TW201901585A - Method, device, server and medium for measuring the damage compensation cost of human injury - Google Patents
Method, device, server and medium for measuring the damage compensation cost of human injury Download PDFInfo
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Abstract
Description
本發明涉及電腦技術領域,特別係涉及一種人傷理賠定損費用測算方法、裝置、伺服器和介質。The present invention relates to the field of computer technology, and in particular, to a method, device, server, and medium for calculating a personal injury claim compensation loss cost.
在保險行業內,人傷理賠為較常見的一種理賠類型。In the insurance industry, personal injury claims are a more common type of claims.
在傳統的方式中,人傷理賠主要依靠醫療核賠專業人員根據其自身業務經營、傷者損傷情況以及治療情況等進行人工評估,以測算人傷理賠的定損費用。但以人工方式測算人傷理賠之定損費用耗時較長,效率較低。In the traditional method, personal injury claims mainly rely on medical assessment professionals to perform manual assessments based on their own business operations, injuries and treatment of the injured, so as to calculate the fixed damage costs of personal injury claims. However, it is time-consuming and inefficient to calculate the fixed cost of injury claims manually.
因此,如何有效提高人傷理賠之定損費用的測算效率為目前需要解決的一個技術問題。Therefore, how to effectively improve the efficiency of the calculation of the fixed loss cost of personal injury claims is a technical problem that needs to be solved at present.
基於此,有必要針對上述技術問題,提供一種有效提高人傷理賠的定損費用的測算效率的人傷理賠定損費用測算方法、裝置、伺服器和介質。Based on this, it is necessary to provide a method, a device, a server, and a medium for calculating the human injury claims fixed loss cost which effectively improve the calculation efficiency of the human injury claims fixed loss cost in view of the above technical problems.
一種人傷理賠定損費用測算方法,包括:A method for calculating the cost of determining personal injury claims, including:
接收終端發送的人傷定損請求,該人傷定損請求中攜帶傷者資訊;Receive a personal injury and damage request sent by the terminal, and the personal injury and damage request carries the injured person's information;
根據該定損請求調用人傷定損模型;According to the determination request, the human injury determination model is called;
將該傷者資訊輸入至該人傷定損模型,透過該人傷定損模型計算多個定損專案對應的定損時長;Enter the injured person's information into the person's injury and damage loss model, and calculate the fixed loss time corresponding to multiple fixed loss projects through the person's injury and damage loss model;
利用多個定損專案對應的定損時長計算人傷理賠對應的定損費用。Calculate the fixed loss cost corresponding to personal injury claims by using the fixed loss time corresponding to multiple fixed loss projects.
一種人傷理賠定損費用測算裝置,該裝置包括:A device for measuring the cost of determining personal injury claims, the device includes:
接收模組,用於接收終端發送的人傷定損請求,該人傷定損請求中攜帶傷者資訊;A receiving module for receiving a personal injury and damage determination request sent by the terminal, and the personal injury and damage determination request carries the injured person's information;
調用模組,用於根據該定損請求調用人傷定損模型;A calling module, which is used to call the human injury and fixed damage model according to the fixed loss request;
測算模組,用於將該傷者資訊輸入至該人傷定損模型,透過該人傷定損模型計算多個定損專案對應的定損時長;利用多個定損專案對應的定損時長計算人傷理賠對應的定損費用。A measurement module is used to input the injured person's information into the person's fixed damage model, and calculate the fixed loss time corresponding to multiple fixed loss projects through the personal damage fixed loss model; using the fixed loss corresponding to multiple fixed loss projects The long-term calculation of the fixed damage costs corresponding to the personal injury claims.
一種伺服器,包括記憶體、處理器及存儲在記憶體上並可在處理器上運行的電腦程式,該處理器執行該程式時實現上述實施方式中的步驟。A server includes a memory, a processor, and a computer program stored on the memory and operable on the processor. When the processor executes the program, the steps in the foregoing implementation manner are implemented.
一種電腦可讀存儲介質,其上存儲有電腦程式,該電腦程式被處理器執行時實現上述實施方式中的步驟。A computer-readable storage medium stores a computer program thereon. When the computer program is executed by a processor, the steps in the foregoing implementation manner are implemented.
上述人傷理賠定損費用測算方法、裝置、伺服器和介質,當接收人傷定損請求時,調用人傷定損模型。將人傷定損請求中所攜帶之傷者資訊輸入至人傷定損模型,透過該人傷定損模型計算多個定損專案對應的定損時長。從而利用多個定損專案對應的定損時長計算人傷理賠所需的定損費用。於整個過程中,完全不需人工參與,透過調用人傷定損模型即可自動測算出人傷理賠所需的定損費用,有效節省人工測算的耗時,提高定損費用的測算效率。The above-mentioned method, device, server and medium for calculating the personal injury and loss compensation costs, when receiving the personal injury and loss compensation request, call the personal injury and loss compensation model. The injury information carried in the personal injury and damage damage request is input into the personal injury and damage damage model, and the fixed damage duration corresponding to multiple fixed damage projects is calculated through the personal injury and damage damage model. In this way, the fixed loss time corresponding to multiple fixed loss projects is used to calculate the fixed loss cost required for personal injury claims. Throughout the entire process, there is no need for human involvement at all, and the fixed damage cost required for personal injury claims can be automatically calculated by invoking the human damage determination model, which effectively saves time in manual calculation and improves the efficiency of the fixed loss calculation.
為使本發明的目的、技術方案及優點更加清楚明白,下列結合附圖及實施方式,對本發明進行進一步詳細說明。應當理解,此處描述的具體實施方式僅用以解釋本發明,並不用於限定本發明。In order to make the objectives, technical solutions, and advantages of the present invention clearer, the following further describes the present invention in detail with reference to the accompanying drawings and embodiments. It should be understood that the specific embodiments described herein are only used to explain the present invention and are not intended to limit the present invention.
本發明實施方式中所提供之人傷理賠定損費用測算方法,可應用於如圖1所示之應用環境中。理賠終端102與伺服器104透過網路連接。理賠人員在處理人傷理賠時可透過該理賠終端102輸入傷者資訊。該理賠終端102利用傷者資訊生成人傷定損請求,並且將人傷定損請求發送至該伺服器104。該伺服器104上預先建立人傷定損模型。當該伺服器104接收人傷定損請求時,調用人傷定損模型。該伺服器104將傷者資訊輸入至人傷定損模型,透過人傷定損模型計算多個定損專案對應的定損時長。該伺服器104根據定損專案獲取對應的定損費用測算標準。該伺服器104利用定損時長與定損費用的測算標準分別計算多個定損項目對應的定損費用,將多個定損項目對應的定損費用進行累計得到人傷理賠對應的定損費用。於整個過程中,完全不需人工參與,有效節省人工測算的耗時,提高定損費用的測算效率。The method for calculating the personal injury and loss compensation costs provided in the embodiment of the present invention can be applied to the application environment shown in FIG. 1. The claims terminal 102 and the server 104 are connected through a network. The claimant may enter the injured person's information through the claim terminal 102 when processing the claim for injury. The claim terminal 102 uses the injured person's information to generate a personal injury determination request, and sends the personal injury determination request to the server 104. A fixed injury model for human injury is established on the server 104 in advance. When the server 104 receives the human injury and damage loss request, it calls the human injury and damage loss model. The server 104 inputs the injured person's information into the human injury fixed loss model, and calculates the fixed loss time corresponding to multiple fixed loss projects through the human injury fixed loss model. The server 104 obtains a corresponding fixed loss cost calculation standard according to the fixed loss project. The server 104 calculates the fixed loss cost corresponding to multiple fixed loss items by using the fixed loss duration and the fixed loss measurement standard, and accumulates the fixed loss costs corresponding to the multiple fixed loss items to obtain the fixed loss corresponding to the personal injury claim. cost. In the whole process, no manual participation is required at all, which effectively saves time for manual calculation and improves the efficiency of calculation of the fixed loss cost.
於一實施方式中,如圖2所示,提供一種人傷理賠定損費用測算方法,以該方法應用於伺服器為例進行說明,具體包括下列步驟:In an embodiment, as shown in FIG. 2, a method for calculating a personal injury claim compensation cost is provided. The method is applied to a server as an example for illustration, and specifically includes the following steps:
步驟202,接收終端發送的人傷定損請求,人傷定損請求中攜帶了傷者資訊。In step 202, a personal injury and loss determination request sent by the terminal is received, and the personal injury and loss determination request carries the injured person information.
終端可為理賠終端,亦可為客戶終端。終端包括電腦、個人筆記型電腦、平板電腦、智慧手機以及個人數位助理等。伺服器可接收理賠人員在處理人傷理賠時透過理賠終端所發送的人傷定損請求。伺服器亦可接收客戶申請人傷理賠時利用客戶終端所發送的人傷定損請求。人傷定損請求中攜帶傷者資訊。傷者資訊包括傷者基本資訊和傷者醫療資訊。傷者基本資訊包括傷者姓名、性別、年齡以及所在地區等。傷者醫療資訊包括傷者的損傷部位、醫療專案、診斷編碼、手術名稱以及手術類型等。The terminal can be a claims terminal or a client terminal. Terminals include computers, personal notebooks, tablets, smartphones, and personal digital assistants. The server can receive the personal injury determination request sent by the claims officer through the claims terminal when processing the personal injury claims. The server can also receive the personal injury determination request sent by the client terminal when the client applies for injury compensation. The personal injury determination request carries the injured person's information. Injured information includes basic information about the injured and medical information about the injured. The wounded's basic information includes the wounded's name, gender, age, and area. The injured medical information includes the injured part, medical project, diagnostic code, operation name, and operation type.
步驟204,根據定損請求調用人傷定損模型。Step 204: Invoke the human damage and fixed damage model according to the fixed loss request.
步驟206,將傷者資訊輸入至人傷定損模型,透過人傷定損模型計算多個定損專案對應的定損時長。In step 206, the wounded person's information is inputted into the human injury fixed loss model, and the fixed injury duration corresponding to multiple fixed loss projects is calculated through the human injury fixed loss model.
伺服器上預先建立人傷定損模型。人傷定損模型可以多元函數形式所表達。人傷定損模型之多元函數包括多個因數變數。The human injury fixed damage model is established in advance on the server. The human injury and damage model can be expressed in the form of a multivariate function. The multivariate function of the human injury determination model includes multiple factor variables.
於其中一實施方式中,人傷定損模型包括:F = f(x,y,z,k,g);其中,F為定損項目對應的定損時長; x、y、z、k及g為因數欄位,其中,x為診斷編碼;y為手術類型;z為年齡區間;k為所在地區;g為性別。In one embodiment, the human injury determination model includes: F = f (x, y, z, k, g); where F is the length of the fixed loss corresponding to the fixed loss item; x, y, z, k And g are factor fields, where x is the diagnostic code; y is the type of surgery; z is the age range; k is the region; g is the gender.
伺服器上係部署資料庫。資料庫中存儲當前人傷定損模型對應的人傷定損資料表。人傷定損資料表中包括多個因數欄位,因數欄位包括定損項目、定損時長、診斷編碼、手術類型、年齡區間、所在地區以及性別等。其中,定損項目包括誤工、護理和營養補助等。人傷定時資料表中的因數欄位的資料可根據預設時間段內的歷史人傷定損資料計算獲得。伺服器可按照設置的頻率對人傷定時資料表進行更新,以確保每一因數欄位的內容準確無誤。The deployment database is on the server. The database stores the personal injury and damage damage data table corresponding to the current personal injury and damage damage model. The personal injury and damage information table includes multiple factor fields. The factor fields include the fixed damage item, the fixed damage duration, the diagnosis code, the type of surgery, the age range, the area, and the gender. Among them, loss-of-loss items include lost time, care and nutrition assistance. The data of the factor field in the personal injury timing data table can be calculated based on the historical personal injury fixed damage data within a preset period of time. The server can update the personal injury timing data table according to the set frequency to ensure that the content of each factor field is accurate.
伺服器於接收定損請求之後,會調用人傷定損模型。伺服器根據人傷定損模型的因數變數在傷者資訊中獲取所需資訊,將所需資訊輸入至人傷定損模型。人傷定損模型在人傷定損資料表中查詢每一因數變數對應的因數欄位,得到多個定損項目對應的定損時長。人傷定損模型可同時輸出多個定損項目對應的定損時長。定損時長可有多種單位,例如,可以天為單位,亦可以周為單位,進一步可以小時為單位等。After the server receives the damage determination request, it will call the human damage determination model. The server obtains required information from the injured person's information according to the factor variables of the fixed injury model, and inputs the required information into the fixed injury model. The human injury and damage loss model queries the factor field corresponding to each factor variable in the human injury and damage loss data table to obtain the fixed loss duration corresponding to multiple fixed loss items. The human injury and damage damage model can simultaneously output the fixed damage time corresponding to multiple fixed damage items. There can be multiple units of the fixed loss duration, for example, it can be in units of days, weeks, or even hours.
對人傷定損模型計算多個定損專案對應的定損時長進行舉例說明。北京地區的代碼為201,左側股骨粉碎性骨折的代碼為G.42.4.1,手術治療的代碼為2,男性的代碼為 M,年齡區間為36-50歲。若人傷定損請求中攜帶傷者資訊包括男性,年齡為40歲,所在地區為北京,受損部位為左側股骨粉碎性骨折,診斷編碼為G.42.4.1,採用手術治療。則伺服器可將上述資訊輸入至人傷定損模型,得到如下資料關係F = f(G.42.4.1,2,36-50,201,M)。由此得到(186,90,90)。即誤工定損時長為186天,護理定損時長為90天,營養補助定損時長為90天。The calculation of the fixed-loss time corresponding to multiple fixed-loss projects by the human injury and fixed-loss model is exemplified. The code in Beijing is 201, the code for comminuted fracture of the left femur is G.42.4.1, the code for surgery is 2, the code for men is M, and the age range is 36-50 years. If the personal injury and damage information request includes a male, the age is 40 years old, the area is Beijing, the damaged part is a left femoral comminuted fracture, the diagnosis code is G.42.4.1, and surgery is used. Then the server can input the above information into the human injury and fixed damage model, and obtain the following data relationship F = f (G.42.4.1, 2, 36-50, 201, M). This gives (186, 90, 90). That is, the length of lost work and fixed damage is 186 days, the length of fixed loss of nursing is 90 days, and the length of fixed loss of nutritional assistance is 90 days.
步驟208,利用多個定損項目對應的定損時長計算人傷理賠對應的定損費用。Step 208: Calculate a fixed loss cost corresponding to a personal injury claim using the fixed loss duration corresponding to multiple fixed loss items.
伺服器利用人傷定損模型計算多個定損專案對應的定損時長之後,根據定損專案獲取對應的定損費用測算標準。定損費用測算標準可與定損時長之單位相對應。例如,定損費用測算標準可為以天所計算之日均定損金額,亦可為以周所計算之周均定損金額,進一步可為以小時所計算之時均定損金額等。由於不同地區以及不同行業的誤工費、護理費以及營養補助費等可能會不同,因此伺服器還可進一步按照傷者所在區域和/或行業獲取對應的定損費用測算標準。After the server uses the human injury and fixed loss model to calculate the fixed loss duration corresponding to multiple fixed loss projects, the server obtains the corresponding fixed loss cost calculation standard according to the fixed loss project. The standard for calculating the fixed loss cost may correspond to the unit of the fixed loss duration. For example, the standard for determining fixed loss costs may be the daily average fixed loss amount calculated in days, or the weekly average fixed loss amount calculated in weeks, and further may be the hourly average fixed loss amount calculated in hours. Since the cost of lost work, nursing care, and nutritional assistance may be different in different regions and different industries, the server may further obtain the corresponding standard for determining the fixed cost according to the area and / or industry of the injured person.
伺服器利用定損時長與定損費用的測算標準分別計算多個定損項目對應的定損費用。具體而言,定損費用=定損時長*定損費用的測算標準。例如,定損時長以天為單位,定損費用的測算標準為日均定損金額。誤工定損時長為186天,誤工日均定損金額為300元,則誤工定損費用=186*300=55800元。伺服器將多個定損項目對應的定損費用進行累計得到人傷理賠對應的定損費用。The server calculates the fixed loss cost corresponding to multiple fixed loss items using the fixed loss duration and the fixed loss cost measurement standard. Specifically, fixed loss cost = fixed loss duration * standard for measuring fixed loss cost. For example, the fixed loss duration is in units of days, and the standard for measuring fixed loss costs is the average daily fixed loss amount. The length of lost work and fixed damage is 186 days, and the average fixed loss amount per day of lost work is 300 yuan, so the cost of lost work and fixed damage = 186 * 300 = 55800 yuan. The server accumulates the fixed-loss costs corresponding to multiple fixed-loss items to obtain the fixed-loss costs corresponding to personal injury claims.
本實施方式中,當接收到人傷定損請求時,調用人傷定損模型。將人傷定損請求中攜帶的傷者資訊輸入至人傷定損模型,透過該人傷定損模型計算多個定損專案對應的定損時長。從而利用多個定損專案對應的定損時長計算人傷理賠所需的定損費用。於整個過程中,完全不需人工參與,透過調用人傷定損模型即可自動測算出人傷理賠所需的定損費用,有效節省人工測算的耗時,提高定損費用的測算效率。In this embodiment, when a human injury and loss determination request is received, a human injury and loss determination model is called. The injury information carried in the personal injury and damage loss request is input into the personal injury and damage loss model, and the fixed injury time corresponding to multiple fixed loss projects is calculated through the personal injury and damage loss model. In this way, the fixed loss time corresponding to multiple fixed loss projects is used to calculate the fixed loss cost required for personal injury claims. Throughout the entire process, there is no need for human involvement at all, and the fixed damage cost required for personal injury claims can be automatically calculated by invoking the human damage determination model, which effectively saves time in manual calculation and improves the efficiency of the fixed loss calculation.
進一步,對於不需要進行定損時長計算之人傷理賠,伺服器可根據傷者資訊中攜帶的定損專案獲取對應的定損費用。不需要進行定損時長之定損項目包括死亡賠償、精神撫慰和傷殘賠償等。Further, for a person's injury claim that does not require the calculation of the fixed-loss duration, the server can obtain the corresponding fixed-loss fee according to the fixed-loss project carried in the injured person's information. The fixed damage items that do not require a fixed damage duration include death compensation, mental comfort and disability compensation.
於一實施方式中,該方法還包括:獲取預設時間段內的歷史人傷定損資料;歷史人傷定損資料包括多個因數欄位;對因數欄位對應的歷史人傷定損資料進行聚類分析,得到多個因數欄位對應的聚類結果;利用聚類結果對人傷定損模型進行優化。In an embodiment, the method further includes: obtaining historical personal injury and damage determination data within a preset time period; historical personal injury and determination damage data includes a plurality of factor fields; and historical human injury and determination damage data corresponding to the factor fields Cluster analysis was performed to obtain clustering results corresponding to multiple factor fields; the clustering results were used to optimize the human injury and damage model.
由於人傷理賠方面之規定會隨時間變化進行調整。所調整之內容包括損傷部位、手術名稱、年齡或者性別等。為了在人傷理賠時能夠確保計算出準確的人傷定損費用,需要對人傷定損模型進行優化。Due to personal injury compensation regulations will be adjusted over time. The adjusted content includes the site of injury, the name of the operation, age or gender. In order to ensure that the accurate injury injury damage calculation can be calculated when claiming for injury, the injury injury damage model needs to be optimized.
具體而言,伺服器可在資料庫中獲取預設時間段內的多個傷者的歷史人傷定損資料。預設時間段可為一年,亦可為半年,進一步可為一個季度等。歷史人傷定損資料包括多個因數欄位,例如,定損項目、定損時長、診斷編碼、手術類型、年齡區間、所在地區以及性別等。伺服器將每一傷者的歷史人傷定損資料作為一樣本,將每一因數欄位的欄位名作為一維度。伺服器對每一維度之樣本進行聚類分析。伺服器採用聚類分析演算法,例如K-means演算法,將每一因數欄位的欄位名作為資料物件依次對多個樣本進行反覆運算計算,計算出每一維度所對應之聚類結果。例如,伺服器獲取性別、年齡、損傷部位和醫療專案此等維度,對多個樣本分別進行聚類分析,得到某一個年齡區間內,相同性別、相同損傷部位以及相同醫療項目的定損時長。伺服器對照每個因數欄位的欄位名,利用聚類結果對人傷定損資料表進行更新。Specifically, the server may obtain historical injury damage determination data of multiple wounded persons in a preset period of time in the database. The preset time period can be one year, six months, or even a quarter. The historical human injury and damage information includes multiple factor fields, such as the fixed damage item, the fixed damage duration, the diagnosis code, the type of surgery, the age range, the area and the gender. The server treats the historical injury and damage data of each injured person as a sample, and uses the field name of each factor field as a dimension. The server performs cluster analysis on samples of each dimension. The server uses a cluster analysis algorithm, such as the K-means algorithm. The field name of each factor field is used as a data object to sequentially perform multiple calculations on multiple samples to calculate the clustering result corresponding to each dimension. . For example, the server obtains dimensions such as gender, age, injury site, and medical project, and performs cluster analysis on multiple samples to obtain the fixed damage duration of the same gender, same injury site, and the same medical project in an age range . The server uses the clustering result to update the personal injury and damage damage data table against the field names of each factor field.
進一步,若利用多個維度聚類分析後所得到之定損時長在預設範圍內,伺服器還可根據維度對預算範圍內之誤工時長進行均值計算。均值計算包括平均值計算或平方均值計算等。例如,經過聚類分析後,得到:性別係男性,年齡在30-40歲之間骨折的誤工時長為198天,年齡在40-50歲之間誤工時長為199天,年齡在40-50歲之間的誤工時長為200天,則對該等誤工時長進行均值分析,如取平均值為199天。伺服器可將人傷定損資料表中的男性,年齡在30-50歲之間骨折的誤工時長更新為199天。Further, if the fixed loss time obtained after clustering analysis using multiple dimensions is within a preset range, the server may also perform an average calculation of the lost working time within the budget range according to the dimensions. Mean calculation includes mean calculation or square mean calculation. For example, after cluster analysis, we get: males of gender, age of 30-40 years, lost time for fractures is 198 days, age of 40-50 years of time is 199 days, age of 40- If the length of lost work between the age of 50 and 200 days is 200 days, then the average analysis of the length of such lost work hours is made, and the average value is 199 days. The server can update the number of lost-time workers with fractures between the age of 30-50 years for men in the injury and injury data sheet to 199 days.
伺服器透過人傷定時資料表進行更新,由此可使人傷定損模型在人傷定時資料表中能夠查詢到更新後之定損時長,從而實現對人傷定損模型的優化。由此可在人傷理賠時能夠確保計算出準確的人傷定損費用。The server updates through the personal injury timing data table, so that the human injury fixed loss model can query the updated fixed loss time in the human injury timing data table, thereby realizing the optimization of the human injury fixed loss model. In this way, it is possible to ensure the accurate calculation of the fixed injury and loss expenses when claiming for injury.
於一實施方式中,在接收人傷定損請求的步驟之前,還包括:在多個網站抓取新聞內容;對多種新聞內容進行大資料分析,得到與保險事故相關的內容;若根據與保險事故相關的內容識別出待理賠事故,則根據待理賠事故生成理賠任務,將理賠任務發送至理賠終端,以使理賠終端在處理人傷理賠時生成人傷定損請求。In an embodiment, before the step of receiving a personal injury and damage request, the method further includes: crawling news content on multiple websites; performing big data analysis on various news content to obtain content related to insurance accidents; The accident-related content identifies a pending claim accident, and then a claim task is generated based on the pending claim accident, and the claim task is sent to the claim terminal, so that the claim terminal generates a personal injury determination request when processing the personal injury claim.
本實施方式中,人傷理賠可為客戶在遭遇保險事故時由理賠人員主動提供之理賠服務。為了能夠向客戶提供主動理賠服務,伺服器可利用爬蟲技術中多個網站採集新聞內容,對採集到的新聞內容進行大資料分析。如果能夠在大資料分析的結果中識別出待理賠事故,則伺服器生成相應的理賠任務,將理賠任務發送至理賠終端,由理賠人員前去向客戶提供主動理賠服務。In this embodiment, a personal injury claim can be a claim service provided by a claimant when a customer encounters an insured accident. In order to be able to provide customers with active claims services, the server can use multiple websites in the crawler technology to collect news content and conduct large data analysis on the collected news content. If a pending claims accident can be identified in the results of the big data analysis, the server generates a corresponding claim task, sends the claim task to the claim terminal, and the claim officer goes to provide the client with an active claim service.
具體而言,伺服器對由多個網站所採集之新聞內容進行大資料分析。伺服器可獲取與保險相關的關鍵字,例如,車禍、飛機失事、地震和爆炸等,利用關鍵字對所採集之新聞內容進行聚類分析,得到與保險事故相關的內容。伺服器對所採集之新聞內容進行大資料分析,可視為對新聞內容之初級篩選。伺服器對篩選所得到之內容,即與保險相關的內容仍需要做進一步處理,以此來識別與保險相關的內容是否涉及待理賠的保險事故。識別是否存在待理賠的保險事故的方式可包括數種。Specifically, the server performs big data analysis on news content collected by multiple websites. The server can obtain keywords related to insurance, such as car accidents, plane crashes, earthquakes, explosions, etc., and use keywords to perform cluster analysis on the collected news content to obtain content related to insurance accidents. The server performs big data analysis on the collected news content, which can be regarded as the primary screening of news content. The server still needs to further process the content obtained by the screening, that is, the content related to insurance, so as to identify whether the content related to insurance involves an insurance accident to be claimed. There are several ways to identify the existence of an insured event pending settlement.
於其中一實施方式中,伺服器可獲取與保險事故相關的內容中的事故基本資訊,根據事故基本資訊生成事故查勘任務,將查勘任務發送至查勘人員對應的查勘終端。由查勘人員去事故現場進行查勘,若存在需要理賠的客戶,則查勘終端向伺服器返回待理賠客戶資訊。伺服器接收查勘終端返回的待理賠客戶資訊,根據待理賠客戶資訊記錄與保險事故相關的內容所對應的待理賠事故。In one of the embodiments, the server may obtain basic accident information in the content related to the insurance accident, generate an accident investigation task according to the basic accident information, and send the investigation task to the investigation terminal corresponding to the surveyor. The survey staff will go to the accident site to conduct an investigation. If there are customers who need to claim compensation, the survey terminal will return the information of the customer to be compensated to the server. The server receives the information of the claims pending customer returned by the survey terminal, and records the claims pending incident corresponding to the content related to the insurance incident according to the information of the claims pending client information.
於其中一實施方式中,伺服器可獲取與保險事故相關的內容的圖片,識別圖片中是否有人臉,若有,則進一步識別該人臉是否為被保險之客戶圖像。若是,則伺服器根據客戶圖像記錄與保險事故相關的內容所對應的待理賠事故。In one of the embodiments, the server may obtain a picture of the content related to the insurance accident, identify whether there is a human face in the picture, and if so, further identify whether the human face is an insured customer image. If so, the server records, according to the customer's image, the accident to be claimed corresponding to the content related to the insurance accident.
若根據保險事故相關的內容識別出存在待理賠事故,則伺服器可根據待理賠事故獲取對應的客戶資訊,根據客戶資訊在資料庫中提取對應的保單資訊。伺服器根據保單資訊和待理賠事故生成理賠任務,將理賠任務發送至理賠終端。理賠人員根據理賠終端接收到的理賠任務去為客戶提供主動理賠服務。從而可使客戶在遭遇保險事故時能夠及時享受到理賠服務。If it is identified that there is a pending claim accident according to the content related to the insurance incident, the server can obtain corresponding customer information according to the pending claim accident, and extract the corresponding policy information from the database based on the customer information. The server generates a claim task based on the policy information and the pending incident, and sends the claim task to the claim terminal. Claims officers provide active claims services to customers based on claims tasks received by claims terminals. This enables customers to enjoy claims services in a timely manner in the event of an insurance accident.
於一實施方式中,在對多種新聞內容進行大資料分析,得到與保險事故相關的內容的步驟之後,還包括:在與保險事故相關的內容中獲取圖片,對圖片進行識別;若在圖片中識別出人臉,則進一步識別人臉是否為被保險的客戶圖像;若是,則記錄與保險事故相關的內容所對應的待理賠事故。In an embodiment, after performing the big data analysis on various news contents to obtain the content related to the insurance accident, the method further includes: obtaining a picture from the content related to the insurance accident, and identifying the picture; if it is in the picture, If a human face is recognized, it is further recognized whether the human face is an insured customer image; if it is, a pending accident corresponding to the content related to the insurance accident is recorded.
本實施方式中,伺服器可根據大資料分析的結果,獲取與保險事故相關的內容中的事故基本資訊。事故基本資訊包括事故時間、事故地點以及事故類型等。伺服器可根據事故基本資訊生成事故查勘任務,將查勘任務發送至查勘人員對應的查勘終端。伺服器可根據事故地點獲取相應區域範圍內的查勘人員標識,根據查勘人員標識與事故類型,查詢熟悉該事故類型的查勘人員標識。伺服器將查勘任務發送至該查勘人員標識對應的查勘終端。由此可使熟悉該事故類型的查勘人員能及時去進行查勘,以便識別本次事故中是否存在需要理賠的客戶。若存在需要理賠的客戶,則查勘人員透過查勘終端輸入待理賠客戶資訊,查勘終端將待理賠客戶資訊上傳至伺服器。伺服器接收待理賠客戶資訊之後,根據待理賠客戶資訊獲取對應的保單資訊。保單資訊包括保單狀態以及對應的理賠條款。若保單狀態為有效並且本次保險事故符合理賠條款的規定,則伺服器記錄與保險事故相關的內容所對應的待理賠事故。由此可準確識別出待理賠事故。由於一起保險事故中可能會涉及至少一待理賠客戶,因此透過分配查勘任務之方式讓查勘人員前去查勘,能夠準確識別出每一需要理賠的客戶。從而確保能夠為每一遭遇保險事故的客戶提供及時有效的理賠服務。於理賠人員主動提供理賠服務時,可按照上述實施方式中所提供之方式快速準確計算人傷理賠對應的定損費用。進而能有效提高理賠效率。In this embodiment, the server may obtain the basic accident information in the content related to the insurance accident according to the result of the big data analysis. The basic information of the accident includes the time of the accident, the location of the accident, and the type of the accident. The server can generate the accident investigation task according to the basic information of the accident, and send the investigation task to the investigation terminal corresponding to the investigation personnel. The server can obtain the surveyor's identification within the corresponding area according to the location of the accident, and query the surveyor's identification familiar with the type of accident based on the surveyor's identification and the type of the accident. The server sends the survey task to the survey terminal corresponding to the surveyor's identification. As a result, survey personnel familiar with the type of accident can conduct surveys in a timely manner in order to identify whether there are customers in this accident that need to be compensated. If there are customers who need to settle claims, the surveyor enters the information of the client to be settled through the survey terminal, and the survey terminal uploads the information of the client to be settled to the server. After the server receives the information of the claiming customer, it obtains the corresponding policy information according to the information of the claiming customer. Policy information includes policy status and corresponding claims terms. If the policy status is valid and the insured event complies with the provisions of the claims clause, the server records the pending incident corresponding to the content related to the insured event. This can accurately identify the pending claims. Because an insured accident may involve at least one customer to be settled, by assigning survey tasks to surveyors, they can accurately identify each customer who needs compensation. In this way, we can provide timely and effective claims services for every customer who encounters an insured accident. When a claimant provides a claim service on his own initiative, he can quickly and accurately calculate the fixed loss cost corresponding to a personal injury claim in the manner provided in the above embodiment. This can effectively improve claims efficiency.
於一實施方式中,如圖3所示,提供一種人傷理賠定損費用測算裝置,包括:接收模組302、調用模組304和測算模組306,其中:In an embodiment, as shown in FIG. 3, a device for calculating a personal injury claim compensation cost is provided, which includes a receiving module 302, a calling module 304, and a measuring module 306, wherein:
接收模組302,用於接收終端發送的人傷定損請求,人傷定損請求中攜帶傷者資訊。The receiving module 302 is configured to receive a personal injury and loss determination request sent by the terminal, and the personal injury and loss determination request carries the injured person information.
調用模組304,用於根據定損請求調用人傷定損模型。The calling module 304 is used to call the human injury and damage damage model according to the damage request.
測算模組306,用於將傷者資訊輸入至人傷定損模型,透過人傷定損模型計算多個定損專案對應的定損時長;利用多個定損專案對應的定損時長計算人傷理賠對應的定損費用。A measurement module 306 is used for inputting the injured person's information into the personal injury and damage damage model, and calculating the fixed damage time corresponding to multiple fixed damage projects through the human damage and fixed damage model; Corresponding fixed damage costs for personal injury claims.
於其中一實施方式中,人傷定損模型包括:F = f(x,y,z,k,g);其中, F為定損項目對應的定損時長;x、y、z、k及g為因數欄位,其中, x為診斷編碼;y為手術類型;z為年齡區間;k為所在地區;g為性別。In one embodiment, the human injury determination model includes: F = f (x, y, z, k, g); where F is the length of the fixed loss corresponding to the fixed loss item; x, y, z, k And g are factor fields, where x is the diagnostic code; y is the type of surgery; z is the age range; k is the area; g is the gender.
於其中一實施方式中,該裝置還包括:優化模組308,用於獲取預設時間段內的歷史人傷定損資料;歷史人傷定損資料包括多個因數欄位;對因數欄位對應的歷史人傷定損資料進行聚類分析,得到多個因數欄位對應的聚類結果;利用聚類結果對人傷定損模型進行優化。In one of the embodiments, the device further includes: an optimization module 308 for obtaining historical human injury and loss determination data within a preset time period; the historical human injury and loss determination data includes multiple factor fields; the logarithmic factor field The corresponding historical human injury and damage loss data is clustered to obtain clustering results corresponding to multiple factor fields. The clustering result is used to optimize the human injury and damage loss model.
於一實施方式中,如圖4所示,該裝置還包括:內容採集模組310、內容分析模組312和理賠模組314,其中:In an embodiment, as shown in FIG. 4, the device further includes: a content collection module 310, a content analysis module 312, and a claims module 314, of which:
內容採集模組310,用於在多個網站抓取新聞內容。The content collection module 310 is configured to capture news content on multiple websites.
內容分析模組312,用於對多種新聞內容進行大資料分析,得到與保險事故相關的內容。The content analysis module 312 is configured to analyze a large amount of news content to obtain content related to insurance accidents.
理賠模組314,用於若根據與保險事故相關的內容識別出待理賠事故,則根據待理賠事故生成理賠任務,將理賠任務發送至理賠終端,以使理賠終端在處理人傷理賠時生成人傷定損請求。A claim module 314 is used to generate a claim task according to the claim related accident if it is identified based on the content related to the insured accident, and send the claim task to the claim terminal so that the claim terminal generates a person when processing the claim Damage damage request.
於其中一實施方式中,該裝置還包括:查勘模組316,用於根據與保險事故相關的內容生成事故查勘任務,將事故查勘任務發送至查勘終端;接收查勘終端返回的查勘資訊;若查勘資訊中包括客戶資訊,則記錄與保險事故相關的內容所對應的待理賠事故。In one of the embodiments, the device further includes: a survey module 316 for generating an accident survey task according to the content related to the insurance accident, and sending the accident survey task to the survey terminal; receiving the survey information returned by the survey terminal; The information includes customer information, and records the claims pending corresponding to the content related to the insurance accident.
於一實施方式中,提供一種伺服器,如圖5所示,該伺服器包括透過系統匯流排連接的處理器、記憶體、存儲在記憶體上並可在處理器上運行的電腦程式以及網路介面等。其中,處理器用於提供計算和控制能力。記憶體為電腦程式的運行提供環境。網路介面用於據以與外部的查勘終端或理賠終端透過網路連接通信。處理器執行電腦程式時實現下列步驟:In an embodiment, a server is provided. As shown in FIG. 5, the server includes a processor connected through a system bus, a memory, a computer program stored on the memory and running on the processor, and a network. Road interface, etc. Among them, the processor is used to provide computing and control capabilities. Memory provides an environment for running computer programs. The network interface is used to communicate with external survey terminals or claims terminals via a network connection. When the processor executes a computer program, the following steps are performed:
接收終端發送的人傷定損請求,人傷定損請求中攜帶傷者資訊;Receiving the personal injury and damage request sent by the terminal, and the personal injury and damage request carries the injured person's information;
根據定損請求調用人傷定損模型;According to the fixed damage request, the human damage fixed damage model is called;
將傷者資訊輸入至人傷定損模型,透過人傷定損模型計算多個定損專案對應的定損時長;Enter the injured person's information into the human injury fixed loss model, and calculate the fixed loss time corresponding to multiple fixed loss projects through the human injury fixed loss model;
利用多個定損專案對應的定損時長計算人傷理賠對應的定損費用。Calculate the fixed loss cost corresponding to personal injury claims by using the fixed loss time corresponding to multiple fixed loss projects.
該伺服器可以獨立的伺服器或者由多個伺服器所組成的伺服器集群所實現。本領域技術人員可理解,圖5中所示之結構,僅係與本發明相關的部分結構的框圖,並不構成對本發明所應用於其上的伺服器的限定,具體之伺服器可包括比圖中所示更多或更少之部件,或者組合某些部件,或者具有不同之部件配置。The server can be implemented by an independent server or a server cluster composed of multiple servers. Those skilled in the art can understand that the structure shown in FIG. 5 is only a block diagram of a part of the structure related to the present invention, and does not constitute a limitation on the server to which the present invention is applied. The specific server may include There are more or fewer parts than shown in the figure, or some parts are combined, or have different part configurations.
於一實施方式中,人傷定損模型包括:F = f(x,y,z,k,g);其中, F為定損項目對應的定損時長;x、y、z、k及g為因數欄位,其中,x為診斷編碼;y為手術類型;z為年齡區間;k為所在地區;g為性別。In an embodiment, the human injury determination model includes: F = f (x, y, z, k, g); where F is a fixed loss duration corresponding to a fixed loss item; x, y, z, k, and g is the factor field, where x is the diagnostic code; y is the type of surgery; z is the age range; k is the region; g is the gender.
於一實施方式中,處理器執行電腦程式時還實現下列步驟:In an embodiment, when the processor executes a computer program, the following steps are further implemented:
獲取預設時間段內的歷史人傷定損資料;歷史人傷定損資料包括多個因數欄位;Obtain historical personal injury and damage damage data within a preset time period; historical personal injury and damage damage data includes multiple factor fields;
對因數欄位對應的歷史人傷定損資料進行聚類分析,得到多個因數欄位對應的聚類結果;Perform cluster analysis on the historical human injury and damage data corresponding to the factor field to obtain the clustering results corresponding to multiple factor fields;
利用聚類結果對人傷定損模型進行優化。The clustering results were used to optimize the model of human injury.
於一實施方式中,處理器執行電腦程式時還實現下列步驟:In an embodiment, when the processor executes a computer program, the following steps are further implemented:
在多個網站抓取新聞內容;Crawl news content on multiple websites;
對多種新聞內容進行大資料分析,得到與保險事故相關的內容;Big data analysis of various news content to get content related to insurance accidents;
若根據與保險事故相關的內容識別出待理賠事故,則根據待理賠事故生成理賠任務,將理賠任務發送至理賠終端,以使得理賠終端在處理人傷理賠時生成人傷定損請求。If a claim accident is identified based on the content related to the insurance accident, a claim task is generated based on the pending claim accident, and the claim task is sent to the claim terminal, so that the claim terminal generates a personal injury determination request when processing the personal injury claim.
於一實施方式中,處理器執行電腦程式時還實現下列步驟:In an embodiment, when the processor executes a computer program, the following steps are further implemented:
根據與保險事故相關的內容生成事故查勘任務,將事故查勘任務發送至查勘終端;Generate accident investigation tasks according to the content related to insurance accidents, and send the accident investigation tasks to the investigation terminal;
接收查勘終端返回的查勘資訊;Receive survey information returned by survey terminals;
若查勘資訊中包括客戶資訊,則記錄與保險事故相關的內容所對應的待理賠事故。If customer information is included in the survey information, then the pending claims incident corresponding to the content related to the insurance incident is recorded.
於一實施方式中,提供一種電腦可讀存儲介質,其上存儲有電腦程式,電腦程式被處理器執行時實現下列步驟:In one embodiment, a computer-readable storage medium is provided, on which a computer program is stored. When the computer program is executed by a processor, the following steps are implemented:
接收終端發送的人傷定損請求,人傷定損請求中攜帶傷者資訊;Receiving the personal injury and damage request sent by the terminal, and the personal injury and damage request carries the injured person's information;
根據定損請求調用人傷定損模型;According to the fixed damage request, the human damage fixed damage model is called;
將傷者資訊輸入至人傷定損模型,透過人傷定損模型計算多個定損專案對應的定損時長;Enter the injured person's information into the human injury fixed loss model, and calculate the fixed loss time corresponding to multiple fixed loss projects through the human injury fixed loss model;
利用多個定損專案對應的定損時長計算人傷理賠對應的定損費用。Calculate the fixed loss cost corresponding to personal injury claims by using the fixed loss time corresponding to multiple fixed loss projects.
於一實施方式中,人傷定損模型包括:F = f(x,y,z,k,g);其中, F為定損項目對應的定損時長;x、y、z、k及g為因數欄位,其中,x為診斷編碼;y為手術類型;z為年齡區間;k為所在地區;g為性別。In an embodiment, the human injury determination model includes: F = f (x, y, z, k, g); where F is a fixed loss duration corresponding to a fixed loss item; x, y, z, k, and g is the factor field, where x is the diagnostic code; y is the type of surgery; z is the age range; k is the region; g is the gender.
於一實施方式中,電腦程式被處理器執行時還實現下列步驟:In an embodiment, when the computer program is executed by the processor, the following steps are also implemented:
獲取預設時間段內的歷史人傷定損資料;歷史人傷定損資料包括多個因數欄位;Obtain historical personal injury and damage damage data within a preset time period; historical personal injury and damage damage data includes multiple factor fields;
對因數欄位對應的歷史人傷定損資料進行聚類分析,得到多個因數欄位對應的聚類結果;Perform cluster analysis on the historical human injury and damage data corresponding to the factor field to obtain the clustering results corresponding to multiple factor fields;
利用聚類結果對人傷定損模型進行優化。The clustering results were used to optimize the model of human injury.
於一實施方式中,電腦程式被處理器執行時還實現下列步驟:In an embodiment, when the computer program is executed by the processor, the following steps are also implemented:
在多個網站抓取新聞內容;Crawl news content on multiple websites;
對多種新聞內容進行大資料分析,得到與保險事故相關的內容;Big data analysis of various news content to get content related to insurance accidents;
若根據與保險事故相關的內容識別出待理賠事故,則根據待理賠事故生成理賠任務,將理賠任務發送至理賠終端,以使得理賠終端在處理人傷理賠時生成人傷定損請求。If a claim accident is identified based on the content related to the insurance accident, a claim task is generated based on the pending claim accident, and the claim task is sent to the claim terminal, so that the claim terminal generates a personal injury determination request when processing the personal injury claim.
於一實施方式中,電腦程式被處理器執行時還實現下列步驟:In an embodiment, when the computer program is executed by the processor, the following steps are also implemented:
根據與保險事故相關的內容生成事故查勘任務,將事故查勘任務發送至查勘終端;Generate accident investigation tasks according to the content related to insurance accidents, and send the accident investigation tasks to the investigation terminal;
接收查勘終端返回的查勘資訊;Receive survey information returned by survey terminals;
若查勘資訊中包括客戶資訊,則記錄與保險事故相關的內容所對應的待理賠事故。If customer information is included in the survey information, then the pending claims incident corresponding to the content related to the insurance incident is recorded.
本發明技術領域通常知識者可理解實現上述實施方式方法中之全部或部分流程,係可透過電腦程式指令相關之硬體所完成,该程式可存儲於一非易失性電腦可讀取存儲介質中,該程式於執行時,可包括如上述各方法之實施方式之流程。其中,該存儲介質可為磁碟、光碟、唯讀存儲記憶體(Read-Only Memory,ROM)等。Those of ordinary skill in the technical field of the present invention can understand that all or part of the processes in the implementation method described above can be completed by computer program instructions related hardware, the program can be stored in a non-volatile computer readable storage medium In the execution, the program may include the processes of the implementation methods of the above methods. The storage medium may be a magnetic disk, an optical disk, a read-only memory (ROM), or the like.
以上實施方式之各技術特徵可進行任意組合,為使描述簡潔,未對上述實施方式中各個技術特徵所有可能之組合皆進行描述,然而,只要該些技術特徵之組合不存在矛盾,皆應當認為其係本發明說明書中所記載之範圍。The technical features of the above embodiments can be arbitrarily combined. In order to make the description concise, all possible combinations of the technical features in the above embodiments are not described. However, as long as there is no contradiction in the combination of these technical features, it should be considered This is the range described in the specification of the present invention.
以上實施方式僅表達本發明數種實施方式,其描述較為具體和詳細,但並不能因此而理解為對本發明之專利範圍的限制。應當指出,對於本領域之通常知識者而言,於不脫離本發明構思的前提下,還可做出若干變化與改良,此等皆屬於本發明之保護範圍。因此,本發明專利之保護範圍應以所附申請專利範圍為準。The above embodiments only express several embodiments of the present invention, and their descriptions are more specific and detailed, but they cannot be construed as limiting the patent scope of the present invention. It should be pointed out that for those of ordinary skill in the art, without departing from the concept of the present invention, several changes and improvements can be made, all of which belong to the protection scope of the present invention. Therefore, the scope of protection of the invention patent shall be subject to the scope of the attached patent application.
102‧‧‧理賠終端 102‧‧‧claims terminal
104‧‧‧伺服器 104‧‧‧Server
202‧‧‧步驟 202‧‧‧step
204‧‧‧步驟 204‧‧‧step
206‧‧‧步驟 206‧‧‧step
208‧‧‧步驟 208‧‧‧step
302‧‧‧接收模組 302‧‧‧Receiving module
304‧‧‧調用模組 304‧‧‧Call module
306‧‧‧測算模組 306‧‧‧Calculation module
308‧‧‧優化模組 308‧‧‧Optimization module
310‧‧‧內容採集模組 310‧‧‧Content Acquisition Module
312‧‧‧內容分析模組 312‧‧‧Content Analysis Module
314‧‧‧理賠模組 314‧‧‧claims module
316‧‧‧查勘模組 316‧‧‧ Survey module
圖1為本發明實施方式之人傷理賠定損費用測算方法應用環境圖。 圖2為本發明實施方式之人傷理賠定損費用測算方法之流程圖。 圖3為本發明實施方式之人傷理賠定損費用測算裝置之結構圖。 圖4為本發明實施方式之人傷理賠定損費用測算裝置之結構圖。 圖5為本發明實施方式之伺服器之結構圖。FIG. 1 is a diagram of an application environment of a method for calculating a personal injury claim and fixed loss cost according to an embodiment of the present invention. FIG. 2 is a flowchart of a method for calculating a personal injury and loss compensation cost according to an embodiment of the present invention. FIG. 3 is a structural diagram of a personal injury compensation fixed loss cost calculation device according to an embodiment of the present invention. FIG. 4 is a structural diagram of a personal injury compensation fixed loss cost calculation device according to an embodiment of the present invention. FIG. 5 is a structural diagram of a server according to an embodiment of the present invention.
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