CN109658258A - Amount for which loss settled based on big data adjusts method, apparatus, computer equipment automatically - Google Patents
Amount for which loss settled based on big data adjusts method, apparatus, computer equipment automatically Download PDFInfo
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- CN109658258A CN109658258A CN201811320250.8A CN201811320250A CN109658258A CN 109658258 A CN109658258 A CN 109658258A CN 201811320250 A CN201811320250 A CN 201811320250A CN 109658258 A CN109658258 A CN 109658258A
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- 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
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Abstract
This application involves big data technical field, in particular to a kind of amount for which loss settled based on big data adjusts method, apparatus, computer equipment automatically.The described method includes: obtaining people's case type information of being in danger of core duty personnel's input；According to people's case type information of being in danger, responsibility managing detailed catalogue corresponding with people's case type information of being in danger is matched based on big data, wherein the responsibility managing detailed catalogue includes responsibility attribute, responsibility feature and calculation formula；Data required for the calculating determined in the calculation formula according to the responsibility attribute, the responsibility feature；The corresponding amount for which loss settled of people's case type information of being in danger described in being calculated automatically according to the calculation formula.Realize the automatic purpose for calculating amount for which loss settled, it is intended to solve existing amount for which loss settled, need the personnel of adjusting to spend a lot of time and manually adjusted, lead to the problem of wasting a large amount of manpower.
Description
Technical field
This application involves big data technical field, in particular to a kind of amount for which loss settled based on big data side of adjustment automatically
Method, device, computer equipment.
Background technique
In insurance field, incurred loss by the property of insurer or personal life when insurance risk and making occurs for insurer
When being damaged, insurance company will fulfil reparation or pay the behavior of responsibility according to the contract.It is specific in order to obtain to need to hold
The liability to pay compensation of load, insurance company need to obtain corresponding insurance responsibility according to different people's case type information determinations that is in danger,
Due to being in danger, people's case type information is extremely complex, and adjustment personnel need to take a significant amount of time to determine to obtain corresponding guarantor
Dangerous responsibility, therefore working efficiency is low, needs to waste a large amount of manpower,
Apply for content
In view of the shortcomings of the prior art, the application propose a kind of amount for which loss settled based on big data adjust automatically method, apparatus,
Computer equipment, it is intended to solve existing amount for which loss settled, need the personnel of adjusting to spend a lot of time and manually adjusted, cause to waste
The problem of a large amount of manpower.
The technical solution that the application proposes is:
A kind of amount for which loss settled based on big data adjusts method automatically, which comprises
Obtain people's case type information of being in danger of core duty personnel's input；
According to people's case type information of being in danger, matched based on big data corresponding with people's case type information of being in danger
Responsibility managing detailed catalogue, wherein the responsibility managing detailed catalogue includes responsibility attribute, responsibility feature and calculation formula；
Data required for the calculating determined in the calculation formula according to the responsibility attribute, the responsibility feature；
The corresponding amount for which loss settled of people's case type information of being in danger described in being calculated automatically according to the calculation formula.
Further, it is described acquisition core duty personnel input be in danger people's case type information the step of in, comprising:
Default people's case type information of being respectively in danger；
Receive core duty personnel according to be in danger situation it is described it is default be respectively in danger in people's case type information select it is corresponding go out
The selection of dangerous people's case type information inputs instruction；
It obtains the selection input and instructs corresponding people's case type information of being in danger.
Further, it is in danger according to described people's case type information, based on big data matching and the people that is in danger
In the step of case type information corresponding responsibility managing detailed catalogue, comprising:
The matching relationship of default be respectively in danger people's case type information and the Corresponding matching relationship of different responsibility managing detailed catalogues
Library；
People's case type information of being in danger is matched in the matching relationship library；
Corresponding responsibility managing detailed catalogue is matched in the matching relationship library.
Further, it is in danger according to described people's case type information, based on big data matching and the people that is in danger
In the step of case type information corresponding responsibility managing detailed catalogue, comprising:
The case coding different to people's case type information configuration of being respectively in danger；
Different responsibility codes is configured to each responsibility managing detailed catalogue；
It is corresponding from different responsibility codes to preset different case codings；
After getting people's case type information of being in danger, the corresponding case of people's case type information of being in danger described in extraction
Part coding；
According to the corresponding case coding of people's case type information of being in danger, corresponding responsibility code is matched；
According to corresponding responsibility code is matched to, the corresponding responsibility detail letter of people's case type information of being in danger described in acquisition
Breath.
Further, calculating in the calculation formula is determined according to the responsibility attribute, the responsibility feature described
In the step of required data, comprising:
Formula data and claim data in the calculation formula are determined according to the responsibility attribute, the responsibility feature,
Wherein the formula data includes compensation ratio, deductible excess and subsidy day volume, and the claim data includes medical bills, setting loss ratio
Example, subsidy number of days and delay duration.
Further, it is in danger described in being calculated automatically described according to the calculation formula the corresponding reason of people's case type information
After the step of paying for the amount of money, comprising:
Receive the formula modification instruction of core duty personnel's input；
The specified calculation formula of instruction modification is modified according to the formula.
Further, it is in danger described in being calculated automatically described according to the calculation formula the corresponding reason of people's case type information
After the step of paying for the amount of money, comprising:
People's case type information of being in danger, the responsibility attribute, the responsibility feature, the calculation formula are shown
In the same page.
The application also provides a kind of amount for which loss settled based on big data and adjusts device automatically, and described device includes:
Module is obtained, for obtaining people's case type information of being in danger of core duty personnel's input；
Matching module, for people's case type information of being in danger according to, based on big data matching and people's case of being in danger
The corresponding responsibility managing detailed catalogue of part type information, wherein the responsibility managing detailed catalogue includes responsibility attribute, responsibility feature and calculating
Formula；
Determining module, for determining the calculating institute in the calculation formula according to the responsibility attribute, the responsibility feature
The data needed；
Computing module, for the corresponding Claims Resolution of people's case type information that is in danger described in being calculated automatically according to the calculation formula
The amount of money.
The application also provides a kind of computer equipment, including memory and processor, and the memory is stored with computer
The step of program, the processor realizes method described in any of the above embodiments when executing the computer program.
The application also provides a kind of computer readable storage medium, is stored thereon with computer program, the computer journey
The step of method described in any of the above embodiments is realized when sequence is executed by processor.
According to above-mentioned technical solution, the application is the utility model has the advantages that obtain people's case type letter that is in danger of core duty personnel's input
Breath, according to the corresponding responsibility managing detailed catalogue of people's case type information matches that is in danger, then further according to the duty in responsibility managing detailed catalogue
Attribute, responsibility feature is appointed to determine that the calculation formula in responsibility managing detailed catalogue calculates required data, later according to calculation formula
Automatically amount for which loss settled is calculated, realizes the automatic purpose for calculating amount for which loss settled, it is intended to solve existing amount for which loss settled, need to manage
Calculation personnel, which spend a lot of time, manually to be adjusted, and the problem of wasting a large amount of manpower is caused.
Detailed description of the invention
Fig. 1 is the flow chart for adjusting method automatically using the amount for which loss settled provided by the embodiments of the present application based on big data；
Fig. 2 is the functional module for adjusting device automatically using the amount for which loss settled provided by the embodiments of the present application based on big data
Figure；
Fig. 3 is the structural schematic block diagram using computer equipment provided by the embodiments of the present application.
Specific embodiment
It is with reference to the accompanying drawings and embodiments, right in order to which the objects, technical solutions and advantages of the application are more clearly understood
The application is further elaborated.It should be appreciated that specific embodiment described herein is only used to explain the application, and
It is not used in restriction the application.
As shown in Figure 1, the embodiment of the present application proposes that a kind of amount for which loss settled based on big data adjusts method, the side automatically
Method the following steps are included:
Step S101, people's case type information of being in danger of core duty personnel's input is obtained.
After insurant is in danger, Claims Resolution request will be proposed, the insurance company people that needs to be in danger provides dangerous situation condition information,
It is convenient for adjusting.Core duty personnel will obtain assessment according to situation information of being in danger and obtain people's case type information of being in danger, and core blames people
Member will be in danger people's case type information input into adjustment system, and adjustment system will acquire people's case of being in danger of core duty personnel's input
Type information.
In the present embodiment, in step s101, comprising:
Default people's case type information of being respectively in danger；
It receives core duty personnel and selects the selection of corresponding people's case type information of being in danger to input instruction according to situation of being in danger；
It obtains the selection input and instructs corresponding people's case type information of being in danger.
People's case type information of being respectively in danger is preset in adjustment system, default people's case type information of being respectively in danger is blamed for core
Personnel are selected accordingly, and after completing default people's case type information of being respectively in danger, core blames personnel according to the situation choosing that is in danger
Corresponding people's case type information of being in danger is selected, selects corresponding people's case class of being in danger in default be respectively in danger in people's case type information
Type information receives selection input and instructs, receiving selection after core duty personnel's completion selection is in danger people's case type information
After input instruction, according to selection input instruction, obtains selection input and instruct corresponding people's case type information of being in danger.
Specifically, adjustment system has preset the option of a variety of people's case type information of being in danger, and core duty personnel are by choosing
People's case type information of being in danger is inputted, to obtain corresponding people's case type information of being in danger.
In the present embodiment, people's case type information of being in danger includes that people hurts class and inhuman hurts class two major classes.Wherein people hurts class
Be divided into: unexpected hospitalization benefit, disease patient subsidy, disease hospitalization benefit, unexpected outpatient service, is surprisingly hospitalized, meaning at unexpected outpatient service subsidy
Outer accident, unexpected deformity, disease patient, disease be hospitalized, the deformity of disease accident, disease, major disease and other people hurt；It is non-
People, which hurts class and is divided into: flight delay/cancellation/makes preparation for dropping, property loss, travelling change, luggage is delayed, other public transports are prolonged
It misses, examination does not pass through and the types such as other inhuman wounds.Core, which blames personnel, according to the people that is in danger provides dangerous situation condition information to choose pair
The people's case type information of being in danger answered, so that adjustment system obtains people's case type information of being in danger of input.In addition, hurting for people
Class can also be subdivided into medical class, subsidy class, disability die class, major disease class and other people hurt several classes such as class, medical class
Including unexpected outpatient service, it is unexpected be hospitalized, the case types such as unexpected disabled, disease patient and disease are hospitalized；Subsidy class includes unexpected
The case types such as hospitalization benefit, unexpected outpatient service subsidy, disease patient subsidy and disease hospitalization benefit；Disability dies class including anticipating
The case types such as outer deformity, contingency, disease accident and disease deformity；Major disease class only includes major disease, other
It includes that other people hurt that people, which hurts class,；The corresponding case type of personnel's input is blamed by the way that the classification of multiple case types is arranged convenient for core.
Step S102, it is in danger according to people's case type information, based on big data matching and people's case class of being in danger
The corresponding responsibility managing detailed catalogue of type information, wherein the responsibility managing detailed catalogue includes responsibility attribute, responsibility feature and calculation formula.
After getting and being in danger people's case type information, the people's case type information that will be in danger is matched, and is matched and is gone out
The corresponding responsibility managing detailed catalogue of dangerous people's case type information, to obtain responsibility managing detailed catalogue.In the present embodiment, responsibility detail
Information includes responsibility attribute, responsibility feature and calculation formula.
In the present embodiment, in step s 102, comprising:
Default people's case type information of being respectively in danger；
Receive core duty personnel according to be in danger situation it is described it is default be respectively in danger in people's case type information select it is corresponding go out
The selection of dangerous people's case type information inputs instruction；
It obtains the selection input and instructs corresponding people's case type information of being in danger.
Preset matching relationship library, matching relationship library include respectively be in danger people's case type information and different responsibility managing detailed catalogues
Corresponding matching relationship, after getting and being in danger people's case type information, the people's case type information that will be in danger is in matching relationship
It is matched in library, corresponding responsibility managing detailed catalogue is matched in matching relationship library, to obtain people's case type letter that is in danger
Cease corresponding responsibility managing detailed catalogue.
In some embodiments, in step s 102, comprising:
The case coding different to people's case type information configuration of being respectively in danger；
Different responsibility codes is configured to each responsibility managing detailed catalogue；
It is corresponding from different responsibility codes to preset different case codings；
After getting people's case type information of being in danger, the corresponding case of people's case type information of being in danger described in extraction
Part coding；
According to the corresponding case coding of people's case type information of being in danger, corresponding responsibility code is matched；
According to corresponding responsibility code is matched to, the corresponding responsibility detail letter of people's case type information of being in danger described in acquisition
Breath.
Different codings is configured to people's case type information of being respectively in danger, each responsibility managing detailed catalogue respectively, to people's case of being respectively in danger
Part type information configures different case codings, different responsibility codes is configured to each responsibility managing detailed catalogue, at this point, the people that is respectively in danger
Case type information respectively corresponds a case coding, and each responsibility managing detailed catalogue respectively corresponds a responsibility code, in completion case
The part coding case coding different with presetting after the configuration of responsibility code is corresponding from different responsibility codes, is getting
It is in danger after people's case type information, since people's case type information of being in danger can correspond to a case coding, extracts people's case of being in danger
Case coding is matched, is encoded according to case after extracting case coding by the corresponding case coding of part type information
Corresponding responsibility code is matched, after being matched to corresponding responsibility code, according to the corresponding responsibility managing detailed catalogue of responsibility code,
Acquisition is in danger the corresponding responsibility managing detailed catalogue of people's case type information.
Step S103, according to required for the calculating that the responsibility attribute, the responsibility feature determine in the calculation formula
Data.
After obtaining responsibility managing detailed catalogue, responsibility managing detailed catalogue includes responsibility attribute, responsibility feature and calculation formula, root
Data required for the calculating in calculation formula are determined according to responsibility attribute, responsibility feature.
In the present embodiment, in step s 103, comprising:
Formula data and claim data in the calculation formula are determined according to the responsibility attribute, the responsibility feature,
Wherein the formula data includes compensation ratio, deductible excess and subsidy day volume, and the claim data includes medical bills, setting loss ratio
Example, subsidy number of days and delay duration.
Data required for calculating in calculation formula include formula data and claim data, according to responsibility attribute, responsibility
Feature determines formula data and claim data in calculation formula, and in the present embodiment, formula data includes compensation ratio, abatement
Volume and subsidy day volume, claim data include medical bills, setting loss ratio, subsidy number of days and delay duration.It is, according to responsibility
Attribute, responsibility feature determine compensation ratio, deductible excess, subsidy day volume, medical bills, setting loss ratio, subsidy in calculation formula
Number of days and delay duration.
In the present embodiment, responsibility attribute includes that subsidy, disease, outpatient service, medical treatment and multiple classifications, the responsibility such as be hospitalized are special
Point includes multiple features such as morbilli, flight delay, general hospitalization benefit.Specifically, responsibility attribute includes 18 classifications, and responsibility is special
Point includes 128 classes, and by responsibility attribute, responsibility is special and calculation formula is combined composition and includes 1000 multiple and different responsibilities
Detail.
In the present embodiment, in step s 103, comprising:
Identify whether the calculation formula is calculation formula for medical class；
If the calculation formula be for the calculation formula for medical class, obtain described in be in danger people's case type information institute
Claims Resolution organization information；
According to the Claims Resolution organization information where people's case type information of being in danger, obtain in the calculation formula with it is described
The corresponding sub- calculation formula of Claims Resolution organization information where people's case type information of being in danger；
Required for determining the calculating of the calculation formula neutron calculation formula according to the responsibility attribute, the responsibility feature
Data.
For the calculation formula of medical class, different mechanisms is subordinate branch of the insurance company in different regions, by
Claims Resolution policy slightly difference in different regions, therefore there is some difference for calculation formula.By the way that the same calculation formula is arranged
Including multiple sub- calculation formula, adjustment system implementation mechanism difference can be made to configure, i.e., identical calculation formula allows different
Mechanism is calculated using different sub- calculation formula.After obtaining calculation formula, calculation formula is identified, identification meter
Calculate whether formula is calculation formula for medical class, if calculation formula is obtained out for the calculation formula for medical class
Claims Resolution organization information where dangerous people's case type information is getting the Claims Resolution mechanism letter where being in danger people's case type information
After breath, according to the Claims Resolution organization information where people's case type information of being in danger, obtain in calculation formula with people's case of being in danger
The corresponding sub- calculation formula of Claims Resolution organization information where part type information, after obtaining sub- calculation formula, according to responsibility category
Property, the responsibility feature determine data required for the calculating of calculation formula neutron calculation formula.
Step S104, the corresponding Claims Resolution gold of people's case type information of being in danger described in being calculated automatically according to the calculation formula
Volume.
After data required for calculating in determining calculation formula, calculation formula can be carried out calculating, according to calculating
Formula calculates the corresponding amount for which loss settled of people's case type information that is in danger automatically.To realize that basis is in danger people's case type information certainly
It is dynamic that amount for which loss settled is calculated, the workload of adjustment personnel is substantially reduced, is improved work efficiency, a large amount of manpowers are saved.
In some embodiments, after step s 104, comprising:
It is in danger described in acquisition the account of the corresponding insurant of people's case type information；
The amount for which loss settled is transferred accounts to described and is in danger in the account of the corresponding insurant of people's case type information.
Automatically amount for which loss settled is being calculated, is needing to transfer accounts amount for which loss settled to insurant, to obtain people's case of being in danger
The account of the corresponding insurant of type information transfers accounts amount for which loss settled to the people that is in danger after obtaining the account of insurant
In the account of the corresponding insurant of case type information.To realize the purpose quickly compensated.
In the present embodiment, after step s 104, comprising:
The formula for receiving core duty personnel's input modifies instruction；
The specified calculation formula of instruction modification is modified according to the formula.
Calculation formula can have modification or more news, for this purpose, core duty personnel's input modifies to calculation formula
Formula modify instruction, receive core duty personnel input formula modify instruction, receive formula modification instruction after, according to public affairs
Formula modifies the specified calculation formula of instruction modification, to achieve the purpose that modify calculation formula or update calculation formula.
In the present embodiment, after step s 104, comprising:
People's case type information of being in danger, the responsibility attribute, the responsibility feature, the calculation formula are shown
In the same page.
After calculating amount for which loss settled automatically, people's case type information that will be in danger, responsibility feature, is calculated responsibility attribute
Formula shows that in the same page, duty personnel are illustrated insurant for the origin of amount for which loss settled in order to core.
In conclusion people's case type information of being in danger of core duty personnel's input is obtained, according to people's case type information of being in danger
Corresponding responsibility managing detailed catalogue is matched, then determines that responsibility is bright further according to the responsibility attribute in responsibility managing detailed catalogue, responsibility feature
Data required for calculation formula in thin information calculates, calculate amount for which loss settled according to calculation formula later automatically, realize
The automatic purpose for calculating amount for which loss settled, it is intended to solve existing amount for which loss settled, need the personnel of adjusting to spend a lot of time progress artificial
Adjustment, leads to the problem of wasting a large amount of manpower.
As shown in Fig. 2, the embodiment of the present application proposes that a kind of amount for which loss settled based on big data adjusts device 1, device 1 automatically
Including obtaining module 11, matching module 12, determining module 13 and computing module 14.
Module 11 is obtained, for obtaining people's case type information of being in danger of core duty personnel's input.
After insurant is in danger, Claims Resolution request will be proposed, the insurance company people that needs to be in danger provides dangerous situation condition information,
It is convenient for adjusting.Core duty personnel will obtain assessment according to situation information of being in danger and obtain people's case type information of being in danger, and core blames people
Member will be in danger people's case type information input into adjustment system, and adjustment system will acquire people's case of being in danger of core duty personnel's input
Type information.
In the present embodiment, obtaining module 11 includes:
First presetting module, for default people's case type information of being respectively in danger；
First receiving module selects corresponding people's case type information of being in danger according to situation of being in danger for receiving core duty personnel
Selection input instruction；
First obtains module, instructs corresponding people's case type information of being in danger for obtaining the selection input.
People's case type information of being respectively in danger is preset in adjustment system, default people's case type information of being respectively in danger is blamed for core
Personnel are selected accordingly, and after completing default people's case type information of being respectively in danger, core blames personnel according to the situation choosing that is in danger
Corresponding people's case type information of being in danger is selected, selects corresponding people's case class of being in danger in default be respectively in danger in people's case type information
Type information receives selection input and instructs, receiving selection after core duty personnel's completion selection is in danger people's case type information
After input instruction, according to selection input instruction, obtains selection input and instruct corresponding people's case type information of being in danger.
Specifically, adjustment system has preset the option of a variety of people's case type information of being in danger, and core duty personnel are by choosing
People's case type information of being in danger is inputted, to obtain corresponding people's case type information of being in danger.
In the present embodiment, people's case type information of being in danger includes that people hurts class and inhuman hurts class two major classes.Wherein people hurts class
Be divided into: unexpected hospitalization benefit, disease patient subsidy, disease hospitalization benefit, unexpected outpatient service, is surprisingly hospitalized, meaning at unexpected outpatient service subsidy
Outer accident, unexpected deformity, disease patient, disease be hospitalized, the deformity of disease accident, disease, major disease and other people hurt；It is non-
People, which hurts class and is divided into: flight delay/cancellation/makes preparation for dropping, property loss, travelling change, luggage is delayed, other public transports are prolonged
It misses, examination does not pass through and the types such as other inhuman wounds.Core, which blames personnel, according to the people that is in danger provides dangerous situation condition information to choose pair
The people's case type information of being in danger answered, so that adjustment system obtains people's case type information of being in danger of input.In addition, hurting for people
Class can also be subdivided into medical class, subsidy class, disability die class, major disease class and other people hurt several classes such as class, medical class
Including unexpected outpatient service, it is unexpected be hospitalized, the case types such as unexpected disabled, disease patient and disease are hospitalized；Subsidy class includes unexpected
The case types such as hospitalization benefit, unexpected outpatient service subsidy, disease patient subsidy and disease hospitalization benefit；Disability dies class including anticipating
The case types such as outer deformity, contingency, disease accident and disease deformity；Major disease class only includes major disease, other
It includes that other people hurt that people, which hurts class,；The corresponding case type of personnel's input is blamed by the way that the classification of multiple case types is arranged convenient for core.
Matching module 12, for people's case type information of being in danger according to, based on big data matching and the people that is in danger
The corresponding responsibility managing detailed catalogue of case type information, wherein the responsibility managing detailed catalogue includes responsibility attribute, responsibility feature and meter
Calculate formula.
After getting and being in danger people's case type information, the people's case type information that will be in danger is matched, and is matched and is gone out
The corresponding responsibility managing detailed catalogue of dangerous people's case type information, to obtain responsibility managing detailed catalogue.In the present embodiment, responsibility detail
Information includes responsibility attribute, responsibility feature and calculation formula.
In the present embodiment, matching module 12 includes:
Second presetting module, for default people's case type information of being respectively in danger；
Second receiving module, for receiving core duty personnel according to situation of being in danger in default people's case type letter that is respectively in danger
The selection of corresponding people's case type information of being in danger is selected to input instruction in breath；
Second obtains module, instructs corresponding people's case type information of being in danger for obtaining the selection input.
Preset matching relationship library, matching relationship library include respectively be in danger people's case type information and different responsibility managing detailed catalogues
Corresponding matching relationship, after getting and being in danger people's case type information, the people's case type information that will be in danger is in matching relationship
It is matched in library, corresponding responsibility managing detailed catalogue is matched in matching relationship library, to obtain people's case type letter that is in danger
Cease corresponding responsibility managing detailed catalogue.
In some embodiments, matching module 12 includes:
First configuration module, for being encoded to the different case of people's case type information configuration of being respectively in danger；
Second configuration module, for configuring different responsibility codes to each responsibility managing detailed catalogue；
Third presetting module, the case coding for presetting different are corresponding from different responsibility codes；
First extraction module, for after getting people's case type information of being in danger, people's case of being in danger described in extraction
The corresponding case coding of part type information；
First matching module matches corresponding for the corresponding case coding of people's case type information of being in danger according to
Responsibility code；
First obtains module, is matched to corresponding responsibility code for basis, people's case type information of being in danger described in acquisition
Corresponding responsibility managing detailed catalogue.
Different codings is configured to people's case type information of being respectively in danger, each responsibility managing detailed catalogue respectively, to people's case of being respectively in danger
Part type information configures different case codings, different responsibility codes is configured to each responsibility managing detailed catalogue, at this point, the people that is respectively in danger
Case type information respectively corresponds a case coding, and each responsibility managing detailed catalogue respectively corresponds a responsibility code, in completion case
The part coding case coding different with presetting after the configuration of responsibility code is corresponding from different responsibility codes, is getting
It is in danger after people's case type information, since people's case type information of being in danger can correspond to a case coding, extracts people's case of being in danger
Case coding is matched, is encoded according to case after extracting case coding by the corresponding case coding of part type information
Corresponding responsibility code is matched, after being matched to corresponding responsibility code, according to the corresponding responsibility managing detailed catalogue of responsibility code,
Acquisition is in danger the corresponding responsibility managing detailed catalogue of people's case type information.
Determining module 13, for determining the calculating in the calculation formula according to the responsibility attribute, the responsibility feature
Required data.
After obtaining responsibility managing detailed catalogue, responsibility managing detailed catalogue includes responsibility attribute, responsibility feature and calculation formula, root
Data required for the calculating in calculation formula are determined according to responsibility attribute, responsibility feature.
In the present embodiment, determining module 13 includes:
First determining module, for determining the public affairs in the calculation formula according to the responsibility attribute, the responsibility feature
Formula data and claim data, wherein the formula data includes compensation ratio, deductible excess and subsidy day volume, the claim data packet
Include medical bills, setting loss ratio, subsidy number of days and delay duration.
Data required for calculating in calculation formula include formula data and claim data, according to responsibility attribute, responsibility
Feature determines formula data and claim data in calculation formula, and in the present embodiment, formula data includes compensation ratio, abatement
Volume and subsidy day volume, claim data include medical bills, setting loss ratio, subsidy number of days and delay duration.It is, according to responsibility
Attribute, responsibility feature determine compensation ratio, deductible excess, subsidy day volume, medical bills, setting loss ratio, subsidy in calculation formula
Number of days and delay duration.
In the present embodiment, responsibility attribute includes that subsidy, disease, outpatient service, medical treatment and multiple classifications, the responsibility such as be hospitalized are special
Point includes multiple features such as morbilli, flight delay, general hospitalization benefit.Specifically, responsibility attribute includes 18 classifications, and responsibility is special
Point includes 128 classes, and by responsibility attribute, responsibility is special and calculation formula is combined composition and includes 1000 multiple and different responsibilities
Detail.
In the present embodiment, determining module 13 includes:
First identification module, whether the calculation formula is calculation formula for medical class for identification；
Third obtains module, if for the calculation formula be for the calculation formula for medical class, obtain it is described go out
Claims Resolution organization information where dangerous people's case type information；
4th obtains module, for the Claims Resolution organization information where people's case type information of being in danger according to, obtains institute
State sub- calculation formula corresponding with the Claims Resolution organization information where people's case type information of being in danger in calculation formula；
Second determining module, for determining the calculation formula neutron gauges according to the responsibility attribute, the responsibility feature
Calculate data required for the calculating of formula.
For the calculation formula of medical class, different mechanisms is subordinate branch of the insurance company in different regions, by
Claims Resolution policy slightly difference in different regions, therefore there is some difference for calculation formula.By the way that the same calculation formula is arranged
Including multiple sub- calculation formula, adjustment system implementation mechanism difference can be made to configure, i.e., identical calculation formula allows different
Mechanism is calculated using different sub- calculation formula.After obtaining calculation formula, calculation formula is identified, identification meter
Calculate whether formula is calculation formula for medical class, if calculation formula is obtained out for the calculation formula for medical class
Claims Resolution organization information where dangerous people's case type information is getting the Claims Resolution mechanism letter where being in danger people's case type information
After breath, according to the Claims Resolution organization information where people's case type information of being in danger, obtain in calculation formula with people's case of being in danger
The corresponding sub- calculation formula of Claims Resolution organization information where part type information, after obtaining sub- calculation formula, according to responsibility category
Property, the responsibility feature determine data required for the calculating of calculation formula neutron calculation formula.
Computing module 14, for the corresponding reason of people's case type information of being in danger described in being calculated automatically according to the calculation formula
Pay for the amount of money.
After data required for calculating in determining calculation formula, calculation formula can be carried out calculating, according to calculating
Formula calculates the corresponding amount for which loss settled of people's case type information that is in danger automatically.To realize that basis is in danger people's case type information certainly
It is dynamic that amount for which loss settled is calculated, the workload of adjustment personnel is substantially reduced, is improved work efficiency, a large amount of manpowers are saved.
In some embodiments, device 1 includes:
5th obtains module, for obtaining the account of the corresponding insurant of people's case type information that is in danger；
It transfers accounts module, for transferring accounts the amount for which loss settled to the corresponding insurant of people's case type information that is in danger
Account in.
Automatically amount for which loss settled is being calculated, is needing to transfer accounts amount for which loss settled to insurant, to obtain people's case of being in danger
The account of the corresponding insurant of type information transfers accounts amount for which loss settled to the people that is in danger after obtaining the account of insurant
In the account of the corresponding insurant of case type information.To realize the purpose quickly compensated.
In the present embodiment, device 1 includes:
Third receiving module, for receiving the formula modification instruction of core duty personnel's input；
Modified module, for modifying the specified calculation formula of instruction modification according to the formula.
Calculation formula can have modification or more news, for this purpose, core duty personnel's input modifies to calculation formula
Formula modify instruction, receive core duty personnel input formula modify instruction, receive formula modification instruction after, according to public affairs
Formula modifies the specified calculation formula of instruction modification, to achieve the purpose that modify calculation formula or update calculation formula.
In the present embodiment, device 1 includes:
Display module, for by people's case type information of being in danger, the responsibility attribute, the responsibility feature, described
Calculation formula is shown in the same page.
After calculating amount for which loss settled automatically, people's case type information that will be in danger, responsibility feature, is calculated responsibility attribute
Formula shows that in the same page, duty personnel are illustrated insurant for the origin of amount for which loss settled in order to core.
In conclusion people's case type information of being in danger of core duty personnel's input is obtained, according to people's case type information of being in danger
Corresponding responsibility managing detailed catalogue is matched, then determines that responsibility is bright further according to the responsibility attribute in responsibility managing detailed catalogue, responsibility feature
Data required for calculation formula in thin information calculates, calculate amount for which loss settled according to calculation formula later automatically, realize
The automatic purpose for calculating amount for which loss settled, it is intended to solve existing amount for which loss settled, need the personnel of adjusting to spend a lot of time progress artificial
Adjustment, leads to the problem of wasting a large amount of manpower.
As shown in figure 3, also providing a kind of computer equipment in the embodiment of the present application, which can be service
Device, internal structure can be as shown in Figure 3.The computer equipment includes processor, the memory, net connected by system bus
Network interface and database.Wherein, the processor of the Computer Design is for providing calculating and control ability.The computer equipment
Memory includes non-volatile memory medium, built-in storage.The non-volatile memory medium is stored with operating system, computer journey
Sequence and database.The internal memory provides environment for the operation of operating system and computer program in non-volatile memory medium.
The database of the computer equipment adjusts the data such as the model of method for storing the amount for which loss settled based on big data automatically.The meter
The network interface for calculating machine equipment is used to communicate with external terminal by network connection.When the computer program is executed by processor
To realize that a kind of amount for which loss settled based on big data adjusts method automatically.
Above-mentioned processor executes the step of above-mentioned amount for which loss settled based on big data adjusts method automatically: obtaining core duty personnel
People's case type information of being in danger of input；According to people's case type information of being in danger, is matched based on big data and be in danger with described
The corresponding responsibility managing detailed catalogue of people's case type information, wherein the responsibility managing detailed catalogue include responsibility attribute, responsibility feature and
Calculation formula；Data required for the calculating determined in the calculation formula according to the responsibility attribute, the responsibility feature；Root
The corresponding amount for which loss settled of people's case type information of being in danger described in being calculated automatically according to the calculation formula.
In one embodiment, above-mentioned acquisition core duty personnel input be in danger people's case type information the step of in, comprising:
Default people's case type information of being respectively in danger；
Receive core duty personnel according to be in danger situation it is described it is default be respectively in danger in people's case type information select it is corresponding go out
The selection of dangerous people's case type information inputs instruction；
It obtains the selection input and instructs corresponding people's case type information of being in danger.
In one embodiment, above-mentioned people's case type information of being in danger according to, based on big data matching with it is described go out
In the step of dangerous people's case type information corresponding responsibility managing detailed catalogue, comprising:
The matching relationship of default be respectively in danger people's case type information and the Corresponding matching relationship of different responsibility managing detailed catalogues
Library；
People's case type information of being in danger is matched in the matching relationship library；
Corresponding responsibility managing detailed catalogue is matched in the matching relationship library.
In one embodiment, above-mentioned people's case type information of being in danger according to, based on big data matching with it is described go out
In the step of dangerous people's case type information corresponding responsibility managing detailed catalogue, comprising:
The case coding different to people's case type information configuration of being respectively in danger；
Different responsibility codes is configured to each responsibility managing detailed catalogue；
It is corresponding from different responsibility codes to preset different case codings；
After getting people's case type information of being in danger, the corresponding case of people's case type information of being in danger described in extraction
Part coding；
According to the corresponding case coding of people's case type information of being in danger, corresponding responsibility code is matched；
According to corresponding responsibility code is matched to, the corresponding responsibility detail letter of people's case type information of being in danger described in acquisition
Breath.
In one embodiment, above-mentioned to be determined in the calculation formula according to the responsibility attribute, the responsibility feature
In the step of data required for calculating, comprising:
Formula data and claim data in the calculation formula are determined according to the responsibility attribute, the responsibility feature,
Wherein the formula data includes compensation ratio, deductible excess and subsidy day volume, and the claim data includes medical bills, setting loss ratio
Example, subsidy number of days and delay duration.
In one embodiment, it is above-mentioned calculated automatically according to the calculation formula described in people's case type information of being in danger it is corresponding
Amount for which loss settled the step of after, comprising:
The formula for receiving core duty personnel's input modifies instruction；
The specified calculation formula of instruction modification is modified according to the formula.
In one embodiment, it is above-mentioned calculated automatically according to the calculation formula described in people's case type information of being in danger it is corresponding
Amount for which loss settled the step of after, comprising:
People's case type information of being in danger, the responsibility attribute, the responsibility feature, the calculation formula are shown
In the same page.
It will be understood by those skilled in the art that structure shown in Fig. 3, only part relevant to application scheme is tied
The block diagram of structure does not constitute the restriction for the computer equipment being applied thereon to application scheme.
The computer equipment of the embodiment of the present application obtains people's case type information of being in danger of core duty personnel's input, according to out
The corresponding responsibility managing detailed catalogue of dangerous people's case type information matches, then further according to the responsibility attribute in responsibility managing detailed catalogue, duty
The feature of appointing determines that the calculation formula in responsibility managing detailed catalogue calculates required data, is calculated automatically according to calculation formula later
Amount for which loss settled realizes the automatic purpose for calculating amount for which loss settled, it is intended to solve existing amount for which loss settled, the personnel of adjusting is needed to spend greatly
The amount time is manually adjusted, and the problem of wasting a large amount of manpower is caused.
One embodiment of the application also provides a kind of computer readable storage medium, is stored thereon with computer program, calculates
Machine program realizes that a kind of amount for which loss settled based on big data adjusts method automatically when being executed by processor, specifically: obtain core duty
People's case type information of being in danger of personnel's input；According to people's case type information of being in danger, based on big data matching with it is described
The corresponding responsibility managing detailed catalogue of people's case type information of being in danger, wherein the responsibility managing detailed catalogue includes responsibility attribute, responsibility spy
Point and calculation formula；Number required for the calculating determined in the calculation formula according to the responsibility attribute, the responsibility feature
According to；The corresponding amount for which loss settled of people's case type information of being in danger described in being calculated automatically according to the calculation formula.
In one embodiment, above-mentioned acquisition core duty personnel input be in danger people's case type information the step of in, comprising:
Default people's case type information of being respectively in danger；
Receive core duty personnel according to be in danger situation it is described it is default be respectively in danger in people's case type information select it is corresponding go out
The selection of dangerous people's case type information inputs instruction；
It obtains the selection input and instructs corresponding people's case type information of being in danger.
In one embodiment, above-mentioned people's case type information of being in danger according to, based on big data matching with it is described go out
In the step of dangerous people's case type information corresponding responsibility managing detailed catalogue, comprising:
The matching relationship of default be respectively in danger people's case type information and the Corresponding matching relationship of different responsibility managing detailed catalogues
Library；
People's case type information of being in danger is matched in the matching relationship library；
Corresponding responsibility managing detailed catalogue is matched in the matching relationship library.
In one embodiment, above-mentioned people's case type information of being in danger according to, based on big data matching with it is described go out
In the step of dangerous people's case type information corresponding responsibility managing detailed catalogue, comprising:
The case coding different to people's case type information configuration of being respectively in danger；
Different responsibility codes is configured to each responsibility managing detailed catalogue；
It is corresponding from different responsibility codes to preset different case codings；
After getting people's case type information of being in danger, the corresponding case of people's case type information of being in danger described in extraction
Part coding；
According to the corresponding case coding of people's case type information of being in danger, corresponding responsibility code is matched；
According to corresponding responsibility code is matched to, the corresponding responsibility detail letter of people's case type information of being in danger described in acquisition
Breath.
In one embodiment, above-mentioned to be determined in the calculation formula according to the responsibility attribute, the responsibility feature
In the step of data required for calculating, comprising:
Formula data and claim data in the calculation formula are determined according to the responsibility attribute, the responsibility feature,
Wherein the formula data includes compensation ratio, deductible excess and subsidy day volume, and the claim data includes medical bills, setting loss ratio
Example, subsidy number of days and delay duration.
In one embodiment, it is above-mentioned calculated automatically according to the calculation formula described in people's case type information of being in danger it is corresponding
Amount for which loss settled the step of after, comprising:
The formula for receiving core duty personnel's input modifies instruction；
The specified calculation formula of instruction modification is modified according to the formula.
In one embodiment, above-mentioned, calculated automatically according to the calculation formula described in be in danger people's case type information pair
After the step of amount for which loss settled answered, comprising:
People's case type information of being in danger, the responsibility attribute, the responsibility feature, the calculation formula are shown
In the same page.
The storage medium of the embodiment of the present application obtains people's case type information of being in danger of core duty personnel's input, according to being in danger
The corresponding responsibility managing detailed catalogue of people's case type information matches, then further according to the responsibility attribute in responsibility managing detailed catalogue, responsibility
Feature determines that the calculation formula in responsibility managing detailed catalogue calculates required data, calculates reason automatically according to calculation formula later
The amount of money is paid for, realizes the automatic purpose for calculating amount for which loss settled, it is intended to solve existing amount for which loss settled, need to adjust personnel Hua great Liang
Time is manually adjusted, and the problem of wasting a large amount of manpower is caused.
Those of ordinary skill in the art will appreciate that realizing all or part of the process in above-described embodiment method, being can be with
Relevant hardware is instructed to complete by computer program, the computer program can be stored in a non-volatile computer
In read/write memory medium, the computer program is when being executed, it may include such as the process of the embodiment of above-mentioned each method.Wherein,
Any reference used in provided herein and embodiment to memory, storage, database or other media,
Including non-volatile and/or volatile memory.Nonvolatile memory may include read-only memory (ROM), programming ROM
(PROM), electrically programmable ROM (EPROM), electrically erasable ROM (EEPROM) or flash memory.Volatile memory may include
Random access memory (RAM) or external cache.By way of illustration and not limitation, RAM is available in many forms,
Such as static state RAM (SRAM), dynamic ram (DRAM), synchronous dram (SDRAM), double speed are according to rate SDRAM (SSRSDRAM), enhancing
Type SDRAM (ESDRAM), synchronization link (Synchlink) DRAM (SLDRAM), memory bus (Rambus) direct RAM
(RDRAM), direct memory bus dynamic ram (DRDRAM) and memory bus dynamic ram (RDRAM) etc..
The foregoing is merely the preferred embodiments of the application, not to limit the application, all essences in the application
Made any modifications, equivalent replacements, and improvements etc. within mind and principle should all include within the scope of protection of this application.
Claims (10)
1. a kind of amount for which loss settled based on big data adjusts method automatically, which is characterized in that the described method includes:
Obtain people's case type information of being in danger of core duty personnel's input；
According to people's case type information of being in danger, duty corresponding with people's case type information of being in danger is matched based on big data
Appoint managing detailed catalogue, wherein the responsibility managing detailed catalogue includes responsibility attribute, responsibility feature and calculation formula；
Data required for the calculating determined in the calculation formula according to the responsibility attribute, the responsibility feature；
The corresponding amount for which loss settled of people's case type information of being in danger described in being calculated automatically according to the calculation formula.
2. the amount for which loss settled according to claim 1 based on big data adjusts method automatically, which is characterized in that obtained described
Take core duty personnel input be in danger people's case type information the step of in, comprising:
Default people's case type information of being respectively in danger；
It receives core duty personnel and selects the corresponding people that is in danger in default be respectively in danger in people's case type information according to situation is in danger
The selection of case type information inputs instruction；
It obtains the selection input and instructs corresponding people's case type information of being in danger.
3. the amount for which loss settled according to claim 1 based on big data adjusts method automatically, which is characterized in that at described
According to people's case type information of being in danger, responsibility detail corresponding with people's case type information of being in danger is matched based on big data
In the step of information, comprising:
The matching relationship library of default be respectively in danger people's case type information and the Corresponding matching relationship of different responsibility managing detailed catalogues；
People's case type information of being in danger is matched in the matching relationship library；
Corresponding responsibility managing detailed catalogue is matched in the matching relationship library.
4. the amount for which loss settled according to claim 1 based on big data adjusts method automatically, which is characterized in that at described
According to people's case type information of being in danger, responsibility detail corresponding with people's case type information of being in danger is matched based on big data
In the step of information, comprising:
The case coding different to people's case type information configuration of being respectively in danger；
Different responsibility codes is configured to each responsibility managing detailed catalogue；
It is corresponding from different responsibility codes to preset different case codings；
After getting people's case type information of being in danger, the corresponding case of people's case type information of being in danger described in extraction is compiled
Code；
According to the corresponding case coding of people's case type information of being in danger, corresponding responsibility code is matched；
According to corresponding responsibility code is matched to, the corresponding responsibility managing detailed catalogue of people's case type information of being in danger described in acquisition.
5. the amount for which loss settled according to claim 1 based on big data adjusts method automatically, which is characterized in that at described
In the step of determining data required for the calculating in the calculation formula according to the responsibility attribute, the responsibility feature, comprising:
Formula data and claim data in the calculation formula are determined according to the responsibility attribute, the responsibility feature, wherein
The formula data includes compensation ratio, deductible excess and subsidy day volume, the claim data include medical bills, setting loss ratio,
Subsidy number of days and delay duration.
6. the amount for which loss settled according to claim 1 based on big data adjusts method automatically, which is characterized in that at described
After the step of people's case type information of being in danger described in being calculated automatically according to the calculation formula corresponding amount for which loss settled, comprising:
Receive the formula modification instruction of core duty personnel's input；
The specified calculation formula of instruction modification is modified according to the formula.
7. the amount for which loss settled according to claim 1 based on big data adjusts method automatically, which is characterized in that at described
After the step of people's case type information of being in danger described in being calculated automatically according to the calculation formula corresponding amount for which loss settled, comprising:
People's case type information of being in danger, the responsibility attribute, the responsibility feature, the calculation formula are shown same
In the page.
8. a kind of amount for which loss settled based on big data adjusts device automatically, which is characterized in that described device includes:
Module is obtained, for obtaining people's case type information of being in danger of core duty personnel's input；
Matching module, for people's case type information of being in danger according to, based on big data matching and people's case class of being in danger
The corresponding responsibility managing detailed catalogue of type information, wherein the responsibility managing detailed catalogue includes responsibility attribute, responsibility feature and calculation formula；
Determining module, required for the calculating for being determined in the calculation formula according to the responsibility attribute, the responsibility feature
Data；
Computing module, for the corresponding Claims Resolution gold of people's case type information of being in danger described in being calculated automatically according to the calculation formula
Volume.
9. a kind of computer equipment, including memory and processor, the memory are stored with computer program, feature exists
In the processor realizes method described in any one of claims 1 to 7 when executing computer program the step of.
10. a kind of computer readable storage medium, is stored thereon with computer program, which is characterized in that the computer program
The step of method described in any one of claims 1 to 7 is realized when being executed by processor.
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| Application Number | Priority Date | Filing Date | Title |
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| CN201811320250.8A CN109658258A (en) | 2018-11-07 | 2018-11-07 | Amount for which loss settled based on big data adjusts method, apparatus, computer equipment automatically |
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| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| CN201811320250.8A CN109658258A (en) | 2018-11-07 | 2018-11-07 | Amount for which loss settled based on big data adjusts method, apparatus, computer equipment automatically |
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| CN109658258A true CN109658258A (en) | 2019-04-19 |
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| Application Number | Title | Priority Date | Filing Date |
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| CN201811320250.8A Pending CN109658258A (en) | 2018-11-07 | 2018-11-07 | Amount for which loss settled based on big data adjusts method, apparatus, computer equipment automatically |
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Cited By (1)
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