total Claims Resolution coefficient corresponding with the declaration form to be settled a claim；According to described total
Claims Resolution coefficient determine corresponding amount for which loss settled.
A kind of computer readable storage medium, is stored thereon with computer instruction, which realizes when being executed by processor
Following steps：The Claims Resolution request that user terminal is sent is received, extracts the number of policy included in the Claims Resolution request and corresponding reason
Information is paid for, number of policy to be settled a claim and corresponding Claims Resolution information are respectively stored into database；It is obtained from database and waits to manage
Pay for the number of policy of declaration form；Product information of insuring corresponding with the number of policy is obtained according to the number of policy；It is insured according to described
Product information determines insurance responsibility information corresponding with the product information of insuring；It obtains corresponding with the insurance responsibility information
Quantitative attributes；Quantitative attributes corresponding with the quantitative attributes are captured from the Claims Resolution information in database according to the number of policy
Information；Determine quantitative attributes value corresponding with each quantitative attributes information；According to the corresponding qualitative category of each quantitative attributes information
Property value determines amount for which loss settled corresponding with the declaration form to be settled a claim.
In one embodiment, performed by the processor according to the number of policy from the Claims Resolution information in database
The step of capturing quantitative attributes information corresponding with the quantitative attributes includes：Searched from database according to the number of policy with
The corresponding Claims Resolution information of the number of policy；It is extracted and the quantitative attributes from the Claims Resolution information by the way of fields match
Corresponding quantitative attributes information.
In one embodiment, the corresponding quantitative attributes value of each quantitative attributes information of basis performed by the processor
The step of determining amount for which loss settled corresponding with the declaration form to be settled a claim includes：It determines to wait to manage with described according to each quantitative attributes value
Pay for the corresponding Claims Resolution scene of declaration form；Corresponding amount for which loss settled is determined according to the Claims Resolution scene.
In one embodiment, performed by the processor according to each quantitative attributes value determine with it is described treat Claims Resolution protect
Single corresponding Claims Resolution scene includes：It is searched in the tree pre-established according to each quantitative attributes value and waits to settle a claim with described
The matched destination path of declaration form, wherein, each node layer in the tree represents a quantitative attributes, the qualitative category
Property corresponding different quantitative attributes values correspond to different branches under each node layer respectively；It is determined according to the destination path
Claims Resolution scene corresponding with the destination path.
In one embodiment, the corresponding quantitative attributes value of each quantitative attributes information of basis performed by the processor
Determine that amount for which loss settled corresponding with the declaration form to be settled a claim includes：Calculate the corresponding Claims Resolution coefficient of each quantitative attributes value；According to
The corresponding Claims Resolution coefficient of each quantitative attributes value determines total Claims Resolution coefficient corresponding with the declaration form to be settled a claim；According to described total
Claims Resolution coefficient determine corresponding amount for which loss settled.
One of ordinary skill in the art will appreciate that realizing all or part of flow in above-described embodiment method, being can be with
Relevant hardware is instructed to complete by computer program, which can be stored in a computer-readable storage and be situated between
In matter, the program is when being executed, it may include such as the flow of the embodiment of above-mentioned each method.Wherein, aforementioned storage medium can be
The non-volatile memory mediums such as magnetic disc, CD, read-only memory (Read-Only Memory, ROM) or random storage note
Recall body (Random Access Memory, RAM) etc..
Each technical characteristic of embodiment described above can be combined arbitrarily, to make description succinct, not to above-mentioned reality
It applies 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, it is all considered to be the range of this specification record.
Embodiment described above only expresses the several embodiments of the present invention, and description is more specific and detailed, but simultaneously
It cannot therefore be construed as limiting the scope of the patent.It should be pointed out that those of ordinary skill in the art are come
It says, 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
Range.Therefore, the protection domain of patent of the present invention should be determined by the appended claims.
Claims (10)
1. a kind of processing method of settlement of insurance claim, the method includes：
The Claims Resolution request that user terminal is sent is received, the number of policy included in the Claims Resolution request is extracted and corresponding Claims Resolution is believed
Number of policy to be settled a claim and corresponding Claims Resolution information are respectively stored into database by breath；
The number of policy of declaration form to be settled a claim is obtained from database；
Product information of insuring corresponding with the number of policy is obtained according to the number of policy；
Insurance responsibility information corresponding with the product information of insuring is determined according to the product information of insuring；
Obtain quantitative attributes corresponding with the insurance responsibility information；
Quantitative attributes information corresponding with the quantitative attributes is captured from the Claims Resolution information in database according to the number of policy；
Quantitative attributes value corresponding with each quantitative attributes information is determined according to the corresponding mapping ruler of each quantitative attributes information；
Amount for which loss settled corresponding with the declaration form to be settled a claim is determined according to the corresponding quantitative attributes value of each quantitative attributes information.
2. according to the method described in claim 1, it is described captured from the Claims Resolution information in database according to the number of policy with
The corresponding quantitative attributes information of the quantitative attributes includes：
Claims Resolution information corresponding with the number of policy is searched from database according to the number of policy；
By the way of fields match quantitative attributes information corresponding with the quantitative attributes is extracted from the Claims Resolution information.
3. the according to the method described in claim 1, it is characterized in that, corresponding qualitative category of each quantitative attributes information of the basis
Property value determines that amount for which loss settled corresponding with the declaration form to be settled a claim includes：
Claims Resolution scene corresponding with the declaration form to be settled a claim is determined according to each quantitative attributes value；
Corresponding amount for which loss settled is determined according to the Claims Resolution scene.
4. according to the method described in claim 3, it is characterized in that, described determine to wait to manage with described according to each quantitative attributes value
The corresponding Claims Resolution scene of declaration form is paid for include：
It is searched and the matched target road of declaration form to be settled a claim in the tree pre-established according to each quantitative attributes value
Diameter, wherein, each node layer in the tree represents a quantitative attributes, and the corresponding difference of the quantitative attributes is qualitative
Property value corresponds to the different branches under each node layer respectively；
Claims Resolution scene corresponding with the destination path is determined according to the destination path.
5. the according to the method described in claim 1, it is characterized in that, corresponding qualitative category of each quantitative attributes information of the basis
Property value determines that amount for which loss settled corresponding with the declaration form to be settled a claim includes：
Calculate the corresponding Claims Resolution coefficient of each quantitative attributes value；
Total Claims Resolution coefficient corresponding with the declaration form to be settled a claim is determined according to the corresponding Claims Resolution coefficient of each quantitative attributes value；
Corresponding amount for which loss settled is determined according to total Claims Resolution coefficient.
6. a kind of processing unit of settlement of insurance claim, described device include：
Memory module, for receiving the Claims Resolution request of user terminal transmission, extract in the Claims Resolution request number of policy that includes and
Number of policy to be settled a claim and corresponding Claims Resolution information are respectively stored into database by corresponding Claims Resolution information；
Number of policy acquisition module, for obtaining the number of policy of declaration form to be settled a claim from database；
Obtaining product information module, for obtaining product information of insuring corresponding with the number of policy according to the number of policy；
Information responsible determining module determines insurance corresponding with the product information of insuring for product information of insuring according to
Information responsible；
Quantitative attributes determining module, for obtaining quantitative attributes corresponding with the insurance responsibility information；
Handling module, it is corresponding with the quantitative attributes for being captured from the Claims Resolution information in database according to the number of policy
Quantitative attributes information；
Quantitative attributes value determining module, for being determined and each qualitative category according to the corresponding mapping ruler of each quantitative attributes information
The property corresponding quantitative attributes value of information；
Amount of money determining module, for being determined and the declaration form to be settled a claim according to the corresponding quantitative attributes value of each quantitative attributes information
Corresponding amount for which loss settled.
7. device according to claim 6, the handling module includes：
Searching module, for searching Claims Resolution information corresponding with the number of policy from database according to the number of policy；
Extraction module, for extraction to be corresponding with the quantitative attributes fixed from the Claims Resolution information by the way of fields match
Property attribute information.
8. device according to claim 6, which is characterized in that the amount of money determining module includes：
It settles a claim scene determining module, for determining Claims Resolution field corresponding with the declaration form to be settled a claim according to each quantitative attributes value
Scape；
Amount for which loss settled determining module, for determining corresponding amount for which loss settled according to the Claims Resolution scene.
9. 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 claim 1-5 when performing the computer program
The step of any one the method.
10. a kind of computer readable storage medium, is stored thereon with computer instruction, which is characterized in that the instruction is by processor
The step of claim 1-5 any one the methods are realized during execution.
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| CN201710612992.7A CN108257028A (en) | 2017-07-25 | 2017-07-25 | Processing method, device, computer equipment and the storage medium of settlement of insurance claim |
| PCT/CN2018/084985 WO2019019746A1 (en) | 2017-07-25 | 2018-04-28 | Method and apparatus for processing insurance claim settlement, computer device and storage medium |
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|---|---|---|---|
| CN201710612992.7A CN108257028A (en) | 2017-07-25 | 2017-07-25 | Processing method, device, computer equipment and the storage medium of settlement of insurance claim |
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| WO (1) | WO2019019746A1 (en) |
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