JP2009230380A - Support method and support system of maintenance procedure processing, and computer program for making computer execute support of maintenance procedure processing - Google Patents

Abstract

<P>PROBLEM TO BE SOLVED: To smooth a maintenance operation by providing information useful for efficiently processing a maintenance procedure for an insurance contract. <P>SOLUTION: The method comprises: steps of receiving input of claim information including contract identification information and a claim content and determining a type of maintenance procedure; specifying a contract of the claim object from a contract information DB based on the contract identification information, and searching change history information of the contract; specifying, based on the type of maintenance procedure, a decision reference of the maintenance procedure from a decision reference table; determining and outputting a decision level in reference to the change history associated with the decision reference, the change history information of the contract searched from the contract information DB and the claim content contained in the claim information; receiving input of decided information showing completion of the maintenance procedure related to the claim according to the decision level; and updating, upon input of the decided information, the contract information and change history information stored in the contact information DB according to the claim information. <P>COPYRIGHT: (C)2010,JPO&INPIT

Description

  The present invention relates to an insurance company computer system comprising an input device, an output device, a control device, and a storage device for storing computer software. The present invention relates to a method for supporting processing of a maintenance procedure, a system for executing the method, and a computer program for causing a computer system to execute the method.

  Life insurance contracts often have long-term contract relationships ranging from several years to several tens of years, so the contractor's lifestyle and home environment change during that period, often requiring changes to the contract details. . Such contract information is changed by a maintenance procedure in which a contractor, an heir, or the like requests various changes from the insurance company. When an insurance company receives a request from a policyholder, the insurance company presents the customer with a predetermined invoice prepared by the insurance company, and fills in necessary information such as contract information and the address and name of the policyholder, seals, and required attached documents. Get back with. The insurance company also checks the invoices received (including attached documents; the same shall apply hereinafter) against the internal approval criteria, and if any are found deficient, the customer points out deficiencies and requests corrections. ing.

  Such invoices are inspected by a person in charge of office work based on experience, checklists of inspection items, and the like. In general, there are more than 100 types of claims, such as changes in insurance premiums paid, changes in insurance amount, changes in recipients, changes to contracts such as addition / change / cancellation of special contracts, cancellations, etc. However, since there are hundreds of patterns depending on the presence or absence of special contracts, it is difficult to check accurately and promptly after checking the inspection items for each claim. In addition, the number of such claims is several million per year for large life insurance companies, so it is not easy to secure personnel for inspections and educate them, which causes an increase in costs. ing.

  In addition, in order to notify customers of invoice incompleteness, it is common to use a standard notification form to improve business efficiency. However, as described above, invoices are provided for various types of variations. Therefore, it is not easy to point out the details that are incomplete in this standard notice in a concrete and easy-to-understand manner. For this reason, there is a possibility that a defect occurs between the customer and the correction request is made multiple times. Appropriate skills are required to point out such incompleteness of the invoice, which increases the human burden of inspection.

  On the other hand, when finalizing the billing procedure (update the master file after inspection / approval), the clerks enter all billing items such as the security number and billing details on the in-house online entry screen. . For this reason, the input work is complicated and human error is likely to occur.

  Furthermore, until the billing procedure is completed, only a limited number of persons, such as departments in charge and persons in charge, are able to grasp the progress. For this reason, if it takes a long time from receipt of an invoice with a name or seal from a customer to completion, it is not possible to promptly answer when a customer makes a call to the call center or the like.

  In order to solve the above-described problems, for example, in Patent Documents 1 to 4 below, various methods for improving the efficiency of insurance company operations have been proposed.

JP 2002-117226 A JP 2002-189853 A JP 2002-230269 A JP 2002-28897A

  By the way, in any of the above-described conventional techniques, when a maintenance procedure is requested, it is only necessary to inspect the suitability of the procedure, such as the form of the invoice and attached documents, and the relevance to other related procedures. Not checked until. So, for example, when accepting and processing an application for a loan based on an insurance contract, and accepting an application for a reduction in the insurance amount for the same insurance contract, if you proceed in the order received, as a result You will be allowed to lend beyond the limit.

  On the other hand, assuming such a case, checking the relevance of all of a huge number of maintenance procedures with other related procedures in addition to the current check items is a quick and efficient maintenance task. Processing is hindered, and there are problems in terms of customer service and costs.

  The present invention has been made to solve such a problem, and provides maintenance information by providing useful information for efficiently processing the maintenance procedure of the insurance contract, and also by changing the contract information. The purpose is to provide a method, a system, and a program for grasping the influence on the maintenance work and smoothly carrying out the maintenance work.

  According to a first main aspect of the present invention, insurance from a customer who has concluded a life insurance policy by a computer system of an insurance company comprising an input means, an output means, a control means, and a storage device for storing computer software. A method for supporting processing of maintenance procedures such as billing of money, change of contract contents, etc., wherein the storage device is a method of paying insurance policyholders and insured personal information, types of special contracts, and insurance premiums A contract information database (DB) that stores information on life insurance contracts such as these, and change history information including the date and items when these pieces of information are changed, in association with the contract identification information, and a number of types of maintenance procedures An approval criteria table that stores at least the approval criteria set in relation to the change history, and in this method, the claim accepting means includes the contract identification information and the contract. A bill accepting step for accepting input of billing information including contents, and a search means identify a contract to be billed from the contract information DB based on the entered contract identification information, and retrieve change history information of the contract A search step, and an approval criteria specifying means for searching the approval criteria table by the type of the maintenance procedure determined based on the received claim information, and an approval criteria specifying step of specifying the approval criteria of the maintenance procedure, The level determination means refers to the maintenance procedure with reference to the change history associated with the specified approval criteria, the change history information of the contract retrieved from the contract information DB, and the charge content included in the charge information. An approval level determination step for determining and outputting the approval level of the approval authority and necessary documents, and the approval level at which the approved information receiving means determines the maintenance procedure related to the claim. Accordingly, the accepted information receiving step for accepting the input of the approved information indicating that it has been completed, and the contract information updating means when the approved information is input, the contract information stored in the contract information DB according to the claim information. And a contract information updating step for updating the information and the change history information, respectively.

  In this context, “maintenance procedures” in life insurance companies generally include changes in the names of policyholders and insured persons, changes in the contents of main contracts, cancellations, additions and cancellations of special contracts, contractor loans, hospitalization benefits, It is a general term for procedures for insurance claims, etc., and processing this maintenance procedure by an insurance company is called maintenance work.

  This maintenance procedure is distinct from the “simple change procedure” for changing specific items that have a very low impact on policyholders. This “simple change procedure” accepts changes to specific items after confirming that the contract is the subject of the contract with the insurance policy number, name, etc., by telephone, fax, sales office, etc. Update DB. In other words, it is not necessary to submit an invoice or make a decision at the head office.

  In addition, “decision criteria” in this specification is a standard that is preliminarily set according to the type of maintenance procedure, and information such as the authorization authority (authorizer level) and necessary certificates (attached documents) included. On the other hand, “decision level” refers to procedural mistakes related to the interests of customers and insurance companies, such as loans exceeding the above limit and sending documents to persons other than insurance contracts. The decision criteria are specifically modified according to the possibility (risk level), and are individually determined specifically in relation to the types of maintenance procedures, change history information, billing information, and other procedures that are simultaneously continued. The

  Furthermore, “customer” generally refers to an “insurance policyholder” who has signed an insurance contract with an insurance company, but there are not a few contracts between the policyholder and the insured person, and any person applies for the maintenance procedure. there is a possibility. Therefore, in this specification, unless otherwise specified, all persons who can request maintenance procedures are referred to as “customers”.

  In addition, according to the second main aspect of the present invention, there is provided an input means, an output means, a control means, and a storage device for storing computer software. It is a system that supports the processing of maintenance procedures such as content changes, and information on life insurance contracts such as personal information of insurance policyholders and insured persons, types of special contracts, and payment methods for premiums (payments), etc. The relationship between at least the change history for each type of maintenance procedure, and the contract information database (DB) that stores the change history information including the date and item when the information is changed in association with the contract identification information. An approval criteria table for storing the approval criteria set in step (b), billing acceptance means for accepting input of billing information including contract identification information and billing details, and based on the entered contract identification information. Based on the type of the maintenance procedure determined based on the received billing information and the search means for identifying the contract to be billed from the contract information DB and retrieving the change history information of the contract. Included in the claim information is an approval criteria specifying means for specifying the approval criteria for the maintenance procedure from the table, a change history associated with the specified approval criteria, change history information of the contract retrieved from the contract information DB, and the billing information And the approval level determination means for determining and outputting the approval authority of the maintenance procedure and the approval level of necessary documents, and the maintenance procedure related to the request has been determined according to the determined approval level. The accepted information receiving means for accepting the input of approved information indicating that, and when the approved information is input, stored in the contract information DB according to the billing information System characterized by about information and the change history information and a contract information updating means for each update is provided.

  Further, according to the third main aspect of the present invention, a customer who has concluded a life insurance contract with a computer system of an insurance company having an input means, an output means, a control means, and a storage device for storing computer software. A computer program for executing processing for supporting processing of maintenance procedures such as claiming insurance claims, changing contract contents, etc., wherein the storage device stores personal information of insurance policyholders and insured persons, types of special contracts A contract information database (DB) for storing life insurance contract information such as insurance premium (payment) payment method and change history information including the date and items when the information is changed in association with the contract identification information. ) And an approval criteria table that stores at least the approval criteria set in relation to the change history for each type of maintenance procedure. The bill is received from the contract information DB based on the inputted contract identification information by the charge receiving procedure in which the charge receiving means receives the input of the billing information including the contract identification information and the billing contents. And a search procedure for searching the change history information of the contract, and the approval criteria specifying means from the approval criteria table based on the type of the maintenance procedure determined based on the accepted claim information. The approval criteria specifying procedure for specifying the approval criteria, the approval level determination means, the change history associated with the specified approval criteria, the change history information of the contract retrieved from the contract information DB, and the billing information An approval level determination procedure for determining and outputting the approval authority of this maintenance procedure and the approval level of required documents, etc., with reference to the contents of the included claims, and the approval information receiver However, when the finalized information acceptance procedure for accepting the input of finalized information indicating that the maintenance procedure related to the request has been completed according to the determined final approval level, and when the finalized information is input, the contract information updating means And a contract information update procedure for updating the contract information and the change history information stored in the contract information DB according to the billing information, respectively.

  According to the present invention, based on the relevance of the contract information change history, the authority for approval (branch approval or head office approval, etc.) and necessary attached documents (such as certified copy of family register or seal certificate issued within a predetermined period) Judgment level was decided. Such a determination result of the approval level is very useful information for smoothly performing the approval operation and various administrative procedures before and after the approval operation. In particular, even a person who is unfamiliar with the paperwork of maintenance procedures can quickly perform appropriate in-house processing according to the type of maintenance procedure received.

  In addition, when judging the above-mentioned decision level, the contract information change history related to the maintenance procedure is referred to, so that procedural mistakes associated with the change of the contract information can be easily detected and appropriately processed. Can do.

  Furthermore, referring to the change history of the contract information as necessary, there is also a secondary effect that the following inappropriate acts can be prevented. For example, a third party who does not have a claim right applies for a procedure to change the policyholder's address or beneficiary without the knowledge of the policyholder, and immediately impersonates the policyholder to claim the insurance amount or amount Suppose you apply for conservation procedures such as lowering the price. In such a case, if the insurance company does not check the relevance to the change history of the contract information related to the maintenance procedure requested later, notification of payment of the premium or payment of the adjusted premium due to reduction will be issued. , It will be sent to the new address or sent to the new recipient. Such an act can be effectively prevented by referring to the change history of the contract information. In addition, since the decision criteria (whether to refer to the change history, etc.) are specified based on the type of maintenance procedure, smooth processing of maintenance work is not hindered.

Hereinafter, embodiments of the present invention will be described with reference to the drawings.
FIG. 1 is a network configuration diagram of an embodiment of the present invention. The maintenance work processing system (maintenance procedure processing support system) denoted by reference numeral 1 in this figure is a branch office that supervises a plurality of sales offices and branch offices (hereinafter collectively referred to as “branches”) 3 of the life insurance company 2. One or two or more computer systems provided in a branch / service center (SC) or a head office (hereinafter collectively referred to as “head office”) 4 are configured in cooperation. This system 1 has a new contract conclusion function for newly signing an insurance contract with a customer (potential contractor) 5, a maintenance work function for accepting and processing a change of contract information from the customer 5 who has concluded the contract, and It has an information management function for registering / updating personal information and contract information of the contractor 5 in the database, and receiving and processing inquiries. That is, this maintenance work processing system 1 is provided with various well-known functions such as a customer information management server, contract information management server, staff information management server, WEB server, and approval processing system, as well as maintenance work support unique to the present invention. It has a function. In the following, for convenience of explanation, it is assumed that the maintenance work processing system 1 is composed of the main frame of the head office 4.

  The maintenance work processing system 1 is connected to branch terminals 6 installed in a large number of branches 3 throughout the country via an in-house communication line network such as a LAN or WAN, or a public line network such as the Internet. The various requests from the customer 5 described above are made by the person in charge of the branch 3 from the customer 5 who has visited the branch 3 (an office worker, a sales person, a call center power-receiving person, etc .; hereinafter collectively referred to as a “branch person in charge”). Information received verbally or by phone is input to this terminal 6, or information received by the sales representative at the home or work place of the customer 5 is transmitted from the mobile terminal to this terminal 6 via a communication line. The information is transmitted to the maintenance work processing system 1. The customer 5 can log in to the user page on the WEB with the communication terminal 9 such as his / her own PC and directly input it to the maintenance work processing system 1 via the WEB server.

  Here, in order to change the contract details, a simple change procedure that can be received verbally at the telephone, fax, or branch office 3 and processed by the person in charge, and an invoice in a prescribed format with the necessary documents attached are submitted. There is a maintenance procedure that is approved according to predetermined approval standards. In this embodiment, in any change procedure, the branch person in charge inputs the identification information (insurance policy number, etc.) of the insurance contract related to the change and the change contents from the branch terminal 6 and performs maintenance work via the in-house communication network. It is transmitted to the processing system 1 and recorded and managed as change history information for each contract. Regarding the maintenance procedure, the contract information is updated after a predetermined approval process. Then, with respect to the maintenance procedure related to the contract requested thereafter, an approval process (maintenance work) is performed with reference to the change history information.

  Next, with reference to FIG. 1, the outline process of the maintenance work process in this embodiment is demonstrated. In the following example, the customer 5 applies for a maintenance procedure at the counter (telephone) of the branch 3.

  First, the customer 5 applies for the change of the contract information by presenting the identification information (insurance policy number, etc.) of the insurance contract and the items and contents to be changed at the window of the branch 3 of the insurance company 2 (S1). The branch person in charge inputs the application information presented by the customer 5 to the branch terminal 6 and transmits it to the maintenance business processing system 1 of the head office 4 (S2). The maintenance business processing system 1 identifies a target contract based on the received application information. Here, when the operator or manager of the head office determines and inputs the type of the maintenance procedure based on the billing information, the maintenance work processing system 1 determines the approval criteria for the procedure, and the personal information of the customer 5, the contract information, Invoice data is generated by combining the identification information (bar code) of the maintenance procedure (S3). At this stage, the progress management of the maintenance procedure is started. In addition, a maintenance procedure type table in which billing information and a maintenance procedure type are associated and registered is provided in the branch terminal 6 and the maintenance work processing system 1, and the type of maintenance procedure is automatically determined based on the received billing information. It may be.

  Next, the maintenance work processing system 1 outputs the generated bill data to a printer, prints the bill for the maintenance procedure (S4), and sends it to the customer 5 by mail (S5). At this time, in accordance with the above-mentioned approval criteria, it is preferable to print and enclose a cover sheet clearly stating the billing procedure and necessary attached documents.

  When the customer 5 returns the invoice filled with necessary items and the necessary attached documents to the branch 3 (S6), the person in charge of the branch prints the invoice with the barcode reader 8 connected to the branch terminal 6 The read barcode is read (S7), and the identification information of the maintenance procedure is transmitted to the maintenance work processing system 1 (S8). The maintenance business processing system 1 searches the database for the contract and maintenance procedure information to be targeted from the received maintenance procedure identification information, and collects information such as the checklist of this maintenance procedure and the authorizer from the database, and performs the approval process. Is executed (S9). When the approval process is completed, the contract information is updated according to the contents of the request (S10). Further, procedure completion notice data for notifying the customer that the maintenance procedure has been approved is generated (S11) and output from the printer (S12). Then, the printed procedure completion notice is sent to the customer 5 by mail or the like (S13). Note that the maintenance procedure invoice data and procedure completion notice data described above may be transmitted to a data center or the like for printing and shipping to the customer.

Next, with reference to the functional block diagram of FIG. 2, the configuration of the maintenance work processing system 1 of the present embodiment that performs the above-described functions will be described.
As shown in FIG. 2A, the system 1 is connected to a CPU 11 of a mainframe (computer system) installed in a head office 4 or the like via a system bus 12 with an external storage device 14 such as a RAM 13, a magnetic disk, and an input / output. An interface (I / F) 15 is connected. An input device 17 such as a keyboard and a mouse, an output device 18 such as a liquid crystal display, and a communication device 19 such as a modem are connected to the input / output I / F 15. The storage device 14 includes a data storage area 14a and a program storage area 14b, and a software program that implements the functions of the present invention is installed in the program storage area 14b.

  In such a hardware configuration, the person in charge of the branch inputs various data from the branch terminal 6 and transmits it to the maintenance work processing system 1, and the operator of the head office 4 and the person who makes the decision receive various data from the input device 17. By inputting, the CPU 11 reads out the software program, loads it onto the RAM 13 and executes a predetermined procedure, thereby performing the functions of the present invention in cooperation with the OS (operation system).

  As shown in FIG. 2B, the data storage area 14a of the storage device 14 includes a contract information database (DB) 22, an approval criteria table 23, a checkpoint table 24, a progress management database (DB) 25, and invoice information. A database (DB) 26 and a guide sentence table 27 are provided. Part or all of the data managed in these databases and tables is managed by the master file of the data center that centrally manages various data, and is synchronized with each database etc. at a predetermined cycle, mirroring, etc. It is configured so that it can be distributed at multiple branch offices.

  The contract information DB 22 includes the name of the policyholder / insured person, the family structure, the customer's personal information such as the date of customer registration, the information of the branch in charge and the person in charge, the payment status of insurance premiums, Information that is the basis of an insurance contract such as a supply history, and change history information including the date and items when these pieces of information are changed are stored in association with the contract identification information (such as an insurance policy number). When one customer 5 has concluded a plurality of insurance contracts, this contract information DB 22 displays the change history of all contracts with identification information (customer management number, insurance policy number of the first contract, etc.). Store in association with.

  Insurance contracts continue for a long period of time, and customer lifestyles change during that time, so it is often necessary to review contracts and change personal information. Therefore, in addition to bibliographic items such as address, name, and work place, we decided to register changes in the contract itself as change history information.

  The approval criteria table 23 stores approval criteria set in relation to the above-described contract information change history, customer attributes, maintenance procedure types, and the like for each of a number of maintenance procedure types. Specifically, as shown in FIG. 3, the authority for approval, the type of attached document, the storage period of the invoice, and the like are stored for each type of maintenance procedure. The type of the maintenance procedure is classified according to, for example, whether payment of money to the customer 5 occurs and the payment amount in order to be linked to the risk of the action to be prevented. Then, for each type of maintenance procedure, a criterion is set as to whether to refer to the change history information of the contract to be billed or the change history information of another contract of the customer 5. Even if there is no problem if you look only at individual maintenance procedures and simple change procedures, there is a possibility that the risk will increase when combined with the types of maintenance procedures before and after and the details of the request (conditions). In order to prevent inadequate processing such as payment and overpayment and the action of a third party without a claim right, it is preferable to refer to the change history information of the target contract.

  For example, if the transfer account information has been changed immediately (within a few months) immediately before claiming insurance claims or policyholder loans, there is no risk if the account holder after the change is the contractor itself, Transfer instructions to accounts other than contractors are risky. In addition, after completion of the maintenance procedure, a completion report is sent to the registered address of the claimant, including the meaning of confirmation of validity, but the address immediately before the claim for insurance claims and policyholder loans (within several months) If changes have been made, insurance claims may be made by third parties without the customer's knowledge. Although it is practically impossible for clerks, finalists, etc. to quickly and accurately determine the degree of risk corresponding to many combinations of types of maintenance procedures, billing details, and change history information. This can be done by referring to the approval criteria table 23 and the contract information DB 22. In addition, it is preferable to make a distinction in the application channel because the mail application has a higher risk than the case where it is applied in front of the branch office or the customer's home.

  Here, it generally takes several days to two weeks for the maintenance procedure invoice to be finalized after being returned from the customer 5, so a plurality of pending maintenance procedures for one contract are pending at the same time. It is possible. Depending on the type of the maintenance procedure, there is a risk that inconsistency will occur when processing is performed in the received order, and it is infamous to refer to the above-described change history information. For example, if a request for “change in payee” or “change in bank account” is requested first, followed by “insurance payment”, it may be a request from a third party without a claim. There is. In addition, if “cancellation of this contract” is requested first and “addition of special contract” is requested immediately thereafter, the previous maintenance procedure is likely to be an error of the customer 5.

  For this reason, the approval criteria table 23 of the present embodiment includes a plurality of second approval criteria including the approval order, approval level, or necessary attached documents when a plurality of maintenance procedures for one contract are continued at the same time. It is stored in association with the type of maintenance procedure. In particular, for maintenance procedures involving payment of cash, in addition to past change history information stored in this contract information DB 22, it is possible to prevent claims from third parties who have no claim for other ongoing maintenance procedures. Therefore, it is preferable to strictly determine the approval criteria, such as submitting multiple types of identity verification documents (licenses, insurance cards, etc.). In addition, since the simplified change procedure also increases the risk of inappropriate acts in relation to a specific maintenance procedure, the second procedure is similar to the above even when the maintenance procedure and the simple change procedure are continued at the same time. It is preferable to be subject to approval criteria. Specifically, in this second approval criteria, when an address change request is made during insurance claim processing, or vice versa, an insurance claim is made immediately after the address change, etc. Includes suspending the processing of the previous claim or both claims. In this case, the progress management DB 25 and the contract information DB 22 are both flagged (maintenance procedures and simple change procedures) with a flag indicating that they are “procedures requiring attention” to prompt the attention of the authorizer.

  The checkpoint table 24 associates checkpoints for the person in charge of the branch and the employees in the examination department of the head office 4 to determine whether or not the description contents of the invoice returned from the customer 5 and the attached documents are appropriate, with the type of maintenance procedure. To store. Checkpoints include, for example, “change in payee”, “whether it is a charge from the customer,” “is there any other contract for this customer,” “has confirmed the change history,” “from attached document issuance Checkpoints such as “within 6 months” are stored. As will be described later, if checked information is not input to all checkpoints, the process does not proceed to an approval process (circulation to the approver, input of approved information, etc.).

  The progress management DB 25 stores the processing status of the maintenance procedure in association with the contract identification information (insurance policy number). In addition, as described above, when a plurality of maintenance procedures or maintenance procedures and simple change procedures are continued for one contract identification information, the processing statuses are stored in association with each other.

  The invoice information DB 26 stores the types of attached documents necessary for each maintenance procedure and the invoice format of each maintenance procedure in association with the types of maintenance procedures. As shown in FIG. 4, the invoice form includes a bar code indicating a column signed by the customer 5, a display column for information on insurance contracts, a display column for billing information for maintenance procedures, and identification information for maintenance procedures. And have.

  Here, the necessary attached documents are registered in the above-mentioned approval criteria table 23, but differ depending on the request information of the maintenance procedure. For example, maintenance procedures that require insurance companies to pay cash to customers, such as claims for insurance claims and cancellation of special contracts, may be overpaid. The type of attached document varies depending on the amount charged. For example, depending on the amount billed, 1) identity verification documents (copies of licenses, etc.) only 2) identity verification documents and medical institution certificates (medical certificates, etc.) 3) identity verification documents, medical institution certificates and public Set in multiple stages, such as documents issued by public institutions (such as seal certificates). For death insurance claims, regardless of the amount, official documents such as family register copies showing the relationship between the policyholder and the insured (bereaved family, etc.) are attached. On the other hand, procedures such as changing work or home phone numbers are less relevant to overpayments and double payments, so the attached documents are simplified or unnecessary.

  The guidance sentence table 27 stores incomplete descriptions of invoice items, explanations of incomplete attached documents, and explanations of correction contents for eliminating these insufficiency in association with the types of incompleteness. When the invoice for the maintenance procedure sent back from the customer 5 is checked by the administrative staff such as the branch 3 or the head office 4 as a result of checking the above checkpoints, a guideline will be generated as described later. The means 40 can automatically generate a defective manual to be sent to the customer 5 by selecting and synthesizing an appropriate explanatory text sample from the guidance text table 27.

  Further, as shown in FIG. 5, the guide sentence table 27 also stores templates such as a bill guide form and explanatory text. In this guide, a document (health insurance card, driver's license, etc.) to be attached to the invoice and an explanation of the conditions (expiration date, description items, etc.) are written. The customer 5 prepares necessary documents with reference to the guide, signs and seals the bill, and returns it to the branch of the insurance company 2 or the like.

  As shown in FIG. 2B, the software program installed in the program storage area 14b includes a bill receiving means 30, a contract information search means (billing content determination means, alarm output means) 31, an approval criteria specifying means 32, Approval level determination means 33, invoice data generation means (invoice information search means, invoice output means) 34, approved information reception means 35, progress management means 36, contract information update means 37, and maintenance work support means (check) Point output means, checkpoint input accepting means, checkpoint monitoring means, and guidance sentence creating means) 38. Each of these means is actually an independent program, routine, subroutine, module or the like, and the computer system functions as each means by causing the CPU 11 to execute the program procedure on the RAM 13. .

  The bill accepting unit 30 accepts input of billing information including contract identification information and billing contents transmitted from the branch terminal 6 or input by the operator such as the head office 4 via the input device 17 and stores it in the storage device 14. To store. When the customer 5 applies for the maintenance procedure from the user-dedicated page on the WEB, the bill accepting means 30 obtains billing information via the WEB server. Based on the received billing information, the person in charge of the branch or the manager determines whether the procedure is a maintenance procedure or a simple change request procedure. If the procedure is a maintenance procedure, the type is identified and input. The claim receiving means 30 may determine the type of maintenance procedure based on a determination table or the like. In this case, since the items that can be changed by the simple change request procedure are limited, the branch terminal 6 may determine whether it is a maintenance procedure or a simple change request procedure.

  The contract information search means 31 searches the contract information DB 22 for the contract information to be billed and the change history information of the contract based on the input contract identification information, and temporarily stores it in the memory. Here, customer 5 may have multiple insurance contracts, but the name (new name and maiden name, differences in kanji, etc.), telephone number, and workplace of the policyholder, policyholder, or insured Since certain items such as insurance receipt information are common to multiple contracts for the same person, if changes are applied for only some contracts, forgetting the existence of other contracts It is likely that this is a procedure by a third party who does not have a claim. Therefore, in such a case, it is preferable to output an alarm notifying that a change request has not been issued for other contracts, in addition to the normal approval rule of the maintenance procedure, making the personal authentication level more strict. .

  Therefore, the contract information search unit 31 of the present embodiment has a function of determining whether the requested content of the maintenance procedure is a change related to a specific item among items common to the plurality of contracts of the customer 5; A function for specifying all other contracts of the customer 5 in addition to the contract to be billed from the contract information DB 22 in the case of a change of a specific item, and searching for the contract information and change history information; And a function of outputting a predetermined alarm when the change of the specific item is not performed for another contract with reference to the change history information regarding all the contracts made. Specifically, a predetermined message is transmitted to the branch terminal 7 for display, or guidance document data to be sent to the customer 5 is generated and output to the printer. As described above, the approval criteria when such a plurality of contracts exist are also registered in the approval criteria table 23.

  The approval criteria specifying means 32 specifies the approval criteria for the maintenance procedure from the approval criteria table 23 based on the type of maintenance procedure determined by the claim receiving means 30 and passes it to the approval level determination means 33. The specified approval criteria is specifically composed of numbers and symbols of about several to 10 digits, whether or not reference to the change history information is necessary, codes of specific items to be watched in the change history information, Includes identification information for the approval level (branch / headquarters, official code of the approver, etc.) and the required attached documents (whether only identity verification documents or certificates of medical institutions or public institutions are required) . Note that the specified approval criteria may be implemented as program logic.

  The approval level determination means 33 refers to the change history associated with the specified approval criteria, the change history information of the contract retrieved from the contract information DB 22, and the charge content included in the charge information. It determines and outputs the approval authority for maintenance procedures and the approval level of necessary documents. Specifically, the update date and update item of the contract information retrieved from the contract information DB 22, the determined maintenance procedure type and billing content, the maintenance procedure type and change history registered in the approval criteria table 23 Judgment level is determined according to the relevance.

  The approval level is different from the approval standards that are determined uniformly according to the type of insurance contract and the type of maintenance procedure. It is necessary to consider the relationship with other procedures and the relationship with other contracts of the customer 5.

  For example, in relation to the change history information, mispayment or double payments, etc., when the maintenance procedure is “insurance claim” and the recipient is changed one week ago and when it is changed three years ago. Therefore, it is preferable to make the decision level different accordingly. Further, if the maintenance procedure is “name change / name change procedure”, the change time of the recipient does not affect the double payment, and therefore it is not necessary to consider this change history information when determining the approval level.

  In relation to the contents of claims for the maintenance procedure, even if the claim is the same, the impact of double payment etc. is marked in the claim for 10,000 yen hospital visit and the claim for death insurance of 10 million yen. Different. Even if special contracts are added or changed, there are those that cannot be added due to the medical history or occupation of the insured.

  In addition, in relation to other procedures, when multiple maintenance procedures continue for one contract at the same time, or in the past change history information with specific items such as address change and insurance transfer account change The magnitude of influence varies depending on the relationship. Other procedures in this case include both maintenance procedures and quick change procedures. That is, when the approval level determination means 33 receives the second maintenance procedure or the simple change procedure for the same contract as the first maintenance procedure before the approval, the type of the first or second maintenance procedure, or Based on the type of the simple change procedure, the approval level is determined by searching the approval criteria table for the second approval criteria.

  In relation to other contracts, as described in the contract information search means 31, the change history information of all contracts of the customer 5 searched from the contract information DB 22 is referred to, and is common among a plurality of contracts. The approval level is determined based on whether the item has been changed. Note that the contract information search condition may be set in relation to the product type, procedure type, customer attribute, and the like.

  The invoice data generation means 34 determines the invoice format of the maintenance procedure and the necessary information from the invoice information DB 26 based on the determined maintenance procedure type and the approval level determined by the approval level determination means 33. A function for retrieving information on attached documents, a function for generating maintenance procedure identification information in the form of a bar code in association with the policy number of a contract related to maintenance procedures, and information on attached documents in the retrieved invoice format The invoice data generated by combining the extracted contract information and the generated bar code is output to a printer, the invoice for the maintenance procedure (see FIG. 4) is printed, and sent to the customer 5 by a method such as mailing. It has the function to do.

  The progress management means 36 has a function of registering and managing the processing status of the billing procedure in the progress management DB 25. Specifically, when the bill receiving unit 30 receives billing information from the customer 5 via the branch terminal 6, the bill data generating unit 34 generates bill data and transmits the bill to the customer 5. When the maintenance work support means 38 generates guidance text data explaining the incompleteness of the invoice and transmits the guidance text to the customer 5, and when the approved information receiving means 35 receives the approved information. The progress data including the contract identification information is received from each means, and the corresponding maintenance procedure is searched from the progress management DB 25 to update the progress information. The progress management means 36 accepts input of the maintenance procedure identification information (bar code) when the invoice is returned from the customer 5 and the status information when the invoice is circulated to the approver. The progress management DB 25 is updated.

  The contract information updating unit 37 acquires the identification information of the maintenance procedure approved from the approved information receiving unit 35, specifies the maintenance procedure from the contract information DB 22, and follows the billing information acquired by the claim receiving unit 30. The contract information and change history information stored in the contract information DB 22 are updated. The contract information updating means 37 also has a function of accepting a contract information change request based on the simple change request procedure described above, updating the contract information registered in the contract information DB 22 and registering the update date. Have.

  The maintenance work support means 38 has a function for supporting the work for the clerks to check the invoice returned from the customer 5 and generates guidance text data when the invoice is found incomplete, and sends it to the customer 5. It has the function to do.

  First, the invoice check business support function reads the invoice bar code returned from the customer 5 by the bar code reader 8 connected to the branch terminal 6 and transmits the maintenance procedure identification information. The type of the maintenance procedure is specified from the contract information DB 22, all checkpoints of the maintenance procedure are extracted from the checkpoint table 24, a check list (see FIG. 8) is generated and returned to the branch terminal 6. . The returned checklist is displayed on the display of the branch terminal 6, and the branch person in charge checks the incompleteness of the bill while looking at the checklist. As a result, human errors can be avoided, and inexperienced personnel can check bills with the same accuracy and speed as veteran employees. The check list may be printed and sent to the branch by mail or the like.

  In addition, when the person in charge of the head office 4 or the service center checks the invoice, the generated check list is displayed on the display (18) of the maintenance work processing system 1 as it is. In the following, an example will be described in which a check list is displayed on the branch terminal 6 and the branch person in charge checks the invoice.

  The results of checking the invoice invoices, the types of attached documents, the expiration date, etc., by the branch person in charge, for example, check the radio button written at each check point, or are active by default. Change the "Unconfirmed" button to "Confirmed", or change the input box that displays "false" or "Unconfirmed" to "true" or "Confirmed" by pull-down. The entered checked information is transmitted to the maintenance work processing system 1.

  The maintenance work support means 38 monitors whether or not the checked information has been acquired for all the checkpoints, and when all the checked information has been acquired, the decision-making authority (the branch office) of the approval level determined by the approval level determination means 33. Approval instruction information is output to a higher-level organization such as a branch office or a head office that supervises the above, and a cover sheet (see FIG. 9) is prepared to circulate the bill and attached documents. In other words, unless all checkpoints are checked, it is not possible to shift to the approval process. The approval instruction information is transmitted by the maintenance work support means 38 to the terminal of the approval organization (authorizer) by e-mail or the like, and is also transmitted to the progress management means 36 together with the identification information of the maintenance procedure. Thereby, the processing status of the progress management DB 25 is updated. In the decision-making body, a message indicating that there is an “unprocessed invoice” is displayed on the terminal, and the contract type and billing information of this maintenance procedure is displayed in the “unprocessed box”. Even in this case, the decision-making body (the decision-maker) must make a decision based on the decision document after the actual decision document (invoice, attached document, etc.) has been circulated. Or part or all of the display on the “unprocessed box” may be omitted.

  Next, the guidance text data creation function receives the input information when the person in charge of the branch finds the incompleteness of the invoice and inputs the incompleteness item on the incompleteness input screen (see FIG. 10), In addition to searching the invoice information DB 26 for amendments and their explanations, the contract information DB 22 is searched for the customer's name, insurance product name, maintenance procedure reception date, billing details, etc. This is a function for generating guidance document data shown in FIG. 11 by combining with a sentence form and outputting it to a printer. The guidance text printed by the printer is sent from the head office 4 to the registered address of the customer 5. As mentioned above, checkpoints for invoices vary widely depending on the type of maintenance procedure, the contents of the request, etc. Therefore, it is very troublesome and incomplete to create such incomplete explanatory documents one by one. It is necessary to acquire appropriate experience to convey the items and correction items accurately so as not to cause discomfort to the customer 5. Therefore, it is possible to prepare a guidance document for the customer 5 automatically only by designating incomplete items in advance, preparing incomplete invoice patterns, corrections, and explanations for each type of maintenance procedure. I made it. When this guidance document is returned from the customer 5, the invoice is checked again according to the check list described above by the branch person or the like.

Hereinafter, detailed functions of the system 1 will be described together with actual operations with reference to the flowchart of FIG.
First, when the customer 5 offers to change the contract information at a sales office or branch office, the branch person in charge inputs the insurance policy number and the bibliographic items of the customer 5 into the branch terminal 6, and the bill receiving means 30 inputs the information. The received information is received (S20). Based on this information, the person in charge of the branch discriminates and inputs the type of maintenance procedure (S21). At this point, the progress management means 36 generates maintenance procedure identification information, registers it in the progress management DB 25, and starts progress management (S22).

  Next, the approval criteria specifying means 32 is activated and searches the approval criteria table 23 for approval criteria related to the type of the determined maintenance procedure (S23). At the same time, the contract information search means 31 searches the contract information DB 22 for the change history information of the target contract (S24). According to the information collected in this way, the decision level determination means 33 determines the relationship between the maintenance procedure and the change history information according to the above-described method (S25).

  Here, if another contract exists for the contractor of the target contract (Yes in S26), the process returns to S24 to search for change history information related to the other contract. After repeating these processes for all contracts, the approval level determination means 33 monitors whether there are any pending maintenance procedures or simple change procedures for the same contractor (S27). If there are other simultaneous procedures (Yes in S27), the relevance with the approval criteria is determined again for the same purpose as referring to the change history. In addition to individual contract information, when basic information such as bibliographic items of customers is centrally managed in the customer database (DB), etc., when a change procedure for specific items such as address and name is accepted, You may make it update customer DB according to customer identification information etc., without referring to change history information of contract information DB22. In this case, it is preferable to perform a process such as outputting a warning so that even if a change of address is accepted for a part of the plurality of contracts, a decision cannot be made.

  At this time, the approval level determination means 33 determines the approval level of the maintenance procedure based on the collected data and the determination result (S28). Subsequently, the invoice data generation means 34 retrieves the invoice format from the invoice information DB 26, and generates invoice data by inserting contract information, contractor's personal information, etc. into the invoice format. The bill is printed (S29). At this time, the bill data generation means 34 transmits the maintenance procedure identification information to the progress management means 36 to update the maintenance procedure progress information (S30). This invoice is mailed to the registered address of the customer 5.

  When the customer 5 signs and seals the received invoice and returns it together with the instructed attachment (S31), the person in charge of the branch reads the identification information of the maintenance procedure with the barcode reader 8, and the maintenance business processing system 1 to send. Even at this time, the progress information of the maintenance procedure is updated (S32). Further, the maintenance work support means 38 creates a check list regarding the maintenance procedure and transmits it to the branch terminal 6 (S33). As described above, this check list is displayed on the display of the branch terminal 6.

  According to this check list, the person in charge of the branch determines whether or not the invoice is incomplete (S34). If there is no incompleteness, information indicating "Checked" is input to all check points (S35). Whether or not all “checked” information has been input is monitored by the maintenance work support means 38. If at least one “checked” information has not been input, the information is regarded as “incomplete” and is not transferred to the approval process. When all are checked, an in-house cover letter for delivering the invoice to the approver is printed from the branch terminal 6, and approval instruction information is transmitted to the approver terminal, management department, etc. (S36). At this point, the progress information is updated to “check completed” (S37). The person in charge of the branch attaches the above-mentioned in-house cover letter to the invoice and circulates it to a predetermined approval organization.

  On the other hand, if a deficiency in the invoice is found (when an incomplete item is received from the branch terminal 6 and a deficient invoice is received), the maintenance work support means 38 generates guidance text data for the customer 5. Then, the guidance text is printed (S38). This guidance text is also mailed to the registered address of the customer 5. At this time, the progress information is updated to “incomplete” (S39). The invoice with the incompleteness is enclosed in the guide sentence, and when the customer corrects the invoice according to the guide sentence and returns it, the process returns to S31 and the process is repeated.

  When the invoice arrives at the approver and the approver enters the approved information on the in-house terminal (S40), the contract information is instructed to be updated, and the progress information of the maintenance procedure is “completed (approved)”. (S41).

  Then, the contract information update unit 37 updates the information registered in the contract information DB 22 according to the contents of the request, registers the update date and the update item (change history) (S42), and the progress management unit 36 performs the maintenance procedure. The progress information is updated to “data updated” and the process is terminated (S43).

  Next, referring to the screen examples of FIGS. 7 to 13, invoice creation processing (S 29), inspection result input and bill delivery to the approver (S 33 to S 35), invoice Each process of the inquiry (S38) when there is a defect in the maintenance work and the progress inquiry of the maintenance work will be described.

First, the bill creation process (S29) will be described with reference to the screen example of FIG.
In this process, when the branch person in charge inputs an insurance policy number on a processing menu screen (not shown) displayed on the display of the branch terminal 6, the “trial calculation / invoice data creation screen” of FIG. 7 is displayed. On the left side of this screen, contract data retrieved based on the policy number is displayed. The person in charge of the branch checks “Invoice Creation” at the top of the screen, and then the customer 5 individually selects and inputs the conditions that the customer 5 desires to change. In this example, the main contract is not changed, and “reduction” and “cancellation” are claimed for a plurality of special contracts.

  When all items are selected and the “Send” button at the top left of the screen is pressed, a confirmation screen is displayed. On this confirmation screen, the person in charge of the branch confirms the changed premiums, the attributes of the claimant, etc., and then presses the “Send” button or the “Next” button. Transition. On this screen, when the destination is confirmed and the “Send” button is pressed, the input data, the retrieved contract data, etc. are transmitted to the maintenance business processing system 1 of the head office 4 and the invoice data generating means 34. Is instructed to generate bill data and guide document data. The generated invoice data and guidance document data are output to the printer 7, and the maintenance procedure invoice of FIG. 4 and the guidance document of FIG. 5 are printed and mailed from the head office 4 to the registered address of the customer.

Next, referring to the screen example of FIG. 8 and the example of the in-house cover letter of FIG. 9, the process of inputting the inspection result and distributing the invoice to the approver (S33 to S35) will be described.
This process starts when the person in charge of the branch reads the barcode (see FIG. 4) displayed on the invoice returned from the customer 5 with the barcode reader 8. The read identification information of the maintenance procedure is transmitted to the maintenance business processing system 1 of the head office 4, and the inspection input screen of FIG. 8 including the contract information and the check list of the maintenance procedure is generated and displayed on the branch terminal 6. The person in charge of the branch checks the invoices and attached documents returned from the customer 5 in accordance with the check items, and sequentially inputs the inspection results (any one of “OK”, “NG”, “?”) To the check points. If it is “OK” for all items, the “Send” button at the upper left of the screen is pressed to display the submitted document confirmation screen. If you check the type of document on this screen and press the “Send” button, the screen will move to the inspection result confirmation screen. When the check result and the like are finally confirmed on this screen and the “print” button is pressed, the in-house cover letter shown in FIG. 9 is sent to the printer 7 connected to the branch terminal 6. . At the same time, decision instruction information (warning, etc.) is sent to the decision maker terminal.

Next, the processing (S38) when the invoice is incomplete will be described with reference to the screen examples of FIGS. 10 to 11 and the example of the guidance sentence of FIG.
This process is started when at least one “NG” or “?” Is included in the check list on the inspection input screen shown in FIG. First, a deficiency input screen is displayed on the branch terminal 6 and accepts input of information related to the type of document among deficient items discovered by the person in charge of the branch. On the left side of this screen, change history information about this contract (in-process / file-updated information) is displayed to alert the branch staff.

  When the person in charge of the branch inputs a document type or the like on this screen and presses a “send” button at the upper left of the screen, a specific incomplete input screen shown in FIG. 10 is displayed. When the person in charge of the branch inputs a deficiency item on this screen and presses the “Send” button, contract information and deficiency information are transmitted to the maintenance work processing system 1 of the head office 4. When the maintenance work processing system 1 receives the deficient information, the maintenance work support means 38 generates guide text data (shown in FIG. 11) sent to the customer and displays it on the branch terminal 6. The person in charge of the branch confirms an incomplete explanation on this screen, inputs a small number of items such as a greeting, and presses the “Send” button. Then, the maintenance work support means 38 outputs the guide sentence data including the additionally inputted information to the printer, and prints the incomplete invoice guide sentence shown in FIG. This guidance text is mailed from the head office 4 to the registered address of the customer.

Finally, the maintenance work progress inquiry process will be described with reference to the screen example of FIG.
When customer 5 inquires about the progress of the maintenance procedure by telephone or at the counter, entering the policy number on the transaction menu screen (not shown) and pressing the “Inquiry for Progress” button will display the inquiry screen in FIG. Is done. In this example, it takes nine days from invoice creation to approval and contract information update.

  In addition, this invention is not limited to said embodiment, A various deformation | transformation is possible in the range which does not change the summary of invention.

  For example, in the above embodiment, the maintenance work processing system 1 is configured by a mainframe such as the head office 4, but the system may be configured by a server installed in the branch and the branch terminal 6. In addition, when a part of the maintenance procedure can be approved by the branch, the system can be configured by the branch terminal 6 alone.

  In addition, the approval criteria, various types of identification information, the format of bills and guidance sentences, etc. are not limited to the above examples.

FIG. 1 is a network configuration diagram of an embodiment of the present invention. FIG. 2 is a functional block diagram showing a schematic configuration of the maintenance work processing system. FIG. 3 is a diagram illustrating a data structure of the approval criteria table. FIG. 4 is a diagram illustrating an example of a maintenance procedure invoice. FIG. 5 is a diagram showing an example of an invoice cover sheet. FIG. 6 is a flowchart showing a maintenance work process. FIG. 7 is a diagram illustrating an example of an invoice creation screen. FIG. 8 is a diagram illustrating an example of an inspection result input screen. FIG. 9 is a diagram showing an example of an in-house cover letter of a maintenance procedure invoice. FIG. 10 is a diagram showing an example of an incomplete bill input screen. FIG. 11 is a diagram showing an example of a screen for creating a guide sentence for incomplete bills. FIG. 12 is a diagram illustrating an example of an incomplete guide for a bill. FIG. 13 is a diagram illustrating an example of a display screen for a maintenance job progress inquiry result.

Explanation of symbols

DESCRIPTION OF SYMBOLS 1 ... Maintenance business processing system 2 ... Life insurance company 3 ... Branch 4 ... Head office 5 ... Customer 6 ... Branch terminal 7 ... Printer 8 ... Bar code reader 9 ... Communication terminal 11 ... CPU
12 ... System bus 13 ... RAM
DESCRIPTION OF SYMBOLS 14 ... External storage device 14a ... Data storage area 14b ... Program storage area 15 ... Input / output interface 17 ... Input device 18 ... Output device 19 ... Communication device 20 ... Removable recording medium 21 ... Drive 22 ... Contract information database (DB)
23 ... Decision criteria table 24 ... Checkpoint table 25 ... Progress management database (DB)
26 ... Invoice information database (DB)
27 ... Guidance sentence table 30 ... Billing acceptance means 31 ... Contract information retrieval means 32 ... Authorization criteria identification means 33 ... Authorization level determination means 34 ... Invoice data generation means 35 ... Approved information acceptance means 36 ... Progress management means 37 ... Contract Information update means 38 ... maintenance work support means 40 ... guidance sentence generation means

Claims (13)

By means of an insurance company's computer system equipped with input means, output means, control means, and a storage device for storing computer software, it is possible to carry out maintenance procedures such as claiming insurance claims from customers who have entered into life insurance contracts, changing contract details, etc. A method of supporting processing,
The storage device
Life insurance contract information such as personal information of policyholders and insured persons, types of special contracts, insurance premium (payment) payment methods, etc., and change history information including the date and items when such information was changed A contract information database (DB) stored in association with each contract identification information;
An approval criteria table that stores at least the approval criteria set in relation to the change history for each type of maintenance procedure,
This method
A claim accepting step for accepting an input of billing information including contract identification information and billing details;
A search step in which a search unit specifies a contract to be billed from the contract information DB based on the input contract identification information, and searches for change history information of the contract;
An approval criteria specifying means for searching the approval criteria table by the type of maintenance procedure determined based on the received claim information, and for determining the approval criteria of the maintenance procedure;
The approval level determination means refers to the change history associated with the specified approval criteria, the change history information of the contract retrieved from the contract information DB, and the content of the charge included in the claim information, and An approval level determination process for determining and outputting the approval level of the procedure and the approval level of necessary documents,
An approved information receiving step for receiving an input of approved information indicating that the maintenance procedure according to the request has been completed in accordance with the determined approval level;
The contract information update means includes a contract information update step of updating the contract information and the change history information stored in the contract information DB according to the billing information when the approved information is input, respectively. how to. The method of claim 1, wherein
The approval level determination step includes the update date and update item of the contract information retrieved from the contract information DB, the determined maintenance procedure type and billing content, and the maintenance procedure type and change registered in the approval criteria table. A method for determining an approval level according to history relevance. The method of claim 1, wherein
The storage device includes a bill information database (DB) for storing the types of attached documents necessary for each maintenance procedure and the bill format of each maintenance procedure in association with the type of the maintenance procedure,
This method further
The invoice information search means, based on the approval level determined in the approval level determination step and the type of maintenance procedure determined in the claim acceptance step, the invoice format of the procedure from the invoice information DB and Invoice information search process to search for necessary attachment information,
The invoice output means generates the invoice data by combining the information of the attached document and the extracted contract information in the retrieved invoice format, and outputs the invoice data for presentation to the customer as a maintenance procedure invoice And a bill output step. The method of claim 3, comprising:
The storage device includes a progress management database (DB) for storing a processing status from acceptance of the maintenance procedure to completion thereof in association with the contract identification information or the identification information of the maintenance procedure,
The method further includes a case where the bill receiving means accepts input of billing information from a customer, a case where the bill output means outputs a bill of maintenance procedure, and a case where the settled information accepting means accepts settled information. When the input is received, the progress management means receives the progress data including the contract identification information or the maintenance procedure identification information from each means, and searches the corresponding maintenance procedure from the progress management DB to update the progress information. A method characterized by having a progress management process. The method of claim 4, wherein
The contract information DB also stores change history information changed by a simple change request procedure other than the maintenance procedure from a customer for a specific item of contract information,
The approval criteria table stores approval criteria set in relation to a change history changed by either the maintenance procedure or the simple change request procedure for each type of maintenance procedure,
The claim acceptance step determines whether the procedure is a maintenance procedure or a simple change request procedure when an input of billing information is received from a customer for a specific item of contract information, and if it is a maintenance procedure, further determines the type of the maintenance procedure A method characterized by what is to be done. The method of claim 4, wherein
The progress management DB stores, for one contract identification information, the processing statuses of a plurality of maintenance procedures or the processing statuses of maintenance procedures and simple change procedures in association with each other.
The approval criteria table includes any one of an approval order, an approval level, or a required attached document when a plurality of maintenance procedures or maintenance procedures and simplified change procedures are pending at the same time for one contract. The approval criteria are stored in association with each maintenance procedure type,
When the approval level determination step receives a second maintenance procedure or a simple change procedure for the same contract as the first maintenance procedure before the approval, the type of the first or second maintenance procedure or the simple change procedure A method for determining a decision level by retrieving a second decision criterion from a decision criteria table based on the type of the decision. The method of claim 3, wherein
The storage device includes a checkpoint table that stores checkpoints for determining whether or not a description content of an invoice or an attached document is appropriate in association with a type of maintenance procedure,
This method further
When the checkpoint output means is presented to the customer in the invoice output step and the maintenance procedure type of the invoice returned from the customer is input via the input means, the checkpoint output means is based on the maintenance procedure type. A checkpoint output step of extracting one or more checkpoints of the maintenance procedure from the checkpoint table and outputting them to an output device;
A checkpoint input accepting step for accepting input of checked information for one or more checkpoints output to the output means;
Checkpoint monitoring means monitors whether the checked information has been input for all checkpoints, and when the checked information is input, according to the approval level determined in the approval level determination step, the checkpoint monitoring means performs the maintenance procedure. And a checkpoint monitoring step for outputting approval instruction information. The method of claim 7, wherein
The storage device includes a guide sentence table that stores a description of incompleteness of the description items of the invoice, a description of incompleteness of the attached document, and a description of the correction content that solves the insufficiency in association with the type of defect,
This method further
In the checkpoint input reception step, when a defect is found in the bill returned from the customer, the guidance sentence creating means explains the defect, the correction contents, and the correction contents to eliminate the defect from the guidance sentence table. And a guide sentence creating step of creating a guide document for a customer by combining these into a guide sentence form. The method of claim 1, wherein
The approval criteria table stores, in addition to the change history, approval criteria that are set in relation to whether payment is made to the customer by the maintenance procedure and the payment amount,
In the approval level determination step, when the type of the accepted maintenance procedure involves payment of money, the approval level corresponding to the payment amount is specified from the approval criteria table to determine the approval level. And how to. The method of claim 1, wherein
The contract information DB stores, when one customer has a plurality of insurance contracts, the change history of all contracts in association with customer identification information,
The search step is to search change history information regarding all contracts of this customer from the contract information DB based on contract identification information,
Whether the approval level determination step corresponds to any one of the change history associated with the approval criteria specified in the approval criteria specifying step and the change history information of all the contracts of the customer retrieved from the contract information DB The method is characterized in that the decision level is determined based on the above. The method of claim 10, wherein:
The search step specifies customer identification information based on the input contract identification information, and searches all other contracts of the customer from the contract information DB based on the customer identification information,
This method further
A billing content determining step for determining whether the billing content of the accepted maintenance procedure is a change related to a specific item among items common to the plurality of contracts of the customer;
When the content of the maintenance procedure request is a change of a specific item, the alarm output means refers to the change history information on all the searched contracts, and the change of the specific item has been made for other contracts. And an alarm output step for outputting a predetermined alarm when there is no alarm. This system is equipped with input means, output means, control means, and a storage device for storing computer software, and is a system that supports the processing of maintenance procedures such as claims from customers who have entered into life insurance contracts and changes in contract contents. And
Life insurance contract information such as personal information of policyholders and insured persons, types of special contracts, insurance premium (payment) payment methods, etc., and change history information including the date and items when such information was changed A contract information database (DB) stored in association with each contract identification information;
An approval criteria table that stores at least the approval criteria set in relation to the change history for each type of maintenance procedure,
Bill accepting means for accepting input of billing information including contract identification information and billing details;
Search means for identifying a contract to be billed from the contract information DB based on the entered contract identification information and searching for change history information of the contract;
Based on the type of maintenance procedure determined based on the received claim information, an approval criteria specifying means for specifying the approval criteria of the maintenance procedure from the approval criteria table;
With reference to the change history associated with the specified approval criteria, the change history information of the contract retrieved from the contract information DB, and the content of the charge included in the request information, the approval authority and necessity of this maintenance procedure An approval level determination means for determining and outputting an approval level of a document and the like;
Approved information receiving means for receiving input of approved information indicating that the maintenance procedure according to the request has been completed in accordance with the determined approval level;
A system comprising: contract information updating means for updating contract information and change history information stored in the contract information DB according to the billing information when approved information is input. Maintenance procedures such as claiming insurance claims from customers who have signed life insurance contracts, changing contract details, etc. to computer systems of insurance companies equipped with input means, output means, control means, and a storage device for storing computer software A computer program for executing a process that supports the process,
The storage device
Life insurance contract information such as personal information of policyholders and insured persons, types of special contracts, insurance premium (payment) payment methods, etc., and change history information including the date and items when such information was changed A contract information database (DB) stored in association with each contract identification information;
An approval criteria table that stores at least the approval criteria set in relation to the change history for each type of maintenance procedure,
This program
A bill accepting procedure for accepting input of billing information including contract identification information and billing details;
A search procedure in which a search unit specifies a contract to be billed from the contract information DB based on the input contract identification information, and searches for change history information of the contract;
An approval criteria specifying means for specifying the approval criteria of the maintenance procedure from the approval criteria table based on the type of the maintenance procedure determined based on the received claim information;
The approval level determination means refers to the change history associated with the specified approval criteria, the change history information of the contract retrieved from the contract information DB, and the content of the charge included in the claim information, and Decision level judgment procedure for judging and outputting the decision authorization level of required procedures and required documents, etc.,
An approved information receiving means for receiving an input of approved information indicating that the maintenance procedure according to the request has been completed according to the determined approval level;
The contract information update means includes a contract information update procedure for updating the contract information and the change history information stored in the contract information DB according to the billing information when the approved information is input, respectively. Computer program.

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