WO2017161897A1 - 基于健康管理的保险精算方法和系统 - Google Patents

基于健康管理的保险精算方法和系统 Download PDF

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Publication number
WO2017161897A1
WO2017161897A1 PCT/CN2016/105117 CN2016105117W WO2017161897A1 WO 2017161897 A1 WO2017161897 A1 WO 2017161897A1 CN 2016105117 W CN2016105117 W CN 2016105117W WO 2017161897 A1 WO2017161897 A1 WO 2017161897A1
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health
insurance
information
user
module
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PCT/CN2016/105117
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English (en)
French (fr)
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张贯京
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深圳市前海安测信息技术有限公司
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Publication of WO2017161897A1 publication Critical patent/WO2017161897A1/zh

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    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
    • G06Q40/08—Insurance

Definitions

  • the present invention relates to the field of data processing technologies, and in particular, to an insurance actuarial method and system based on health management.
  • insurance companies introduce a variety of insurance products, and insurance sales personnel are directed to different people according to the type and characteristics of insurance products.
  • the insured person is required to carry out the necessary medical examination before finalizing the premium and the insured amount.
  • the premium is relatively high and the insurance amount will be adjusted.
  • Premiums and insured amounts are adjusted based on the actual physical condition of the insured and the expected risk.
  • the existing insurance actuarial methods and systems refer to the medical examination report of the insured person, once the medical examination report is formed before the insurance, the insurance amount and the premium are fixed, and the health management process is not combined and the health index of the insured person is changed.
  • the insurance premiums and insurance premiums of the insured personnel are adjusted, and the insurance product design structure is unreasonable, which increases the operational risks of the insurance company.
  • the main purpose of the present invention is to provide an insurance actuarial method and system based on health management, which aims to solve the problem that the existing insurance products do not combine the health management process and adjust the insured personnel according to the changes in the health index of the insured personnel.
  • the premiums and insurance premiums lead to unreasonable design of insurance products and increase the operational risks of insurance companies.
  • the present invention provides an insurance actuarial method based on health management.
  • the health management-based actuarial method includes the following steps:
  • the step of generating the user's health index value according to the health information according to the evidence-based medical database comprises:
  • the evidence-based medical database is used to store a preset health information and health index mapping table.
  • the health information includes a plurality of categories of health information
  • the evidence-based medical database stores health index information corresponding to each category of health information within a corresponding preset range.
  • the step of adjusting the insurance factor according to the health index value comprises:
  • the pre-stored weight determination relationship table matches the weight value of the insurance type corresponding health index value of the user to be insured in the insurance factor;
  • the present invention also provides an insurance actuarial system based on health management.
  • the health management-based actuarial system includes a health risk assessment module, an insurance factor adjustment module, and an insurance product creation module, wherein:
  • the health risk assessment module is configured to acquire health information of the user according to a preset period, and generate a health index value of the user according to the health information according to the evidence-based medical database;
  • the insurance factor adjustment module is configured to adjust an insurance factor according to the health index value
  • the insurance product creation module is configured to generate an insurance product according to the adjusted insurance factor.
  • the health risk assessment module includes an information acquisition sub-module, an information matching sub-module, and a calculation sub-module, wherein:
  • the information acquisition sub-module is configured to acquire health information of the user according to a preset period
  • the information matching sub-module is configured to match corresponding health index information in the evidence-based medical database with the health information of the user as a keyword;
  • the calculation sub-module is configured to calculate a health index value of the user according to a weight ratio preset by the health index information.
  • the evidence-based medical database is used to store a preset health information and health index mapping table.
  • the health information includes a plurality of categories of health information
  • the evidence-based medical database stores health index information corresponding to each category of health information within a corresponding preset range.
  • the insurance factor adjustment module includes an insurance type determination sub-module, a weight determination sub-module, and an insurance factor determination sub-module, wherein:
  • the insurance type determining sub-module is configured to obtain an insurance type that the user intends to participate in;
  • the weight determination sub-module is configured to match, according to the insurance type that the user intends to insure, from the pre-stored weight determination relationship table, the weight value of the health-type corresponding health index value in the insurance factor that the user intends to insure ;
  • the insurance factor determination sub-module is configured to determine, according to the weight value, an actuarial factor and a non-actuarial factor after the user passes the health risk assessment.
  • the health management-based insurance actuarial method and system monitors user's physical signs information through long-term, and performs health assessment and health intervention on users through a healthy cloud platform, in a preset period.
  • the user's health risk is assessed, and the insurance factor is adjusted according to the health risk assessment result, thereby improving the accuracy of the actuarial results.
  • the user's premium and insurance amount can be periodically adjusted according to the user's health data, which improves the reasonableness of the insurance product structure. Sexuality reduces the operational risk of insurance companies.
  • FIG. 1 is a schematic structural diagram of a preferred embodiment of an operating environment of an actuarial system based on health management according to the present invention
  • FIG. 2 is a schematic diagram of functional modules of a second server according to a preferred embodiment of the present invention.
  • FIG. 3 is a schematic diagram of functional modules of a preferred embodiment of a health insurance based actuarial system according to the present invention.
  • FIG. 4 is a schematic flow chart of an actuarial method based on health management according to the present invention.
  • FIG. 5 is a schematic diagram showing the refinement flow of S20 in FIG. 4;
  • FIG. 6 is a schematic diagram showing the refinement flow of S30 in FIG. 4.
  • the present invention provides an insurance actuarial method and system based on health management, which performs health assessment and health intervention on a healthy cloud platform through long-term monitoring of user vital information, in a preset cycle.
  • the user's health risk is assessed, and the insurance factor is adjusted according to the health risk assessment result, thereby affecting the actuarial results.
  • the user's premium and insurance amount can be periodically adjusted according to the user's health data, which improves the rationality of the insurance product structure. Reduce the operational risk of insurance companies
  • FIG. 1 is a schematic structural diagram of a preferred embodiment of an operating environment of a life actuarial system based on health management according to the present invention.
  • the operating environment of the actuarial system based on the health management of the present invention includes the smart terminal 1, the first server 2, the second server 3, and the smart terminal 1 and the first server 2 are connected through a network.
  • the first server 2 and the second server 3 are connected through a network.
  • the health management terminal system 10 operates in the smart terminal 1
  • the health management cloud service system 20 operates in the first server 2
  • the health management based actuarial system 30 operates in the second server 3.
  • the smart terminal 1 is configured to collect health information of the user, and send the health information to the first server 2.
  • the health information includes, but is not limited to, the user's vital information, athletic information, and dietary information.
  • the first server 2 is configured to generate health intervention information according to the health information, and send the health intervention information feedback to the smart terminal 1 for viewing by the user.
  • the health intervention information includes, but is not limited to, dietary intervention information, exercise intervention information, and medication guidance information.
  • the first server 2 is further configured to send the health information to the second server 3, where the third server is configured to perform health risk assessment on the user according to the health information, and adjust according to a preset risk according to the health risk index.
  • the insurance factor based on the adjusted insurance factor, generates insurance products, and outputs insurance premiums, premiums, and other insurance-related information.
  • FIG. 2 is a schematic diagram of functional modules of a second server according to a preferred embodiment of the present invention.
  • the health management-based actuarial system operates in the second server 3, and the second server 3 includes, but is not limited to, a health management-based actuarial system 30, a storage unit 32, and a processing unit 34. And a communication unit 36.
  • the storage unit 32 may be a read only storage unit ROM, an electrically erasable storage unit EEPRO
  • flash memory unit FLASH or solid hard disk FLASH or solid hard disk.
  • the processing unit 34 may be a central processing unit (CPU), a microcontroller (MCU), a data processing chip, or an information processing unit having a data processing function.
  • CPU central processing unit
  • MCU microcontroller
  • data processing chip or an information processing unit having a data processing function.
  • the communication unit 36 is a wireless communication interface with remote wireless communication function, for example, support
  • GSM Global System for Mobile communications
  • GPRS Wireless Fidelity
  • WCDMA Wideband Code Division Multiple Access
  • CDMA Code Division Multiple Access
  • TD-SCDMA Wideband Code Division Multiple Access
  • WiMAX TD-LTE
  • FDD-LT Frequency Division Multiple Access
  • the health management based actuarial system 30 includes a health risk assessment module 301, an insurance factor adjustment module 302, and an insurance product creation module 303.
  • a module referred to in the present invention refers to a series of computer program instruction segments that can be executed by the processing unit 34 and that are capable of performing a fixed function, which are stored in the storage unit 32.
  • the health risk assessment module 301 is configured to acquire health information of a user sent by the first server 2 according to a preset period, and generate a user's health according to the health information according to the evidence-based medical database. Index value.
  • the evidence-based medical database is configured to store a preset health information and health index mapping table, and the evidence-based medical database is pre-stored in the storage unit 32.
  • FIG. 3 is a schematic diagram of functional modules of a preferred embodiment of a health management based actuarial system according to the present invention.
  • the health risk assessment module 301 includes an information acquisition sub-module 3011, an information matching sub-module 3012, and a calculation sub-module 3013, where the information acquisition sub-module 3011 is configured to acquire health information of the user according to a preset period; The preset period can be 1 month, half year or 1 year, and can be set according to the type of insurance and the needs of the insurance company.
  • the information matching sub-module 3012 is configured to match the corresponding health index information in the evidence-based medical database with the health information of the user as a keyword.
  • the evidence-based medical database stores health index information corresponding to each category of health information in a corresponding preset range.
  • the calculating sub-module 3013 is configured to calculate a health index value of the user according to a weight ratio preset by the health index information.
  • the insurance factor adjustment module 302 is configured to adjust an insurance factor according to the health index value.
  • the insurance factor adjustment module 302 includes an insurance type determination sub-module 3021, a weight determination sub-module 3022, and an insurance factor determination sub-module 3023.
  • the insurance type determining sub-module 3021 is configured to acquire the insurance type of the user to be insured; the insurance type to be insured may be set in advance in the health management-based actuarial system 30, for example, set to a pull-down menu. The form is for the user to choose.
  • the weight determination sub-module 3022 is configured to match, according to the insurance type to be insured, from the weight determination relationship table pre-stored in the storage unit 32, the insurance type corresponding health index value of the user to be insured in the insurance factor.
  • Weight value For example: The health index value is used as the impact factor of disease insurance and life insurance products, and the weight value is set to a large proportion (for example, 20% or more) to reduce the output risk of insurance products; as other insurance products
  • the impact factor ⁇ the weight value is set to a smaller proportion (for example: below 20%).
  • the insurance factor determination sub-module 3023 is configured to determine, according to the weight value, an actuarial factor and a non-actuarial factor after the user passes the health risk assessment.
  • the insurance product creation module 303 is configured to generate an insurance product according to the adjusted insurance factor.
  • the insurance product creation module 303 determines the insurance information of the user according to the actuarial factor and the non-actuarial factor and produces an insurance policy.
  • the insurance information includes, but is not limited to, the insured object, the contracted scope, the premium, the insured amount, and other insurance attributes.
  • Other insurance attributes include, but are not limited to, rules, formulas, and terms.
  • the invention monitors the user's physical condition information through long-term, conducts health assessment and health intervention on the user through the healthy cloud platform, evaluates the user's health risk in a preset period, and adjusts the insurance factor according to the health risk assessment result, thereby improving The accuracy of the actuarial results, the user's premiums and insured amount can be periodically adjusted according to the user's health data, improving the rationality of the insurance product structure and reducing the operational risk of the insurance company.
  • FIG. 4 is a schematic flowchart diagram of an insurance actuarial method based on health management according to the present invention.
  • the health management-based actuarial method runs in the second server 3, and includes the following steps:
  • S10 Acquire user health information according to a preset period
  • the information obtaining sub-module 3011 of the health risk assessment module 301 acquires the health information of the user sent by the first server 2 according to a preset period, and the preset period may be 1 month, half year, or 1 Years can be set according to the type of insurance and the needs of the insurance company.
  • S20 generating a user's health index value according to the health information according to the evidence-based medical database
  • the health risk assessment module 301 generates a user's health index value according to the health information according to the evidence-based medical database.
  • the evidence-based medical database is configured to store a preset health information and a health index map, and the evidence-based medicine database is pre-stored in the storage unit 32.
  • FIG. 5 is a schematic diagram of the refinement process of S20 in FIG. 4, including the following steps:
  • S201 matching corresponding health index information in the evidence-based medical database with the health information of the user as a keyword;
  • the information matching sub-module 3012 matches the corresponding health index information in the evidence-based medical database with the health information of the user as a keyword.
  • the health information includes a plurality of different types of health information, such as vital sign information, sports information, and diet information, correspondingly, the health information of each category stored in the evidence-based medical database corresponds to a corresponding preset range. Health index information.
  • S202 Calculate a health index value of the user according to a weight ratio preset by the health index information.
  • FIG. 6 is a schematic diagram of a refinement process of S30 in FIG. 4. Specifically, step S30 includes the following steps:
  • S301 Obtain an insurance type that the user intends to participate in
  • the insurance type determining sub-module 3021 obtains the insurance type that the user intends to insure.
  • the type of insurance to be insured may be set in advance in the health management-based actuarial system 30, for example, in the form of a drop-down menu for the user to select.
  • S302 matching, according to the insurance type that the user intends to participate, from the pre-stored weight determination relationship table.
  • the type of insurance that the user intends to insure corresponds to the weight value of the health index value in the insurance factor;
  • the health index value is used as an impact factor of disease insurance and life insurance products, and the weight value is set to a large proportion (for example, 20% or more) to reduce the output risk of the insurance product; as other insurance products
  • the impact factor ⁇ the weight value is set to a smaller proportion (for example: 20% or less).
  • S303 Determine, according to the weight value, an actuarial factor and a non-actuarial factor after the user passes the health risk assessment.
  • S40 Generate an insurance product according to the adjusted insurance factor.
  • the insurance product creation module 303 determines the insurance information of the user according to the actuarial factor and the non-actuarial factor and produces an insurance policy.
  • the insurance information includes, but is not limited to, the insured object, the scope of the contract, the premium, the insured amount, and other insurance attributes.
  • Other insurance attributes include, but are not limited to, rules, formulas, and terms
  • the invention monitors the user's physical condition information through long-term, and conducts health assessment and health intervention on the user through the healthy cloud platform, evaluates the user's health risk in a preset period, and adjusts the insurance factor according to the health risk assessment result, thereby improving The accuracy of the actuarial results, the user's premiums and insured amount can be periodically adjusted according to the user's health data, improving the rationality of the insurance product structure and reducing the operational risk of the insurance company.
  • the health management-based insurance actuarial method and system monitors user's physical condition information through long-term, and performs health assessment and health intervention on the user through the healthy cloud platform, in a preset period.
  • the user's health risk is assessed, and the insurance factor is adjusted according to the health risk assessment result, thereby improving the accuracy of the actuarial results.
  • the user's premium and insurance amount can be periodically adjusted according to the user's health data, which improves the reasonableness of the insurance product structure. Sexuality reduces the operational risk of insurance companies.

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Abstract

一种基于健康管理的保险精算方法和系统，所述方法包括如下步骤：按照预设的周期获取用户的健康信息（S10），根据所述健康信息按照循证医学数据库生成用户的健康指数值（S20）；根据所述健康指数值调整保险因子（S30）；根据所述调整后的保险因子生成保险产品（S40）。所述基于健康管理的保险精算方法和系统，通过长期监测用户体征信息，利用健康云平台对用户进行健康评估和健康干预，在预设的周期内对用户的健康风险进行评估，根据健康风险评估结果调整保险因子，从而提高保险精算结果的准确性，用户的保费和保额能够根据用户的健康数据进行周期性调整，提高了保险产品架构的合理性，降低了保险公司的运营风险。

Description

基于健康管理的保险精算方法和系统 技术领域
[0001] 本发明涉及数据处理技术领域， 尤其涉及一种基于健康管理的保险精算方法和 系统。
背景技术
[0002] 目前， 保险公司推出各种各样的保险产品， 保险销售人员根据保险产品的类别 以及特点定向地推销给不同的人群。 对于疾病类保险产品， 在最终确定保费以 及保额前， 需要参保人员进行必要的体检， 对于患某类疾病风险较高的参保人 员， 保费相对较高， 保额也会做调整， 即会根据参保人员的实际身体状况以及 预期风险来调整保费和保额。 现有的保险精算方法和系统虽然有参考参保人员 的体检报告， 但在参保前体检报告一旦形成， 保额和保费即固定， 没有结合健 康管理过程并根据参保人员身体健康指数的变化及吋调整参保人员的保费和保 额， 保险产品设计架构不合理， 增大了保险公司的运营风险。
技术问题
[0003] 本发明的主要目的在于提供一种基于健康管理的保险精算方法和系统， 旨在解 决现有保险产品没有结合健康管理过程并根据参保人员身体健康指数的变化及 吋调整参保人员的保费和保额， 导致保险产品设计架构不合理， 增大了保险公 司的运营风险的问题。
问题的解决方案
技术解决方案
[0004] 为实现上述目的， 本发明提供了一种基于健康管理的保险精算方法。
[0005] 所述基于健康管理的保险精算方法包括如下步骤：
[0006] 按照预设的周期获取用户的健康信息；
[0007] 根据所述健康信息按照循证医学数据库生成用户的健康指数值；
[0008] 根据所述健康指数值调整保险因子；
[0009] 根据所述调整后的保险因子生成保险产品。 [0010] 优选地， 所述根据所述健康信息按照循证医学数据库生成用户的健康指数值的 步骤包括：
[0011] 以所述用户的健康信息为关键词在所述循证医学数据库中匹配对应的健康指数 f π息；
[0012] 根据所述健康指数信息预设的权重比例计算该用户的健康指数值。
[0013] 优选地， 所述循证医学数据库用于存储预设的健康信息与健康指数映射表。
[0014] 优选地， 所述健康信息包括多种类别的健康信息， 所述循证医学数据库中存储 了每一种类别的健康信息在对应预设范围内对应的健康指数信息。
[0015] 优选地， 所述根据所述健康指数值调整保险因子的步骤包括：
[0016] 获取用户拟参保的保险类型；
[0017] 根据所述用户拟参保的保险类型从预先存储的权重确定关系表匹配出该用户拟 参保的保险类型对应健康指数值在保险因子中的权重值；
[0018] 根据所述权重值确定该用户经过健康风险评估后的精算因子和非精算因子。
[0019]
[0020] 本发明还提供了一种基于健康管理的保险精算系统。
[0021] 所述基于健康管理的保险精算系统包括健康风险评估模块、 保险因子调整模块 以及保险产品创建模块， 其中：
[0022] 所述健康风险评估模块用于按照预设的周期获取用户的健康信息， 并根据所述 健康信息按照循证医学数据库生成用户的健康指数值；
[0023] 所述保险因子调整模块用于据所述健康指数值调整保险因子；
[0024] 所述保险产品创建模块用于根据所述调整后的保险因子生成保险产品。
[0025] 优选地， 所述健康风险评估模块包括信息获取子模块、 信息匹配子模块以及计 算子模块， 其中：
[0026] 所述信息获取子模块用于按照预设的周期获取用户的健康信息；
[0027] 所述信息匹配子模块用于以所述用户的健康信息为关键词在所述循证医学数据 库中匹配对应的健康指数信息；
[0028] 所述计算子模块用于根据所述健康指数信息预设的权重比例计算该用户的健康 指数值。 [0029] 优选地， 所述循证医学数据库用于存储预设的健康信息与健康指数映射表。
[0030] 优选地， 所述健康信息包括多种类别的健康信息， 所述循证医学数据库中存储 了每一种类别的健康信息在对应预设范围内对应的健康指数信息。
[0031] 优选地， 所述保险因子调整模块包括保险类型确定子模块、 权重确定子模块以 及保险因子确定子模块， 其中：
[0032] 所述保险类型确定子模块用于获取用户拟参保的保险类型；
[0033] 所述权重确定子模块用于根据所述用户拟参保的保险类型从预先存储的权重确 定关系表匹配出该用户拟参保的保险类型对应健康指数值在保险因子中的权重 值；
[0034] 所述保险因子确定子模块用于根据所述权重值确定该用户经过健康风险评估后 的精算因子和非精算因子。
发明的有益效果
有益效果
[0035] 相较于现有技术， 本发明提供的基于健康管理的保险精算方法和系统， 通过长 期监测用户体征信息， 通过健康云平台对用户进行健康评估和健康干预， 在预 设的周期内对用户的健康风险进行评估， 根据健康风险评估结果调整保险因子 ， 从而提高保险精算结果的准确性， 用户的保费和保额能够根据用户的健康数 据进行周期性调整， 提高了保险产品架构的合理性， 降低了保险公司的运营风 险。
对附图的简要说明
附图说明
[0036] 图 1为本发明基于健康管理的保险精算系统运行环境较佳实施例的结构示意图
[0037] 图 2为本发明第二服务器较佳实施例的功能模块示意图；
[0038] 图 3为本发明基于健康管理的保险精算系统较佳实施例的功能模块示意图；
[0039] 图 4为本发明基于健康管理的保险精算方法的流程示意图；
[0040] 图 5为图 4中 S20的细化流程示意图；
[0041] 图 6为图 4中 S30的细化流程示意图。 实施该发明的最佳实施例
本发明的最佳实施方式
[0042] 为更进一步阐述本发明为达成上述目的所采取的技术手段及功效， 以下结合附 图及较佳实施例， 对本发明的具体实施方式、 结构、 特征及其功效进行详细说 明。 应当理解， 此处所描述的具体实施例仅仅用以解释本发明， 并不用于限定 本发明。
[0043] 为实现本发明目的， 本发明提供了一种基于健康管理的保险精算方法和系统， 通过长期监测用户体征信息， 通过健康云平台对用户进行健康评估和健康干预 ， 在预设的周期内对用户的健康风险进行评估， 根据健康风险评估结果调整保 险因子， 从而影响保险精算结果， 用户的保费和保额能够根据用户的健康数据 进行周期性调整， 提高了保险产品架构的合理性， 降低了保险公司的运营风险
[0044] 参照图 1所示， 图 1为本发明基于健康管理的保险精算系统运行环境较佳实施例 的结构示意图。
[0045] 在本实施例中， 本发明基于健康管理的保险精算系统运行环境包括智能终端 1 、 第一服务器 2、 第二服务器 3， 所述智能终端 1与所述第一服务器 2通过网络连 接， 所述第一服务器 2与所述第二服务器 3通过网络连接。 健康管理终端系统 10 运行于所述智能终端 1中， 健康管理云服务系统 20运行于所述第一服务器 2中， 基于健康管理的保险精算系统 30运行于第二服务器 3中。 所述智能终端 1用于采 集用户的健康信息， 并将所述健康信息发送至第一服务器 2。 所述健康信息包括 但不限于用户的体征信息、 运动信息和饮食信息。 所述第一服务器 2用于根据所 述健康信息生成健康干预信息， 并将所述健康干预信息反馈发送至智能终端 1供 用户査看。 所述健康干预信息包括但不限于饮食干预信息、 运动干预信息以及 用药指导信息。 所述第一服务器 2还用于将所述健康信息发送至第二服务器 3， 所述第三服务器用于根据所述健康信息对用户进行健康风险评估， 根据健康风 险指数按照预设的规则调整保险因子， 再根据调整后的保险因子生成保险产品 ， 输出保额、 保费以及其他保险相关信息。
[0046] [0047] 参照图 2所示， 图 2为本发明第二服务器较佳实施例的功能模块示意图。 在本实 施例中， 所述基于健康管理的保险精算系统运行于第二服务器 3中， 所述第二服 务器 3包括但不限于， 基于健康管理的保险精算系统 30、 存储单元 32、 处理单元 34以及通讯单元 36。
[0048] 所述的存储单元 32可以为一种只读存储单元 ROM, 电可擦写存储单元 EEPRO
M、 快闪存储单元 FLASH或固体硬盘等。
[0049] 所述的处理单元 34可以为一种中央处理器 （Central Processing Unit, CPU) 、 微控制器 （MCU) 、 数据处理芯片、 或者具有数据处理功能的信息处理单元。
[0050] 所述的通讯单元 36为一种具有远程无线通讯功能的无线通讯接口， 例如， 支持
GSM、 GPRS、 WCDMA、 CDMA、 TD-SCDMA、 WiMAX、 TD-LTE、 FDD-LT
E等通讯技术的通讯接口。
[0051] 所述基于健康管理的保险精算系统 30包括健康风险评估模块 301、 保险因子调 整模块 302以及保险产品创建模块 303。 本发明所称的模块是指一种能够被所述 处理单元 34执行并且能够完成固定功能的一系列计算机程序指令段， 其存储在 存储单元 32中。
[0052] 结合图 1所示， 所述健康风险评估模块 301用于按照预设的周期获取第一服务器 2发送的用户的健康信息， 并根据所述健康信息按照循证医学数据库生成用户的 健康指数值。
[0053] 具体地， 所述循证医学数据库用于存储预设的健康信息与健康指数映射表， 所 述循证医学数据库预先存储于所述存储单元 32中。
[0054] 参照图 3所示， 图 3为本发明基于健康管理的保险精算系统较佳实施例的功能模 块示意图。
[0055] 所述健康风险评估模块 301包括信息获取子模块 3011、 信息匹配子模块 3012以 及计算子模块 3013， 所述信息获取子模块 3011用于按照预设的周期获取用户的 健康信息； 所述预设的周期可以是 1个月、 半年或者 1年， 可以根据保险类型以 及保险公司的需求设置。 所述信息匹配子模块 3012用于以该用户的健康信息为 关键词在所述循证医学数据库中匹配对应的健康指数信息。 当所述健康信息包 括体征信息、 运动信息和饮食信息等多种不同类别的健康信息吋， 对应地， 所 述循证医学数据库中存储了每一种类别的健康信息在对应预设范围内对应的健 康指数信息。 所述计算子模块 3013用于根据所述健康指数信息预设的权重比例 ， 计算该用户的健康指数值。
[0056] 所述保险因子调整模块 302用于根据所述健康指数值调整保险因子。
[0057] 具体地， 所述保险因子调整模块 302包括保险类型确定子模块 3021、 权重确定 子模块 3022以及保险因子确定子模块 3023。 所述保险类型确定子模块 3021用于 获取用户的拟参保的保险类型； 所述拟参保的保险类型可以预先在基于健康管 理的保险精算系统 30中提前设置好， 例如设置为下拉菜单的形式供使用者选择 。 所述权重确定子模块 3022用于根据所述拟参保的保险类型从预先存储在存储 单元 32中的权重确定关系表匹配出该用户拟参保的保险类型对应健康指数值在 保险因子中的权重值； 例如： 所述健康指数值作为疾病类保险和人寿类保险产 品的影响因子吋， 权重值设置为较大比例 （例如 20%以上） ， 以降低保险产品的 输出风险； 作为其他保险产品的影响因子吋， 权重值设置为较小比例 （例如： 2 0%以下） 。 所述保险因子确定子模块 3023用于根据所述权重值确定该用户经过 健康风险评估后的精算因子和非精算因子。
[0058] 所述保险产品创建模块 303用于根据所述调整后的保险因子生成保险产品。
[0059] 具体地， 所述保险产品创建模块 303根据所述精算因子和非精算因子确定该用 户的保险信息并生产保险单。 所述保险信息包括但不限于， 被保对象、 承包范 围、 保费、 保额以及其他保险属性。 其他保险属性包括但不限于规则、 公式和 条款。
[0060] 本发明通过长期监测用户体征信息， 通过健康云平台对用户进行健康评估和健 康干预， 在预设的周期内对用户的健康风险进行评估， 根据健康风险评估结果 调整保险因子， 从而提高保险精算结果的准确性， 用户的保费和保额能够根据 用户的健康数据进行周期性调整， 提高了保险产品架构的合理性， 降低了保险 公司的运营风险。
[0061]
[0062] 本发明的另外一个方面， 提供了一种与上述基于健康管理的保险精算系统对应 的方法。 [0063] 参照图 4所示， 图 4为本发明基于健康管理的保险精算方法的流程示意图。
[0064] 在本实施例中， 结合图 1、 图 2和图 3所示， 所述基于健康管理的保险精算方法 运行于第二服务器 3中， 包括如下步骤：
[0065] S10: 按照预设的周期获取用户的健康信息；
[0066] 具体地， 健康风险评估模块 301中的信息获取子模块 3011按照预设的周期获取 第一服务器 2发送的用户的健康信息， 所述预设的周期可以是 1个月、 半年或者 1 年， 可以根据保险类型以及保险公司的需求设置。
[0067] S20: 根据所述健康信息按照循证医学数据库生成用户的健康指数值；
[0068] 具体地， 健康风险评估模块 301根据所述健康信息按照循证医学数据库生成用 户的健康指数值。 所述循证医学数据库用于存储预设的健康信息与健康指数映 射表， 所述循证医学数据库预先存储于所述存储单元 32中。
[0069] 参照图 5所示， 图 5为图 4中 S20的细化流程示意图， 包括如下步骤：
[0070]
[0071] S201 : 以所述用户的健康信息为关键词在所述循证医学数据库中匹配对应的健 康指数信息；
[0072] 具体地， 信息匹配子模块 3012以该用户的健康信息为关键词在所述循证医学数 据库中匹配对应的健康指数信息。 当所述健康信息包括体征信息、 运动信息和 饮食信息等多种不同类别的健康信息吋， 对应地， 所述循证医学数据库中存储 了每一种类别的健康信息在对应预设范围内对应的健康指数信息。
[0073] S202: 根据所述健康指数信息预设的权重比例计算该用户的健康指数值。
[0074] S30: 根据所述健康指数值调整保险因子；
[0075] 参照图 6所示， 图 6为图 4中 S30的细化流程示意图， 具体地， 步骤 S30包括如下 步骤：
[0076] S301 : 获取用户拟参保的保险类型；
[0077] 具体地， 保险类型确定子模块 3021获取用户拟参保的保险类型。 所述拟参保的 保险类型可以预先在基于健康管理的保险精算系统 30中提前设置好， 例如设置 为下拉菜单的形式供使用者选择。
[0078] S302: 根据所述用户拟参保的保险类型从预先存储的权重确定关系表匹配出该 用户拟参保的保险类型对应健康指数值在保险因子中的权重值；
[0079] 例如： 所述健康指数值作为疾病类保险和人寿类保险产品的影响因子吋， 权重 值设置为较大比例 （例如 20%以上） ， 以降低保险产品的输出风险； 作为其他保 险产品的影响因子吋， 权重值设置为较小比例 （例如： 20%以下） 。
[0080] S303: 根据所述权重值确定该用户经过健康风险评估后的精算因子和非精算因 子。
[0081] S40: 根据所述调整后的保险因子生成保险产品。
[0082] 具体地， 保险产品创建模块 303根据所述精算因子和非精算因子确定该用户的 保险信息并生产保险单。 所述保险信息包括但不限于， 被保对象、 承包范围、 保费、 保额以及其他保险属性。 其他保险属性包括但不限于规则、 公式和条款
[0083] 本发明通过长期监测用户体征信息， 通过健康云平台对用户进行健康评估和健 康干预， 在预设的周期内对用户的健康风险进行评估， 根据健康风险评估结果 调整保险因子， 从而提高保险精算结果的准确性， 用户的保费和保额能够根据 用户的健康数据进行周期性调整， 提高了保险产品架构的合理性， 降低了保险 公司的运营风险。
[0084] 以上仅为本发明的优选实施例， 并非因此限制本发明的专利范围， 凡是利用本 发明说明书及附图内容所作的等效结构或等效功能变换， 或直接或间接运用在 其他相关的技术领域， 均同理包括在本发明的专利保护范围内。
工业实用性
[0085] 相较于现有技术， 本发明提供的基于健康管理的保险精算方法和系统， 通过长 期监测用户体征信息， 通过健康云平台对用户进行健康评估和健康干预， 在预 设的周期内对用户的健康风险进行评估， 根据健康风险评估结果调整保险因子 ， 从而提高保险精算结果的准确性， 用户的保费和保额能够根据用户的健康数 据进行周期性调整， 提高了保险产品架构的合理性， 降低了保险公司的运营风 险。

Claims
权利要求书
一种基于健康管理的保险精算方法， 其特征在于， 所述基于健康管理 的保险精算方法包括如下步骤： 按照预设的周期获取用户的健康信息 ； 根据所述健康信息按照循证医学数据库生成用户的健康指数值； 根 据所述健康指数值调整保险因子； 根据所述调整后的保险因子生成保 |½：厂口口。
如权利要求 1所述的基于健康管理的保险精算方法， 其特征在于， 所 述根据所述健康信息按照循证医学数据库生成用户的健康指数值的步 骤包括： 以所述用户的健康信息为关键词在所述循证医学数据库中匹 配对应的健康指数信息； 根据所述健康指数信息预设的权重比例计算 该用户的健康指数值。
如权利要求 2所述的基于健康管理的保险精算方法， 其特征在于， 所 述循证医学数据库用于存储预设的健康信息与健康指数映射表。 如权利要求 3所述的基于健康管理的保险精算方法， 其特征在于， 所 述健康信息包括多种类别的健康信息， 所述循证医学数据库中存储了 每一种类别的健康信息在对应预设范围内对应的健康指数信息。 如权利要求 1所述的基于健康管理的保险精算方法， 其特征在于， 所 述根据所述健康指数值调整保险因子的步骤包括： 获取用户拟参保的 保险类型； 根据所述用户拟参保的保险类型从预先存储的权重确定关 系表匹配出该用户拟参保的保险类型对应健康指数值在保险因子中的 权重值； 根据所述权重值确定该用户经过健康风险评估后的精算因子 和非精算因子。
一种基于健康管理的保险精算系统， 其特征在于， 所述基于健康管理 的保险精算系统包括健康风险评估模块、 保险因子调整模块以及保险 产品创建模块， 其中： 所述健康风险评估模块用于按照预设的周期获 取用户的健康信息， 并根据所述健康信息按照循证医学数据库生成用 户的健康指数值； 所述保险因子调整模块用于据所述健康指数值调整 保险因子； 所述保险产品创建模块用于根据所述调整后的保险因子生 成保险产品。
[权利要求 7] 如权利要求 6所述的基于健康管理的保险精算系统， 其特征在于， 所 述健康风险评估模块包括信息获取子模块、 信息匹配子模块以及计算 子模块， 其中： 所述信息获取子模块用于按照预设的周期获取用户的 健康信息； 所述信息匹配子模块用于以所述用户的健康信息为关键词 在所述循证医学数据库中匹配对应的健康指数信息； 所述计算子模块 用于根据所述健康指数信息预设的权重比例计算该用户的健康指数值
[权利要求 8] 如权利要求 7所述的基于健康管理的保险精算系统， 其特征在于， 所 述循证医学数据库用于存储预设的健康信息与健康指数映射表。
[权利要求 9] 如权利要求 8所述的基于健康管理的保险精算系统， 其特征在于， 所 述健康信息包括多种类别的健康信息， 所述循证医学数据库中存储了 每一种类别的健康信息在对应预设范围内对应的健康指数信息。
[权利要求 10] 如权利要求 6所述的基于健康管理的保险精算系统， 其特征在于， 所 述保险因子调整模块包括保险类型确定子模块、 权重确定子模块以及 保险因子确定子模块， 其中： 所述保险类型确定子模块用于获取用户 拟参保的保险类型； 所述权重确定子模块用于根据所述用户拟参保的 保险类型从预先存储的权重确定关系表匹配出该用户拟参保的保险类 型对应健康指数值在保险因子中的权重值； 所述保险因子确定子模块 用于根据所述权重值确定该用户经过健康风险评估后的精算因子和非 精算因子。
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