CN116012169A - Method and system for screening risk of insurance claim settlement based on position data - Google Patents
Method and system for screening risk of insurance claim settlement based on position data Download PDFInfo
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- CN116012169A CN116012169A CN202211648104.4A CN202211648104A CN116012169A CN 116012169 A CN116012169 A CN 116012169A CN 202211648104 A CN202211648104 A CN 202211648104A CN 116012169 A CN116012169 A CN 116012169A
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Abstract
The invention provides a method and a system for screening risk of insurance claims based on position data. The method comprises the following steps: acquiring basic information of the insurance surveyor entering and exiting the automobile repair shop by using positioning equipment on the insurance surveyor; according to the basic information of the insurance surveyor entering and exiting the automobile repair shop, combining a first risk assessment model and a second risk assessment model to carry out risk assessment on the automobile repair shop entering and exiting by the insurance surveyor, and obtaining a risk assessment level; and carrying out different levels of risk management and control and risk early warning on the insurance policy of the automobile repair factory in the process of insurance exploration according to the risk assessment levels and combining the corresponding damage assessment and maintenance amount abnormal range of each risk assessment level.
Description
Technical Field
The invention provides a method and a system for screening risk of insurance claims based on position data, and belongs to the technical field of insurance risk management and control.
Background
The insurance claims refer to the action of the insurance company according to contract regulation to fulfill compensation or pay responsibility when the insurance label generates insurance accident and causes the property of the insured person to be lost or the life of the person to be damaged or other insurance accidents agreed by the insurance policy are at risk and need to pay insurance money. In short, insurance claims are the act of an insurer processing claims made by the insured after a risk accident of the insured life. In insurance management, insurance claims are a specific implementation of insurance compensation functions.
In the insurance claim settlement process, an insurance investigation worker needs to collect evidence and evaluate site conditions aiming at an emergency site and conduct accident damage assessment, so that the insurance claim settlement management and control is particularly important in order to avoid the occurrence of illegal conditions in the accident damage assessment process. The management and control of the insurance claims in the prior art still needs to be manually checked and evaluated, and the management and control of the insurance claims are easy to cause the problems of low management and control efficiency and high supervision error rate through a manual checking and evaluating mode.
Disclosure of Invention
The invention provides a method and a system for screening risk of insurance claims based on position data, which are used for solving the problems of low management and control efficiency and high supervision error rate of the existing insurance claims, and the adopted technical scheme is as follows:
a method of conducting insurance claim risk screening based on location data, the method comprising:
acquiring basic information of the insurance surveyor entering and exiting the automobile repair shop by using positioning equipment on the insurance surveyor;
according to the basic information of the insurance surveyor entering and exiting the automobile repair shop, combining a first risk assessment model and a second risk assessment model to carry out risk assessment on the automobile repair shop entering and exiting by the insurance surveyor, and obtaining a risk assessment level;
and carrying out different levels of risk management and control and risk early warning on the insurance policy of the automobile repair factory in the process of insurance exploration according to the risk assessment levels and combining the corresponding damage assessment and maintenance amount abnormal range of each risk assessment level.
Further, the method for acquiring the basic information of the insurance inspector entering and exiting the automobile repair shop by using the positioning equipment on the insurance inspector comprises the following steps:
recording the position information of the insurance surveyor in real time by using positioning equipment on the insurance surveyor;
extracting first basic information of the insurance surveyor entering into the automobile repair shop under the condition of no risk from the position information; wherein the first type of basic information comprises the position of a garage, the name of the garage and the number of times that an insurance surveyor enters the garage under the condition of no danger;
extracting second-type basic information of the insurance surveyor entering into the automobile repair shop under the condition of danger from the position information; wherein the second type of basic information comprises an estimated loss amount, a maintenance amount and a customer satisfaction evaluation score value under the dangerous situation.
Further, according to the basic information of the insurance surveyor entering and exiting the automobile repair shop, combining the first risk assessment model and the second risk assessment model to perform risk assessment on the automobile repair shop entering and exiting by the insurance surveyor, to obtain a risk assessment level, including:
extracting first type basic information in the basic information, and carrying out risk assessment on the automobile repair shop by combining a first risk assessment model to obtain a first risk assessment value of the automobile repair shop; wherein the first risk assessment model comprises:
A 1 ＞5.7A 2
wherein F is 1 Representing a first risk assessment value; c (C) 1 Indicating the number of times the insurance surveyor enters the auto repair shop during the working time; c (C) 2 Indicating the number of times the insurance surveyor enters the auto repair shop during non-working time; a is that 1 Representing a first reference risk factor, A 1 The range of the value of (2) is 10-15; a is that 2 Representing a first reference risk adjustment factor; a is that 3 Representing a second reference risk factor, A 3 The value range of (2) is 2.8-5; t (T) i Indicating the stay time of the ith entrance of the insurance investigation person to the auto repair shop; t (T) 0 Indicating a preset stay threshold time, and T 0 The value range of (2) is 20 min-35 min;
when the first risk assessment value exceeds a preset first risk assessment threshold value, determining that the current automobile repair shop has primary risk, and carrying out primary risk identification on the automobile repair shop;
and extracting second-class basic information in the basic information, and carrying out risk assessment on the automobile repair shop by utilizing the second-class basic information and combining a second risk assessment model and a primary risk identifier to obtain a risk assessment level of the automobile repair shop.
Further, extracting a second type of basic information in the basic information, performing risk assessment on the automobile repair shop by using the second type of basic information and combining a second risk assessment model and a primary risk identifier, and obtaining a risk assessment level of the automobile repair shop, wherein the method comprises the following steps:
extracting second-type basic information in the basic information, carrying out risk assessment on the automobile repair shop by combining a second risk assessment model, and obtaining a second risk assessment value of the automobile repair shop
Determining the automotive repair shop as a target object when the second risk assessment value exceeds a preset second risk assessment threshold;
judging whether the target object has a primary risk identifier, and when the target object has the primary risk identifier, determining that the automobile repair shop corresponding to the target object is a high-level risk; and when the target object does not have the primary risk identification, the automobile repair shop corresponding to the target object is considered as a medium-level risk.
Wherein the second risk assessment model is as follows:
wherein F is 2 Representing a second risk assessment value; m is M d Representing the loss amount; m is M v Representing the actual maintenance amount; h represents a customer satisfaction evaluation score value; a is that 4 Representing a third reference risk factor, A 4 The range of the value of (2) is 5-10.
Further, according to the risk assessment levels, combining the damage assessment level and the maintenance amount abnormal range corresponding to each risk assessment level, performing different levels of risk management and risk early warning on the insurance policy of the automobile repair factory in the insurance investigation process, including:
setting an abnormal maintenance amount range for the auto repair shop with the risk assessment level being primary risk;
setting an abnormal maintenance amount range for the auto repair shop with the risk assessment level being a medium risk;
setting an abnormal maintenance amount range for the auto repair shop with the risk assessment level of high-level risk;
and performing risk management and control on the actual damage and maintenance amount under the dangerous situation in the damage assessment and maintenance amount abnormal range corresponding to the risk assessment level of the automobile repair factory, and performing risk early warning when the actual damage and maintenance amount exceed the upper limit of the damage assessment and maintenance amount abnormal range corresponding to the risk assessment level.
A system for insurance claim risk screening based on location data, the system comprising:
the basic information acquisition module is used for acquiring basic information of the insurance inspector entering and exiting the automobile repair factory by utilizing positioning equipment on the insurance inspector;
the risk assessment module is used for carrying out risk assessment on the automobile repair factory accessed by the insurance inspector according to the basic information of the automobile repair factory accessed by the insurance inspector in combination with the first risk assessment model and the second risk assessment model to obtain a risk assessment level;
and the management and control early warning module is used for carrying out different levels of risk management and control and risk early warning on the insurance policy of the automobile repair factory in the insurance investigation process according to the risk assessment levels and combining the damage assessment and maintenance amount abnormal range corresponding to each risk assessment level.
Further, the basic information acquisition module includes:
the positioning monitoring module is used for recording the position information of the insurance surveyor in real time by utilizing positioning equipment on the insurance surveyor;
the first information extraction module is used for extracting first basic information of the insurance surveyor entering and exiting the automobile repair shop under the condition of no risk from the position information; wherein the first type of basic information comprises the position of a garage, the name of the garage and the number of times that an insurance surveyor enters the garage under the condition of no danger;
the second information extraction module is used for extracting second type basic information of the insurance surveyor entering and exiting the automobile repair shop under the condition of danger from the position information; wherein the second type of basic information comprises an estimated loss amount, a maintenance amount and a customer satisfaction evaluation score value under the dangerous situation.
Further, the risk assessment module includes:
the first risk assessment module is used for extracting first type basic information in the basic information, carrying out risk assessment on the automobile repair shop by combining a first risk assessment model, and obtaining a first risk assessment value of the automobile repair shop; wherein the first risk assessment model comprises:
A 1 ＞5.7A 2
wherein F is 1 Representing a first risk assessment value; c (C) 1 Indicating the number of times the insurance surveyor enters the auto repair shop during the working time; c (C) 2 Indicating the number of times the insurance surveyor enters the auto repair shop during non-working time; a is that 1 Representing a first reference risk factor, A 1 The range of the value of (2) is 10-15; a is that 2 Representing a first reference risk adjustment factor; a is that 3 Representing a second reference risk factor, A 3 The value range of (2) is 2.8-5; t (T) i Indicating the stay time of the ith entrance of the insurance investigation person to the auto repair shop; t (T) 0 Indicating a preset stay threshold time, and T 0 The value range of (2) is 20 min-35 min;
the primary risk judging module is used for determining that the current automobile repair shop has primary risk when the first risk evaluation value exceeds a preset first risk evaluation threshold value, and carrying out primary risk identification on the automobile repair shop;
the second risk assessment module is used for extracting second type basic information in the basic information, carrying out risk assessment on the automobile repair factory by utilizing the second type basic information and combining a second risk assessment model and a primary risk identifier, and obtaining the risk assessment level of the automobile repair factory.
Further, the second risk assessment module includes:
the evaluation value acquisition module is used for extracting second-type basic information in the basic information, carrying out risk evaluation on the automobile repair shop by combining a second risk evaluation model, and acquiring a second risk evaluation value of the automobile repair shop
A target object determining module, configured to determine the auto repair shop as a target object when the second risk assessment value exceeds a preset second risk assessment threshold;
the risk grading module is used for judging whether the target object has a primary risk identifier, and when the target object has the primary risk identifier, the automobile repair shop corresponding to the target object is considered to be a high-level risk; and when the target object does not have the primary risk identification, the automobile repair shop corresponding to the target object is considered as a medium-level risk.
Wherein the second risk assessment model is as follows:
wherein F is 2 Representing a second risk assessment value; m is M d Representing the loss amount; m is M v Representing the actual maintenance amount; h represents a customer satisfaction evaluation score value; a is that 4 Representing a third reference risk factor, A 4 The range of the value of (2) is 5-10.
Further, the control early warning module includes:
the first range setting module is used for setting an abnormal range of the maintenance amount for the automobile repair shop with the risk assessment level of primary risk;
the second range setting module is used for setting an abnormal range of the maintenance amount for the automobile repair shop with the risk assessment level of intermediate risk;
a third range setting module, configured to set a maintenance amount abnormal range for an automotive repair shop whose risk assessment level is a high-level risk;
and the monitoring and early warning module is used for performing risk management and control on the actual damage assessment and the maintenance amount under the dangerous situation in the damage assessment and maintenance amount abnormal range corresponding to the risk assessment level of the automobile repair factory, and performing risk early warning when the actual damage assessment and the maintenance amount exceed the upper limit of the damage assessment and maintenance amount abnormal range corresponding to the risk assessment level.
The invention has the beneficial effects that:
according to the method and the system for carrying out insurance claim risk screening based on the position data, the actual position of the insurance inspector is positioned and monitored, the insurance inspector and the corresponding automobile repair factory are subjected to risk assessment, the risk level of the corresponding automobile repair factory in the insurance claim process is obtained through the risk assessment, and effective insurance claim risk screening is achieved through the method. Meanwhile, the corresponding maintenance amount abnormal range is set for the automobile repair factories with different risk grades, so that the efficiency of managing and controlling the claim risk can be effectively improved. Meanwhile, the method and the system for screening the risk of the insurance claim based on the position data can effectively replace a manual mode to conduct automatic risk management and control of the insurance claim, effectively improve the risk management and control efficiency of the insurance claim, further reduce the error rate of risk management and control of the insurance claim, and completely avoid the problem of high error rate caused by subjective errors and information omission in the artificial auditing and evaluating process.
Drawings
FIG. 1 is a flow chart of a method according to the present invention;
FIG. 2 is a second flowchart of the method of the present invention;
fig. 3 is a system block diagram of the system of the present invention.
Detailed Description
The preferred embodiments of the present invention will be described below with reference to the accompanying drawings, it being understood that the preferred embodiments described herein are for illustration and explanation of the present invention only, and are not intended to limit the present invention.
The embodiment of the invention provides a method for screening risk of insurance claims based on position data, as shown in fig. 1, comprising the following steps:
s1, acquiring basic information of an insurance inspector entering and exiting an automobile repair shop by using positioning equipment on the insurance inspector;
s2, carrying out risk assessment on the automobile repair shop accessed by the insurance inspector according to basic information accessed by the insurance inspector and combining a first risk assessment model and a second risk assessment model to obtain a risk assessment level;
and S3, carrying out different levels of risk management and control and risk early warning on the insurance policy of the automobile repair factory in the insurance investigation process according to the risk assessment levels and combining the damage assessment and maintenance amount abnormal range corresponding to each risk assessment level.
Wherein, utilize the locating device on the insurance investigation person's body to obtain the basic information that the insurance investigation person got in and out the auto repair shop, include:
s101, recording the position information of an insurance surveyor in real time by using positioning equipment on the insurance surveyor;
s102, extracting first basic information of the insurance surveyor entering into and exiting from an automobile repair shop under the condition of no risk from the position information; wherein the first type of basic information comprises the position of a garage, the name of the garage and the number of times that an insurance surveyor enters the garage under the condition of no danger;
s103, extracting second-type basic information of the insurance surveyor entering into and exiting from the automobile repair shop under the condition of danger from the position information; wherein the second type of basic information comprises an estimated loss amount, a maintenance amount and a customer satisfaction evaluation score value under the dangerous situation.
The working principle of the technical scheme is as follows: firstly, acquiring basic information of an insurance inspector entering into and exiting from an automobile repair shop by using positioning equipment on the insurance inspector; then, according to the basic information of the insurance surveyor entering and exiting the automobile repair shop, combining a first risk assessment model and a second risk assessment model to carry out risk assessment on the automobile repair shop entering and exiting by the insurance surveyor, and obtaining a risk assessment level; and finally, carrying out different levels of risk management and control and risk early warning on the insurance policy of the automobile repair factory in the insurance investigation process according to the risk assessment levels and combining the damage assessment and maintenance amount abnormal range corresponding to each risk assessment level.
The technical scheme has the effects that: according to the method for carrying out insurance claim risk screening based on the position data, the actual position of the insurance inspector is positioned and monitored, risk assessment is carried out on the insurance inspector and the corresponding automobile repair factory, the risk level of the corresponding automobile repair factory in the insurance claim process is obtained through the risk assessment, and effective insurance claim risk screening is achieved through the method. Meanwhile, the corresponding maintenance amount abnormal range is set for the automobile repair factories with different risk grades, so that the efficiency of managing and controlling the claim risk can be effectively improved. Meanwhile, the method for screening the risk of the insurance claim based on the position data can effectively replace a manual mode to conduct automatic risk management and control of the insurance claim, effectively improves the risk management and control efficiency of the insurance claim, further reduces the error rate of risk management and control of the insurance claim, and can completely avoid the problem of high error rate caused by subjective errors and information omission in the artificial auditing and evaluating process.
According to one embodiment of the invention, according to basic information of the insurance surveyor entering and exiting the automobile repair shop, the risk assessment is carried out on the automobile repair shop which the insurance surveyor enters and exiting by combining the first risk assessment model and the second risk assessment model, so as to obtain a risk assessment level, and the method comprises the following steps:
s201, extracting first type basic information in the basic information, and carrying out risk assessment on the automobile repair shop by combining a first risk assessment model to obtain a first risk assessment value of the automobile repair shop; wherein the first risk assessment model comprises:
A 1 ＞5.7A 2
wherein F is 1 Representing a first risk assessment value; c (C) 1 Indicating the number of times the insurance surveyor enters the auto repair shop during the working time; c (C) 2 Indicating the number of times the insurance surveyor enters the auto repair shop during non-working time; a is that 1 Representing a first reference risk factor, A 1 The range of the value of (2) is 10-15; a is that 2 Representing a first reference risk adjustment factor; a is that 3 Representing a second reference risk factor, A 3 The value range of (2) is 2.8-5; t (T) i Indicating the stay time of the ith entrance of the insurance investigation person to the auto repair shop; t (T) 0 Indicating a preset stay threshold time, and T 0 The value range of (2) is 20 min-35 min;
s202, when the first risk assessment value exceeds a preset first risk assessment threshold value, determining that the current automobile repair shop has primary risk, and carrying out primary risk identification on the automobile repair shop;
and S203, extracting second-class basic information in the basic information, and carrying out risk assessment on the automobile repair shop by utilizing the second-class basic information and combining a second risk assessment model and a primary risk identifier to obtain a risk assessment level of the automobile repair shop.
As shown in fig. 2, extracting a second type of basic information in the basic information, performing risk assessment on the automobile repair shop by using the second type of basic information in combination with a second risk assessment model and a primary risk identifier, and obtaining a risk assessment level of the automobile repair shop includes:
s2031, extracting second-type basic information in the basic information, carrying out risk assessment on the automobile repair shop by combining a second risk assessment model, and obtaining a second risk assessment value of the automobile repair shop
S2032, determining the auto repair shop as a target object when the second risk assessment value exceeds a preset second risk assessment threshold;
s2033, judging whether the target object has a primary risk identifier, and when the target object has the primary risk identifier, determining that the automobile repair shop corresponding to the target object is a high-level risk; and when the target object does not have the primary risk identification, the automobile repair shop corresponding to the target object is considered as a medium-level risk.
Wherein the second risk assessment model is as follows:
wherein F is 2 Representing a second risk assessment value; m is M d Representing the loss amount; m is M v Representing the actual maintenance amount; h represents a customer satisfaction evaluation score value; a is that 4 Representing a third reference risk factor, A 4 The range of the value of (2) is 5-10.
The working principle and the effect of the technical scheme are as follows: the method is used for carrying out risk assessment on the insurance surveyors and the corresponding automotive repair factories by positioning and monitoring the actual positions of the insurance surveyors, and acquiring the risk level of the corresponding automotive repair factories in the insurance claim settlement process through the risk assessment, so that effective insurance claim settlement risk screening is realized. Meanwhile, the risk evaluation values obtained through the first risk evaluation model and the second risk evaluation model can be subjected to targeted evaluation according to different basic information by combining target objects under different conditions, so that the accuracy of the risk evaluation values is effectively improved, and the accuracy of risk screening and risk grading is further improved.
According to one embodiment of the invention, risk management and risk early warning of different levels are carried out on the insurance policy of the auto repair factory in the process of insurance exploration according to the risk assessment levels and combining the damage assessment and maintenance amount abnormal range corresponding to each risk assessment level, and the method comprises the following steps:
s301, setting an abnormal maintenance amount range for a garage with the risk assessment level being a primary risk;
s302, setting an abnormal maintenance amount range for a garage with the risk assessment level being a medium risk;
s303, setting an abnormal maintenance amount range for the auto repair shop with the risk assessment level being a high-level risk;
s304, performing risk management and control on actual damage and maintenance amount under the situation of danger in the damage assessment and maintenance amount abnormal range corresponding to the risk assessment level of the automobile repair factory, and performing risk early warning when the actual damage assessment and maintenance amount exceeds the upper limit of the damage assessment and maintenance amount abnormal range corresponding to the risk assessment level.
The working principle of the technical scheme is as follows: firstly, setting an abnormal maintenance amount range for a garage with the risk assessment level as a primary risk; then, setting an abnormal maintenance amount range for the auto repair shop with the risk assessment level being a medium risk; subsequently, setting an abnormal maintenance amount range for the auto repair shop with the risk assessment level of high-level risk; and finally, performing risk management and control on the actual damage and maintenance amount under the situation of danger in the damage assessment and maintenance amount abnormal range corresponding to the risk assessment level of the automobile repair factory, and performing risk early warning when the actual damage and maintenance amount exceed the upper limit of the damage assessment and maintenance amount abnormal range corresponding to the risk assessment level.
The technical scheme has the effects that: the efficiency of claim risk management and control can be effectively improved by setting the corresponding maintenance amount abnormal range for the automobile repair factories with different risk grades. Meanwhile, through an automatic early warning mode, early warning efficiency and early warning timeliness are effectively improved.
The embodiment of the invention provides a system for screening risk of insurance claims based on position data, as shown in fig. 3, the system comprises:
the basic information acquisition module is used for acquiring basic information of the insurance inspector entering and exiting the automobile repair factory by utilizing positioning equipment on the insurance inspector;
the risk assessment module is used for carrying out risk assessment on the automobile repair factory accessed by the insurance inspector according to the basic information of the automobile repair factory accessed by the insurance inspector in combination with the first risk assessment model and the second risk assessment model to obtain a risk assessment level;
and the management and control early warning module is used for carrying out different levels of risk management and control and risk early warning on the insurance policy of the automobile repair factory in the insurance investigation process according to the risk assessment levels and combining the damage assessment and maintenance amount abnormal range corresponding to each risk assessment level.
Wherein, the basic information acquisition module includes:
the positioning monitoring module is used for recording the position information of the insurance surveyor in real time by utilizing positioning equipment on the insurance surveyor;
the first information extraction module is used for extracting first basic information of the insurance surveyor entering and exiting the automobile repair shop under the condition of no risk from the position information; wherein the first type of basic information comprises the position of a garage, the name of the garage and the number of times that an insurance surveyor enters the garage under the condition of no danger;
the second information extraction module is used for extracting second type basic information of the insurance surveyor entering and exiting the automobile repair shop under the condition of danger from the position information; wherein the second type of basic information comprises an estimated loss amount, a maintenance amount and a customer satisfaction evaluation score value under the dangerous situation.
The working principle of the technical scheme is as follows: firstly, basic information of an insurance inspector entering and exiting an automobile repair shop is acquired by a basic information acquisition module through positioning equipment on the insurance inspector; then, using a risk assessment module to carry out risk assessment on the automobile repair factory accessed by the insurance inspector according to the basic information of the automobile repair factory accessed by the insurance inspector by combining a first risk assessment model and a second risk assessment model, and obtaining a risk assessment level; and finally, carrying out different levels of risk management and control and risk early warning on the insurance policy of the automobile repair factory in the insurance investigation process by combining the damage assessment and maintenance amount abnormal range corresponding to each risk assessment level through the management and early warning module according to the risk assessment level.
The operation process of the basic information acquisition module comprises the following steps:
firstly, recording the position information of an insurance inspector in real time by using positioning equipment on the insurance inspector through a positioning monitoring module;
then, a first information extraction module is adopted to extract first basic information of the insurance inspector entering and exiting the automobile repair shop under the condition of no danger from the position information; wherein the first type of basic information comprises the position of a garage, the name of the garage and the number of times that an insurance surveyor enters the garage under the condition of no danger;
finally, extracting second-type basic information of the insurance surveyor entering and exiting the automobile repair shop under the condition of danger from the position information through a second information extraction module; wherein the second type of basic information comprises an estimated loss amount, a maintenance amount and a customer satisfaction evaluation score value under the dangerous situation.
The technical scheme has the effects that: according to the system for carrying out insurance claim risk screening based on the position data, the actual position of the insurance inspector is positioned and monitored, risk assessment is carried out on the insurance inspector and the corresponding automobile repair factory, the risk level of the corresponding automobile repair factory in the insurance claim process is obtained through the risk assessment, and effective insurance claim risk screening is achieved through the mode. Meanwhile, the corresponding maintenance amount abnormal range is set for the automobile repair factories with different risk grades, so that the efficiency of managing and controlling the claim risk can be effectively improved. Meanwhile, the system for screening the risk of the insurance claim based on the position data can effectively replace a manual mode to conduct automatic risk management and control of the insurance claim, effectively improve the risk management and control efficiency of the insurance claim, further reduce the error rate of risk management and control of the insurance claim, and completely avoid the problem of high error rate caused by subjective errors and information omission in the artificial auditing and evaluating process.
In one embodiment of the present invention, the risk assessment module includes:
the first risk assessment module is used for extracting first type basic information in the basic information, carrying out risk assessment on the automobile repair shop by combining a first risk assessment model, and obtaining a first risk assessment value of the automobile repair shop; wherein the first risk assessment model comprises:
A 1 ＞5.7A 2
wherein F is 1 Representing a first risk assessment value; c (C) 1 Indicating the number of times the insurance surveyor enters the auto repair shop during the working time; c (C) 2 Indicating the number of times the insurance surveyor enters the auto repair shop during non-working time; a is that 1 Representing a first reference risk factor, A 1 The range of the value of (2) is 10-15; a is that 2 Representing a first reference risk adjustment factor; a is that 3 Representing a second reference risk factor, A 3 The value range of (2) is 2.8-5; t (T) i Indicating the stay time of the ith entrance of the insurance investigation person to the auto repair shop; t (T) 0 Indicating a preset stay threshold time, and T 0 The value range of (2) is 20 min-35 min;
the primary risk judging module is used for determining that the current automobile repair shop has primary risk when the first risk evaluation value exceeds a preset first risk evaluation threshold value, and carrying out primary risk identification on the automobile repair shop;
the second risk assessment module is used for extracting second type basic information in the basic information, carrying out risk assessment on the automobile repair factory by utilizing the second type basic information and combining a second risk assessment model and a primary risk identifier, and obtaining the risk assessment level of the automobile repair factory.
Wherein the second risk assessment module comprises:
the evaluation value acquisition module is used for extracting second-type basic information in the basic information, carrying out risk evaluation on the automobile repair shop by combining a second risk evaluation model, and acquiring a second risk evaluation value of the automobile repair shop
A target object determining module, configured to determine the auto repair shop as a target object when the second risk assessment value exceeds a preset second risk assessment threshold;
the risk grading module is used for judging whether the target object has a primary risk identifier, and when the target object has the primary risk identifier, the automobile repair shop corresponding to the target object is considered to be a high-level risk; and when the target object does not have the primary risk identification, the automobile repair shop corresponding to the target object is considered as a medium-level risk.
Wherein the second risk assessment model is as follows:
wherein F is 2 Representing a second risk assessment value; m is M d Representing the loss amount; m is M v Representing the actual maintenance amount; h represents a customer satisfaction evaluation score value; a is that 4 Representing a third reference risk factor, A 4 The range of the value of (2) is 5-10.
The working principle of the technical scheme is as follows: the running process of the risk assessment module comprises the following steps:
firstly, extracting first type basic information in the basic information through a first risk assessment module, and carrying out risk assessment on the automobile repair shop by combining a first risk assessment model to obtain a first risk assessment value of the automobile repair shop; then, when the first risk assessment value exceeds a preset first risk assessment threshold value, determining that the current automotive repair shop has primary risk by utilizing a primary risk judgment module, and carrying out primary risk identification on the automotive repair shop; and then, extracting second-class basic information in the basic information by adopting a second risk assessment module, and carrying out risk assessment on the automobile repair shop by utilizing the second-class basic information and combining a second risk assessment model and a primary risk identifier to obtain a risk assessment level of the automobile repair shop.
Wherein, the operation process of the second risk assessment module comprises:
firstly, extracting second-class basic information in the basic information through an evaluation value acquisition module, carrying out risk evaluation on the automobile repair shop by combining a second risk evaluation model, and acquiring a second risk evaluation value of the automobile repair shop
Then, determining, by a target object determining module, the automotive repair shop as a target object when the second risk assessment value exceeds a preset second risk assessment threshold;
finally, judging whether the target object has a primary risk identifier by adopting a risk grading module, and when the target object has the primary risk identifier, determining that the automobile repair shop corresponding to the target object is a high-level risk; and when the target object does not have the primary risk identification, the automobile repair shop corresponding to the target object is considered as a medium-level risk.
The technical scheme has the effects that: the method is used for carrying out risk assessment on the insurance surveyors and the corresponding automotive repair factories by positioning and monitoring the actual positions of the insurance surveyors, and acquiring the risk level of the corresponding automotive repair factories in the insurance claim settlement process through the risk assessment, so that effective insurance claim settlement risk screening is realized. Meanwhile, the risk evaluation values obtained through the first risk evaluation model and the second risk evaluation model can be subjected to targeted evaluation according to different basic information by combining target objects under different conditions, so that the accuracy of the risk evaluation values is effectively improved, and the accuracy of risk screening and risk grading is further improved.
In one embodiment of the present invention, the control early warning module includes:
the first range setting module is used for setting an abnormal range of the maintenance amount for the automobile repair shop with the risk assessment level of primary risk;
the second range setting module is used for setting an abnormal range of the maintenance amount for the automobile repair shop with the risk assessment level of intermediate risk;
a third range setting module, configured to set a maintenance amount abnormal range for an automotive repair shop whose risk assessment level is a high-level risk;
and the monitoring and early warning module is used for performing risk management and control on the actual damage assessment and the maintenance amount under the dangerous situation in the damage assessment and maintenance amount abnormal range corresponding to the risk assessment level of the automobile repair factory, and performing risk early warning when the actual damage assessment and the maintenance amount exceed the upper limit of the damage assessment and maintenance amount abnormal range corresponding to the risk assessment level.
The working principle of the technical scheme is as follows: the operation process of the control early warning module comprises the following steps:
firstly, setting an abnormal maintenance amount range for an automotive repair shop with the risk assessment level of primary risk through a first range setting module; then, a second range setting module is adopted to set an abnormal range of the maintenance amount for the automobile repair shop with the risk assessment level of intermediate risk; then, setting an abnormal maintenance amount range for the auto repair shop with the risk assessment level of high-grade risk through a third range setting module;
and finally, performing risk management and control on the actual damage assessment and the maintenance amount under the dangerous situation in the damage assessment and maintenance amount abnormal range corresponding to the risk assessment level of the automobile repair factory by adopting a monitoring and early warning module, and performing risk early warning when the actual damage assessment and the maintenance amount exceed the upper limit of the damage assessment and maintenance amount abnormal range corresponding to the risk assessment level.
The technical scheme has the effects that: the efficiency of claim risk management and control can be effectively improved by setting the corresponding maintenance amount abnormal range for the automobile repair factories with different risk grades. Meanwhile, through an automatic early warning mode, early warning efficiency and early warning timeliness are effectively improved.
It will be apparent to those skilled in the art that various modifications and variations can be made to the present invention without departing from the spirit or scope of the invention. Thus, it is intended that the present invention also include such modifications and alterations insofar as they come within the scope of the appended claims or the equivalents thereof.
Claims (10)
1. A method of conducting insurance claim risk screening based on location data, the method comprising:
acquiring basic information of the insurance surveyor entering and exiting the automobile repair shop by using positioning equipment on the insurance surveyor;
according to the basic information of the insurance surveyor entering and exiting the automobile repair shop, combining a first risk assessment model and a second risk assessment model to carry out risk assessment on the automobile repair shop entering and exiting by the insurance surveyor, and obtaining a risk assessment level;
and carrying out different levels of risk management and control and risk early warning on the insurance policy of the automobile repair factory in the process of insurance exploration according to the risk assessment levels and combining the corresponding damage assessment and maintenance amount abnormal range of each risk assessment level.
2. The method of claim 1, wherein obtaining basic information of the insurance inspector in and out of a garage using positioning equipment on the insurance inspector comprises:
recording the position information of the insurance surveyor in real time by using positioning equipment on the insurance surveyor;
extracting first basic information of the insurance surveyor entering into the automobile repair shop under the condition of no risk from the position information; wherein the first type of basic information comprises the position of a garage, the name of the garage and the number of times that an insurance surveyor enters the garage under the condition of no danger;
extracting second-type basic information of the insurance surveyor entering into the automobile repair shop under the condition of danger from the position information; wherein the second type of basic information comprises an estimated loss amount, a maintenance amount and a customer satisfaction evaluation score value under the dangerous situation.
3. The method of claim 1, wherein performing risk assessment on the insurance carrier in accordance with basic information of the insurance carrier in and out of the garage in combination with the first risk assessment model and the second risk assessment model to obtain a risk assessment level comprises:
extracting first type basic information in the basic information, and carrying out risk assessment on the automobile repair shop by combining a first risk assessment model to obtain a first risk assessment value of the automobile repair shop;
when the first risk assessment value exceeds a preset first risk assessment threshold value, determining that the current automobile repair shop has primary risk, and carrying out primary risk identification on the automobile repair shop;
and extracting second-class basic information in the basic information, and carrying out risk assessment on the automobile repair shop by utilizing the second-class basic information and combining a second risk assessment model and a primary risk identifier to obtain a risk assessment level of the automobile repair shop.
4. A method according to claim 3, wherein extracting a second type of basic information from the basic information, performing risk assessment on the automotive repair shop by using the second type of basic information in combination with a second risk assessment model and a primary risk identifier, and obtaining a risk assessment level of the automotive repair shop comprises:
extracting second-type basic information in the basic information, carrying out risk assessment on the automobile repair shop by combining a second risk assessment model, and obtaining a second risk assessment value of the automobile repair shop
Determining the automotive repair shop as a target object when the second risk assessment value exceeds a preset second risk assessment threshold;
judging whether the target object has a primary risk identifier, and when the target object has the primary risk identifier, determining that the automobile repair shop corresponding to the target object is a high-level risk; and when the target object does not have the primary risk identification, the automobile repair shop corresponding to the target object is considered as a medium-level risk.
5. The method of claim 1, wherein performing different levels of risk management and risk early warning on the insurance policy of the automotive repair shop in the process of the insurance investigation according to the risk assessment levels in combination with the corresponding damage and maintenance amount anomaly range of each risk assessment level comprises:
setting an abnormal maintenance amount range for the auto repair shop with the risk assessment level being primary risk;
setting an abnormal maintenance amount range for the auto repair shop with the risk assessment level being a medium risk;
setting an abnormal maintenance amount range for the auto repair shop with the risk assessment level of high-level risk;
and performing risk management and control on the actual damage and maintenance amount under the dangerous situation in the damage assessment and maintenance amount abnormal range corresponding to the risk assessment level of the automobile repair factory, and performing risk early warning when the actual damage and maintenance amount exceed the upper limit of the damage assessment and maintenance amount abnormal range corresponding to the risk assessment level.
6. A system for insurance claim risk screening based on location data, the system comprising:
the basic information acquisition module is used for acquiring basic information of the insurance inspector entering and exiting the automobile repair factory by utilizing positioning equipment on the insurance inspector;
the risk assessment module is used for carrying out risk assessment on the automobile repair factory accessed by the insurance inspector according to the basic information of the automobile repair factory accessed by the insurance inspector in combination with the first risk assessment model and the second risk assessment model to obtain a risk assessment level;
and the management and control early warning module is used for carrying out different levels of risk management and control and risk early warning on the insurance policy of the automobile repair factory in the insurance investigation process according to the risk assessment levels and combining the damage assessment and maintenance amount abnormal range corresponding to each risk assessment level.
7. The system of claim 6, wherein the basic information acquisition module comprises:
the positioning monitoring module is used for recording the position information of the insurance surveyor in real time by utilizing positioning equipment on the insurance surveyor;
the first information extraction module is used for extracting first basic information of the insurance surveyor entering and exiting the automobile repair shop under the condition of no risk from the position information; wherein the first type of basic information comprises the position of a garage, the name of the garage and the number of times that an insurance surveyor enters the garage under the condition of no danger;
the second information extraction module is used for extracting second type basic information of the insurance surveyor entering and exiting the automobile repair shop under the condition of danger from the position information; wherein the second type of basic information comprises an estimated loss amount, a maintenance amount and a customer satisfaction evaluation score value under the dangerous situation.
8. The system of claim 6, wherein the risk assessment module comprises:
the first risk assessment module is used for extracting first type basic information in the basic information, carrying out risk assessment on the automobile repair shop by combining a first risk assessment model, and obtaining a first risk assessment value of the automobile repair shop;
the primary risk judging module is used for determining that the current automobile repair shop has primary risk when the first risk evaluation value exceeds a preset first risk evaluation threshold value, and carrying out primary risk identification on the automobile repair shop;
the second risk assessment module is used for extracting second type basic information in the basic information, carrying out risk assessment on the automobile repair factory by utilizing the second type basic information and combining a second risk assessment model and a primary risk identifier, and obtaining the risk assessment level of the automobile repair factory.
9. The system of claim 8, wherein the second risk assessment module comprises:
the evaluation value acquisition module is used for extracting second-type basic information in the basic information, carrying out risk evaluation on the automobile repair shop by combining a second risk evaluation model, and acquiring a second risk evaluation value of the automobile repair shop
A target object determining module, configured to determine the auto repair shop as a target object when the second risk assessment value exceeds a preset second risk assessment threshold;
the risk grading module is used for judging whether the target object has a primary risk identifier, and when the target object has the primary risk identifier, the automobile repair shop corresponding to the target object is considered to be a high-level risk; and when the target object does not have the primary risk identification, the automobile repair shop corresponding to the target object is considered as a medium-level risk.
10. The system of claim 6, wherein the control pre-warning module comprises:
the first range setting module is used for setting an abnormal range of the maintenance amount for the automobile repair shop with the risk assessment level of primary risk;
the second range setting module is used for setting an abnormal range of the maintenance amount for the automobile repair shop with the risk assessment level of intermediate risk;
a third range setting module, configured to set a maintenance amount abnormal range for an automotive repair shop whose risk assessment level is a high-level risk;
and the monitoring and early warning module is used for performing risk management and control on the actual damage assessment and the maintenance amount under the dangerous situation in the damage assessment and maintenance amount abnormal range corresponding to the risk assessment level of the automobile repair factory, and performing risk early warning when the actual damage assessment and the maintenance amount exceed the upper limit of the damage assessment and maintenance amount abnormal range corresponding to the risk assessment level.
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