KR20230018181A - System and Method for Simulating Expected Insurance and Confirmation of Claim Availability - Google Patents

Abstract

The present invention relates to a system and a method for confirming the claim availability and simulating expected insurance, wherein the system and the method enable the confirmation of claim availability and of simulation results for expected insurance on a mobile platform with simple inputs to enhance convenience for the insured. The system comprises: a credit information management server which, when a user transmits personal information of the user and requires insurance contract information of the user through a mobile platform, receives the same and provides the insurance contract information through the mobile platform; an insurance claim confirmation and management server which, when the user inputs information required for confirming insurance claim availability, receives necessary information through the mobile platform, generates information items required for determining the immunity or liability of a corresponding insurance-special option-collateral, provides data input fields in a specific format in order to have necessary values input through a mobile terminal of the insured, and provides an analysis result for confirming claim availability; and a mobile terminal which has the insured input information of the insured in a data input field within the specific format provided by the insurance claim confirmation and management server and lets the insured confirm the analysis result for confirming the claim availability.

Description

System and Method for Simulating Expected Insurance and Confirmation of Claim Availability}

The present invention relates to insurance claim management, and specifically, a system for confirming insurance claim feasibility and expected insurance claim simulation that enhances the convenience of policyholders by allowing them to check whether insurance claim can be made on a mobile platform with a simple input and to check the result of expected insurance payment simulation and methods.

People living in modern society are threatened by various accidents that may occur anytime, anywhere, and insurance is a system created to compensate for economic losses caused by accidents related to human life or property.

This insurance system is a social form of economic provision that helps people maintain a stable family life.

In general, claims for benefits from health insurance claims by hospitals are simply billed through an automated system. Since there are not many applicable designated items for claiming benefits for such health insurance, it is systematized so that the patient's treatment information and treatment cost details are transmitted to one server of the Health Insurance Corporation through automation.

However, an automated system for claiming benefits through actual loss medical insurance is still insufficiently developed. There are many treatment items covered compared to benefit items, and it is difficult to standardize due to differences in servers and applications for each insurance company and each hospital.

In addition, insurance prior to standardization differs in terms of coverage depending on the time of subscription, and due to rather complicated coverage and terms and conditions, not only customers (users, patients, insurers) but also insurance planners are unable to obtain compensation details and required documents for claims. There is a lot of confusion about

Therefore, in insurance claims based on medical records, there are many cases in which unnecessary documents are received or additional documents are required due to mistakes or omissions, resulting in reclaiming.

The insurance company requests re-claim, and in the process, the costs and time incurred due to issuance of documents cause inconvenience to the policyholder, the insurance company, and the hospital. On the other hand, insurance companies intentionally urge omission of insurance payment by exploiting the policyholder's ignorance of the contents of the contract, which is emerging as a social problem along with consumer complaints.

As such, the technology for claiming and paying insurance money in the prior art has a gap between the consumer and the insurance company due to the tedious screening process, complexity of the subscription process, vast terms, complicated guarantees and special contracts, and subscription to insurance products. However, there were frequent cases in which patients did not know whether their disease or treatment records could be covered by insurance.

That is, since the insurer does not accurately recognize the coverage of the insurance product he or she subscribes to, it may be very difficult to determine whether his/her disease can be covered by the insurance product he/she subscribes to.

Accordingly, after receiving a diagnosis, the insured person has the inconvenience of having to confirm the corresponding information by making an inquiry to an insurance agent (FC) or an insurer about what can be guaranteed through the insurance he or she subscribes to.

In particular, insurance policyholders do not know whether I am in a situation where I can receive insurance money when making an insurance claim. In many cases, they do not file a claim because it is cumbersome to inquire at the call center, because it is a small amount, or because it is difficult to easily check whether or not they can receive insurance money.

Therefore, there is a demand for development of a technology that makes it easy to inquire collectively about the insurance subscribed by the user and to inquire medical records, enables insurance claims anywhere, and prevents reclaiming from occurring.

Republic of Korea Patent Registration No. 10-1873147 Republic of Korea Patent No. 10-1741960 Republic of Korea Patent Publication No. 10-2021-0020704

The present invention is to solve the problems of the insurance claim management technology of the prior art, and it is possible to check the possibility of claiming insurance money on a mobile platform with a simple input and check the result of simulation of expected insurance money, thereby increasing the convenience of the policy holder. Its purpose is to provide a system and method for confirming and predicting insurance money simulation.

The present invention provides a system and method for checking whether an insurance claim is possible and simulating expected insurance money, which can prevent omission of an insurance claim even if the policyholder does not accurately remember or understand the coverage of the insurance product he or she subscribes to. Its purpose is to provide

The present invention allows the policy holder to inquire and check whether there are products, special contracts, and collateral that can be received by claiming insurance money in the insurance contract held by the policy holder, thereby increasing the convenience of insurance money claim possibility and expected insurance money simulation system And to provide a method for that purpose.

The present invention helps insurance consumers to solve information asymmetry problems caused by insurance system problems and complicated and difficult insurance products, in which insurance money can be paid only when insurance money is claimed, thereby preventing omission of insurance money claims. Its purpose is to provide a system and method for confirming availability and simulating expected insurance money.

In the present invention, when a keyword registered in the DB is identified in the value processed in collateral identification, the collateral matched by keyword is identified, and information input items matched by collateral are combined to remove duplicated items. The purpose is to provide a system and method for checking whether insurance claims are possible and simulating expected insurance payments.

In the present invention, product names, guarantee classifications, and guarantee names are grouped into a single font, special symbols and blanks are removed, and when product names and guarantee classifications overlap or product names and guarantee names overlap, through the securities information processing step of removing duplication Its purpose is to provide a system and method for checking the possibility of claiming insurance money and simulating the expected insurance money, which enables accurate calculation of expected insurance money.

Other objects of the present invention are not limited to the above-mentioned objects, and other objects not mentioned above will be clearly understood by those skilled in the art from the description below.

In order to achieve the above object, the insurance claim feasibility check and expected insurance amount simulation system according to the present invention transmits the user's personal information through a mobile platform, receives the request for the user's insurance contract information, and contracts the insurance through the mobile platform. Credit information management server that provides information; When a user enters the information necessary to confirm whether the policyholder can claim insurance money, the necessary information is provided through the mobile platform and the information items necessary for determining the exemption of the corresponding insurance product-special contract-collateral are generated Insurance claim confirmation management server that provides data input fields in a specific form so that necessary values can be entered through the mobile terminal of the insurance policyholder and provides analysis results for insurance claim confirmation; insurance claim confirmation management server It is characterized in that it includes; a mobile terminal that allows the user to input information in the data input field in the specific form provided and to check the analysis result for insurance claim confirmation.

Here, the mobile platform managed and provided by the insurance claim confirmation management server receives the necessary information through the mobile platform and creates the information items necessary for determining the exemption of the insurance product-special contract-collateral through the mobile terminal of the policyholder. A control unit that provides a data input field in a specific format so that necessary values can be entered and provides analysis results for insurance claim confirmation; and an input unit that enables input of necessary information for insurance claim confirmation. And, a communication unit that supports communication between the insurance policyholder's mobile terminal, insurance claim confirmation management server, and credit information management server, and a display unit that supports providing data input fields in a specific form and confirming analysis results on a mobile terminal. characterized by

In addition, the insurance claim confirmation management server searches insurance contract information through the contract information management server of each financial company that manages the credit information source server or the user's financial product contract information on the mobile platform through the policyholder's mobile terminal, or A securities information reception unit that receives the security information of the insurance you have subscribed to when it is transmitted, and a collateral identification unit that identifies the collateral matched to the keyword by matching whether there is a keyword registered in the DB in the result value from which duplicate matters have been removed; Result of configuring the information input item composition unit that identifies collateral matched by keyword and combines information input items matched by collateral but removes duplicate items to form a form, and information input form by collateral to input information to policyholders It is characterized in that it includes an information input request unit that provides, and an input information receiving unit that receives information when the policyholder inputs information corresponding to the person in the data input field of the form provided by the information input request unit and returns.

In addition, the insurance claim confirmation management server judges exemption for each collateral constituting the policyholder's policy information based on the information entered by the policyholder received through the input information receiver, and if the judgment result is "not liable", "claim" A claim subject collateral identification unit that identifies a claim as "subject", and an expected insurance amount calculation unit that calculates the "total expected insurance amount" by calculating the expected insurance amount of each collateral identified as "subject to claim" and summing up the expected insurance amount of each collateral; Further comprising a simulation result providing unit for guiding the insurance policyholder to the "total expected insurance amount", which is the sum of the collateral identified as "subject to claim", the expected insurance amount for each collateral, and the expected insurance amount for each collateral, through the policyholder's mobile terminal. do.

In addition, the insurance claim confirmation management server bundles each product name, guarantee classification, and guarantee name into a single bundle, removes special symbols and blanks, and removes duplicates when product names and guarantee classifications overlap or product names and guarantee names overlap. It is characterized in that it further comprises an information processing unit.

In order to achieve another object, the insurance claim feasibility check and expected insurance amount simulation method according to the present invention includes the steps of the insurance policyholder requesting the insurance claim confirmation management server to determine whether or not the policy holder can claim the insurance he or she subscribes to through a mobile platform; Sending user personal information from the platform to the credit information management server and requesting the user's insurance contract information; Receiving insurance contract information from the credit information management server through the mobile platform to the insurance claim confirmation management server; Insurance claim confirmation management Requesting, by the server, information necessary for checking whether or not insurance claims can be made to the policyholder's mobile terminal through the mobile platform; It is characterized in that it includes; receiving the provision; step of providing the analysis result for insurance claim confirmation from the insurance claim confirmation management server so that the insurance policy holder can check it through the mobile platform.

Here, in the step of receiving insurance contract information from the credit information management server through the mobile platform to the insurance claim confirmation management server, the policyholder manages the credit information source server or user's financial product contract information on the mobile platform through the mobile terminal of the policyholder When insurance contract information is inquired through the contract information management server of each financial company, or when the policy information of the insurance subscribed by the principal is transmitted, the insurance claim confirmation management server receives it.

And the detailed securities information items received are insurance company name, insurance product name, guarantee classification, guarantee name, guarantee amount, and contract date. It includes insurance period and contract status items, and in the case of my data operators, it is characterized by including the user's past insurance payment history, burden insurance setting information, foreclosure setting information, and moral risk setting information.

In addition, the step of requesting information necessary to confirm whether insurance claims are possible through the policyholder's mobile terminal includes the process of processing securities information. It is characterized by including bundling, removing special symbols and blanks, and removing duplicates when product names and guarantee classifications overlap or product names and guarantee names overlap.

In addition, the step of requesting information necessary to confirm whether insurance claims can be made through the policyholder's mobile terminal includes a collateral identification process, and the collateral identification process is based on the result value processed in the securities information processing process, which is registered in the DB of the insurance claim confirmation management server. It is characterized in that it includes a process of trying to match whether there is a keyword, and if there is a matching keyword, identifying it as a collateral matched with a keyword registered in the DB of the insurance claim confirmation management server.

And the identified collateral is characterized in that it includes insurance for injury hospitalization medical expenses, daily injury hospitalization insurance, disease hospitalization daily insurance, stroke diagnosis insurance, fracture diagnosis insurance, image diagnosis insurance, attorney appointment cost insurance, and car accident fine insurance items. .

In addition, the step of requesting the information necessary to confirm whether or not insurance claims can be made through the policyholder's mobile terminal includes the process of configuring the information input form for each collateral, and the process of configuring the information input form for each collateral is based on the value processed in the collateral identification process. When the keyword is confirmed, it is characterized by including a process of identifying collateral matched by keyword and combining information input items matched by collateral, but removing duplicate items to form a form.

In addition, when the user inputs the information necessary for checking whether or not the insurance claim is possible through the policyholder's mobile terminal, the next input field is determined according to the input value of the preceding input field at the stage where the insurance claim confirmation management server receives the necessary information and forms a form. A method of obtaining information through the creation of a variable form in which information items to be requested are changed, or a method of obtaining information using a non-variable form that presents all input fields and allows the user to select and input only the relevant information, or a method of obtaining information using a two-way chat function A question-and-answer type information acquisition method using a chatbot that asks for information and receives information in natural language, or a selective information acquisition method using a chatbot that borrows a two-way chat function but presents options for necessary information items and inputs them through selection It is characterized by using.

And the step of providing the insurance claim confirmation management server with the analysis results for insurance claim confirmation so that the insurance policyholder can check it through the mobile platform includes the claim target collateral identification process, and the information entered by the policyholder in the insurance claim confirmation management server It is characterized in that the exemption is judged for each collateral constituting the policyholder's policy information by using, and when the judgment result is "not liable", it is identified as "subject to claim".

In addition, for the calculation of the expected insurance amount, the expected insurance amount of each collateral identified as "subject of claim" is calculated, and the expected insurance amount of each collateral is added to calculate the "total expected insurance amount". It is characterized by providing the "total expected insurance amount", which is the sum of the collateral identified as "subject to claim", the expected insurance amount for each collateral, and the expected insurance amount for each collateral, through the mobile terminal of the policyholder.

As described above, the insurance claim feasibility check and expected insurance payment simulation system and method according to the present invention have the following effects.

First, it enhances the convenience of policyholders by allowing them to check whether insurance claims can be claimed on a mobile platform and check the results of simulation of expected insurance payments with simple input.

Second, even if the policy holder does not accurately remember or understand the coverage of the insurance product he or she subscribes to, it can prevent omission of insurance claims.

Third, it is possible to increase the convenience of claiming insurance money by allowing the policy holder to inquire and check whether there are products, special contracts, and collateral that can be received by claiming insurance money in the insurance contract he/she holds.

Fourth, it helps to prevent the omission of insurance claims by helping insurance consumers with information asymmetry problems caused by complex and difficult insurance products and problems in the insurance system in which the review of whether to pay insurance money can be proceeded only when the insurance money is claimed.

Fifth, when the keywords registered in the DB are identified in the value processed in the collateral identification, the collateral matched by keyword is identified, and the information input items matched by collateral are combined to remove duplicate items, so that the expected insurance amount can be accurately calculated. make it possible

Sixth, product name, guarantee classification, and guarantee name are grouped into a single block, special symbols and blanks are removed, and securities information processing steps are performed to eliminate duplication in cases where product names and guarantee classifications overlap or product names and guarantee names overlap. It is possible to calculate the expected insurance amount.

1 is a flow chart of the overall service of the insurance claim feasibility check and expected insurance amount simulation system according to the present invention
2 is an overall configuration diagram of a system for checking whether insurance claims are possible and simulating expected insurance payments according to the present invention;
3 is a detailed configuration diagram of a mobile platform managed and provided by the insurance claim confirmation management server according to the present invention.
Figure 4 is a flow chart showing a method for checking whether insurance claims can be made and simulating expected insurance money according to the present invention.
5 is a flow chart for configuring an input form for configuring information input items
6 is a block diagram showing a method for acquiring question-and-answer type information according to an embodiment of the present invention.
7 is a block diagram showing a method for obtaining selective information according to another embodiment of the present invention.

Hereinafter, a preferred embodiment of a system and method for checking whether an insurance claim is possible and simulating an expected insurance amount according to the present invention will be described in detail.

The characteristics and advantages of the insurance claim feasibility check and expected insurance payment simulation system and method according to the present invention will become clear through a detailed description of each embodiment below.

1 is an overall service flow diagram of a system for checking whether an insurance claim is possible and simulating expected insurance money according to the present invention.

The insurance claim feasibility check and expected insurance amount simulation system and method according to the present invention are designed to increase the convenience of policyholders by enabling them to check whether insurance claim feasibility and expected insurance amount simulation results are confirmed on a mobile platform with a simple input.

In particular, an insurance system that prevents omission of insurance claims even when the policyholder does not accurately remember or understand the coverage of the insurance product he or she subscribes to, and allows the review of whether or not to pay insurance money only after claiming the insurance money It is intended to help insurance consumers with information asymmetry problems caused by disputes and complicated and difficult insurance products.

To this end, the present invention may include a configuration that allows the policyholder to inquire and confirm whether there is a product, special contract, or security that can be received by claiming insurance money in the insurance contract held by the policyholder himself.

In the present invention, when a keyword registered in the DB is identified in the value processed in collateral identification, the collateral matched by keyword is identified, and information input items matched by collateral are combined to remove duplicated items. It may include a configuration that makes this possible.

In the present invention, product names, guarantee classifications, and guarantee names are grouped into a single font, special symbols and blanks are removed, and when product names and guarantee classifications overlap or product names and guarantee names overlap, through the securities information processing step of removing duplication It may include a configuration that enables accurate calculation of expected insurance money.

In the following description, the 'credit information management server' may be the 'credit information source server' or the 'contract information management server' of each financial company that manages the user's financial product contract information in the case of a My Data provider, but is not limited thereto. .

The insurance claim feasibility check and expected insurance amount simulation system and method according to the present invention performs insurance claim feasibility check and expected insurance amount simulation as shown in FIG. 1 .

First, ① when the policyholder requests confirmation through the mobile platform managed and provided by the insurance claim confirmation management server 200 whether or not the policy holder can claim the insurance he or she has subscribed to through the mobile terminal 300 of the policyholder, ② on the mobile platform The user's personal information is transmitted to the credit information management server 100 (which may be the 'contract information management server' of each financial company that manages the user's financial product contract information in the case of a credit information source server or My Data provider) and Request insurance contract information.

③ Insurance contract information is provided from the credit information management server 100 to the mobile platform, and ④ insurance contract information is provided to the insurance claim confirmation management server 200 through the mobile platform.

And ⑤⑥ insurance claim confirmation management server 200 requests information necessary for confirming whether or not insurance claim can be made to the policyholder's mobile terminal 300 through the mobile platform.

⑦ When the user inputs information necessary for checking whether insurance claims are possible through the policyholder's mobile terminal 300, the necessary information is provided to the insurance claim confirmation management server 200 through ⑧ the mobile platform.

⑨ The insurance claim confirmation management server 200 provides the analysis result for insurance claim confirmation through the mobile platform to the policyholder's mobile terminal 300, including ⑩ claim details, preparation documents, and expected insurance money items, so that the policyholder can check it. do.

In this way, when the insurance policyholder transmits the policy information of the insurance that the policy holder has subscribed to to the insurance claim confirmation management server 200, the insurance claim confirmation management server 200 enters the policy information into the insurance claim omission prevention system to enter the insurance product- It creates the information items necessary for determining the exemption of special contract-collateral.

The insurance claim confirmation management server 200 provides a data input field in a specific format so that the insurance policyholder can input a value for the information item (data) necessary for determining the waiver.

The policyholder inputs his or her own information into a data input field in a specific form provided by the insurance claim confirmation management server 200 .

The insurance claim confirmation management server 200 inputs the information entered by the policyholder into the program logic installed in the insurance claim confirmation management server 200 to generate a result of determining the policyholder's insurance product-special contract-collateral exemption .

Here, the securities information may include, but is not limited to, the insurance company subscribed to, the name of the insurance product, the name of the special contract, the name of the security, the date of subscription, the subscription amount, and contract status data.

In the case of my data operators, it may include, but is not limited to, the user's past insurance payment history, burden insurance setting information, seizure setting information, and moral risk setting information.

In addition, information items necessary for determining exemption may include, but are not limited to, diagnosis code, diagnosis date, surgery status, hospitalization status, hospitalization days, and medical expense amount data items.

And the contractor's information entered in the data input field in the specific form is diagnosis code: "S32.1", diagnosis date: "2021.07.01", surgery status: "N", medical expenses: "1,250,550 won", hospitalization status: "Y", days hospitalized: "5 days", and the like, but are not limited thereto.

The policyholder's policyholder's policyholder's policyholder's insurance product-special contract-coverage coverage may include items such as actual loss medical expenses coverage: "indemnity", sickness hospitalization day coverage: "indemnification", general disease surgery cost coverage: "immunity", etc. Not limited to this.

The insurance claim feasibility check and expected insurance money simulation system according to the present invention will be described in detail as follows.

2 is an overall configuration diagram of a system for checking whether an insurance claim is possible and simulating expected insurance money according to the present invention.

As shown in FIG. 2, the insurance claim feasibility check and expected insurance amount simulation system according to the present invention transmits user personal information through a mobile platform, receives the request for the user's insurance contract information, and provides insurance contract information through the mobile platform. When the credit information management server 100 provides and the user enters the information necessary to confirm whether the policyholder can claim insurance money, the necessary information is provided through the mobile platform, and the information item necessary for determining the exemption of the corresponding insurance product-special contract-collateral An insurance claim confirmation management server 200 that generates and provides a data input field in a specific format so that necessary values can be input through the mobile terminal 300 of the policy holder, and provides analysis results for insurance claim confirmation; Includes a mobile terminal 300 that allows the policyholder to input his/her information into a data input field in a specific form provided by the insurance claim confirmation management server 200 and check the analysis result for insurance claim confirmation do.

Here, the mobile platform managed and provided by the insurance claim confirmation management server 200 receives the necessary information through the mobile platform and creates the information items necessary for determining the exemption of the corresponding insurance product-special contract-collateral to the mobile terminal of the policyholder. The control unit 200a provides a data input field in a specific format so that necessary values can be input through 300 and performs control to provide analysis results for insurance claim confirmation, and necessary information for insurance claim confirmation An input unit 200b for performing input, a communication unit 200c for supporting communication between the mobile terminal 300 of the insurance policyholder, the insurance claim confirmation management server 200, and the credit information management server 100, and data It includes a display unit 200d that provides input fields in a specific form and supports checking analysis results on the mobile terminal 300 .

The detailed configuration of the control unit of the mobile platform provided by the insurance claim confirmation management server 200 is as follows.

3 is a detailed configuration diagram of a mobile platform provided by the insurance claim confirmation management server according to the present invention.

As shown in FIG. 3, the mobile platform provided by the insurance claim confirmation management server 200 allows the policyholder to use the mobile platform through the policyholder mobile terminal 300 to access the credit information source server (my data provider, the user's financial product contract information). It can also be the 'contract information management server' of each financial company that is being managed) to retrieve insurance contract information or check the insurance certificate held by the person, etc. Information receiving unit 31, product name, warranty classification, and warranty name are bundled into one word, special symbols and blanks are removed, and if product name and guarantee classification overlap or product name and guarantee name overlap, securities information to remove duplication A processing unit 32 and a collateral identification unit 33 that matches the result value processed by the securities information processing unit 32 to see if there is a keyword registered in the DB to identify a collateral matched to the keyword, and collateral identification When the keyword registered in the DB is confirmed in the value processed in section 33, the collateral matched by the keyword is identified, and the information input items matched by the collateral are combined, but duplicate items are removed to configure the form. The configuration unit 34, the information input request unit 35 that provides the result of configuring the information input form by collateral to input information to the policyholder, and the data input of the form provided by the policyholder in the information input request unit 35 When the information corresponding to the person is entered in the field and the reply is received, the input information receiving unit 36 receives the information, and the policyholder judges the exemption for each collateral constituting the policyholder's policy information based on the information entered by the policyholder. If is "non-indemnity", the claim subject collateral identification unit 37, which identifies it as "claim subject", calculates the expected insurance amount of each collateral identified as "claim subject", and adds up all expected insurance amounts of each collateral to obtain "expected insurance amount" The expected insurance amount calculation unit 38 that calculates the "total amount", and the "total expected insurance amount" that adds up the collateral identified as "claim subject" to the policyholder, the expected insurance amount for each collateral, and the expected insurance amount for each collateral, the policyholder moba It includes a simulation result providing unit 39 that guides through the terminal 300 .

The detailed description of the method for checking whether insurance claims are possible and simulating expected insurance payments according to the present invention is as follows.

4 is a flowchart showing a method for checking whether an insurance claim is possible and simulating an expected insurance payment according to the present invention.

As shown in FIG. 4, the method for checking whether insurance claims can be made and simulating expected insurance money according to the present invention comprises a securities information receiving step (S401), a securities information processing step (S402), a collateral identification step (S403), and an information input form for each collateral. Step (S404), information input request step (S405), input information reception step (S406), claim target collateral identification step (S407), expected insurance amount calculation step (S408), claim availability and expected insurance amount information step (S409) include

First, in the stock information receiving step (S401), the insurance policyholder on the mobile platform through the policyholder mobile terminal 300 credit information source server (in the case of My Data operators, each financial company managing contract information for financial products of the user) server'), the credit information management server 100 receives it when the policy information of the insurance subscribed by the principal is transmitted, such as inquiring insurance contract information or checking the insurance certificate held by the principal.

Subsequently, in the securities information processing step (S402), product names, guarantee classifications, and guarantee names are grouped into a single bundle in the insurance claim confirmation management server 200, special symbols and blanks are removed, product names and guarantee classifications are duplicated, or product names If there is a duplication of the guarantee name and the guarantee name, the duplication is removed.

And in the collateral identification step (S403), matching is attempted to see if there is a keyword registered in the DB of the insurance claim confirmation management server 200 to the result value processed in the securities information processing step.

If there is a matching keyword, it is identified as a collateral matched with a keyword registered in the DB of the insurance claim confirmation management server 200 .

Subsequently, in the step of constructing an information input form for each collateral (S404), when the keyword registered in the DB is identified in the value processed in the collateral identification step, collateral matched by keyword is identified, and information input items matched by collateral are combined. Duplicate items are removed to compose the form.

In the information input request step (S405), a result of configuring an information input form for each collateral is provided to the policyholder to input information.

At this time, data input fields are combined, redundancies are removed, and forms are created according to (1) whether a question is necessary and (2) a question priority rule.

Then, in the step of receiving the input information (S406), the insurance policyholder enters and returns the information corresponding to the person in the data input field of the form provided by the insurance claim confirmation management server 200, and the insurance claim confirmation management server 200 returns the insurance claim confirmation management server 200. Receives the contractor's input information

And in the claim target collateral identification step (S407), the insurance claim confirmation management server 200 utilizes the information input by the policyholder to determine exemption for each collateral constituting the policyholder's policy information. If the judgment result is "not responsible", it is identified as "subject of claim".

Subsequently, the expected insurance amount calculation step (S408) calculates the expected insurance amount of each collateral identified as "claim subject" and calculates the "total amount of expected insurance amount" by adding up all the expected insurance amount of each collateral.

In addition, in the claim availability and expected insurance amount information step (S409), the policyholder is provided with the policyholder's mobile terminal (the total amount of expected insurance money), which is the sum of the collateral identified as "claimable", the expected insurance money for each collateral, and the expected insurance money for each collateral. 300).

The detailed configuration of each step of the method for checking whether insurance claim is possible and simulating expected insurance money according to the present invention will be described as follows.

As shown in Table 1, the detailed securities information items received in the securities information receiving step (S401) may include insurance company name, insurance product name, guarantee category, guarantee name, guarantee amount, contract date, insurance period, and contract status items. Yes, and in the case of my data operators, the user's past insurance payment history, burden insurance setting information, seizure setting information, and moral risk setting information may be included, but are not limited thereto.

And in the stock information processing step (S402), each product name, guarantee classification, and guarantee name are grouped into a single bundle, and special symbols and blanks are removed. If product names and guarantee classifications overlap or product names and guarantee names overlap, duplicates are removed. The guaranteed amount, sign-up date, guarantee period, and contract status are saved and used when calculating the expected insurance amount.

An example of stock information processing is as follows.

Before Processing: (Product Name) Universal Living Care Lifetime 3.0 None_Standard_Non-temporary, (Guarantee Classification) Actual Loss Medical Expenses, (Guarantee Name) Accident Hospitalization Medical Expenses → After Processing: Actual Loss Medical Expenses Hospitalization Medical Expenses

Before Processing: (Product Name) Universal Living Care Lifetime 3.0 None_Standard_Non-temporary, (Guarantee Classification) Daily Hospitalization, (Guarantee Name) Daily Hospitalization for Injury → After Processing: Daily Hospitalization for Injury

Before Processing: (Product Name) Universal Living Care Lifetime 3.0 None_Standard_Non-temporary, (Guarantee Classification) Stroke Diagnosis, (Guarantee Name) Universal Living Care Lifetime 3.0 None_Standard_Non-temporary → After Processing: Stroke Diagnosis

Before Processing: (Product Name) Universal Living Care Lifetime 3.0 None_Standard_Non-temporary, (Guarantee Classification) Fracture Diagnosis, (Guarantee Name) Universal Living Care Lifetime 3.0 None_Standard_Non-temporary → After Processing: Fracture Diagnosis

Before Processing: (Product Name) Universal Living Care Lifetime 3.0 None_Standard_Non-Time, (Guarantee Classification) Major Burn Diagnosis, (Guarantee Name) Universal Living Care Lifetime 3.0 None_Standard_Non-Time → After Processing: Severe Burn Diagnosis

Before processing: (Product name) (Non-) KB Driver Insurance and Safe Living Story (21.06) 2 types (23335), (Guarantee category) Damages for car accident attorney appointment costs (driver) (20-year renewal type) → After processing: Car accident 20-year renewal sentence for damages caused by attorney appointment costs

In the collateral identification step (S403), matching is attempted to see if there is a keyword registered in the DB in the result value processed in the stock information processing. If there is a matching keyword, it is identified as a collateral that matches the keyword registered in the DB.

An example of a collateral identification keyword is shown in Table 2, and the identified collateral is injury hospitalization medical expense insurance, injury hospitalization daily insurance, sickness hospitalization insurance, stroke diagnosis insurance, fracture diagnosis insurance, burn diagnosis insurance, attorney appointment cost insurance, Including, but not limited to, car accident penalty claims.

The step of constructing an information input form for each security (S404) and the step of requesting information input (S405) are described in detail as follows.

5 is a flow chart for configuring an input form for configuring information input items.

5 shows a method of obtaining information through creation of a flexible form, and the following input field is determined according to the input value of the preceding input field, and the information items constituting the form are changed.

Table 3 shows the information acquisition method using the non-variable form in the step of configuring the information input form for each security (S404), presenting all input fields and allowing the user to select and input only the relevant information.

Input field items may include items such as accident type, hospitalization status, hospitalization start date, hospitalization end date, co-payment, diagnosis code, diagnosis date, car accident status, lawyer appointment fee, lawyer appointment fee, fine occurrence status, and fine amount. Yes, but not limited thereto.

6 is a block diagram showing a method for acquiring question-and-answer type information according to an embodiment of the present invention.

6 shows a question-and-answer type information acquisition method using a chatbot. Using a two-way chat function, information on necessary information items is asked and the information is input in natural language.

7 is a configuration diagram illustrating a method for obtaining selective type information according to another embodiment of the present invention.

7 shows a selective information acquisition method using a chatbot, which borrows a two-way chat function, but presents options for necessary information items so that they can be input through selection.

And in the input information receiving step (S406), the insurance policyholder inputs the information applicable to the person in the data input field of the form provided by the insurance claim confirmation management server 200 as shown in Table 4, and the insurance claim confirmation management server 200 and the insurance claim confirmation management server 200 receives the input information of the policyholder.

And in the claim target collateral identification step (S407), the insurance claim confirmation management server 200 uses the information entered by the policyholder as shown in Table 5 to determine the exemption for each collateral constituting the policyholder's policy information and Identifies the claimable collateral.

And in the expected insurance amount calculation step (S408), as shown in Table 6, the expected insurance amount of each collateral identified as "claim subject" is calculated and the expected insurance amount of each collateral is summed to calculate the "total amount of expected insurance amount".

The insurance claim feasibility check and expected insurance amount simulation system and method according to the present invention described above increase the convenience of the policyholder by enabling them to check the insurance claim feasibility and the expected insurance amount simulation result on a mobile platform with a simple input, and insurance This is to prevent omission of insurance claims even if the policyholder does not remember or understand exactly the coverage of the insurance product he or she subscribes to.

In particular, it is designed to increase the convenience of claiming insurance money by allowing the policy holder to inquire and check whether there are products, special contracts, and collateral that can be received by claiming insurance money in the insurance contract he or she holds.

As described above, it will be understood that the present invention is implemented in a modified form without departing from the essential characteristics of the present invention.

Therefore, the specified embodiments should be considered from an explanatory point of view rather than a limiting point of view, and the scope of the present invention is shown in the claims rather than the foregoing description, and all differences within the equivalent range are considered to be included in the present invention. will have to be interpreted

100. Credit information management server
200. Insurance claim confirmation management server
300. Contractor mobile terminal

Claims (15)

A credit information management server that transmits user personal information through a mobile platform, receives a user's request for insurance contract information, and provides insurance contract information through a mobile platform;
When the user enters the information necessary for the policyholder to confirm whether or not the policyholder can make a claim, the necessary information is provided through the mobile platform, and the information items necessary for determining the exemption of the insurance product-special contract-collateral are created and necessary through the mobile terminal of the policyholder. an insurance claim confirmation management server that provides a data input field in a specific form so that a value can be entered and provides analysis results for insurance claim confirmation;
A mobile terminal that allows the policy holder to enter his/her information into a data input field in a specific form provided by the insurance claim confirmation management server and check the analysis result for insurance claim confirmation; characterized in that it includes Insurance claim feasibility check and expected insurance payment simulation system. The method of claim 1, wherein the mobile platform managed and provided by the insurance claim confirmation management server,
By receiving the necessary information through the mobile platform, the information items necessary for determining the exemption of the insurance product-special contract-guarantee are created, and the data input field is provided in a specific format so that the necessary value can be entered through the mobile terminal of the policyholder , a control unit that performs control to provide analysis results for insurance claim confirmation;
An input unit that enables input of necessary information for confirming insurance claims;
A communication unit that supports communication between the insurance policyholder's mobile terminal, insurance claim confirmation management server, and credit information management server;
An insurance claim feasibility check and expected insurance money simulation system, characterized in that it includes a display unit that supports the provision of a data input field in a specific form and the analysis result to be checked on a mobile terminal. The method of claim 1, wherein the insurance claim confirmation management server,
Through the mobile terminal of the policyholder, on the mobile platform, the policyholder inquires insurance contract information through the credit information source server or the contract information management server of each financial company that manages the user's financial product contract information, or transmits the policy information of the insurance the person subscribed to. If so, a stock information receiving unit receiving the same;
A collateral identification unit that identifies collateral matched to the keyword by matching whether there is a keyword registered in the DB in the result value from which duplicate matters have been removed;
An information input item composition unit that identifies collateral matched by keyword and combines information input items matched by collateral but removes duplicate items to form a form;
An information input request unit that provides information input form configuration results by collateral to input information to the policyholder;
Insurance claim feasibility check and expected insurance money simulation system comprising an input information receiver for receiving information when the policyholder enters and replies the information corresponding to the person in the data input field of the form provided by the information input request unit. The method of claim 3, wherein the insurance claim confirmation management server,
Based on the information entered by the policyholder received through the input information receiving unit, the exemption is determined for each collateral constituting the policyholder’s policy information, and if the judgment result is “not liable”, the claim subject collateral identified as “claim subject” identification unit,
An expected insurance amount calculation unit that calculates the expected insurance amount of each collateral identified as “subject to claim” and calculates the “total amount of expected insurance amount” by adding up the expected insurance amount of each collateral;
Further comprising a simulation result providing unit for guiding the insurance policyholder to the "total expected insurance amount", which is the sum of the collateral identified as "subject to claim", the expected insurance amount for each collateral, and the expected insurance amount for each collateral, through the policyholder's mobile terminal. A system for checking whether insurance claims are possible and simulating expected insurance payments. The method of claim 3, wherein the insurance claim confirmation management server,
It further includes a securities information processing unit that binds product names, guarantee classifications, and guarantee names into one block, removes special symbols and blanks, and removes duplication when product names and guarantee classifications overlap or product names and guarantee names overlap. A system for checking whether insurance claims are possible and simulating expected insurance payments. Step of the insurance policyholder requesting whether or not the insurance claim of the insurance subscribed by the policyholder can be claimed to the insurance claim confirmation management server through the mobile platform;
Transmitting the user's personal information from the mobile platform to the credit information management server and requesting the user's insurance contract information;
Receiving insurance contract information from the credit information management server through the mobile platform to the insurance claim confirmation management server;
Requesting, by the insurance claim confirmation management server, information necessary for confirming whether or not an insurance claim can be made to a policyholder's mobile terminal through a mobile platform;
receiving necessary information from an insurance claim confirmation management server when the user inputs information necessary for checking whether or not an insurance claim is possible through a policyholder's mobile terminal;
An insurance claim confirmation management server providing an analysis result for insurance claim confirmation through a mobile platform so that the policyholder can check it; insurance claim feasibility confirmation and expected insurance amount simulation method comprising the. The method of claim 6, in the step of receiving insurance contract information from the credit information management server through the mobile platform to the insurance claim confirmation management server,
Through the mobile terminal of the policyholder, on the mobile platform, the policyholder inquires the insurance contract information through the credit information source server or the contract information management server of each financial company that manages the user's financial product contract information, or the policy information of the insurance the person subscribed to A method for checking whether insurance claims are possible and simulating expected insurance payments, characterized in that when transmitted, the insurance claims confirmation management server receives them. The method of claim 7, wherein the received detailed securities information item,
Name of insurance company, name of insurance product, type of guarantee, name of guarantee, amount of guarantee, date of contract. Including the insurance period and contract status items,
In the case of my data operators, a method for checking whether insurance claims are possible and simulating expected insurance payments, characterized by including the user's past insurance payment history, burden insurance setting information, seizure setting information, and moral risk setting information. The method of claim 6, wherein the step of requesting information necessary for confirming whether insurance claims can be made to the policyholder's mobile terminal includes a process of processing securities information,
In the process of processing securities information, product name, guarantee classification, and guarantee name are grouped into a single bundle in the insurance claim confirmation management server, special symbols and blanks are removed, and duplication is eliminated if product name and guarantee classification are duplicated or product name and guarantee name are duplicated. A method for confirming whether an insurance claim is possible and simulating an expected insurance payment, characterized in that it includes removing. The method of claim 6, wherein the step of requesting information necessary for checking whether insurance claims can be made to the policyholder's mobile terminal includes a collateral identification process,
The collateral identification process tries to match the result value processed in the securities information processing process to see if there is a keyword registered in the DB of the insurance claim confirmation management server.
If there is a matching keyword, a method for checking whether insurance claim is feasible and simulating expected insurance money, characterized in that it includes a process of identifying it as a collateral matched with a keyword registered in the DB of the insurance claim confirmation management server. 11. The method of claim 10, wherein the identified security comprises:
Injury hospitalization medical expenses insurance, injury hospitalization daily insurance, sickness hospitalization daily insurance, stroke diagnosis insurance, fracture diagnosis insurance, image diagnosis insurance, attorney appointment cost insurance, car accident fine insurance Estimated insurance payment simulation method. The method of claim 6, wherein the step of requesting information necessary for checking whether or not insurance claims can be made to the policyholder's mobile terminal includes a process of constructing an information input form for each collateral,
In the process of constructing the information input form for each collateral, when the keyword registered in the DB is identified in the value processed in the collateral identification process, the collateral matched by keyword is identified, and the information input items matched by collateral are combined, but duplicate items are removed. A method for confirming whether insurance claims are possible and simulating expected insurance payments, comprising a process of forming a Form. The method of claim 6, wherein when the user inputs information necessary for confirming whether insurance claims can be made through the policyholder's mobile terminal, in the step of receiving the necessary information from the insurance claim confirmation management server,
The following input field is determined according to the input value of the preceding input field, and the information acquisition method through the creation of a variable form in which the information items constituting the form is changed, or
An information acquisition method using a non-variable form that presents all input fields and allows the user to select and input only the relevant information, or
A question-and-answer method of obtaining information using a chatbot that uses a two-way chat function to ask for information on necessary information items and inputs the information in natural language, or
A method for checking whether insurance claims are possible and for simulating expected insurance money, characterized by using a selective information acquisition method using a chatbot that borrows a two-way chat function but presents options for necessary information items and inputs them through selection. The method of claim 6, wherein the step of providing the insurance claim confirmation management server with the analysis result for insurance claim confirmation so that the insurance policyholder can check it through the mobile platform includes a claim subject collateral identification process,
In the insurance claim confirmation management server, information entered by the policyholder is used to determine exemption for each collateral constituting the policyholder's policy information, and if the judgment result is "not liable", it is characterized as "subject to claim" How to check the possibility of claiming insurance money and simulate the expected insurance money. According to claim 14, in order to calculate the expected insurance amount, the expected insurance amount of each security identified as "subject of claim" is calculated and the expected insurance amount of each security is added together to calculate the "total amount of expected insurance amount",
In order to inform the policyholder of claimability and expected insurance amount, it is necessary to provide the insurance policyholder with the "total expected insurance amount", which is the sum of the collateral identified as "subject to claim", the expected insurance amount for each collateral, and the expected insurance amount for each collateral, through the policyholder's mobile terminal. Characteristically, the method of checking the possibility of claiming insurance money and simulating the expected insurance money.

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