CN115222546B - Intelligent analysis management system for insurance business based on big data - Google Patents
Intelligent analysis management system for insurance business based on big data Download PDFInfo
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- CN115222546B CN115222546B CN202210850425.6A CN202210850425A CN115222546B CN 115222546 B CN115222546 B CN 115222546B CN 202210850425 A CN202210850425 A CN 202210850425A CN 115222546 B CN115222546 B CN 115222546B
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- 238000004458 analytical method Methods 0.000 title claims abstract description 87
- 238000012423 maintenance Methods 0.000 claims abstract description 213
- 238000012790 confirmation Methods 0.000 claims abstract description 21
- 238000007726 management method Methods 0.000 claims description 44
- 238000000034 method Methods 0.000 claims description 37
- 238000012797 qualification Methods 0.000 claims description 28
- 238000012550 audit Methods 0.000 claims description 16
- 238000011156 evaluation Methods 0.000 claims description 16
- 239000000463 material Substances 0.000 claims description 9
- 238000004364 calculation method Methods 0.000 claims description 6
- 238000012216 screening Methods 0.000 claims description 3
- 206010063385 Intellectualisation Diseases 0.000 description 2
- 238000010252 digital analysis Methods 0.000 description 2
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- 238000007792 addition Methods 0.000 description 1
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
- G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
- G06Q40/08—Insurance
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06F—ELECTRIC DIGITAL DATA PROCESSING
- G06F16/00—Information retrieval; Database structures therefor; File system structures therefor
- G06F16/20—Information retrieval; Database structures therefor; File system structures therefor of structured data, e.g. relational data
- G06F16/24—Querying
- G06F16/245—Query processing
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- G—PHYSICS
- G06—COMPUTING; CALCULATING OR COUNTING
- G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
- G06Q10/00—Administration; Management
- G06Q10/10—Office automation; Time management
- G06Q10/103—Workflow collaboration or project management
Abstract
The invention discloses an intelligent analysis management system for insurance business based on big data, which comprises a vehicle claim application basic information acquisition module, a claim application preliminary confirmation module, a vehicle breakage information analysis module, a vehicle maintenance project analysis module, a vehicle claim amount checking module, a claim amount payment module and an insurance management database.
Description
Technical Field
The invention belongs to the technical field of insurance business analysis, and relates to an intelligent analysis management system for insurance business based on big data.
Background
Automobile insurance is a very important means for dealing with risks in modern society, and is also an indispensable economic compensation system, when risks are lost, insured persons can avoid more property losses through automobile insurance claims, and insurance companies need to audit the claim application information of the insured persons, because insurance claim audit is the basis of correct payment, the claim audit on automobile insurance is an extremely critical link in the automobile insurance claim process.
At present, general vehicle insurance claim auditing is that an insurance company personnel audits claim application information of an insured person or carries out rough auditing through a platform, and obviously, the vehicle insurance claim auditing mode has the following problems:
1. in the general manual checking and examining process, an inspector of an insurance company needs to collect damaged information of a damaged vehicle and confirms maintenance information corresponding to the damaged vehicle, and further, comparison analysis is carried out according to the confirmed maintenance information and the corresponding maintenance information in the information of the application of the claimant to be claimant during the checking and examining process, the maintenance and confirming process is complex, a large amount of time is required to be consumed, a certain subjectivity exists, meanwhile, the period of manual checking and examining is overlong, and the checking steps are too complicated, so that some troubles are brought to the claimant during the claimant to be claimant to the insured, the enthusiasm and initiative of the following claimant to be claimant to claimant cannot be increased, and on the other hand, the objectivity and comprehensiveness of the checking and examining process cannot be guaranteed, and the accuracy of the result of the claimant to be the claimant to be poor.
2. The method has the advantages that rough auditing is carried out on the claim application information through the platform, the intelligent and automatic level of the auditing mode is not high, the manual dependency is strong, meanwhile, the accuracy and reliability of auditing results cannot be guaranteed through rough auditing, the platform auditing only carries out auditing on the claim application information of an insured person, the authenticity of the claim application information of the insured person cannot be guaranteed, meanwhile, the qualification of the claim application material cannot be intuitively known, the period and efficiency of the claim auditing cannot be improved, the efficiency of follow-up claim money deduction cannot be improved, on the other hand, the platform auditing process is solidified, different error permission ranges cannot be set according to different maintenance information, and the flexibility and scientificity of the platform auditing cannot be improved.
3. The problems of long auditing period, low processing efficiency and weak auditing strength exist in both manual auditing and platform coarseness auditing, the authenticity and the validity of auditing results cannot be effectively ensured, and certain limitations exist.
Disclosure of Invention
The invention aims to provide an intelligent analysis management system for insurance business based on big data, which solves the problems existing in the background technology.
The aim of the invention can be achieved by the following technical scheme:
an intelligent analysis management system for insurance business based on big data, comprising: the system comprises a vehicle claim application basic information acquisition module, a claim application preliminary confirmation module, a vehicle breakage information analysis module, a vehicle maintenance project analysis module, a vehicle claim amount auditing module, a claim money payment module and an insurance management database;
the vehicle claim application basic information acquisition module is used for acquiring claim application amount, claim collection information and claim application material information corresponding to a target claim vehicle, wherein the material information comprises case report information, breakage information and maintenance information;
the claim application preliminary confirmation module is used for carrying out claim application preliminary confirmation on claim application information of the target claim vehicle according to the claim information corresponding to the target claim vehicle;
the vehicle breakage information analysis module is used for evaluating and analyzing breakage levels corresponding to breakage positions of the target claim vehicle according to breakage information corresponding to the target claim vehicle;
the vehicle maintenance project analysis module is used for carrying out claim settlement qualification analysis on the target claim settlement vehicle maintenance project according to the maintenance information corresponding to the target claim settlement vehicle and the damage grade corresponding to each damage position;
the vehicle claim settlement amount auditing module is used for auditing the claim settlement application amount corresponding to the target claim settlement vehicle to obtain the target claim settlement amount corresponding to the target claim settlement vehicle;
the payment module is used for paying the payment according to the target payment amount corresponding to the target payment vehicle and the payment information corresponding to the target payment vehicle.
Optionally, the report information includes accident responsibility types and accident time, the damage information includes damage areas corresponding to each damage position and images corresponding to each damage position, the maintenance information includes the number of maintenance items corresponding to each damage position, the type corresponding to each maintenance item and the price corresponding to each maintenance item, and the accident responsibility types include all responsibilities, primary responsibilities, equal responsibilities, secondary responsibilities and no responsibilities.
Optionally, the preliminary confirmation of the claim application is performed on the claim application information of the target claim vehicle, and the specific confirmation process is as follows:
extracting the insurance type and the insurance period purchased by the target claim vehicle from the insurance management database, and comparing the report information corresponding to the target claim vehicle with the insurance period purchased by the target claim vehicle;
if the accident time corresponding to the target claim vehicle is not within the guarantee period, judging that the target claim vehicle does not have the right to apply for claim settlement;
if the accident time corresponding to the target claim vehicle is within the insurance period, the corresponding claim amount ratio of the target claim vehicle is positioned from the insurance management database according to the accident responsibility type of the target claim vehicle, and the highest claim amount corresponding to the target claim vehicle is obtained according to the corresponding insurance amount of the target claim vehicle.
Optionally, the evaluation analysis is performed on the breakage level corresponding to each breakage position of the target claim vehicle, and the specific analysis process is as follows:
numbering the damage positions of the target claim vehicle according to a preset sequence, and numbering the damage positions as 1,2.
Matching and comparing the image corresponding to each damage position of the target claim vehicle with the characteristic image corresponding to each damage type stored in the insurance management database, screening to obtain the damage type corresponding to each damage position of the target claim vehicle, positioning the weight factor of the damage type corresponding to each damage position of the target claim vehicle from the insurance management database, and marking the weight factor asi is a number corresponding to each damaged position of the target claim vehicle, i=1, 2.
Extracting the area corresponding to each damaged position and the corresponding damaged area in each damaged position from the image corresponding to each damaged position of the target claim vehicle;
substituting the damaged area corresponding to each damaged position of the target claim vehicle and the weight factor corresponding to the damaged type of each damaged position into a calculation formulaObtaining damage degree evaluation coefficient alpha corresponding to each damage position of the target claim vehicle i Wherein S is i ' represents an area corresponding to the ith damaged position of the target claim vehicle, S i Representing the damage area epsilon corresponding to the ith damage position of the target claim vehicle 1 For the weight factor corresponding to the set damage area, kappa i The ith damage position of the vehicle is subjected to damage area ratio corresponding to the set permission target claim;
and matching and comparing the damage degree evaluation coefficient corresponding to each damage position of the target claim vehicle with the damage degree evaluation coefficient range of each damage level corresponding to each damage position stored in the insurance management database, so as to obtain the damage level corresponding to each damage position of the target claim vehicle.
Optionally, the claim-settlement qualification analysis on the maintenance items of the target claim-settlement vehicle includes basic claim-settlement qualification analysis on the maintenance items corresponding to the target claim-settlement vehicle, claim-settlement qualification analysis on the price of the maintenance items corresponding to the target claim-settlement vehicle, and comprehensive claim-settlement qualification analysis on the maintenance items corresponding to the target claim-settlement vehicle.
Optionally, the basic claim settlement qualification analysis is performed on the maintenance items corresponding to the target claim settlement vehicle, and the specific analysis process is as follows:
matching and comparing the damage grade corresponding to each damage position of the target claim vehicle with the damage grade corresponding to each damage position in each historical claim vehicle in the insurance management database, if a certain damage position of the target claim vehicle is consistent with the damage grade corresponding to the damage position in a certain historical claim vehicle, judging the historical claim vehicle as a reference vehicle corresponding to the damage position in the target claim vehicle, counting the number of reference vehicles corresponding to each damage position of the target vehicle, and positioning maintenance information of each reference vehicle corresponding to each damage position of the target claim vehicle from the insurance management database;
extracting the number of maintenance items and the types corresponding to the maintenance items from the maintenance information of the number of the reference vehicles corresponding to the breakage positions of the target claim vehicle, further constructing a reference maintenance item number section corresponding to the breakage positions of the target claim vehicle, and simultaneously constructing a reference maintenance item type set corresponding to the breakage positions of the target claim vehicle;
comparing the number of maintenance items corresponding to each damaged position of the target claim vehicle with the upper limit value of the reference maintenance item number section, if the number of maintenance items corresponding to each damaged position of the target claim vehicle is smaller than or equal to the upper limit value of the reference maintenance item number section, judging that the number of maintenance items corresponding to the target claim vehicle is qualified, if the number of maintenance items corresponding to a certain damaged position of the target claim vehicle is larger than the upper limit value of the reference maintenance item number section, judging that the number of maintenance items corresponding to the damaged position of the target claim vehicle is unqualified, counting the number of damaged positions corresponding to the unqualified number of maintenance items of the target claim vehicle in this way, and marking as Q;
and matching the maintenance item type corresponding to each damaged position of the target claim vehicle with a reference maintenance item type set thereof, judging that the maintenance item type corresponding to the target claim vehicle is qualified if the maintenance item type corresponding to each damaged position of the target claim vehicle is successfully matched with the reference maintenance item type set, judging that the maintenance item type corresponding to the damaged position of the target claim vehicle is unqualified if the maintenance item type corresponding to a certain damaged position of the target claim vehicle is unsuccessfully matched with the reference maintenance item type set, and counting the number of damaged positions corresponding to the unqualified maintenance item type of the target claim vehicle in this way, and marking as W.
Optionally, the claims permit analysis is performed on the maintenance item price corresponding to the target claims vehicle, and the specific analysis process is as follows:
extracting prices corresponding to the maintenance items from the maintenance information corresponding to the number of the reference vehicles at each damaged position of the target claim vehicle, and further constructing a reference maintenance item price interval corresponding to each maintenance item in each damaged position of the target claim vehicle;
and comparing the price corresponding to each maintenance item in each damaged position of the target claim vehicle with the upper limit value of the price interval of the reference maintenance item, judging that the price of the maintenance item corresponding to the target claim vehicle is qualified if the price corresponding to each maintenance item in each damaged position of the target claim vehicle is smaller than the upper limit value of the price interval of the reference maintenance item, judging that the price corresponding to the maintenance item in a certain damaged position of the target claim vehicle is unqualified if the price corresponding to a certain maintenance item in a certain damaged position of the target claim vehicle is larger than the upper limit value of the price interval of the reference maintenance item, and counting the number of damaged positions corresponding to the unqualified price of the maintenance item of the target claim vehicle in this way, and marking as R.
Optionally, the comprehensive claim settlement and qualification analysis is performed on the maintenance items corresponding to the target claim settlement vehicle, and the specific analysis process is as follows:
if the number of the maintenance items corresponding to the target claim vehicle is qualified, the type of the maintenance items corresponding to the target claim vehicle is qualified, and the price of the maintenance items corresponding to the target claim vehicle is qualified, judging that the comprehensive claim corresponding to the target claim vehicle is qualified;
if the number of the maintenance items corresponding to the target claim vehicle, the type of the maintenance items corresponding to the target claim vehicle or the price of the maintenance items corresponding to the target claim vehicle are unqualified, the calculation formula is usedObtaining a difference coefficient corresponding to the number of damaged positions of the target claim vehicleWherein Q ', W ', R ' are respectively the number of damage positions corresponding to the unqualified number of the set permitted maintenance items, the unqualified type of the permitted maintenance items and the unqualified price of the permitted maintenance items, and tau 1, tau 2 and tau 3 are respectively the weight factors corresponding to the set number of the maintenance items, the type of the maintenance items and the price of the maintenance items;
and comparing the difference coefficient corresponding to the number of the breakage positions of the target claim vehicle with the set difference coefficient of the number of the allowed breakage positions, if the difference coefficient corresponding to the number of the breakage positions of the target claim vehicle is smaller than or equal to the difference coefficient of the number of the allowed breakage positions, judging that the comprehensive claim audit corresponding to the target claim vehicle is qualified, otherwise, judging that the comprehensive claim audit corresponding to the target claim vehicle is unqualified.
Optionally, the auditing of the claim application amount corresponding to the target claim vehicle is performed, and the specific judging process is as follows:
when the claims corresponding to the target claim vehicle are comprehensively checked and qualified, counting the claim application amount corresponding to the target claim vehicle, comparing the claim application amount corresponding to the target claim vehicle with the highest claim amount, if the claim application amount corresponding to the target claim vehicle is smaller than or equal to the highest claim amount, judging that the claim application amount corresponding to the target claim vehicle is the target claim amount of the target claim vehicle, otherwise, judging that the highest claim amount corresponding to the target claim vehicle is the target claim amount of the target claim vehicle, and sending the target claim amount of the target claim vehicle to the insurance management background for prompting.
Optionally, the insurance management database is used for storing insurance amount and insurance period purchased by the target claim vehicle, storing characteristic images corresponding to each damage type, corresponding weight factors of each damage type, damage level corresponding to each damage position, damage degree evaluation coefficient range of each damage level corresponding to each damage position, damage information and maintenance information corresponding to the historical claim vehicle, and storing claim amount occupation ratio corresponding to accident responsibility type.
Compared with the prior art, the invention has the following beneficial effects:
1. according to the insurance business intelligent analysis management system based on big data, through preliminary confirmation of the claim settlement application information, further evaluation analysis is carried out on the damage level of the target claim settlement vehicle, analysis is carried out on the maintenance information of the target vehicle, further auditing is carried out on the claim settlement application amount corresponding to the target claim settlement vehicle, and finally the claim settlement payment is carried out, so that the problems of insufficient intellectualization and automation of the claim settlement application information of a current platform are solved, the high-efficiency and accurate auditing of the vehicle claim settlement information is realized, the workload of personnel is greatly reduced, the problem of strong dependence of the rough auditing of the platform on personnel is eliminated, the efficiency of the claim settlement auditing process is effectively improved, the authenticity and reliability of the claim settlement auditing result are effectively ensured, the auditing time is greatly shortened, the efficiency and the effect of the auditing result are improved, and the efficiency of the subsequent claim settlement payment is improved.
2. According to the invention, the damage grade of the target claim-settling vehicle is analyzed by the vehicle damage information analysis module, so that a laying is arranged for subsequent claim-settling qualification analysis of maintenance projects, meanwhile, the problem of subjectivity and limitation of manually collecting and analyzing the vehicle damage information is solved, reliable data is provided for subsequent analysis, the scientificity of the auditing result is ensured to a certain extent, the divergence between an insured and an insurance company is reduced, and the time and difficulty of the claim-settling auditing process are effectively reduced.
3. According to the invention, through the corresponding maintenance information of the historical claim vehicle in the vehicle maintenance project analysis module, the claim settlement qualification analysis is further carried out on the target claim settlement vehicle maintenance project, the flexibility and the digital analysis of the target claim settlement vehicle maintenance information are realized, the qualification condition of claim settlement application materials is intuitively known, meanwhile, the problems of overlong target manual checking period and complicated checking steps are effectively avoided, the flow of insured persons in the claim settlement application process is greatly reduced, the experience of the insured persons in the claim settlement process is improved, and the enthusiasm and the initiative of the follow-up insured persons are further increased.
Drawings
In order to more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings that are needed for the description of the embodiments will be briefly described below, and it is obvious that the drawings in the following description are only some embodiments of the present invention, and that other drawings may be obtained according to these drawings without inventive effort for a person skilled in the art.
Fig. 1 is a schematic view of a module connection structure according to the present invention.
Detailed Description
The following description of the embodiments of the present invention will be made clearly and completely with reference to the accompanying drawings, in which it is apparent that the embodiments described are only some embodiments of the present invention, but not all embodiments. All other embodiments, which can be made by those skilled in the art based on the embodiments of the invention without making any inventive effort, are intended to be within the scope of the invention.
Referring to fig. 1, an intelligent analysis management system for insurance business based on big data includes a basic information acquisition module for vehicle claim application, a preliminary confirmation module for claim application, a damaged information analysis module for vehicle, a maintenance project analysis module for vehicle, a review module for claim amount, a payment module for claim payment and an insurance management database;
the system comprises a vehicle claim application basic information acquisition module, a claim application preliminary confirmation module, a vehicle breakage information analysis module and a vehicle maintenance item analysis module, wherein the vehicle claim application basic information acquisition module is respectively connected with the claim application preliminary confirmation module, the vehicle breakage information analysis module and the vehicle maintenance item analysis module, the insurance management database is respectively connected with the claim application preliminary confirmation module, the vehicle breakage information analysis module and the vehicle maintenance item analysis module, the vehicle maintenance item analysis module is also connected with the vehicle breakage information analysis module and the vehicle claim amount checking module, and the vehicle claim amount checking module is also connected with the claim money payment toggle module.
The system comprises a vehicle claim application basic information acquisition module, a vehicle claim application basic information acquisition module and a vehicle claim application basic information acquisition module, wherein the vehicle claim application basic information acquisition module is used for acquiring claim collection information and claim application material information corresponding to a target claim vehicle, and the material information comprises case report information, breakage information and maintenance information;
in one embodiment, the report information includes an accident responsibility type and an accident time, the damage information includes a damage area corresponding to each damage location and an image corresponding to each damage location, the repair information includes a number of repair items corresponding to each damage location, a type corresponding to each repair item, and a price corresponding to each repair item, wherein the accident responsibility type includes total responsibility, primary responsibility, equal responsibility, secondary responsibility, and no responsibility.
The claim settlement application preliminary confirmation module is used for carrying out preliminary confirmation of claim settlement application on claim settlement application information of the target claim settlement vehicle according to the report information corresponding to the target claim settlement vehicle;
in a specific embodiment, the initial confirmation of the claim application is performed on the claim application information of the target claim vehicle, and the specific confirmation process is as follows:
extracting the insurance type and the insurance period purchased by the target claim vehicle from the insurance management database, and comparing the report information corresponding to the target claim vehicle with the insurance period purchased by the target claim vehicle;
if the accident time corresponding to the target claim vehicle is not within the guarantee period, judging that the target claim vehicle does not have the right to apply for claim settlement;
if the accident time corresponding to the target claim vehicle is within the insurance period, the corresponding claim amount ratio of the target claim vehicle is positioned from the insurance management database according to the accident responsibility type of the target claim vehicle, and the highest claim amount corresponding to the target claim vehicle is obtained according to the corresponding insurance amount of the target claim vehicle.
The highest claim amount corresponding to the target claim vehicle=the insurance amount corresponding to the target claim vehicle×the claim amount corresponding to the target claim vehicle.
The vehicle breakage information analysis module is used for evaluating and analyzing breakage levels corresponding to breakage positions of the target claim vehicle according to breakage information corresponding to the target claim vehicle;
in one embodiment, the damage level corresponding to each damage location of the target claim vehicle is evaluated and analyzed as follows:
numbering the damage positions of the target claim vehicle according to a preset sequence, and numbering the damage positions as 1,2.
Matching and comparing the image corresponding to each damage position of the target claim vehicle with the characteristic image corresponding to each damage type stored in the insurance management database, screening to obtain the damage type corresponding to each damage position of the target claim vehicle, and further positioning the damage corresponding to each damage position of the target claim vehicle from the insurance management databaseThe weight factor of the loss type is recorded asi is a number corresponding to each damaged position of the target claim vehicle, i=1, 2.
Extracting the area corresponding to each damaged position and the corresponding damaged area in each damaged position from the image corresponding to each damaged position of the target claim vehicle;
substituting the damaged area corresponding to each damaged position of the target claim vehicle and the weight factor corresponding to the damaged type of each damaged position into a calculation formulaObtaining damage degree evaluation coefficient alpha corresponding to each damage position of the target claim vehicle i Wherein S is i ' represents an area corresponding to the ith damaged position of the target claim vehicle, S i Representing the damage area epsilon corresponding to the ith damage position of the target claim vehicle 1 For the weight factor corresponding to the set damage area, kappa i The ith damage position of the vehicle is subjected to damage area ratio corresponding to the set permission target claim;
and matching and comparing the damage degree evaluation coefficient corresponding to each damage position of the target claim vehicle with the damage degree evaluation coefficient range of each damage level corresponding to each damage position stored in the insurance management database, so as to obtain the damage level corresponding to each damage position of the target claim vehicle.
It should be noted that the types of breakage of the vehicle include, but are not limited to, scratch, deformation, and breakage.
According to the invention, through analyzing the damage grade of the target claim-settling vehicle, a laying is arranged for the subsequent claim-settling qualification analysis of maintenance projects, meanwhile, the problem of subjectivity and limitation of manually collecting and analyzing the damaged information of the vehicle is solved, reliable data is provided for the subsequent analysis, the scientificity of the auditing result is ensured to a certain extent, the divergence between an insured and an insurance company is reduced, and the time and difficulty of the claim-settling auditing process are effectively reduced.
The vehicle maintenance item analysis module is used for carrying out claim settlement qualification analysis on the target claim vehicle maintenance item according to the maintenance information corresponding to the target claim vehicle and the damage grade corresponding to each damage position;
in one embodiment, the claim qualification analysis for the target claim vehicle repair item includes a base claim qualification analysis for the repair item corresponding to the target claim vehicle, a claim qualification analysis for the repair item price corresponding to the target claim vehicle, and a composite claim qualification analysis for the repair item corresponding to the target claim vehicle.
In another embodiment, the method performs the claim qualification analysis on the maintenance item type corresponding to the target claim vehicle, and the specific analysis process is as follows:
and carrying out basic claim settlement qualification analysis on maintenance items corresponding to the target claim settlement vehicle, wherein the specific analysis process is as follows:
matching and comparing the damage grade corresponding to each damage position of the target claim vehicle with the damage grade corresponding to each damage position in each historical claim vehicle in the insurance management database, if a certain damage position of the target claim vehicle is consistent with the damage grade corresponding to the damage position in a certain historical claim vehicle, judging the historical claim vehicle as a reference vehicle corresponding to the damage position in the target claim vehicle, counting the number of reference vehicles corresponding to each damage position of the target vehicle, and positioning maintenance information of each reference vehicle corresponding to each damage position of the target claim vehicle from the insurance management database;
extracting the number of maintenance items and the types corresponding to the maintenance items from the maintenance information of the number of the reference vehicles corresponding to the breakage positions of the target claim vehicle, further constructing a reference maintenance item number section corresponding to the breakage positions of the target claim vehicle, and simultaneously constructing a reference maintenance item type set corresponding to the breakage positions of the target claim vehicle;
comparing the number of maintenance items corresponding to each damaged position of the target claim vehicle with the upper limit value of the reference maintenance item number section, if the number of maintenance items corresponding to each damaged position of the target claim vehicle is smaller than or equal to the upper limit value of the reference maintenance item number section, judging that the number of maintenance items corresponding to the target claim vehicle is qualified, if the number of maintenance items corresponding to a certain damaged position of the target claim vehicle is larger than the upper limit value of the reference maintenance item number section, judging that the number of maintenance items corresponding to the damaged position of the target claim vehicle is unqualified, counting the number of damaged positions corresponding to the unqualified number of maintenance items of the target claim vehicle in this way, and marking as Q;
and matching the maintenance item type corresponding to each damaged position of the target claim vehicle with a reference maintenance item type set thereof, judging that the maintenance item type corresponding to the target claim vehicle is qualified if the maintenance item type corresponding to each damaged position of the target claim vehicle is successfully matched with the reference maintenance item type set, judging that the maintenance item type corresponding to the damaged position of the target claim vehicle is unqualified if the maintenance item type corresponding to a certain damaged position of the target claim vehicle is unsuccessfully matched with the reference maintenance item type set, and counting the number of damaged positions corresponding to the unqualified maintenance item type of the target claim vehicle in this way, and marking as W.
In yet another embodiment, the claims permit analysis is performed on the repair item price corresponding to the target claims vehicle, and the specific analysis process is as follows:
extracting prices corresponding to the maintenance items from the maintenance information corresponding to the number of the reference vehicles at each damaged position of the target claim vehicle, and further constructing a reference maintenance item price interval corresponding to each maintenance item in each damaged position of the target claim vehicle;
and comparing the price corresponding to each maintenance item in each damaged position of the target claim vehicle with the upper limit value of the price interval of the reference maintenance item, judging that the price of the maintenance item corresponding to the target claim vehicle is qualified if the price corresponding to each maintenance item in each damaged position of the target claim vehicle is smaller than the upper limit value of the price interval of the reference maintenance item, judging that the price corresponding to the maintenance item in a certain damaged position of the target claim vehicle is unqualified if the price corresponding to a certain maintenance item in a certain damaged position of the target claim vehicle is larger than the upper limit value of the price interval of the reference maintenance item, and counting the number of damaged positions corresponding to the unqualified price of the maintenance item of the target claim vehicle in this way, and marking as R.
In another embodiment, the comprehensive claim qualification analysis is performed on the maintenance items corresponding to the target claim vehicle, and the specific analysis process is as follows:
if the number of the maintenance items corresponding to the target claim vehicle is qualified, the type of the maintenance items corresponding to the target claim vehicle is qualified, and the price of the maintenance items corresponding to the target claim vehicle is qualified, judging that the comprehensive claim corresponding to the target claim vehicle is qualified;
if the number of the maintenance items corresponding to the target claim vehicle, the type of the maintenance items corresponding to the target claim vehicle or the price of the maintenance items corresponding to the target claim vehicle are unqualified, the calculation formula is usedObtaining a difference coefficient corresponding to the number of damaged positions of the target claim vehicleWherein Q ', W ', R ' are respectively the number of damage positions corresponding to the unqualified number of the set permitted maintenance items, the unqualified type of the permitted maintenance items and the unqualified price of the permitted maintenance items, and tau 1, tau 2 and tau 3 are respectively the weight factors corresponding to the set number of the maintenance items, the type of the maintenance items and the price of the maintenance items;
and comparing the difference coefficient corresponding to the number of the breakage positions of the target claim vehicle with the set difference coefficient of the number of the allowed breakage positions, if the difference coefficient corresponding to the number of the breakage positions of the target claim vehicle is smaller than or equal to the difference coefficient of the number of the allowed breakage positions, judging that the comprehensive claim audit corresponding to the target claim vehicle is qualified, otherwise, judging that the comprehensive claim audit corresponding to the target claim vehicle is unqualified.
According to the invention, through the corresponding maintenance information of the historical claim vehicle in the vehicle maintenance project analysis module, the claim settlement qualification analysis is further carried out on the target claim settlement vehicle maintenance project, the flexibility and the digital analysis of the target claim settlement vehicle maintenance information are realized, the qualification condition of claim settlement application materials is intuitively known, meanwhile, the problems of overlong target manual checking period and complicated checking steps are effectively avoided, the flow of insured persons in the claim settlement application process is greatly reduced, the experience of the insured persons in the claim settlement process is improved, and the enthusiasm and the initiative of the follow-up insured persons are further increased.
In a specific embodiment, the claims applied amount corresponding to the target claims vehicle is checked, and the specific judgment process is as follows:
when the claims corresponding to the target claim vehicle are comprehensively checked and qualified, counting the claim application amount corresponding to the target claim vehicle, comparing the claim application amount corresponding to the target claim vehicle with the highest claim amount, if the claim application amount corresponding to the target claim vehicle is smaller than or equal to the highest claim amount, judging that the claim application amount corresponding to the target claim vehicle is the target claim amount of the target claim vehicle, otherwise, judging that the highest claim amount corresponding to the target claim vehicle is the target claim amount of the target claim vehicle, and sending the target claim amount of the target claim vehicle to the insurance management background for prompting.
After the target claim vehicle completes the claim, the breakage information, the maintenance information, and the breakage degree evaluation coefficients and the breakage levels corresponding to the breakage positions corresponding to the target claim vehicle are stored in the insurance management database.
The claim application amount corresponding to the target claim vehicle is the sum of the prices corresponding to the maintenance items in the damaged positions of the target claim vehicle.
According to the invention, through preliminary confirmation of the claim settlement application information, further evaluation analysis is carried out on the breakage level of the target claim settlement vehicle, and analysis is carried out on the maintenance information of the target vehicle, further the claim settlement application amount corresponding to the target claim settlement vehicle is audited, and finally the claim settlement payment is paid, so that the problems of insufficient intellectualization and automation of the claim settlement application information of the current platform are solved, the high efficiency and the accurate audit of the vehicle claim settlement information are realized, the workload of personnel is greatly reduced, the problem that the coarse audit of the platform has strong dependence on the personnel is eliminated, the efficiency of the claim settlement audit process is effectively improved, the authenticity and the reliability of the claim settlement audit result are effectively ensured, the audit time is greatly reduced, the audit result efficiency and the effect are improved, and the follow-up claim payment verification efficiency is improved.
The insurance management database is used for storing the insurance limit and the insurance limit purchased by the target claim vehicle, storing the characteristic image corresponding to each damage type, the weight factor corresponding to each damage type, the damage level corresponding to each damage position, the damage degree evaluation coefficient range corresponding to each damage level of each damage position, the damage information and the maintenance information corresponding to the historical claim vehicle, and storing the claim amount occupation ratio corresponding to the accident responsibility type.
The foregoing is merely illustrative of the structures of this invention and various modifications, additions and substitutions for those skilled in the art can be made to the described embodiments without departing from the scope of the invention or from the scope of the invention as defined in the accompanying claims.
Claims (6)
1. An intelligent analysis management system for insurance business based on big data is characterized by comprising: the system comprises a vehicle claim application basic information acquisition module, a claim application preliminary confirmation module, a vehicle breakage information analysis module, a vehicle maintenance project analysis module, a vehicle claim amount auditing module, a claim money payment module and an insurance management database;
the vehicle claim application basic information acquisition module is used for acquiring claim collection information and claim application material information corresponding to a target claim vehicle, wherein the material information comprises case report information, breakage information and maintenance information;
the claim application preliminary confirmation module is used for carrying out claim application preliminary confirmation on claim application information of the target claim vehicle according to the claim information corresponding to the target claim vehicle;
the vehicle breakage information analysis module is used for evaluating and analyzing breakage levels corresponding to breakage positions of the target claim vehicle according to breakage information corresponding to the target claim vehicle;
the vehicle maintenance project analysis module is used for carrying out claim settlement qualification analysis on the target claim settlement vehicle maintenance project according to the maintenance information corresponding to the target claim settlement vehicle and the damage grade corresponding to each damage position;
the vehicle claim settlement amount auditing module is used for auditing the claim settlement application amount corresponding to the target claim settlement vehicle to obtain the target claim settlement amount corresponding to the target claim settlement vehicle;
the payment module is used for paying the payment according to the target payment amount corresponding to the target payment vehicle and the payment information corresponding to the target payment vehicle;
the method comprises the steps of carrying out the claim-settlement qualification analysis on the maintenance items corresponding to the target claim-settlement vehicles, carrying out the claim-settlement qualification analysis on the maintenance item prices corresponding to the target claim-settlement vehicles and carrying out the comprehensive claim-settlement qualification analysis on the maintenance items corresponding to the target claim-settlement vehicles;
and performing basic claim settlement qualification analysis on maintenance items corresponding to the target claim settlement vehicle, wherein the specific analysis process is as follows:
matching and comparing the damage grade corresponding to each damage position of the target claim vehicle with the damage grade corresponding to each damage position in each historical claim vehicle in the insurance management database, if a certain damage position of the target claim vehicle is consistent with the damage grade corresponding to the damage position in a certain historical claim vehicle, judging the historical claim vehicle as a reference vehicle corresponding to the damage position in the target claim vehicle, counting the number of reference vehicles corresponding to each damage position of the target vehicle, and positioning maintenance information of each reference vehicle corresponding to each damage position of the target claim vehicle from the insurance management database;
extracting the number of maintenance items and the types corresponding to the maintenance items from the maintenance information of the number of the reference vehicles corresponding to the breakage positions of the target claim vehicle, further constructing a reference maintenance item number section corresponding to the breakage positions of the target claim vehicle, and simultaneously constructing a reference maintenance item type set corresponding to the breakage positions of the target claim vehicle;
comparing the number of maintenance items corresponding to each damaged position of the target claim vehicle with the upper limit value of the reference maintenance item number section, if the number of maintenance items corresponding to each damaged position of the target claim vehicle is smaller than or equal to the upper limit value of the reference maintenance item number section, judging that the number of maintenance items corresponding to the target claim vehicle is qualified, if the number of maintenance items corresponding to a certain damaged position of the target claim vehicle is larger than the upper limit value of the reference maintenance item number section, judging that the number of maintenance items corresponding to the damaged position of the target claim vehicle is unqualified, counting the number of damaged positions corresponding to the unqualified number of maintenance items of the target claim vehicle in this way, and marking as Q;
matching the maintenance item type corresponding to each damaged position of the target claim vehicle with a reference maintenance item type set thereof, judging that the maintenance item type corresponding to the target claim vehicle is qualified if the maintenance item type corresponding to each damaged position of the target claim vehicle is successfully matched with the reference maintenance item type set, judging that the maintenance item type corresponding to the damaged position of the target claim vehicle is unqualified if the maintenance item type corresponding to a certain damaged position of the target claim vehicle is unsuccessfully matched with the reference maintenance item type set, and counting the number of damaged positions corresponding to the unqualified maintenance item type of the target claim vehicle in this way, wherein W is marked;
the method comprises the following steps of carrying out claim settlement permission analysis on the maintenance item price corresponding to the target claim settlement vehicle:
extracting prices corresponding to the maintenance items from the maintenance information corresponding to the number of the reference vehicles at each damaged position of the target claim vehicle, and further constructing a reference maintenance item price interval corresponding to each maintenance item in each damaged position of the target claim vehicle;
comparing the price corresponding to each maintenance item in each damaged position of the target claim vehicle with the upper limit value of the price interval of the reference maintenance item, judging that the price of the maintenance item corresponding to the target claim vehicle is qualified if the price corresponding to each maintenance item in each damaged position of the target claim vehicle is smaller than the upper limit value of the price interval of the reference maintenance item, judging that the price corresponding to the maintenance item in a certain damaged position of the target claim vehicle is unqualified if the price corresponding to a certain maintenance item in a certain damaged position of the target claim vehicle is larger than the upper limit value of the price interval of the reference maintenance item, and counting the number of damaged positions corresponding to the unqualified price of the maintenance item of the target claim vehicle in this way, and marking as R;
the comprehensive claim settlement and qualification analysis are carried out on maintenance items corresponding to the target claim settlement vehicle, and the specific analysis process is as follows:
if the number of the maintenance items corresponding to the target claim vehicle is qualified, the type of the maintenance items corresponding to the target claim vehicle is qualified, and the price of the maintenance items corresponding to the target claim vehicle is qualified, judging that the comprehensive claim corresponding to the target claim vehicle is qualified;
if the number of the maintenance items corresponding to the target claim vehicle, the type of the maintenance items corresponding to the target claim vehicle or the price of the maintenance items corresponding to the target claim vehicle are unqualified, the calculation formula is usedObtaining a difference coefficient corresponding to the number of damaged positions of the target claim vehicleWherein Q ', W ', R ' are respectively the number of damage positions corresponding to the unqualified number of the set permitted maintenance items, the unqualified type of the permitted maintenance items and the unqualified price of the permitted maintenance items, and tau 1, tau 2 and tau 3 are respectively the weight factors corresponding to the set number of the maintenance items, the type of the maintenance items and the price of the maintenance items;
and comparing the difference coefficient corresponding to the number of the breakage positions of the target claim vehicle with the set difference coefficient of the number of the allowed breakage positions, if the difference coefficient corresponding to the number of the breakage positions of the target claim vehicle is smaller than or equal to the difference coefficient of the number of the allowed breakage positions, judging that the comprehensive claim audit corresponding to the target claim vehicle is qualified, otherwise, judging that the comprehensive claim audit corresponding to the target claim vehicle is unqualified.
2. The intelligent analysis and management system for insurance business based on big data according to claim 1, wherein: the report information comprises accident responsibility types and accident time, the damage information comprises damage areas corresponding to the damage positions and images corresponding to the damage positions, the maintenance information comprises the number of maintenance items corresponding to the damage positions, the types corresponding to the maintenance items and the prices corresponding to the maintenance items, and the accident responsibility types comprise all responsibilities, main responsibilities, equal responsibilities, secondary responsibilities and no responsibilities.
3. The intelligent analysis and management system for insurance business based on big data according to claim 1, wherein: the method comprises the following steps of carrying out preliminary confirmation of claim application on claim application information of a target claim vehicle, wherein the specific confirmation process is as follows:
extracting the insurance type and the insurance period purchased by the target claim vehicle from the insurance management database, and comparing the report information corresponding to the target claim vehicle with the insurance period purchased by the target claim vehicle;
if the accident time corresponding to the target claim vehicle is not within the guarantee period, judging that the target claim vehicle does not have the right to apply for claim settlement;
if the accident time corresponding to the target claim vehicle is within the insurance period, the corresponding claim amount ratio of the target claim vehicle is positioned from the insurance management database according to the accident responsibility type of the target claim vehicle, and the highest claim amount corresponding to the target claim vehicle is obtained according to the corresponding insurance amount of the target claim vehicle.
4. The intelligent analysis and management system for insurance business based on big data according to claim 1, wherein: the damage grade corresponding to each damage position of the target claim vehicle is evaluated and analyzed, and the specific analysis process is as follows:
numbering the damage positions of the target claim vehicle according to a preset sequence, and numbering the damage positions as 1,2.
Matching and comparing the image corresponding to each damage position of the target claim vehicle with the characteristic image corresponding to each damage type stored in the insurance management database, screening to obtain the damage type corresponding to each damage position of the target claim vehicle, positioning the weight factor of the damage type corresponding to each damage position of the target claim vehicle from the insurance management database, and marking the weight factor asi is a number corresponding to each damaged position of the target claim vehicle, i=1, 2.
Extracting the area corresponding to each damaged position and the corresponding damaged area in each damaged position from the image corresponding to each damaged position of the target claim vehicle;
substituting the damaged area corresponding to each damaged position of the target claim vehicle and the weight factor corresponding to the damaged type of each damaged position into a calculation formulaObtaining damage degree evaluation coefficient alpha corresponding to each damage position of the target claim vehicle i Wherein S is i ' represents an area corresponding to the ith damaged position of the target claim vehicle, S i Representing the damage area epsilon corresponding to the ith damage position of the target claim vehicle 1 For the weight factor corresponding to the set damage area, kappa i The ith damage position of the vehicle is subjected to damage area ratio corresponding to the set permission target claim;
and matching and comparing the damage degree evaluation coefficient corresponding to each damage position of the target claim vehicle with the damage degree evaluation coefficient range of each damage level corresponding to each damage position stored in the insurance management database, so as to obtain the damage level corresponding to each damage position of the target claim vehicle.
5. The intelligent analysis and management system for insurance business based on big data according to claim 1, wherein: the method comprises the following specific judgment processes of auditing the claim application amount corresponding to the target claim vehicle:
when the claims corresponding to the target claim vehicle are comprehensively checked and qualified, counting the claim application amount corresponding to the target claim vehicle, comparing the claim application amount corresponding to the target claim vehicle with the highest claim amount, if the claim application amount corresponding to the target claim vehicle is smaller than or equal to the highest claim amount, judging that the claim application amount corresponding to the target claim vehicle is the target claim amount of the target claim vehicle, otherwise, judging that the highest claim amount corresponding to the target claim vehicle is the target claim amount of the target claim vehicle, and sending the target claim amount of the target claim vehicle to the insurance management background for prompting.
6. The intelligent analysis and management system for insurance business based on big data according to claim 1, wherein: the insurance management database is used for storing the insurance limit and the insurance period purchased by the target claim vehicle, storing the characteristic image corresponding to each damage type, the weight factor corresponding to each damage type, the damage level corresponding to each damage position, the damage degree evaluation coefficient range corresponding to each damage level of each damage position, the damage information and the maintenance information corresponding to the historical claim vehicle, and storing the claim amount occupation ratio corresponding to the accident responsibility type.
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