CN114037543A - Insurance claim settlement progress supervision system and supervision method - Google Patents
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Abstract
The insurance claim settlement progress supervising system mainly comprises a verification module, a verification module and a verification module, wherein the verification module is used for verifying the identity information of an insurance client and insurance practitioners so as to ensure that the insurance client and the insurance practitioners can obtain the required supervising information about the insurance claim settlement; the time module is used for setting a plurality of supervising time nodes in the whole insurance product claim period so as to supervise at each supervising time node; the system comprises a marking module, a checking module and a checking module, wherein the marking module is used for marking the supervising result of the insurance claim settlement progress on each time node to obtain a marking check code so as to judge whether the insurance claim settlement progress meets the stipulation of an insurance contract or not, and the marking check code is a four-bit binary check code; the acquisition module is used for acquiring and summarizing all the mark check codes so as to evaluate the whole insurance claim settlement progress and obtain an evaluation result Q; and the transmission module is used for transmitting the evaluation result Q of the insurance claim settlement progress to the insurance client and the insurance staff.
Description
The technical field is as follows:
the invention relates to an insurance claim settlement progress supervising system and a supervising method.
Background art:
the insurance industry refers to the industry that collects the funds in the form of contracts to compensate the economic benefits business of the insured. The insurance market is a place where insurance is bought or sold, i.e., where both parties enter into an insurance contract. It may be a centralized tangible market or a decentralized intangible market.
The organization form of insurance industry can be divided into the following four types according to the different operation bodies: 1. the national operation insurance organization, also called as public insurance, refers to the insurance organization operated by the country, local government or other public groups; 2. the company operates insurance organization, belongs to one of the people's operation insurance organization. According to the form of responsibility, the companies include the forms of a company with limited responsibility, a company with limited shares, an unlimited company, and the like. The stockpile insurance company organization has the characteristics of flexible operation and high business efficiency, but because the control right of the company is controlled in stockholders, the rights and interests of an insured are easily limited and ignored, and thus the company operation insurance organization is supervised and managed by each country legislation; 3. an insurance cooperative organization belongs to a non-company type of people in the operation and insurance, and is an organization which is commonly organized by people or units needing insurance guarantee in the society and processes insurance business in a cooperative mode. There are forms of mutual insurance cooperative, mutual insurance company, insurance cooperative, etc.; 4. the individual operation insurance form, the individual underwriting insurance business is developed through the organization of the labour society; according to the rules of the original 'temporary regulations on the management of insurance enterprises' in China, the organization system of the insurance industry in China is composed of the national insurance administrative department, the Chinese people insurance company, other insurance enterprises and the rural cooperative insurance society of mutual assistance.
In the process of executing claim settlement, the insurance product needs to monitor and check the whole claim settlement period to ensure that the claim settlement links conform to insurance contracts and related laws and regulations; the existing supervision mode is mainly implemented manually, a great deal of energy of insurance practitioners needs to be consumed, and the time cost is high; meanwhile, the supervising information has low transparency and slow feedback speed, so that the insurance client and the insurance practitioners can not master the claim settlement state of the insurance product in real time and can not effectively maintain the rights and interests of the insurance client.
The invention content is as follows:
the embodiment of the invention provides an insurance claim settlement progress supervising system and a supervising method, the structure and the method are reasonable in design, the whole claim settlement period of an insurance product can be automatically and accurately supervised and checked based on the mutual cooperation of a plurality of functional modules, and the time cost and the actual workload of insurance practitioners are reduced; meanwhile, the response speed is high, the man-machine interaction is good, and the insurance product can master the claim settlement state of the insurance product in real time, so that the rights and interests of insurance customers are effectively maintained, and the problems in the prior art are solved.
The technical scheme adopted by the invention for solving the technical problems is as follows:
insurance claim settlement progress supervise system includes:
the verification module is used for verifying the identity information of the insurance client and the insurance staff so as to ensure that the insurance client and the insurance staff can obtain required supervision information about insurance claims;
the time module is used for setting a plurality of supervising time nodes in the whole insurance product claim settlement period so as to supervise at each supervising time node;
the system comprises a marking module, a checking module and a checking module, wherein the marking module is used for marking the supervising result of the insurance claim progress on each time node to obtain a marking check code so as to judge whether the insurance claim progress accords with the stipulation of an insurance contract, and the marking check code is a four-digit binary check code;
the acquisition module is used for acquiring and summarizing all the mark check codes so as to evaluate the progress of the whole insurance claim settlement and obtain an evaluation result Q;
the transmission module is used for transmitting the evaluation result Q of the insurance claim settlement progress to insurance clients and insurance employees;
and the execution module is used for judging whether to execute normal insurance claims according to the numerical value of the evaluation result Q of the insurance claim progress.
The verification module comprises:
the input module is used for inputting the identity information of the current insurance client and insurance practitioner into a database;
the storage module is used for storing the identity information of standard insurance clients and insurance practitioners;
and the comparison module is used for comparing the identity information of the current insurance client and insurance practitioner with the identity information of the standard insurance client and insurance practitioner to verify the authenticity of the identity information of the insurance client and insurance practitioner so as to ensure that the insurance client and insurance practitioner can obtain required supervision information about insurance claims.
The marking module includes:
the counting module is used for correspondingly setting the number of the mark check codes according to the number of the supervising time nodes;
and the supervision module is used for supervising the insurance claim settlement process at each supervision time node to obtain supervision results, and translating the supervision results to obtain corresponding number of mark check codes.
The acquisition module comprises:
the list module is used for counting and summarizing the marked check codes in a form of a table;
the operation module is used for calculating the sum value theta of each mark check code;
and the evaluation module is used for evaluating the normality of the insurance claim settlement progress according to the magnitude of the sum value of each marking check code so as to obtain an evaluation result Q.
And when the evaluation result Q is less than 10, the insurance claim settlement process cannot be normally executed.
An insurance claim settlement progress supervising method, comprising the following steps:
s1, verifying the identity information of the insurance client and the insurance staff to ensure that the insurance client and the insurance staff can obtain the required supervising information about the insurance claim settlement;
s2, setting a plurality of supervising time nodes in the whole insurance product claim period, so that each supervising time node is supervised;
s3, marking the supervising result of the insurance claim settlement progress on each time node to obtain a marking check code so as to judge whether the insurance claim settlement progress conforms to the stipulation of an insurance contract;
s4, collecting and summarizing all the mark check codes, and accordingly evaluating the whole insurance claim settlement progress to obtain an evaluation result Q;
s5, transmitting the evaluation result Q of the insurance claim settlement progress to the insurance client and the insurance staff;
and S6, judging whether to execute normal insurance claim according to the value of the evaluation result Q of the insurance claim progress.
The method for verifying the identity information of the insurance client and the insurance staff to ensure that the insurance client and the insurance staff can obtain the required supervision information about the insurance claim settlement comprises the following steps:
s1.1, inputting the identity information of the current insurance client and insurance practitioner into a database;
s1.2, storing the identity information of standard insurance clients and insurance practitioners;
s1.3, comparing the identity information of the current insurance client and insurance practitioner with the identity information of the standard insurance client and insurance practitioner to verify the authenticity of the identity information of the insurance client and insurance practitioner, so as to ensure that the insurance client and insurance practitioner can obtain required supervision information about insurance claims.
The method comprises the following steps of marking the supervising result of the insurance claim settlement progress on each time node to obtain a marking check code so as to judge whether the insurance claim settlement progress conforms to the provision of an insurance contract:
s3.1, correspondingly setting the number of the marker check codes according to the number of the supervising time nodes;
and S3.2, supervising the insurance claim settlement process at each supervising time node to obtain a supervising result, and translating to obtain corresponding number of mark check codes.
Collecting and summarizing all the marked check codes, so as to evaluate the whole insurance claim settlement progress, and obtaining an evaluation result Q comprises the following steps:
s4.1, counting and summarizing the marked check codes in a form of a table;
s4.2, calculating a sum value theta of each mark check code;
s4.3, evaluating normality of insurance claim settlement progress according to the sum of the check code of each mark, and obtaining an evaluation result Q;
by adopting the structure, the identity information of the insurance client and the insurance practitioner is verified through the verification module, so that the normal transmission of claim settlement and supervision information of the insurance product is ensured; a plurality of supervising time nodes are set in the whole insurance product claim settlement period through a time module, so that each supervising time node is supervised; marking the supervising result of the insurance claim settlement progress on each time node through a marking module to obtain a marking check code; collecting and summarizing all the marked check codes through a collecting module, and evaluating the progress of the whole insurance claim settlement; the evaluation result of the insurance claim settlement progress is transmitted to an insurance client and insurance staff through a transmission module; whether normal insurance claim settlement is executed or not is judged by the execution module according to the numerical value of the evaluation result of the insurance claim settlement progress, and the method has the advantages of high efficiency, reliability, practicability and transparency.
Description of the drawings:
FIG. 1 is a schematic structural diagram of the present invention.
Fig. 2 is a schematic structural diagram of the verification module of the present invention.
Fig. 3 is a schematic structural diagram of a marking module according to the present invention.
Fig. 4 is a schematic structural diagram of the acquisition module of the present invention.
FIG. 5 is a schematic flow chart of the present invention.
The specific implementation mode is as follows:
in order to clearly explain the technical features of the present invention, the following detailed description of the present invention is provided with reference to the accompanying drawings.
As shown in fig. 1 to 5, an insurance claim progress supervising system includes:
the verification module is used for verifying the identity information of the insurance client and the insurance staff so as to ensure that the insurance client and the insurance staff can obtain required supervision information about insurance claims;
the time module is used for setting a plurality of supervising time nodes in the whole insurance product claim settlement period so as to supervise at each supervising time node;
the system comprises a marking module, a checking module and a checking module, wherein the marking module is used for marking the supervising result of the insurance claim progress on each time node to obtain a marking check code so as to judge whether the insurance claim progress accords with the stipulation of an insurance contract, and the marking check code is a four-digit binary check code;
the acquisition module is used for acquiring and summarizing all the mark check codes so as to evaluate the progress of the whole insurance claim settlement and obtain an evaluation result Q;
the transmission module is used for transmitting the evaluation result Q of the insurance claim settlement progress to insurance clients and insurance employees;
and the execution module is used for judging whether to execute normal insurance claims according to the numerical value of the evaluation result Q of the insurance claim progress.
The verification module comprises:
the input module is used for inputting the identity information of the current insurance client and insurance practitioner into a database;
the storage module is used for storing the identity information of standard insurance clients and insurance practitioners;
and the comparison module is used for comparing the identity information of the current insurance client and insurance practitioner with the identity information of the standard insurance client and insurance practitioner to verify the authenticity of the identity information of the insurance client and insurance practitioner so as to ensure that the insurance client and insurance practitioner can obtain required supervision information about insurance claims.
The marking module includes:
the counting module is used for correspondingly setting the number of the mark check codes according to the number of the supervising time nodes;
and the supervision module is used for supervising the insurance claim settlement process at each supervision time node to obtain supervision results, and translating the supervision results to obtain corresponding number of mark check codes.
The acquisition module comprises:
the list module is used for counting and summarizing the marked check codes in a form of a table;
the operation module is used for calculating the sum value theta of each mark check code;
and the evaluation module is used for evaluating the normality of the insurance claim settlement progress according to the magnitude of the sum value of each marking check code so as to obtain an evaluation result Q.
And when the evaluation result Q is less than 10, the insurance claim settlement process cannot be normally executed.
An insurance claim settlement progress supervising method, comprising the following steps:
s1, verifying the identity information of the insurance client and the insurance staff to ensure that the insurance client and the insurance staff can obtain the required supervising information about the insurance claim settlement;
s2, setting a plurality of supervising time nodes in the whole insurance product claim period, so that each supervising time node is supervised;
s3, marking the supervising result of the insurance claim settlement progress on each time node to obtain a marking check code so as to judge whether the insurance claim settlement progress conforms to the stipulation of an insurance contract;
s4, collecting and summarizing all the mark check codes, and accordingly evaluating the whole insurance claim settlement progress to obtain an evaluation result Q;
s5, transmitting the evaluation result Q of the insurance claim settlement progress to the insurance client and the insurance staff;
and S6, judging whether to execute normal insurance claim according to the value of the evaluation result Q of the insurance claim progress.
The method for verifying the identity information of the insurance client and the insurance staff to ensure that the insurance client and the insurance staff can obtain the required supervision information about the insurance claim settlement comprises the following steps:
s1.1, inputting the identity information of the current insurance client and insurance practitioner into a database;
s1.2, storing the identity information of standard insurance clients and insurance practitioners;
s1.3, comparing the identity information of the current insurance client and insurance practitioner with the identity information of the standard insurance client and insurance practitioner to verify the authenticity of the identity information of the insurance client and insurance practitioner, so as to ensure that the insurance client and insurance practitioner can obtain required supervision information about insurance claims.
The method comprises the following steps of marking the supervising result of the insurance claim settlement progress on each time node to obtain a marking check code so as to judge whether the insurance claim settlement progress conforms to the provision of an insurance contract:
s3.1, correspondingly setting the number of the marker check codes according to the number of the supervising time nodes;
and S3.2, supervising the insurance claim settlement process at each supervising time node to obtain a supervising result, and translating to obtain corresponding number of mark check codes.
Collecting and summarizing all the marked check codes, so as to evaluate the whole insurance claim settlement progress, and obtaining an evaluation result Q comprises the following steps:
s4.1, counting and summarizing the marked check codes in a form of a table;
s4.2, calculating a sum value theta of each mark check code;
s4.3, evaluating normality of insurance claim settlement progress according to the sum of the check code of each mark, and obtaining an evaluation result Q;
the working principle of the insurance claim settlement progress supervising system and method provided by the embodiment of the invention is as follows: based on the mutual cooperation of a plurality of functional modules, the whole claim settlement period of the insurance product can be automatically and accurately supervised and checked, and the time cost and the actual workload of insurance practitioners are reduced; meanwhile, the response speed is high, the man-machine interaction is good, the insurance products can master the claim settlement state of the insurance products in real time, so that the rights and interests of insurance clients are effectively maintained, the insurance products with different claim settlement periods can be applied, judged and supervised, and great convenience is provided for the insurance clients and insurance practitioners.
It is particularly noted that, because the insurance product has different claim settlement schedules, in the actual use process, the insurance client will complete the claim settlement process within the effective period of the insurance product, and the system and the method in the technical scheme are used as the basis and assisted by the manual operation of the insurance staff, so as to meet the normal rights and interests of the insurance staff as far as possible on the premise of meeting the legal provisions and the insurance contract.
In the whole scheme, the system mainly comprises a verification module used for verifying the identity information of the insurance client and the insurance staff so as to ensure that the insurance client and the insurance staff can obtain required supervision information about insurance claims; the time module is used for setting a plurality of supervising time nodes in the whole insurance product claim period so as to supervise at each supervising time node; the system comprises a marking module, a checking module and a checking module, wherein the marking module is used for marking the supervising result of the insurance claim settlement progress on each time node to obtain a marking check code so as to judge whether the insurance claim settlement progress meets the stipulation of an insurance contract or not, and the marking check code is a four-bit binary check code; the acquisition module is used for acquiring and summarizing all the mark check codes so as to evaluate the whole insurance claim settlement progress and obtain an evaluation result Q; the transmission module is used for transmitting the evaluation result Q of the insurance claim settlement progress to an insurance client and insurance practitioners; and the execution module is used for judging whether to execute normal insurance claims according to the numerical value of the evaluation result Q of the insurance claim progress, and supervising the insurance claim progress based on the mutual cooperation of the functional modules.
Preferably, the verification module includes: the input module is used for inputting the identity information of the current insurance client and insurance practitioner into the database; the storage module is used for storing the identity information of standard insurance clients and insurance practitioners; and the comparison module is used for comparing the identity information of the current insurance client and insurance practitioner with the identity information of the standard insurance client and insurance practitioner to verify the authenticity of the identity information of the insurance client and insurance practitioner so as to ensure that the insurance client and the insurance practitioner can obtain required supervision information about insurance claims.
Preferably, the marking module comprises: the counting module is used for correspondingly setting the number of the mark check codes according to the number of the supervising time nodes; and the supervision module is used for supervising the insurance claim settlement process at each supervision time node to obtain supervision results, and translating the supervision results to obtain corresponding number of mark check codes.
Preferably, the acquisition module comprises: the list module is used for counting and summarizing the marked check codes in a form of a table; the operation module is used for calculating the sum value theta of each mark check code; and the evaluation module is used for evaluating the normality of the insurance claim settlement progress according to the size of the sum value of each marking check code so as to obtain an evaluation result Q.
Furthermore, the evaluation result Q is n × θ, n is the number of the marked check codes, when the evaluation result Q is greater than or equal to 70, it indicates that the insurance claim settlement process can be normally executed, and when the evaluation result Q is less than 10, it indicates that the insurance claim settlement process cannot be normally executed; for the evaluation standard of the evaluation result, the corresponding value can be finely adjusted according to the variety of the insurance product.
The insurance claim settlement progress supervising method mainly comprises the following steps: s1, verifying the identity information of the insurance client and the insurance staff to ensure that the insurance client and the insurance staff can obtain the required supervising information about the insurance claim settlement; s2, setting a plurality of supervising time nodes in the whole insurance product claim period, so that each supervising time node is supervised; s3, marking the supervising result of the insurance claim settlement progress on each time node to obtain a marking check code so as to judge whether the insurance claim settlement progress conforms to the stipulation of an insurance contract; s4, collecting and summarizing all the mark check codes, and accordingly evaluating the whole insurance claim settlement progress to obtain an evaluation result Q; s5, transmitting the evaluation result Q of the insurance claim settlement progress to the insurance client and the insurance staff; and S6, judging whether to execute normal insurance claim according to the value of the evaluation result Q of the insurance claim progress.
Based on the operation steps, the supervision and inspection of the claim settlement progress of the insurance products are gradually realized, so that the rights and interests of insurance clients are effectively maintained.
In conclusion, the insurance claim progress supervising system and method in the embodiment of the invention are based on the mutual cooperation of the plurality of functional modules, can automatically and accurately supervise and check the whole claim settlement period of the insurance product, and reduce the time cost and the actual workload of insurance practitioners; meanwhile, the response speed is high, the man-machine interaction is good, the insurance products can master the claim settlement state of the insurance products in real time, so that the rights and interests of insurance clients are effectively maintained, the insurance products with different claim settlement periods can be applied, judged and supervised, and great convenience is provided for the insurance clients and insurance practitioners.
The above-described embodiments should not be construed as limiting the scope of the invention, and any alternative modifications or alterations to the embodiments of the present invention will be apparent to those skilled in the art.
The present invention is not described in detail, but is known to those skilled in the art.
Claims (9)
1. Insurance claim settlement progress supervise system, its characterized in that includes:
the verification module is used for verifying the identity information of the insurance client and the insurance staff so as to ensure that the insurance client and the insurance staff can obtain required supervision information about insurance claims;
the time module is used for setting a plurality of supervising time nodes in the whole insurance product claim settlement period so as to supervise at each supervising time node;
the system comprises a marking module, a checking module and a checking module, wherein the marking module is used for marking the supervising result of the insurance claim progress on each time node to obtain a marking check code so as to judge whether the insurance claim progress accords with the stipulation of an insurance contract, and the marking check code is a four-digit binary check code;
the acquisition module is used for acquiring and summarizing all the mark check codes so as to evaluate the progress of the whole insurance claim settlement and obtain an evaluation result Q;
the transmission module is used for transmitting the evaluation result Q of the insurance claim settlement progress to insurance clients and insurance employees;
and the execution module is used for judging whether to execute normal insurance claims according to the numerical value of the evaluation result Q of the insurance claim progress.
2. The insurance claim progress inspection system of claim 1, wherein the verification module comprises:
the input module is used for inputting the identity information of the current insurance client and insurance practitioner into a database;
the storage module is used for storing the identity information of standard insurance clients and insurance practitioners;
and the comparison module is used for comparing the identity information of the current insurance client and insurance practitioner with the identity information of the standard insurance client and insurance practitioner to verify the authenticity of the identity information of the insurance client and insurance practitioner so as to ensure that the insurance client and insurance practitioner can obtain required supervision information about insurance claims.
3. The insurance claim progress review system of claim 1, wherein the marking module comprises:
the counting module is used for correspondingly setting the number of the mark check codes according to the number of the supervising time nodes;
and the supervision module is used for supervising the insurance claim settlement process at each supervision time node to obtain supervision results, and translating the supervision results to obtain corresponding number of mark check codes.
4. The insurance claim progress inspection system of claim 1, wherein the collection module comprises:
the list module is used for counting and summarizing the marked check codes in a form of a table;
the operation module is used for calculating the sum value theta of each mark check code;
and the evaluation module is used for evaluating the normality of the insurance claim settlement progress according to the magnitude of the sum value of each marking check code so as to obtain an evaluation result Q.
5. The insurance claim settlement progress inspection system of claim 4, wherein: and when the evaluation result Q is less than 10, the insurance claim settlement process cannot be normally executed.
6. An insurance claim settlement progress supervising method, which is characterized by comprising the following steps:
s1, verifying the identity information of the insurance client and the insurance staff to ensure that the insurance client and the insurance staff can obtain the required supervising information about the insurance claim settlement;
s2, setting a plurality of supervising time nodes in the whole insurance product claim period, so that each supervising time node is supervised;
s3, marking the supervising result of the insurance claim settlement progress on each time node to obtain a marking check code so as to judge whether the insurance claim settlement progress conforms to the stipulation of an insurance contract;
s4, collecting and summarizing all the mark check codes, and accordingly evaluating the whole insurance claim settlement progress to obtain an evaluation result Q;
s5, transmitting the evaluation result Q of the insurance claim settlement progress to the insurance client and the insurance staff;
and S6, judging whether to execute normal insurance claim according to the value of the evaluation result Q of the insurance claim progress.
7. The insurance claim progress supervising method according to claim 6, wherein the step of verifying the identity information of the insurance client and the insurance practitioner to ensure that the insurance client and the insurance practitioner can obtain the required supervising information about the insurance claim includes the steps of:
s1.1, inputting the identity information of the current insurance client and insurance practitioner into a database;
s1.2, storing the identity information of standard insurance clients and insurance practitioners;
s1.3, comparing the identity information of the current insurance client and insurance practitioner with the identity information of the standard insurance client and insurance practitioner to verify the authenticity of the identity information of the insurance client and insurance practitioner, so as to ensure that the insurance client and insurance practitioner can obtain required supervision information about insurance claims.
8. The insurance claim progress supervising method according to claim 6, wherein the step of marking the supervising result of the insurance claim progress at each time node to obtain a marking check code to judge whether the insurance claim progress conforms to the provision of the insurance contract comprises the steps of:
s3.1, correspondingly setting the number of the marker check codes according to the number of the supervising time nodes;
and S3.2, supervising the insurance claim settlement process at each supervising time node to obtain a supervising result, and translating to obtain corresponding number of mark check codes.
9. The insurance claim progress supervising method according to claim 6, wherein the steps of collecting and summarizing all the marked check codes, thereby evaluating the entire insurance claim progress and obtaining the evaluation result Q comprise:
s4.1, counting and summarizing the marked check codes in a form of a table;
s4.2, calculating a sum value theta of each mark check code;
and S4.3, evaluating the normality of the insurance claim settlement progress according to the sum of the check codes of each mark, thereby obtaining an evaluation result Q.
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