KR100792175B1 - A claim management system and method for compensation of insurance by a virtual consultant - Google Patents

Abstract

The present invention relates to a compensation processing system and method, which is required for compensation processing based on rule-based work rules such as company's manual or audit data and insurance information or work know-how accumulated by personal experience of compensation officer or team leader. It is to enable automatic search and presentation of tasks in the field.

To this end, the present invention provides a web page capable of inputting / inquiring / correction of contract information and personal information, damage situation information, claims and payment information of a customer, and automatically assigns a compensation officer within the system. A compensation processing server for presenting a business task to be processed as a web page; Customer's contract information, personal information, insurance payment information, damage situation information, claims and settlement information, accident vehicle information / accident security / victim sequence related to the contract customer, such as accident receipt number and compensation organization / contact information Implement a compensation processing system that includes a compensation DB that stores compensation-related data, so that the company can provide the best work order through a virtual consultant without a team leader or an upper payer, so that the insurance company can receive incidents / investigations and receive payments. Allow compensation services to be handled remotely in a mobile environment.

Insurance, compensation, processing, rule bases, networks, virtual consultants

Description

A claim management system and method for compensation of insurance by a virtual consultant}

Figure 1 is an operation flow diagram illustrating a process from the receipt of accidents to insurance payments when an accident occurs by a conventional insurance subscriber

2 is a schematic diagram of a compensation processing system through a virtual consultant according to an embodiment of the present invention;

3 is a detailed diagram illustrating the configuration of a compensation processing server of FIG.

4 is an operation flowchart of a compensation processing method through a virtual consultant according to the present invention.

5A to 5J are exemplary views of web pages presented to a general user terminal in a client environment by each process executed by the compensation processing server of the present invention.

6A and 6B are exemplary views of web pages provided from a compensation processing server to a mobile communication terminal in a client environment.

<Explanation of symbols for the main parts of the drawings>

10: mobile communication terminal 20: user terminal

100: compensation processing server 101: accident reception processing unit

102: accident investigation processing unit 103: victim management processing unit

104: damage management processing unit 105: insurance claim / settlement processing unit

106: rule management processing unit 107: risk factor management processing unit

110: reward DB 120: HR DB

210: rule DB 200: rule search engine

The present invention relates to a compensation service processing system and method, and includes a manual related to the company's instructions, audit data and insurance information accumulated in the company, or business know-how accumulated through personal experiences such as compensation officer, investigator or team leader. Based on the rule base and automatically search for the tasks required for the processing of compensation tasks based on the rule base, the virtual consultant can present the best work order through the virtual consultant without the team leader or the senior accountant. The present invention relates to a compensation processing system and method through a virtual consultant that enables the insurance company to remotely handle the compensation work for the insurance company's accident reception / investigation and insurance payment in a mobile environment.

In particular, the present invention receives the compensation work processing information for each incident from the authorized user and stores in the compensation database as the basic data of the damage assessment, and directly retrieves the stored basic data remotely from the outside of the accident site, hospital, maintenance shop, etc. By making it possible to support the sharing of information on each accident occurrence, notification or compensation process, the notification and processing of tasks online, and to carry out all tasks related to the processing and compensation procedures corresponding to each accident. The present invention relates to a field-based compensation business processing system and method through a virtual consultant that enables integrated management in an environment.

Conventional insurance compensation processing system is configured to receive a manager's instructions in a series of business processes from the receipt of an accident to payment of insurance claims and follow-up management when an accident occurs.

FIG. 1 is a flowchart illustrating a process from a case of receiving an accident to a payment of insurance when an accident occurs in a conventional insurance subscriber. Referring to this, the process of carrying out an accident investigation and insurance payment in the case of automobile insurance will be described as follows. same.

When an accident occurs in a vehicle insured with auto insurance, the driver first calls a call center or a compensation center of an insurance company with auto insurance using a mobile communication device or a landline to receive the accident.

The call center or compensation center of the insurance company that received the accident will notify any maintenance company (or hospital) close to the accident site by wire / wireless telephone or fax to notify the fact of the accident. The company (or hospital) sends a tow vehicle (or an ambulance) to the accident site to wear (or be hospitalized) the accident vehicle (or accident).

On the other hand, the person in charge of the accident reception on the insurance company side checks the insurance contract relations or the coverage of the driver who drove the received accident vehicle, using the insurance contract information inside the company. If the insurance contract is confirmed, the accident handling team member of the insurance company or the person in charge of the accident vehicle (or the accident) is selected to allocate the case. (S12)

The accident officer assigned to the accident vehicle visits the accident site to conduct an accident investigation by grasping the on-site condition and / or negligence between the perpetrator and the victim and / or the damage situation (S14). According to whether or not the compensation range and the estimated repair cost (or treatment cost), such as estimating estimates, etc. to determine the contents of the estimate (S16), after the accident personnel in charge of the repair shop (or the accident is hospitalized) Hospital) to check the work process and repair of the accident vehicle (or the degree of damage and treatment of the accident), and then to take photographs, etc. Or manage the treatment progress of the accident. (S18)

Subsequently, when a repairman (or hospital) charges for repaired parts, labor, etc. of a vehicle repaired in this way, is charged by the relevant maintenance company (or hospital), the compensation manager of the insurance company's compensation team is responsible for paying the maintenance fee (or the number of medical expenses). Determination of damages and insurance claims with reference to (S20), the payment of the insurance benefits can be paid to the maintenance company (or hospital) using a "CMS" (Cash Management Service) or bank transfer (S22) After the payment is made, it is possible to continue the follow-up management, such as checking whether the repaired vehicle (or the treated accident) is free of defects (recurrences such as sequelae) (S24).

However, such a conventional process of handling the accidents and victims of the insurance contractor who is in charge of the accident, notification or compensation when the compensation officer or investigator goes to the site when the incident manager and the team leader are instructed by the relevant department head or team leader in the company. Investigate and confirm the treatment status and damage status of the vehicle by yourself. At some point during the investigation process, at the point of accident investigation and confirmation to receive the report of the surveyed data or to receive new business instructions for the next task. At least one or more times will require accident investigations and field checks, such as the need to contact the relevant department heads or team leaders by wire / wireless telephone or fax.

In addition, since the compensation officer or investigator at the scene was not able to directly check the insurance policy, practical guidelines, know-how, etc. in the insurance company after the investigation and confirmation of the accident was completed, After returning to the office, you should record and organize the data with the instructions or advice of the computer and team leader in the office, and then proceed to pay the insurance money through the approval of the team leader.

Therefore, in the conventional insurance business processing system, the accident investigation and compensation work process related to the accident is carried out in the office through the accident investigation procedure outside the office by the accident investigation staff and through consultation or settlement with the accident investigation staff and the team leader or related department head. It was inevitably dualized by dealing with the damage assessment procedures.

For this reason, the conventional insurance business processing system has not been able to carry out the insurance business processing and insurance payment procedures promptly. As a result of this delay, the efficiency of the compensation business has been reduced.

In order to remedy the above-mentioned problems, the recently developed publicly known technology includes Korean Patent Publication No. 2002-84654 (name: Compensation Processing Method and Device through Network of Auto Insurance), and quickly and accurately identify the accident vehicle and repair the vehicle. And auto insurance companies can create a shared space by networking insurers and maintenance companies for effective management, and to reduce the time required for insurance payments by sending photo data or sending quotations of vehicles. Compensation processing methods and apparatus have been developed.

On the other hand, there is another known technology related to the Korean Patent Publication No. 2002-0010348 (name: method and device for compensation of a small amount of automobile insurance), according to this technology, the insurance damage of the accident vehicle is a small case or accident treatment If the process is simple, the company uses a business processing system for centralized damage assessment to transfer the photographic data of the vehicle through the Internet between the insurance company and the maintenance company so that only a small amount of money can be calculated and the payment can be promptly processed. There is disclosed a method of processing a small amount of compensation to reduce the time required to pay insurance claims and to reduce the consumption of manpower.

However, despite the improvement of such a system, the conventional process of investigating accidents and paying insurance works only efficiently in limited cases such as sharing information with a maintenance company using a network or paying small claims. Almost all of the processing of insurance accident investigations and insurance payments is carried out at the scene of accident investigations and the arrangement of information for damages in the office. Since payment procedures are still performed inefficiently, there are many problems.

The present invention is to improve the above problems, the present invention is a business know-how accumulated by the manual or audit data accumulated in the company and personal experiences such as compensation officer, investigator or team leader, etc. It is possible to provide the best work order through the virtual consultant without the team leader or the senior approval by automatically searching the rules based on the rule base and automatically searching for the tasks required for the processing of compensation tasks based on the rule base. The purpose of the present invention is to provide a compensation processing system and method through a virtual consultant which enables the insurance company to remotely handle the compensation work for the insurance company's accident reception / investigation and insurance payment in a mobile environment.

A first aspect of the present invention for achieving the above object is a plurality of client terminals capable of connecting to the Internet through a wired or wireless network; A web page that performs authentication of a user who has a request for access through the client terminal, and inputs / inquiries / corrections of contract information and personal information of the customer, damage situation information by accident reception / investigation, insurance claim and settlement information. To a certified client terminal, assign a compensation officer for processing the compensation business, store the information with the information input / corrected through the web page in the compensation database, and process the compensation officer according to the input / correction information. A reward processing server for searching and presenting a task to the web page; Contract information and personal information of customers, insurance payment information for a certain period of time, damage situation information by receipt / investigation of accidents that are entered or corrected in real time through the web page, claims and settlement information, accidents related to contract customers Compensation processing system including a compensation database for storing information such as vehicle information / accident collateral / victim sequence with compensation-related data, such as accident receipt number and compensation organization / personnel information.

A second aspect of the invention provides a plurality of client terminals capable of connecting to the Internet through a wired or wireless network; A web page that performs authentication of a user who has a request for access through the client terminal, and inputs / inquiries / corrections of contract information and personal information of the customer, damage situation information by accident reception / investigation, insurance claim and settlement information. To a certified client terminal, assign a compensation officer for processing the compensation business, store the information with the information input / corrected through the web page in the compensation database, and process the compensation officer according to the input / correction information. A reward processing server for searching and presenting a task to the web page; Contract information and personal information of customers, insurance payment information for a certain period of time, damage situation information by receipt / investigation of accidents that are entered or corrected in real time through the web page, claims and settlement information, accidents related to contract customers A compensation database for storing information such as vehicle information / accident collateral / victim sequence together with compensation related data such as accident reception number and compensation organization / person in charge; One or more possible condition information for a plurality of item information which is a standard of compensation processing, and a plurality of rule information defined by combining one or more condition information are separately stored, and at least one for each of the plurality of rules. A rule database constituting a task table in correspondence with the above task; It is connected to the compensation processing server, and the compensation officer to process on the basis of the customer's contract information and personal information, the damage situation information according to the incident received / investigation results, claims and settlement information through the web page in real time Compensation processing system including a rule search engine for retrieving a business task from the rule database to feed back to the compensation processing server.

In addition, the compensation processing server provides a web page capable of input / correction of the customer's vehicle information and human information, accident date and time, accident location, degree of damage situation, etc. Generates a serial number corresponding to the incident received through the incident, designates a compensation person for accident investigation and claims / payments, stores it in the compensation database together with the input information and the serial number, and based on the input / corrected information. An accident reception processing unit that searches a task for accident reception processing and executes a series of accident reception processes presented on the web page together with information on a person in charge; Presenting a web page that allows input / retrieval / correction of damage situation information according to the accident investigation result, and stores the information input / corrected through the webpage in a compensation database or the accident investigation process based on the input / correction information An accident investigation processing unit that executes a series of accident investigation processes for searching and presenting a business task for the web page; Presenting a web page capable of inputting / viewing / correcting information for victim management corresponding to the accident investigation result, and storing information input / corrected through the webpage in a compensation database or on the input / corrected information A victim management processing unit which executes a series of victim management processes for searching and presenting the task for the victim management based on the web page; Presenting a web page capable of inputting / viewing / correcting information for managing the damage corresponding to the accident investigation result, and storing the information input / corrected through the webpage in a compensation database or the information input / corrected A damage management processing unit for executing a series of damage management processes for searching and presenting a task for damage management based on the web page; Based on the information entered through the incident reception / investigation process and victim / damage management process, and the insurance policy, insurance / insurance, and compensation authority of the compensation officer stored in the compensation database, the standard insurance money is extracted and the accident occurs. Includes a claim / payment processing unit that provides a comparative basis for calculating insurance claims for notifications or incidents that are being processed, and implements a compensation process that verifies the victim's consent to the claims calculated by the compensation officer and whether or not a higher settlement is made. In addition, a web page capable of inputting / correcting rules stored in the rule database may be provided according to a request of a user having a rule correcting authority. Create a new rule based on the entered / corrected rule by checking the approval A rule management processing unit that executes a series of rule management processes that are changed and stored in the rule database, and / or item information input / corrected through the web page is checked, and the risk point of the corresponding check item information is stored in the reward data. Accumulate and accumulate warning points to analyze the possibility of insurance fraud by retrieving and accumulating from the base, and report the form to detect insurance fraud for accident occurrences, notifications, or compensations that are in excess of the threshold. It may further include a risk management processing unit that fills out the survey form and sends it through a designated email or net-fax.

A third aspect of the present invention is a reward database for storing various information related to customer compensation, a rule database for storing a number of rules and tasks as a standard for compensation processing, and wired / wireless In a network system that is accessible by a plurality of terminals on a network and includes a compensation processing server for constructing and managing a database, and a rule search engine for constructing and managing the rule database, a compensation process executed by the compensation processing server. A method, comprising: (a) a first step of performing authentication for a plurality of users requesting to connect over a network; (b) execute at least one process that enables the processing of the compensation task at the request of each user authenticated in the first step, and thus in connection with the incident receipt / investigation or victim / damage management or claim / payment; Providing a web page capable of inputting / viewing / correcting data; (c) create an accident receipt serial number related to the accident receipt information entered / corrected through the web page, and assign a compensation officer who can handle the accident affairs in charge of the incident receipt with the information entered / corrected Storing in a compensation database; (d) a compensation processing method comprising a fourth step of searching for a task to be processed by the compensation officer from a rule database through a rule search engine and feeding it back to the web page.

The process executed in the second step provides a web page capable of inputting / correcting the customer's vehicle information, personal information, accident date, accident location, degree of damage, etc. Generate a serial number corresponding to the incident received through the web page, designate a person in charge for accident investigation and claim / payment, and store it in the compensation database together with the input information and serial number, and input / correct An accident reception process for searching a task for accident reception based on the information to be executed and executing a series of accident reception processes presented on the web page together with the person's information; Presenting a web page that allows input / retrieval / correction of damage situation information according to the accident investigation result, and stores the information input / corrected through the webpage in a compensation database or the accident investigation process based on the input / correction information An accident investigation process for executing a series of accident investigation processes for searching and presenting a business task for the web page; Presenting a web page capable of inputting / viewing / correcting information for victim management corresponding to the accident investigation result, and storing information input / corrected through the webpage in a compensation database or on the input / corrected information A victim management process for executing a series of victim management processes for searching and presenting work tasks for the management of victims based on the web page; Presenting a web page capable of inputting / viewing / correcting information for managing the damage corresponding to the accident investigation result, and storing the information input / corrected through the webpage in a compensation database or the information input / corrected A damage management process for executing a series of damage management processes for searching and presenting a task for damage management based on the web page; Based on the information entered through the incident reception / investigation process and victim / damage management process, and the insurance policy, insurance / insurance, and compensation authority of the compensation officer stored in the compensation database, the standard insurance money is extracted and the accident occurs. Includes a claim / billing process that provides a comparative baseline for calculating insurance claims for reported or compensating incidents and implements a compensation process that verifies the victim's consent to the claim calculated by the Compensation Officer and whether a higher payer is approved. In addition, a web page capable of inputting / correcting rules stored in the rule database can be provided according to a request of a user having a rule correction authority, and input / correction of rules through the webpage and approval by a higher payer Check whether or not to create a new rule based on the input / corrected rule, or Rule management process executing a series of rule management process for storing the path in the rule database; Check the item information input / corrected through the web page, search and accumulate the risk points of the check item information from the compensation database to calculate a warning point cumulative value for analyzing the possibility of insurance fraud, and the warning At least one or all of the risk management processes for the occurrence of an accident, notification, or compensation for the accumulation of points above the threshold, and the completion of a report or investigation form for the detection of an insurance fraud and sent via designated email or net-fax. It may include.

The objects, features and advantages of the present invention will be more readily understood by reference to the accompanying drawings and the following detailed description.

Hereinafter, with reference to the accompanying drawings will be described in detail the configuration of the embodiment according to the features of the present invention and its effect.

2 is a schematic diagram of a site-based compensation processing system through a virtual consultant according to an embodiment of the present invention, and FIG. 3 is a block diagram illustrating a detailed configuration of the compensation processing server of FIG. As shown in FIG. 2, the system includes a compensation processing server 100 connected to a network such as the Internet so as to be accessible through a plurality of client terminals including a mobile communication terminal 10 or a general user terminal 20. The rule search engine 200 connected to the compensation processing server 100, the compensation database 110 storing various kinds of information related to compensation, the rule database 210, and the personnel database 120 storing personnel information of employees. It includes.

The compensation processing server 100 is a server that performs authentication for a user who has a connection request from a user terminal or a mobile communication terminal through a wired or wireless network, and performs a virtual consultant role only for a request of an authenticated user. Client terminal of web page (refer to FIGS. 5A to 5J and 6A and 6B) for inputting / inquiring / correcting customer's contract information and personal information, damage situation information by accident reception / investigation, insurance claim and settlement information To provide.

In addition, the compensation processing server 100, in particular, if there is an accident reception or investigation, first assigns a compensation officer for processing the compensation work and stores it in the compensation database together with the information input / corrected through the webpage and Search for the task to be handled by the compensation officer according to the input / correction information and present it to the web page (the web page of FIGS. 5A to 5J when using a general user terminal) and a short message indicating that the accident has been received or investigated. Send a message (reconstruct the text screen for the mobile communication terminal using only text as shown in FIGS. 6A and 6B) or an e-mail to the compensation person, and search for the task to be handled by the compensation person and return it through the web pages. . In this case, when the compensation officer accesses the server through the user terminal, it is possible to inquire and input information through a web page as shown in FIGS. 5A to 5J. When accessing the server through the mobile communication terminal, FIGS. 6A and FIG. It is possible to search and input information through a text screen such as 6b.

The compensation processing server 100 is an accident reception processing unit 101, accident investigation processing unit 102, victim management processing unit 103, damage management processing unit 104, insurance claim / payment processing unit (shown in FIG. 105, a rule management processing unit 106, and a risk factor management processing unit 107.

The accident reception processing unit 101 provides a web page (refer to FIG. 5A) that allows input / correction of customer's vehicle information, human information, accident date, accident location, damage status, etc. And generate a serial number corresponding to the accident occurrence, notification or compensation process entered through the web page, and designate a compensation person for accident investigation and claims / payment, and the compensation data together with the input information and serial number. Stores in the base, retrieves the task for the incident reception process based on the input / corrected information and executes a series of accident acceptance process to present to the web page with the contact information. In this case, the accident reception processing unit 101 assigns a person in charge based on the accident area, the branch office, the product type, the accident type, the damage level, the estimated damage amount, the customer grade, etc. when the accident reception information is input / corrected through the web page. If a compensation officer is assigned through the above web page, and the accident reception information is entered / corrected through the web page, one or more maintenance company information for repair of the accident vehicle or one or more hospital information for victim treatment based on the accident area Search for and send a short message or email in real time to the customer's mobile phone or email address received. In addition, the incident reception processing unit 101 sends the response response information to determine whether to agree to the use of the selected response company or hospital, selection response confirmation information enabling the selection of a maintenance company or hospital wants repair or treatment in real time Receive a request to repair a vehicle or treat a victim through an internal online fax or short message that is included in the short message or e-mail that is sent and sent to the selected company or hospital, depending on whether or not the response is returned from the customer. Send the document.

In addition, the accident reception processing unit 101, when input / correction of accident reception information through the web page is made, the warning point cumulative value for the maintenance company information or hospital information based on the risk point of the compensation database is searched for more than the reference value If a cumulative warning point is found, a short message or e-mail containing the content is sent to the compensation person's mobile phone or e-mail address.

The accident investigation processing unit 102 presents a web page (see FIG. 5B) that enables input, inquiry, and correction of damage situation information according to the accident investigation result, and transmits information input / corrected through the web page to a compensation database. It executes a series of accident investigation processes that search and present the task for accident investigation processing based on the inputted / corrected information and present it on the web page. At this time, if it is confirmed that the accident is processed normally or non-financially, the task to be done for each victim / damage is searched from the rule base and returned to the web page. Therefore, if the compensation officer checks the task to be done, the victim / Present a web page (see FIG. 5C) listing the work specification to be done for each damage, thereby allowing the compensation person to re-investigate and enter the content.

When the input of the data through the incident reception and investigation is completed, the accident investigation processing unit 102 first extracts the estimated damage amount for setting the victim management input and basic accounting amount, which is the next process, and presents it through a web page (see FIG. 5D). This allows the compensation officer to set the basic accounting amount for victim management by referring to the estimated damages, or to set the basic accounting amount arbitrarily by the compensation officer.

The victim management processing unit 103 presents a web page (see FIG. 5E) capable of inputting / viewing / correcting information for victim management corresponding to the accident investigation result, and displays information input / corrected through the web page. It executes a series of victim management processes for searching and presenting the task for victim management based on the input / correction information stored in the compensation database and presenting it on the web page.

The damage management processing unit 104 presents a web page (see FIG. 5F) capable of inputting / viewing / correcting information for managing the damage corresponding to the accident investigation result, and is input / corrected through the web page. It executes a series of damage management processes for storing information in a compensation database or searching for a task for damage management based on the input / corrected information and presenting it on the web page.

Claim claim / settlement processing unit 105 is a web page that allows input / inquiry / correction of information for calculating the insurance claim, including injury settlement and / or car repair costs corresponding to the accident investigation and victim / damage investigation results (Fig. 5g and FIG. 5h), and the accident occurred, notified or compensated based on the information entered through the web page and the insurance policy, insurance / insurance, and compensation authority of the compensation officer. Extract and present a comparison standard (standard insurance amount) for calculating the insurance premium (incident settlement amount and / or car repair cost, etc.) of the accident, and refer to the comparison standard for the victim's consent and the team leader for the insurance amount calculated by the compensation person. Implement a compensation process to check whether the top payment is approved.

At this time, the insurance claim / settlement processing unit 105 extracts the standard insurance amount necessary for calculating the insurance premium based on the personal information of the injured victim and the input information investigated by the compensation officer, but based on the amount of damage closest to the degree of injury of the victim. As a result, it is extracted from the insurance payment information for a certain period of time stored in the compensation database and presented through the web page. At this time, the claim claim / payment processing unit 105 presents the comparison criteria by dividing the claim payment information for a predetermined period of time stored in the compensation database according to the reference accident area, damage degree, age, gender, and the like.

In particular, the claim / payment processing unit 105 before the check whether the approval of the team leader or higher settlement required for the payment of the benefits calculated by the compensation officer, whether there is an instruction by the team leader or higher settlement, and the company Check if there is a point of self-audit within the company, and if it is confirmed that there is an instruction by the senior leader of the team, present a web page containing the instructions (see check sheet of FIG. 5J) and mobile phone or email address. A short message or an e-mail is sent, and if a check made by the self-audit is confirmed, a web page (see FIG. 5I) containing the check is presented.

Here, the self-audit factor may be the accumulated audit contents, work instructions, terms and conditions, personal work experience, practical manual, and the like. Table 1 below illustrates the points identified by the self-audit factors.

Error list Self Audit Factor One Have you attached a fee agreement? 1. Adults, Uninsured, Injury 2. The amount of treatment bill is over 1 million won and the payment rate is less than 80% 3. The treatment hospital is a tertiary care institution and the rate of payment is less than 90% 1 & (2/3) 2 Please double check your treatment fee reduction rate. 1. Adults, Uninsured, Injury 2. In the absence process as a result of absence inspection in the victim's process management 3 Overpayment (50% or more) compared to standard insurance Please check the content 1. Adults, Uninsured, Injury 2. Over 50% of the standard insurance payment 1 & 2 4 Appropriate Review of Accidental Leave Loss and Accredited Days (Monthly Real Income Not Calculated) 1. Adults, uninsured, and injured 2. The victim's occupation is paid to a public employee or a company employee without calculating monthly income 3.The occupation of the victim is a public employee or a company employee, which is calculated as the number of days of injured damage. 1 & (2/3) paid 5 Confirmation of adequacy of payment of obstacle insurance (no status confirmation, permanent obstacle recognition within 6 months) 1. Personal, uninsured, injury 2. Non-entry status certificate or non-predicted status certificate 3. Non-incidental case 3. Permanent disability due to stiff injury recognized within 6 months from the accident date (single injury) 4. CT, MRI input and imaging test results are HNP, other than fractures 1 & (2/3/4) 6 Have you confirmed to the recruiting organization manager the collection premium due to the termination of the contract? 1. Adult, Uninsured, Injury 2. Accident Date: Contracted 3. Receipt: Contract Terminated 4. Type of Determination: Compensation 7 Have you confirmed the reason for your occupation, negligence or income change? 1. Adults, Uninsured, Injury 2. Changes in occupation and monthly salary on the 30th of the agreement payment date 3. Termination after payment of injuries or death insurance (when the calculation method is normal or compulsory normal) 4. Excludes compulsory, other closures, general lawsuits and small claims 5. Determination type: Compensation 1 & 2 & 3 & 4 & 5 8 Please check the disguise of recent accidents (more than 2 times) 1. Own car 2. Type of accident = Theft Two cases of theft occurred within 3.1 years 4. Report to the police 5. The same number of the insured person ... ... ...

In addition, the instructions by the upper payer may be at least one of self-contract, seizure, debt, and insurance accidents. In FIG. 5J, the contents of contracts and related documents for checking the contents of contracts to determine whether they are disguised for premium discounts, etc. An example is a web page that includes instructions for disciplining or collecting victim income data. In this case, a result input field for inputting a processing result for each instruction may be provided in the web page.

Also, the claim / payment processing unit 105 here is responsible for determining the claim of the compensation person in the case of the return or point of reference for the calculated claim, as a result of confirming the instructions by the upper payer or the point of view by the self-audit. You can also set it to shrink or cancel.

The claim / payment processing unit 105 searches for the family information of the corresponding compensation officer stored in the personnel database in connection with the personnel database 120 storing the personal information of the employee, and is the beneficiary of the claim. If is included in family information directly related to the person in charge of compensation, the information is presented to the parent or team leader who makes the payment. If the number of mistakes or errors in the payment exceeds the threshold, the compensation is made. You can also search for and present training courses for staff.

The claim / payment processing unit 105 is based on the information input through the accident reception / investigation process and the victim / damage management process, and the insurance terms, company guidelines, and the compensation decision authority of the compensation officer stored in the compensation database. If the insurance benefit extracted and presented differs from the insurance payment information for a certain period of time stored in the compensation database by a certain amount or more, the insurance policyholder can be notified of the information through a short message or e-mail.

The claim / payment processing unit 105 is based on the information input through the accident reception / investigation process and the victim / damage management process, and the insurance terms, company guidelines, and the compensation decision authority of the compensation officer stored in the compensation database. When the insurance benefits extracted and presented differ from the insurance payment information for a certain period of time stored in the compensation database by more than a predetermined value, the contents can be returned to the web page for recognition by the upper payer.

The rule management processing unit 106 may provide a web page capable of inputting / correcting a rule stored in the rule database according to a request of a user having rule correcting authority, and inputting / correcting a rule through the webpage and an upper payer. By checking whether the payment is made by the user, a series of rule management processes for generating or changing a new rule based on the input / corrected rule and storing it in the rule database are executed. Here, the rule management processing unit 106, if there is a generation or change of the rule, an e-mail including whether to generate or change and a list of the generated or changed rule to an e-mail address of a rule management officer who operates and manages a rule database. Be notified.

The risk factor management unit 107 checks item information input / corrected through the web page, searches and accumulates risk points of the check item information from the compensation database, and analyzes the possibility of occurrence of insurance fraud. Accumulation of warning points is calculated, and a report form or investigation form for detecting an insurance fraud should be prepared and sent via designated e-mail or Net-Fax for accidents in which accident accumulation, notification, or compensation for which the warning point accumulation value is higher than the standard value is detected. .

The compensation database 110 is a standard for the payment of insurance premiums by the customer's contract information and personal information, insurance payment information for a certain period in the past, and the accident received / survey entered or corrected in real time through the web page Information such as damage situation information, claims and settlement information, accident vehicle information / accident security / victim sequence related to the contract customer is stored along with compensation-related data such as accident receipt number and compensation organization / contact information. At this time, the compensation processing server 100 periodically updates the insurance payment information stored in the compensation database in accordance with the insurance information paid during the recent predetermined period by the compensation manager and stores it.

In addition, the compensation database 110 may set a plurality of item information that causes an insurance fraud as a criterion for detecting insurance fraud, and store a risk point corresponding to each item information.

The rule database 210 separately stores one or more possible condition information for a plurality of item information which is a standard of compensation processing, and a plurality of rule information defined by combining one or more condition information. At least one task task is mapped to each of a plurality of rules to form a task table as shown in Table 2 below. At this time, the rule database stores business rules based on company guidelines, regulations, and employee experience.

Rule-id Task occurrence condition Lookup Type of work Work order Days to complete B001 Medical Consultation Review 1. Collateral: Adults, except 1 person 2. Age: 40 years old or older 3. Injury level: 08,09 4. Hospitalization days 30 days or more 5. One or more accidents in our company 6. Termination of management! Disclaimer) 1 & 2 & 3 & 4 & 5 & 6 Victim Management Treatment Process Management 3 7 B002 Job Voucher / Income Data Collection 1. Collateral: Adults, Uninsured, Injury, Excluded 1 person 2. Injury benefit: Pension clause 3. Age: 23-60 years 4. Hospitalization days 15 days or more 5. Occupation: Non-applicable benefits (401,601) Applied to business income earners, carpentry, plasterer, and paper work 6. Termination of management! = (Figure, immunity) 1 & 2 & 3 & 4 & 5 & 6 Calculate monthly income Job Income Survey 3 7 B003 Hospital 1. Mortgage: Adults, except 1 person 2. Diagnosis: Diagnosis of more than 3 weeks for grades 8-14 and 4 weeks for grades 1-7 3. Non-operation-> Confirmation status of victims 4. 7 days before the expiry date 5.Q Type Exclude Victims 6.Finish Management! = (Piculation, Indemnity) B012 and Duplicate Check Victim Management Treatment Process Management 3 7 B004 Confirmation of required amount and attempt of agreement 1. Collateral: Adults, Uninsured, Injury, Except 1 person 2. Injury Level: Level 1-3 3. Victims 13 years of age and above 4. Malpractice 30% or more 5. Initial period of 50% or more 6. Termination of management! = ( Doosan Corp. Excluded from settlement of consensus; B008 and duplicate checks 1 & 2 & 3 & 4 & 5 & 6 Victim Management Compromise 2 5 ... ... ... ... ... ... ...

The rule search engine 200 is connected to the compensation processing server and communicates with the compensation processing server through an interface using a program or event ID, and contract information and human information of a customer input or corrected in real time through the web page. Based on the information, the damage situation information according to the accident reception / investigation results, insurance claims and settlement information, the task to be processed by the compensation officer is searched from the rule database and fed back to the compensation processing server, in particular the compensation processing server Whenever the information of the webpage provided through is corrected, the rule database is searched to feed back the task.

4 is an operation flowchart of a field-centered compensation processing method through a virtual consultant according to the present invention. In this configuration, the processing method performed by the compensation processing server includes: (a) a plurality of users requesting connection through a network; (B) at least one process, i.e., incident handling, which enables the processing of the compensation task at the request of each user authenticated in said first stage, i.e. By performing processes such as accident investigation, victim management, damage investigation, security screening, and insurance management, input, inquiry, and correction of various data related to accident reception / investigation or victim / damage management or insurance claim / settlement A second step (S301-S304) of providing a possible web page, and (c) generating and solving an accident reception serial number related to the accident reception information entered / corrected through the web page. (3) a third step (S305-S307) of assigning a compensation person who is in charge of the compensation work of the accident receipt case and storing it in the compensation database together with the input / correction information; And a fourth step (S308-S312) of retrieving the business task from the rule database through a rule search engine and feeding it back to the web page.

5A to 5J are exemplary views of a web page presented to a general user terminal of a client environment by each process executed by the compensation processing server of the present invention, and show the overall operation process by the compensation processing server of the present invention as described above. The explanation is as follows.

Although not shown in the drawing, in the compensation processing server 100 having the configuration as shown in FIG. 2, a process of performing authentication for a plurality of users requesting access through a network is performed. To respond only to the user, and executes at least one or more processes that enable the processing of the compensation task when a user requests to execute the process, and receives an accident reception / investigation or victim / damage management or claim / Provides a web page that allows input, inquiry, and correction of various data related to payment.

Processes performed at this time include processes such as accident reception, accident investigation, victim management, damage management, calculation of injuries settlement, insurance claim and settlement for automobile repair expenses, rule management, and risk management.

The accident reception process is executed in the accident reception processing unit 101. In this process, as shown in FIG. 5A, vehicle information and human information, accident date and time, accident location, damage of the customer for the reception of the accident and the identification of the accident A web page capable of inputting / correcting a situation degree and the like is provided, and generates a serial number corresponding to an incident receipt inputted through the web page. In addition, a compensation officer for accident investigation and insurance claim / payment is designated and stored in the compensation database along with the input information and serial number, and the contact person information is searched for a task for handling the incident reception based on the input / correction information. Along with the above web page or searching for and presenting one or more service provider information for repair of the accident vehicle or one or more hospital information for the treatment of victims, and sending a short message or email to the customer's mobile phone or email address. Through the real-time sending process is processed. Here, the short message and the e-mail sent in real time may include selection response confirmation information enabling selection of a maintenance company or a hospital to be selectively repaired or treated, and message response confirmation information for determining whether to agree to use a designated company or a hospital. It may be included and sent to the customer, depending on whether or not the response is returned from the customer, which may be further sent to the selected company or hospital by internal online fax or short message requesting repair or victim treatment. Will be.

The accident investigation process is executed in the accident investigation processing unit 102. In this process, as shown in FIG. 5B, a web page capable of inputting / searching / correcting the damage situation information according to the accident investigation result is presented, and the web A process of storing information input / corrected through a page in a compensation database or searching for a task for an accident investigation process based on the input / corrected information is presented to the web page. In this process, if there is normal information input or abnormal information input, search the work specification for each victim / damage and present it as a web page. Therefore, if the compensation officer checks the work task to be done, provide the work specification for each victim / damage. The web page as shown in FIG. 5C is again presented. This allows the compensation officer to re-investigate and enter the information.

In particular, in the accident investigation process, when the input of the data through the incident reception and investigation is completed, the accident investigation processing unit 102 extracts a standard insurance premium for calculating the insurance premium and presents it as a comparison standard through a web page as shown in FIG. 5D. Based on the estimated damages, a basic accounting amount may be set for victim management, or a compensation person may arbitrarily determine the basic accounting amount.

The victim management process is executed in the victim management processing unit 103. In this process, as shown in FIG. 5E, a web page capable of inputting / searching / correcting information for victim management corresponding to the accident investigation result is presented. In addition, the process of storing information input / corrected through the webpage in a compensation database or searching for a task for victim management based on the input / corrected information is presented to the webpage.

The damage management process is executed by the damage management processing unit 104. In this process, as shown in FIG. 5F, a web capable of inputting / searching / correcting information for managing the damage corresponding to the accident investigation result is possible. A page is presented, and a process of storing information input / corrected through the webpage in a compensation database or searching for a task for managing damage based on the information input / corrected is presented as the webpage.

The claim / payment process is executed by the claim / payment processing unit 105. In this process, the information input through the accident reception / investigation process and the victim / damage management process as shown in FIGS. 5G and 5H are performed. Web page for calculating the insurance premium for the incident, notification or compensation process is presented by extracting the standard insurance premium based on the insurance policy, the insurance policy and the insurance authority of the compensation officer. The process includes checking the victim's consent for the insurance amount calculated through the web page, confirming the approval of the upper payer, and self-audit. In particular, this process checks whether there is an instruction by the above payer before checking whether the payer calculated by the compensation officer is required to pay. The process of presenting via a web page or sending a short message or an e-mail to an e-mail address is further performed on the terminal of the compensation officer. In this case, the compensation officer may be able to reduce or cancel the insurance decision.

On the other hand, before confirming the settlement of the upper payers required for the payment of the calculated insurance premiums, the process of checking the self-audit matters is performed to search for self-contracts, seizure, debt, and insurance accidents by the compensation officer. When at least one of the contract, seizure, debt, and insurance accidents is found, a short message or email including the contents of the searched self-audit item can be sent to the upper payer's mobile phone or e-mail in real time, or viewed by the upper payer. The presentation process is made through a web page.

In this process, the benefits are extracted based on the personal information of the injured victim and the input information surveyed by the compensation officer, and the amount of damage closest to the victim's degree of injury is collected from the previous payment information stored in the compensation database. Extraction and retrieval process is performed through the web page, and the extraction or retrieval process is carried out for a predetermined period of time (for example, for a period of 3 years from now) stored in the compensation database. Are divided according to the accident area, degree of damage, age, sex, etc. In this process, the information entered through the accident reception / investigation process and the victim / damage management process, and the insurance money extracted based on the insurance policy, company guidelines, and the insurance decision authority of the compensation officer stored in the compensation database are included in the compensation data. If there is any discrepancy between the insurance payment information over a certain period of time stored in the base and informs the policyholder through the short message or e-mail, the policyholder will be informed of the insurance policy criteria, or the incident / The information entered through the investigation process and the victim / damage management process, and the benefits extracted based on the insurance terms, company guidelines, and claims authority's authority to determine the benefits stored in the compensation database, are stored in the compensation database for a period of time. Insurance payment information and a certain value In case of discrepancies, the relevant information is presented on the above web page for recognition by the top payers so that the company's insurance standards can be recognized.

The rule management process is executed in the rule management processing unit 106 and provides a web page capable of input / correction of rules stored in the rule database according to a request of a user having rule correction authority. A process of executing a series of rule management processes for generating a new rule or modifying the rule based on the input / corrected rule and storing it in the rule database is performed by checking whether the input / correction and the approval by the upper payer are performed. In this process, in particular, if there is a generation or change of the rule, an e-mail including whether the generation or change and a list of the generated or changed rule is notified to the e-mail address of a rule manager who operates and manages the rule database. This is done.

The risk management process is executed in the risk management processing unit 107, and checks item information input / corrected through the web page, searches and accumulates and sums risk points of the corresponding check item information from the compensation database. Accumulate warning points to analyze the possibility of insurance fraud, and fill out a notification form or investigation form for the detection of insurance fraud in case of accident occurrences, notifications or compensations for which the warning points accumulate more than the standard value. Or sending through Net-Fax.

Next, create an accident receipt serial number related to the accident receipt information entered / corrected through the web page, and assign a compensation person who can handle and handle the compensation work of the accident receipt incident together with the input / correction information. The process of storing in the compensation database is performed. In this process, the customer's contract information and personal information, insurance payment information for a certain period of time, damage situation information by accident receipt / investigation that is input or corrected in real time through the web page, claims and settlement information, contract customer Information related to the accident vehicle information / accident security / victim sequence is stored in the compensation database along with the compensation related data such as the accident serial number and compensation organization / contact information. In particular, a process of periodically updating and storing insurance payment information stored in the compensation database for the predetermined period of time by insurance information paid during the recent predetermined period by the compensation officer is performed.

Finally, the task of the compensation officer is to retrieve from the rule database through a rule search engine and feed back to the web page whenever the information of the web page is corrected. Distinguish one or more possible condition information for item information and a plurality of rule information defined by combining one or more condition information, and search for at least one task for each of the plurality of rules. The process of presentation is done. In particular, in this process, the compensation person searches for the task to be processed by the compensation person based on the contract information and personal information of the customer which is input or corrected in real time through the web page, the damage situation information according to the incident reception / investigation result, the insurance claim and the settlement information. In addition, in this process, a task for the compensation officer to deal with may be presented through a web page as well as a short message or an e-mail may be sent out.

6A and 6B are exemplary views of a web page provided from a compensation processing server to a mobile communication terminal in a client environment. When the mobile communication terminal is connected to a compensation processing server using a mobile communication terminal, the mobile communication terminal is connected to a general user terminal. In comparison, since the size of the display screen is relatively small, the compensation processing server reconstructs the text screen for the mobile communication terminal by extracting only the text of the main matter from the display contents of the web page presented by the execution of each process as illustrated in the figure. After that, it can be presented to the mobile communication terminal of the client environment. The left screen of FIG. 6A is an example screen showing items that can be executed in the initial state connected to the compensation processing server, and the right screen is a contract when selecting and clicking the "Contract / incident inquiry" item from the example screen of the initial connection state. This is an example screen showing the search results. The left screen of FIG. 6B is an example screen in which items necessary for initial compensation service processing are presented when the user selects and clicks the "initial compensation service" item from the initial screen of the connection initial state. In the case of selecting and clicking the item "Work inquiry", it is an example screen showing the result of the job inquiry to be done together with the incident receipt serial number.

The compensation processing system and method according to the present invention can be modified and applied in various forms within the scope of the technical idea of the present invention. Therefore, the embodiments and the drawings are only for the purpose of describing the contents of the invention in detail, and are not intended to limit the scope of the technical idea of the invention, the scope of the present invention is not limited to the claims to be described later, the equivalent scope thereof It should be judged including.

According to the present invention, it is possible to accumulate data and information, and to efficiently and effectively notify and communicate with related parties, as well as efficient office space, by the compensation staff based on integrated database functions. There is an advantage to provide a reduction in the company's operating costs by using.

In addition, the present invention makes it possible to efficiently perform transactions (decision making) between insurance companies and customers, insurance companies and trading companies, team leaders and employees. Therefore, according to the present invention, the insurance company can not only increase the efficiency of compensation work, but also can reduce costs, thereby improving work productivity, and also improving customer satisfaction by one-stop processing in the field. And the like.

Claims (45)

A plurality of client terminals capable of connecting to the Internet through a wired or wireless network; A web page that performs authentication of a user who has a request for access through the client terminal, and inputs / inquiries / corrections of contract information and personal information of the customer, damage situation information by accident reception / investigation, insurance claim and settlement information. To a certified client terminal, assign a compensation officer for processing the compensation business, store the information with the information input / corrected through the web page in the compensation database, and process the compensation officer according to the input / correction information. A reward processing server for searching and presenting a task to the web page; Contract information and personal information of customers, insurance payment information for a certain period of time, damage situation information by receipt / investigation of accidents that are entered or corrected in real time through the web page, claims and settlement information, accidents related to contract customers Compensation database for storing information such as vehicle information / accident collateral / victim sequence, along with compensation-related data such as accident receipt number and compensation organization / contact information, The compensation database is a compensation processing system through a virtual consultant, characterized in that for setting a plurality of item information that causes insurance fraud, and stores the risk point corresponding to each item information. The method of claim 1, wherein the compensation processing server, Compensation processing system through a virtual consultant, characterized in that by sending a short message or email as well as presenting a task to be handled by the compensation person through a web page. The method of claim 1, wherein the compensation processing server, Compensation processing system through a virtual consultant, characterized in that the insurance payment information for the past predetermined period stored in the compensation database periodically updated and stored by the compensation information paid during the recent predetermined period by the compensation officer. The method of claim 1, One or more possible condition information for a plurality of item information which is a standard of compensation processing, and a plurality of rule information defined by combining one or more condition information are separately stored, and at least one for each of the plurality of rules. A rule database constituting a task table in correspondence with the above task; It is connected to the compensation processing server, and the compensation officer to process on the basis of the customer's contract information and personal information, the damage situation information according to the incident received / investigation results, claims and settlement information through the web page in real time And a rule search engine for retrieving a business task from the rule database and feeding it back to the compensation processing server. The method of claim 4, wherein the rule database, Compensation processing system through a virtual consultant, which stores business rules based on company guidelines, regulations and employee experience. The method of claim 4, wherein the rule search engine, Whenever the information of the web page provided through the compensation processing server is corrected, the compensation database through the virtual consultant, characterized in that to feed back the task by searching the rule database. The method of claim 4, wherein the compensation processing server, Provides a web page that allows input / correction of customer's vehicle information, personal information, accident date, accident location, damage status, etc. to receive an accident and identify the contents of the accident, and responds to incidents received through the web page Create a serial number to designate a person in charge of compensation for accident investigation and insurance claim / payment, and store the information in the compensation database with the input information and serial number, and the task for processing the incident received based on the input / corrected information An accident reception processing unit which executes a series of accident reception processes presented by the web page along with information on the person in charge; Presenting a web page that allows input / retrieval / correction of damage situation information according to the accident investigation result, and stores the information input / corrected through the webpage in a compensation database or the accident investigation process based on the input / correction information An accident investigation processing unit that executes a series of accident investigation processes for searching and presenting a business task for the web page; Presenting a web page capable of inputting / viewing / correcting information for victim management corresponding to the accident investigation result, and storing information input / corrected through the webpage in a compensation database or on the input / corrected information A victim management processing unit which executes a series of victim management processes for searching and presenting work tasks for victim management based on the web page; Presenting a web page capable of inputting / viewing / correcting information for managing the damage corresponding to the accident investigation result, and storing the information input / corrected through the webpage in a compensation database or the information input / corrected A damage management processing unit for executing a series of damage management processes for searching and presenting a task for damage management based on the web page; Based on the information entered through the incident reception / investigation process and victim / damage management process, and the insurance policy, insurance / insurance, and compensation authority of the compensation officer stored in the compensation database, the standard insurance money is extracted and the accident occurs. It includes a claim / payment processing unit that provides a comparative standard for calculating the insurance claims for notifications or accidents in the process of notification or compensation, and executes the compensation process by confirming the victim's consent to the insurance claims calculated by the compensation officer and whether or not the upper settlement is approved. Compensation processing system through a virtual consultant, characterized in that. According to claim 7, The accident reception processing unit, Selective response confirmation information to enable the selection of the service provider or hospital to be repaired or treated, or message response confirmation information to determine whether to agree to use the designated company or hospital, etc. And sending a receipt document requesting vehicle repair or victim treatment through an internal online fax or short message to a selected or designated company or hospital according to the response returned from the corresponding customer. . The method of claim 7, wherein the compensation processing server, According to a request of a user having a rule correcting authority, a web page capable of inputting / correcting a rule stored in the rule database is provided, and checking the input / correction of a rule through the webpage and the approval by a higher payer And a rule management processing unit which executes a series of rule management processes for generating or changing a new rule based on an input / corrected rule and storing it in the rule database. The method of claim 9, wherein the rule management processing unit, When there is a generation or change of the rule, an e-mail including whether the generation or change and a list of the generated or changed rule is notified to an e-mail address of a rule manager in charge of operating and managing a rule database. Compensation processing system through consultants. The method of claim 7, wherein the claim / payment processing unit, Prior to confirming the approval of the upper payer required for payment of the calculated insurance premium, check whether there are instructions by the upper payer and audit by self-audit, and when the instructions or the self audit are confirmed Compensation processing system through a virtual consultant, characterized in that a short message or email is sent to the terminal or email address of a compensation staff member. The method of claim 11, wherein the claim / payment processing unit, And a compensation or a discount system for a virtual consultant, characterized in that the compensation decision authority of the corresponding compensation officer is reduced or canceled when a return or an indication about the calculated insurance premium occurs as a result of confirming the instruction. The method of claim 11, wherein the claim / payment processing unit, In connection with the human resources database that stores the employee's personal information, it searches for error or error information about the corresponding compensation staff, and if the number of mistakes or errors exceeding the standard value is searched and retrieves and presents a training course for the corresponding compensation manager. Compensation processing system through a virtual consultant, characterized in that. The method of claim 11, wherein the claim / payment processing unit, At least one item of self-contract, seizure, debt, and insurance accidents by searching for the self-contract, seizure, debt, and insurance accident by the compensation officer before checking whether the upper payer required to pay the calculated insurance payment is confirmed. If the search is a reward processing system through a virtual consultant, characterized in that for sending a short message or email containing the content of the search in real time to the mobile phone or email of the upper bill. The method of claim 11, wherein the claim / payment processing unit, Based on the personal information of the injured victim and the input information surveyed by the compensation officer, the standard insurance premium is extracted, and the standard insurance premium is derived from the insurance payment information for a certain period of time stored in the compensation database. Compensation processing system through a virtual consultant, characterized in that the extraction and presenting through the web page. The method of claim 15, wherein the claim / payment processing unit, Compensation processing system through a virtual consultant, characterized in that for searching the insurance payment information for a predetermined period stored in the compensation database according to the reference accident area, damage degree, age, gender, and the like. The method of claim 15, wherein the claim / payment processing unit, The information entered through the accident reception / investigation process and the victim / damage management process, and the insurance money extracted based on insurance policy, company guidelines, and compensation decision authority of the compensation officer stored in the compensation database are stored in the compensation database. Compensation processing system through a virtual consultant, characterized in that the information is notified to the policyholder through a short message or e-mail when there is a difference between the insurance payment information over a certain period. The method of claim 15, wherein the claim / payment processing unit, The information entered through the accident reception / investigation process and the victim / damage management process, and the insurance money extracted based on insurance policy, company guidelines, and compensation decision authority of the compensation officer stored in the compensation database are stored in the compensation database. Compensation processing system through a virtual consultant, characterized in that the content is presented on the web page so that the above payment can be recognized by more than a certain amount of difference between the insurance payment information for a certain period. delete The method of claim 1, wherein the compensation processing server, Check the item information input / corrected through the web page, search and accumulate the risk points of the check item information from the compensation database to calculate a warning point cumulative value for analyzing the possibility of insurance fraud, and the warning It includes a risk management processing unit that generates a report form or investigation form for detecting insurance fraud and sends it through a designated e-mail or net-fax for incidents in which accidents, notifications, or compensations with accumulated points exceeding the reference point are sent out. Compensation processing system through virtual consultant. According to claim 1, The accident reception processing unit, In case of inputting / correction of accident reception information through the web page, when accumulating warning points for maintenance company information or hospital information is searched based on the risk points of the compensation database, when accumulating warning points above the reference value are found Compensation processing system through a virtual consultant, characterized in that the short message or email containing the contents are sent in real time to the compensation person's mobile phone or email address. Access is made by a reward database that stores various information related to customer rewards, a rule database that stores a number of rules and tasks as a basis for reward processing, and a plurality of terminals on a wired / wireless network. In the network system comprising a compensation processing server capable of constructing and managing a database and a rule search engine for constructing and managing a database of the rules, the compensation processing method executed by the compensation processing server, (a) a first step of performing authentication for a plurality of users requesting access through a network; (b) execute at least one process that enables the processing of the compensation task at the request of each user authenticated in the first step, and thus in connection with the incident receipt / investigation or victim / damage management or claim / payment; Providing a web page capable of inputting / viewing / correcting data; (c) create an accident receipt serial number related to the accident receipt information entered / corrected through the web page, and assign a compensation officer who can handle the accident affairs in charge of the incident receipt with the information entered / corrected Storing in a compensation database; and (d) a fourth step of searching for a task to be processed by the compensation officer from a rule database through a rule search engine and feeding it back to the web page. The method of claim 22, wherein the third step, Customer's contract information and personal information, insurance payment information for a certain period of time, damage situation information by accident receipt / investigation entered or corrected in real time through the above web page, claims and settlement information, Compensation processing method through a virtual consultant, characterized in that the information such as accident vehicle information / accident collateral / victim sequence is stored in the compensation database along with compensation related data such as accident receipt serial number and compensation organization / contact information. The method of claim 23, wherein the fourth step, Compensating through a virtual consultant comprising the step of presenting the task to be handled by the compensation officer via a web page, and sending a short message or e-mail. The method of claim 22, wherein the third step, Compensation processing method through a virtual consultant, characterized in that for updating the insurance payment information for a predetermined period of time stored in the compensation database periodically by the compensation information paid during the recent predetermined period by the compensation staff. The method of claim 22, wherein the fourth step, Distinguish one or more possible condition information for a plurality of item information which is a standard of compensation processing and a plurality of rule information defined by combining one or more condition information, and at least one or more for each of the plurality of rules Compensation processing method through a virtual consultant, characterized in that search for and present a task (Task). The method of claim 26, wherein the fourth step, Through the above web page, the compensation person searches for the task to be handled by the compensation person based on the contract information and the personal information, the damage situation information according to the accident reception / investigation result, the insurance claim and the settlement information. How to handle compensation through a virtual consultant. The method of claim 26, wherein the fourth step, Compensation processing method through a virtual consultant, characterized in that executed every time the information of the web page provided through the compensation processing server is corrected. The process of claim 22, wherein the process executed in the second step comprises: Provides a web page that allows input / correction of customer's vehicle information, personal information, accident date, accident location, damage status, etc. to receive an accident and identify the contents of the accident, and responds to incidents received through the web page Create a serial number to designate a person in charge of compensation for accident investigation and insurance claim / payment, and store the information in the compensation database with the input information and serial number, and the task for processing the incident received based on the input / corrected information An accident reception process for executing a series of accident reception processes presented by the web page along with the person in charge; Presenting a web page that allows input / retrieval / correction of damage situation information according to the accident investigation result, and stores the information input / corrected through the webpage in a compensation database or the accident investigation process based on the input / correction information An accident investigation process for executing a series of accident investigation processes for searching and presenting a business task for the web page; Presenting a web page capable of inputting / viewing / correcting information for victim management corresponding to the accident investigation result, and storing information input / corrected through the webpage in a compensation database or on the input / corrected information A victim management process for executing a series of victim management processes for searching and presenting work tasks for the management of victims based on the web page; Presenting a web page capable of inputting / viewing / correcting information for managing the damage corresponding to the accident investigation result, and storing the information input / corrected through the webpage in a compensation database or the information input / corrected A damage management process for executing a series of damage management processes for searching and presenting a task for damage management based on the web page; Based on the information entered through the incident reception / investigation process and victim / damage management process, and the insurance policy, insurance / insurance, and compensation authority of the compensation officer stored in the compensation database, the standard insurance money is extracted and the accident occurs. It includes a claim / payment process that provides a comparative basis for calculating the insurance claim for an incident that is being reported or compensated, and executes the compensation process by confirming the victim's consent to the claim calculated by the compensation officer and whether or not a higher payer is settled. Compensation processing method through a virtual consultant, characterized in that the. The method of claim 29, wherein the accident acceptance process, In case of input / correction of accident reception information through the web page, the compensation officer is assigned through the rules of assigning personnel based on the accident area, sales point, product type, accident type, damage degree, estimated damage amount, customer grade, etc. How to handle compensation through a virtual consultant. The method of claim 29, wherein the accident acceptance process, In case of input / correction of accident reception information through the above web page, one or more maintenance company information for repairing the accident vehicle or one or more hospital information for victim treatment is searched based on the accident area. Compensation processing through a virtual consultant comprising the step of sending in real time via a short message or email to a telephone or email address. 32. The method of claim 31, wherein the incident receiving process is Include in the short message or e-mail sent in the above real-time message the confirmation response information to enable the selection of the service provider or hospital to be repaired or treated, and the message response confirmation information to decide whether to agree to use the designated company or hospital. And sending a receipt to the selected company or hospital based on whether a response is returned from the customer or to a designated company or hospital via internal online fax or short message requesting vehicle repair or victim care. Compensation processing through. The process of claim 29, wherein the process executed in the second step comprises: According to a request of a user having a rule correcting authority, a web page capable of inputting / correcting a rule stored in the rule database is provided, and checking the input / correction of a rule through the webpage and the approval by a higher payer And a rule management process for executing a series of rule management processes for generating or changing new rules based on input / corrected rules and storing them in the rule database. 34. The method of claim 33, wherein the rule management process comprises: If there is a generation or change of the rule, notifying the e-mail including the generation or change and a list of the generated or changed rules to an e-mail address of a rule manager in charge of operating and managing a rule database. Reward processing method through a virtual consultant characterized by. The method of claim 29, wherein the claim / billing process is as follows: Prior to confirming the approval of the upper payer required for payment of the calculated insurance premium, check whether there are instructions and self-audit matters by the upper payer, and if the instructions or self-audit matters are confirmed, the instructions or And sending a short message or an e-mail to the terminal or e-mail address of a compensation officer. 37. The claim / billing process of claim 35, wherein And reducing or canceling the insurance decision authority of the corresponding compensation officer when a return or point of reference regarding the calculated insurance money occurs as a result of the instruction check. 37. The claim / billing process of claim 35, wherein In connection with the human resources database that stores the employee's personal information, it searches for error or error information about the corresponding compensation staff, and if the number of mistakes or errors exceeding the standard value is searched and retrieves and presents a training course for the corresponding compensation manager. Compensation processing method through a virtual consultant comprising the step. 37. The claim / billing process of claim 35, wherein At least one item of self-contract, seizure, debt, and insurance accidents by searching for the self-contract, seizure, debt, and insurance accident by the compensation officer before checking whether the upper payer required to pay the calculated insurance payment is confirmed. If the search is characterized in that it comprises the step of sending a short message or an e-mail containing the content of the searched items in real time to the mobile phone or e-mail of the upper payer. 37. The claim / billing process of claim 35, wherein The insurance is extracted based on the personal information of the victim who was injured and the input information surveyed by the compensation officer. Compensation processing through virtual consultant, characterized in that presented through the page. 40. The claim / billing process of claim 39, wherein Compensation processing method through a virtual consultant, characterized in that for searching the insurance payment information for a predetermined period of time stored in the compensation database according to the reference accident area, damage degree, age, gender and the like. 40. The claim / billing process of claim 39, wherein The information entered through the accident reception / investigation process and the victim / damage management process, and the insurance money extracted based on insurance policy, company guidelines, and compensation decision authority of the compensation officer stored in the compensation database are stored in the compensation database. If there is a difference between the insurance payment information and a predetermined value for a certain period of time, a compensation method through a virtual consultant comprising the step of notifying the policyholder by the information through a short message or email. 40. The claim / billing process of claim 39, wherein The information entered through the accident reception / investigation process and the victim / damage management process, and the insurance money extracted based on insurance policy, company guidelines, and compensation decision authority of the compensation officer stored in the compensation database are stored in the compensation database. The compensation method through a virtual consultant, characterized in that the content is presented on the web page so that the higher payment can be recognized if there is a difference between the insurance payment information and a certain value over a certain period. The method of claim 23, wherein the third step, And setting up a plurality of item information which causes insurance fraud, and storing each item information with a risk point in a compensation database. The process of claim 43, wherein the process executed in the second step comprises: Check the item information input / corrected through the web page, search and accumulate the risk points of the check item information from the compensation database to calculate a warning point cumulative value for analyzing the possibility of insurance fraud, and the warning It includes a risk management process that generates a notification form or investigation form for detecting insurance fraud and sends it through a designated e-mail or net-fax for accidents that have accumulated points exceeding a standard value or incidents being processed for compensation. Compensation processing through virtual consultant. 44. The method of claim 43, wherein the incident filing process, In case of inputting / correction of accident reception information through the web page, when accumulating warning points for maintenance company information or hospital information is searched based on the risk points of the compensation database, when accumulating warning points above the reference value are found Comprising the step of sending a short message or email containing the contents in real time to the mobile phone or e-mail address of the compensation person.

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