WO2018228065A1 - 保单数据审核方法、装置、计算机设备和存储介质 - Google Patents

保单数据审核方法、装置、计算机设备和存储介质 Download PDF

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Publication number
WO2018228065A1
WO2018228065A1 PCT/CN2018/084800 CN2018084800W WO2018228065A1 WO 2018228065 A1 WO2018228065 A1 WO 2018228065A1 CN 2018084800 W CN2018084800 W CN 2018084800W WO 2018228065 A1 WO2018228065 A1 WO 2018228065A1
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insured
insurance
information
amount
product
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English (en)
French (fr)
Inventor
袁佳
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Ping An Technology Shenzhen Co Ltd
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Ping An Technology Shenzhen Co Ltd
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    • G—PHYSICS
    • G06—COMPUTING OR CALCULATING; 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 application relates to a policy data review method, device, computer device and storage medium.
  • the customer service personnel insure the customer through the insurance sales system, after the customer service personnel enter the insurance policy, the insurance policy to be entered must be submitted to the policy auditor, and the policy auditor must submit the insurance amount in the policy submitted.
  • the customer insurance information such as customer information, is manually audited to check whether the insurance data meets the specified requirements.
  • the auditor cannot process and review the policy data in time due to the work arrangement, and the customer cannot obtain the insurance audit result in time, and the audit result has a certain delay.
  • the customer personnel need to modify the order and resubmit, and wait for the audit results of the audit personnel to review again, so that the rework rate of the insurance work is higher.
  • the above method of manually reviewing policy data has a problem of long audit period and high rework rate of insured work.
  • a policy data review method is provided.
  • a method for reviewing policy data including:
  • the policy data including the basic information of the insured, the insurance type, and the insurance amount;
  • the product information of the insurance product is obtained, and the result of the insurance recommendation is generated according to the product information of the insurance product and the audit result.
  • a policy data review device comprising:
  • a policy acquisition module configured to obtain policy data, where the policy data includes basic information of the insured, insurance type, and insurance amount;
  • the purchased information inquiry module is configured to query the insured person's historical insurance information according to the insured basic information
  • a quota calculation module configured to calculate, by using the insured person basic information, the insurance type, and the insured person's historical insurance information, an insured person's insurance salesable degree
  • An audit result generating module configured to compare the insured person insurance salesable amount with the insured amount to generate an audit result
  • the result generating module is configured to obtain the product information of the sales insurance product when the audit result is not approved, and generate the insurance recommendation result according to the product information of the sales insurance product and the audit result.
  • a computer apparatus comprising a memory and one or more processors having stored therein computer readable instructions that, when executed by a processor, implement the steps of a policy data review method provided in any one of the embodiments of the present application.
  • One or more non-transitory computer readable instruction storage media storing computer readable instructions, when executed by one or more processors, causing one or more processors to implement any one embodiment of the present application The steps in the policy data review method provided in .
  • FIG. 1 is an application environment diagram of a policy data review method in accordance with one or more embodiments.
  • FIG. 2 is a flow diagram of a policy data review method in accordance with one or more embodiments.
  • FIG. 3 is a flow diagram of a salesability calculation step in accordance with a policy data review method in accordance with one or more embodiments.
  • FIG. 4 is a flow diagram of a step of generating an insurance recommendation result in accordance with a policy data review method in accordance with one or more embodiments.
  • FIG. 5 is a block diagram of a policy data review device in accordance with one or more embodiments.
  • FIG. 6 is a block diagram of a computer device in accordance with one or more embodiments.
  • the policy data review method provided in the embodiment of the present application can be applied to the application environment as shown in FIG. 1.
  • the insurance sales terminal 102 is connected to the server 104 via a network.
  • the server 104 stores customer information of all customers and historical information of all insurances purchased by the customer, wherein the customer includes the applicant and the insured.
  • the insurance sales terminal 102 generates a policy of the insured person's history insurance information according to the insured person's basic information for obtaining the policy data, and sends the request to the server 104. After receiving the request, the server 104 searches locally according to the insured person identification information in the request. The corresponding insured history insurance information is returned to the insurance sales terminal 102.
  • the insurance sales terminal 102 After receiving the insured person's historical insurance information returned by the server 104, the insurance sales terminal 102 calculates the insured person's insurance salesable amount according to the insured's historical insurance information and reviews the policy. It should be noted that the insurance sales terminal 102 may be an insurance sales server.
  • a policy data review method is provided, which can be applied to a terminal or to a server. This embodiment is illustrated by using the method in the terminal. The method specifically includes the following steps:
  • Step 210 Obtain policy data, where the policy data includes the basic information of the insured, the insurance type, and the insurance coverage.
  • each sales channel is subdivided into multiple sub-sales channels according to different sales platforms and agencies.
  • Customers can purchase insurance in different sales channels according to their specific circumstances.
  • the agent salesperson or the customer can enter the policy data into the terminal of each sales channel, and the terminal of each sales channel obtains the policy data entered and reviews the policy data.
  • the terminal of each sales channel obtains the entered policy data and sends it to the policy auditing terminal, and the policy auditing terminal uniformly receives the policy data sent by each sales channel terminal and performs the auditing work.
  • the policy data includes the basic information of the insured, the type of insurance purchased and the amount of insurance coverage.
  • the policy data also includes the task number of the policy, the basic information of the policyholder, and the insurance channel for the order.
  • the basic information of the insured or the insured person includes the name, gender, age, document type, ID number, city code and province code of the insured or the insured.
  • Types of insurance include critical illness insurance, accident insurance and disability insurance.
  • Step 220 Query the insured person's historical insurance information according to the insured basic information.
  • the insured historical insurance information includes information of all historical insurance orders of the insured insured as insurance beneficiaries, wherein the historical insurance orders specifically include other persons or the insured themselves as the insured and the insured themselves as beneficiaries
  • the order also includes the insured's insurance for others and the insured person's order to benefit from it.
  • the terminal After receiving the policy data, the terminal generates an insured historical insurance information request according to the insured basic information, and sends the request to the server. For example, the terminal can read the insured person's document type and the ID number in the insured's basic information and combine it with the policy's task number to generate the insured's historical insurance information request.
  • the terminal may also generate a request according to the insured's name, age, city code, and the like, as long as the insured person's identity can be uniquely determined.
  • the server After receiving the request, the server matches the basic information of the insured in the request with the stored customer information in the system. When the matching is successful, the historical insurance information corresponding to the successfully matched client is obtained, and the historical insurance is queried. The information is returned to the terminal. When the match fails, the server returns a query failure result such as "The customer does not exist" or "The customer is a new customer" to the terminal.
  • the insured historical insurance information includes the types of insurance that the insured has purchased all insurance, the insurance coverage of each type of insurance, the insurance channel, the total insurance coverage of the insurance purchased by each insurance channel, and the total insurance coverage of all purchased insurance. And other information.
  • Step 230 Calculate the insured person's insurance salesable degree by using the insured basic information, the insurance type, and the insured's historical insurance information.
  • the basic information of the insured includes the area code and the age of the insured.
  • the terminal obtains the general rule for calculating the salesable degree of the insured insurance corresponding to the insurance according to the insurance type, and the calculation general rule further sets different calculation sub-rules according to the insured person's age and the division of the area.
  • the terminal queries the area calculation rule of the area according to the insured's area code, and queries the calculation sub-rule corresponding to the age in the area calculation rule according to the insured person's age.
  • the terminal calculates the salesable amount of the insured person's insurance according to the calculated calculation sub-rule and the insured historical insurance information.
  • step 240 the insured person insurance insurance sales amount is compared with the insurance coverage amount to generate an audit result.
  • the terminal compares the calculated insured insured insurance sales amount with the insured person's insurance coverage. When the insured person's insurance coverage can be greater than or equal to the insured amount, the salesable amount of the insured can satisfy the insured. The demand for the insurance coverage, the terminal generates the audit results passed by the audit. When the difference between the insured person's insurance sales and the insured amount data is less than or equal to 0, the salesable degree of the insured type cannot meet the insured's insured amount and the audit result is not passed. The audit results are displayed on the display interface.
  • Step 250 When the audit result is that the audit fails, the product information of the sales insurance product is obtained, and the result of the insurance recommendation is generated according to the product information and the audit result of the sales insurance product.
  • the terminal After the terminal generates the audit result that the audit fails, the terminal obtains the product information of all the insurance products from the local or the sales system server, and obtains the calculation rule of the sales insurance of the insurance products corresponding to each insurance product, according to the various insurance types.
  • the calculation rules and the insured historical insurance information calculate the salesable degree of the products in the insurance product, compare the salesable degree of each insurance product with the audit result, and combine to generate the insurance recommendation result, and display the insurance recommendation result in the display. interface.
  • the above policy data review method after obtaining the policy data, the terminal can automatically obtain the basic information of the insured in the policy by parsing the policy data, the insurance type and the insurance amount of the insurance, and the insured basic information can be inquired to be insured.
  • Timely and automated processing and auditing of data can improve the efficiency of policy review work, reduce audit time, and enable users to obtain audit feedback in a timely manner.
  • the terminal can automatically generate the insurance recommendation result for the user's reference, so that the user can modify the policy according to the suggested result, thereby avoiding unnecessary repeated insurance inspection work due to blind modification. Can effectively reduce the rework rate of insurance work.
  • the insured basic information includes an area code and an insured person age
  • FIG. 3 is a flowchart of step 230 of the policy data review method, specifically including the following steps:
  • Step 2301 determining the area level to which the insured belongs according to the area code.
  • the area code includes a city code, a province code, and the like, and the terminal finds a product delivery area organization code corresponding thereto according to the area code.
  • the terminal acquires the area level division table, and searches for the area classification corresponding to the product delivery area institution code in the area level division table, thereby determining the area level to which the insured belongs.
  • the regional classification of different types of products may be the same or different. Different regional levels correspond to different insured age classification rules, and the upper limit of insurance coverage of insurance products in different regions is also different.
  • the type of product insurance is taken as an example of a critical illness insurance.
  • the regional level corresponding to the critical illness insurance is divided into three levels, namely the regular regional level, the special regional level and other regional levels.
  • the conventional area is the area with more developed economic level and better medical level, such as Beijing, Shanghai and Jiangsu.
  • Special areas are areas with good physical fitness but general economic level, such as Heilongjiang, Inner Mongolia, Jilin and Liaoning; other areas are areas other than conventional areas and special areas.
  • Step 2303 query the age classification level corresponding to the insurance type and the regional level, and determine the age level to which the insured belongs according to the age of the insured and the age classification.
  • the terminal After determining the area level to which the insured belongs, the terminal queries the age classification level corresponding to the area level, compares the insured person's age with the upper and lower limits of each age level, and determines the insured person's belonging.
  • Age level For example, the regular regional level of a critical illness insurance category has five levels of age, the first age level is 60 years and older, the second age level is 50 to 60 years old, and the third age level is 40 to 50 years old.
  • the fourth age class is 18 to 40 years old, and the fifth age class is 18 years old or younger.
  • the calculation method of the salesable amount corresponding to different ages is different.
  • the following steps are not required, and the insured person's insurance insurance can be directly recorded as 0.
  • Step 2305 Obtain an upper limit value of the total insured amount and an upper limit value of the channel insured amount corresponding to the age level.
  • the upper limit of the total insured amount of the insurance that can be sold in different regions and in different age groups in the same region and the upper limit of the insured amount in each sales channel may be the same or different.
  • the maximum insurance coverage for critical illness insurance in A province for the age group of 50 to 60 years old is 10 million yuan, of which the upper limit of the channel insurance premium for online sales channels is 6 million yuan.
  • the maximum amount of channel insurance premiums to be placed is 3 million yuan, and the upper limit of channel insurance premiums for other sales channels is 1 million yuan.
  • the terminal obtains the upper limit value configuration table of the insured amount, and searches for the upper limit value of the total insured amount and the upper limit value of the channel insured amount corresponding to the determined age level.
  • Step 2307 Read the purchased total insured value and the channel purchased insured value in the insured historical insurance information.
  • the purchased total insurance value is the sum of the insured value of all insurance products purchased by the insured, and the channel purchased insurance value is the sum of the insured value of the insured's insurance products purchased by the insured.
  • the terminal searches for the purchased purchase amount of the channel according to the channel information in the policy data.
  • the purchased total insured value refers to the total amount of insurance in all relevant insurance orders as the beneficiary of the insured.
  • the channel purchased insured value refers to the total insured value purchased through the specific sales channels in the total insured amount.
  • Step 2309 the difference between the upper limit value of the total insured value and the purchased total insured value is taken as the first difference, and the difference between the upper limit of the channel insured amount and the purchased amount of the channel is taken as the second difference, and The value of the first difference and the second difference is smaller as the insured person's insurance salesable degree.
  • the first difference calculated by the terminal is the salesable amount of the total insured amount
  • the second difference is the salesable amount of the corresponding channel insured amount
  • the smaller value is taken as the insured person's insured insurance salesable degree.
  • the sales amount can be the minimum amount.
  • the policy data review method in the above embodiment can automatically determine the area level to which the insured belongs according to the area code in the basic information of the insured and the age of the insured, and then use the type of the insurance, and then according to the age of the area to which the insured belongs.
  • the classification level determines the age level to which the insured belongs, and by looking up the insured upper limit configuration table, the upper limit value of the total insured amount and the upper limit of the channel insured amount can be found, and then the insured history is
  • the insurance information is calculated by the difference to obtain the insured person's insurance sales.
  • the terminal associates and uniformly configures the zoning rules, the age division rules, and the security limit of the multiple products, and only needs to obtain the insured information to automatically find out the corresponding calculation parameter information and obtain the calculation result. Therefore, it can effectively improve the calculation efficiency.
  • step 250 in the policy data review method in an embodiment, which specifically includes the following steps:
  • Step 2501 sequentially obtain the upper limit value of the insurance product of the insurance product information in the sales insurance product information.
  • the terminal obtains a list of products in the insurance product category, and the list includes product information of all the insurance products currently being sold, and the product information of each insurance type includes the division information of the regional level, the division information of the age level corresponding to each regional level, and each The upper limit of the total insurance coverage for each type of insurance and the upper limit of the channel coverage for each sales channel.
  • the terminal reads the product information of each insurance product in turn according to the order of the products in the list.
  • Step 2503 Calculate the salesable degree of the insurance product according to the insurance upper limit value and the insured historical insurance information.
  • the terminal searches for the age classification level corresponding to the insured person's area code from the product information of the read insurance, and determines the age level of the insured person in the insurance according to the insured person's age, and finally the terminal from the product information. Find the upper limit value of the total insurance amount corresponding to the age level of the insured person, and find the upper limit of the channel insurance amount corresponding to the channel and age level according to the channel information of the policy data. Calculate the difference between the upper limit of the total insured amount and the insured's purchased total insured value and use it as the first difference to calculate the channel insured upper limit value and the insured's channel purchased insured value. The difference is used as the second difference, and the value obtained by the first difference and the second difference is used as the insured insurance salesable degree.
  • Step 2505 when the calculated difference between the salesable amount and the insured amount is greater than 0, adding the insurance product to the recommendation list, and adding the salesable degree information corresponding to the insurance product to the recommended list, according to the The recommendation list generates the results of the insurance recommendation.
  • the terminal calculates the difference between the salesable amount of the insured insurance and the insurance coverage, and determines whether the difference is greater than 0.
  • the insurance product is added to the recommendation list. Specifically, at least the record is listed in the recommendation list.
  • the insurance product type, product code and other information at the same time, the terminal will calculate the salesable information is also associated with the insurance product record.
  • the terminal calculates the salesable amount of the insured insurance for all insurance products in the insurance product list, and the difference between the sales amount and the insurance amount, all the insurance product information with the difference greater than 0 is aggregated to generate a recommendation list. According to the recommendation list, the results of the recommended insurance recommendation for other insurance products are generated, and the results of the insurance recommendation are displayed on the interface.
  • the insurance products are ordered in descending order of the calculated difference amounts prior to generating the recommendation list.
  • the terminal is pre-set with a level division standard of the difference amount, such as a five-star recommendation level, a Samsung recommendation level, and a one-star recommendation level.
  • a level division standard of the difference amount such as a five-star recommendation level, a Samsung recommendation level, and a one-star recommendation level.
  • the grades of the insurance products are judged, and the insurance products that meet the requirements for salesability are classified and recommended. User-friendly choice.
  • the terminal obtains a coefficient of association degree between each insurance product and the insured person, and arranges the insurance products in descending order of the degree of association coefficient.
  • recommendation based on the relevance of the insurance can make it easier for the user to obtain the insurance information of the product of interest.
  • the terminal after obtaining the audit result that the audit fails, the terminal obtains the list of all the products for sale, calculates the salesable amount of each type of product, and selects the difference between the salesable amount and the insured amount is greater than 0.
  • the product that is, the product that the insured can purchase, generates a recommended recommendation result. Therefore, in the case that the insurance type of the customer is not available, the user can display other insurance product information and alternative insurance plan, so as to prevent the user from modifying the policy without intention after the insurance approval fails, and reducing the repeated filling and review of the policy. And the probability of rework, reducing the workload of the audit. At the same time, it can also reduce the chance of customers abandoning insurance, and avoid the loss of customer resources as much as possible.
  • the method when the audit result is not approved, the method further includes the following steps: obtaining product information of all kinds of products included in the same type of insurance according to the type of insurance in the policy data.
  • the same type of insurance will correspond to a variety of insurance products. There are differences in the amount of insurance coverage, the number of years of payment, the length of protection, the number of social security and whether there are additional risks between various insurance products, resulting in the insurance products.
  • the actual amount of insurance coverage is also different. The actual insurance coverage is high, and the actual insurance coverage of products with long payment period is high, while the actual insurance coverage of products with low insurance coverage and short payment period is low.
  • the terminal obtains the actual insured amount of the products other than the insured's products, and calculates the difference between the insured person's insured insurance sales and the actual insured amount, and adds the product information with the difference greater than 0 to the product adjustment proposal.
  • Product information includes at least the type of insurance, the amount of insurance, the number of years of payment and the number of years of protection.
  • the user can adjust the insurance plan according to the product information listed in the product adjustment suggestion list, and reduce the insured grade and the payment period, so that the user can purchase the insurance product of his or her favorite.
  • the policy data review method further includes: determining, according to the insurance type, whether the insurance belongs to the insurance, and obtaining the basic information of the policyholder in the policy data when the insurance belongs to the insurance. Inquiring, according to the basic information of the insured, the insured person's historical insurance information, calculating the insured's insured insurance salesable degree according to the risk insured calculation rule and the insured's historical insurance information, and insuring the insured person's insurance salesable degree Comparing with the insured amount data to generate an insurer data review result.
  • Exemption insurance refers to the types of insurance related to the vital interests of the insured and the insured, such as accidental death insurance.
  • the products of the exempted insurance should also limit the purchase amount of the insured to prevent the insured from maliciously purchasing and gaining improper profits. Therefore, when the type of insurance is an exemption insurance, it is necessary to review whether the insurance coverage of the policy meets the insurance requirements according to the insured amount of the insured, and also whether the insurance coverage of the policy is satisfied according to the insured's purchased insurance coverage. Insured requirements are reviewed.
  • the insured's historical insurance information includes information on all historical insurance orders of the insured insured as insurance beneficiaries.
  • the historical insurance orders specifically include orders from other people or policyholders themselves as policyholders and policyholders themselves as beneficiaries. This includes the insured's insurance for others and the insured's order to benefit from it.
  • the terminal obtains a list of exempted insurance types, and judges whether the insurance belongs to the insurance according to the type of insurance in the policy data. When it is an exemption insurance, the insured's insurance coverage is reviewed.
  • the method for calculating the salesable degree of the insured insurance and the method for generating the audit result of the insured person are the same as the method for calculating the salesable amount of the insured person's insurance insurance described in the above embodiments, and the method for generating the same is not described herein.
  • the results of the review will be displayed.
  • the audit result of at least one of the policyholder and the insured person is that the review fails, the result of the review failure will be displayed.
  • the terminal when the applicant's audit result is not passed, obtains the list of products in the insurance product, and calculates according to the calculation method of the salesable degree of each insurance product in the above embodiment and the purchased insurance information of the insured.
  • the sales amount of each product is added, and the product with the difference between the sales amount and the insurance amount greater than 0 is added to the recommended list of the insured product, and the product information and the insured in the recommended list of the insured product can be purchased.
  • the product information in the list of available products is matched, and the successfully matched product information is added to the list of insurance suggestions, and the final insurance recommendation result is generated and displayed according to the insurance recommendation list.
  • the terminal determines that the insured type is an exemption insurance
  • the insured person's insurance coverage is also reviewed while the insured's insurance coverage is reviewed, so that the insured's insurance coverage can be effectively validated. Risk control reduces the likelihood of malicious insured.
  • the policy data review method further includes the steps of: reading the identity information in the basic information of the insured, and matching the identity information with the customer identity information in the existing customer list.
  • the matching fails, the audit result of the successful audit is returned, the customer service number in the policy data is read, the customer service self-extension customer list corresponding to the customer service number is searched, and the basic information of the insured person is added to the customer service self-expanding customer list.
  • Customer information can be stored locally on the terminal or on the server.
  • the terminal obtains the customer list locally, or sends an existing customer list request to the server, and the server returns the existing customer list to the terminal.
  • the existing customer list includes basic information such as the customer's customer name, gender, date of birth, document type, and document number.
  • the terminal reads the identity information such as the name and the ID number of the insured, and matches the read identity information with the customer identity information in the existing customer list. When the matching fails, the insured person is insured for the first time and meets the insurance requirements. Without the following review steps, the terminal directly returns the audit result of the successful review. And the customer is a new customer, the terminal adds the customer information to the existing customer list. When the match is successful, continue with the review steps below.
  • the terminal finds the customer service self-extension customer list corresponding to the customer service according to the customer service number in the policy data, and the customer recorded in the customer service self-extension customer list is the customer who purchases the insurance product for the first time through the customer service.
  • the terminal adds the basic information of the insured to the customer service list.
  • the terminal reads the identity information of the policyholder and matches the policyholder with the customer identity information in the existing client list. When the matching fails, the policyholder basic information is added to the existing client list. At the same time, it is added to the customer service list.
  • the client when the client initiates the insured consultation request by means of a telephone or a webpage, the client inputs the identity information, and after obtaining the identity information of the client, the terminal queries the customer service self-expanding client list according to the identity information to check whether there is a matching with the client.
  • Customer service when found, obtain the customer service number, obtain the customer service contact information according to the customer service number, and transfer the customer's consulting request to the corresponding customer service. When not found, randomly select customer service for consultation request transfer.
  • the referral information in the policy data is read is empty, and when not empty, the referrer identity information in the referral information is read, and the referrer identity is read.
  • the information is in the customer service self-extension customer list to check whether there is a customer service matching the introducer. When it exists, the insured information is added to the self-expanding customer list of the corresponding customer service, and the customer service operator operates the related business in the future.
  • the successful review result can be directly fed back, and no unnecessary audit work is required, thereby saving audit time and improving efficiency.
  • customers can be operated by the same customer service, which can build customer trust more quickly, reduce customer churn rate, and also improve customer service sales enthusiasm.
  • FIGS. 2-4 are sequentially displayed as indicated by the arrows, these steps are not necessarily performed in the order indicated by the arrows. Except as explicitly stated herein, the execution of these steps is not strictly limited, and the steps may be performed in other orders. Moreover, at least some of the steps in FIGS. 2-4 may include a plurality of sub-steps or stages, which are not necessarily performed at the same time, but may be executed at different times, these sub-steps or stages The order of execution is not necessarily performed sequentially, but may be performed alternately or alternately with at least a portion of other steps or sub-steps or stages of other steps.
  • a policy data review apparatus comprising:
  • the policy acquisition module 510 is configured to obtain policy data, where the policy data includes the basic information of the insured, the insurance type, and the insurance amount.
  • the purchased information inquiry module 520 is configured to query the insured historical insurance information according to the insured basic information.
  • the quota calculation module 530 is configured to calculate the insured person's insurance salesable degree by using the insured basic information, the insurance type, and the insured historical insurance information.
  • the audit result generating module 540 is configured to compare the salesable amount of the insured person insurance with the insured amount to generate an audit result.
  • the recommended result generating module 550 is configured to obtain the product information of the sales insurance product when the audit result is not approved, and generate the insurance recommendation result according to the product information and the audit result of the sales insurance product.
  • the insured basic information includes an area code and an insured person age
  • the credit calculation module 530 includes:
  • a region level determining module configured to determine, according to the area code, an area level to which the insured belongs
  • the age level determining module is configured to query the age classification level corresponding to the insurance type and the regional level, and determine the age level to which the insured belongs according to the insured person age and age classification level;
  • the upper limit value obtaining module is configured to obtain an upper limit value of the total insured amount and an upper limit value of the channel insured amount corresponding to the age level;
  • the purchased insured value obtaining module is configured to read the purchased total insured value and the channel purchased insured value in the insured historical insurance information;
  • the difference calculation and comparison module is configured to use the difference between the upper limit value of the total insurance amount and the purchased total insurance value as the first difference, and the difference between the upper limit of the channel insurance amount and the purchased purchase amount of the channel is taken as the first The difference between the first difference and the second difference is used as the insured person's insurance sales.
  • the suggested result generation module 550 includes:
  • the product information obtaining module is configured to sequentially obtain the upper limit value of the insurance products of the insurance product information in the sales insurance product information.
  • the product sales quota calculation module is configured to calculate the salesable amount of the insurance product according to the insurance upper limit value and the insured historical insurance information.
  • the recommendation list generating module is configured to add the insurance product to the recommendation list when the calculated difference between the salesable amount and the insured amount is greater than 0, and add the salesable degree information corresponding to the insurance product to the recommended list, and generate according to the recommendation list. Insured recommendation results.
  • the apparatus further includes:
  • the insurance judgment module is used to judge whether the insurance type of the insurance is an exemption insurance according to the insurance type.
  • the insured person's quota calculation module is used to obtain the basic information of the insured in the policy data when the insured insurance belongs to the insurance, and query the insured's historical insurance information according to the basic information of the insured, according to the risk insured calculation rule and the insured history. Insurance information calculates the insured's insurance coverage.
  • the applicant's audit result generation module is used to compare the insured person's insurance insured sales amount with the insured amount data to generate the insured person data audit result.
  • the apparatus further includes:
  • An identity information reading module configured to read identity information in the basic information of the insured
  • An identity matching module configured to match identity information with customer identity information in an existing client list
  • the list information adding module is configured to return the audit result of the successful audit when the matching fails, read the customer service number in the policy data, find the customer service self-extension customer list corresponding to the customer service number, and add the basic information of the insured to the customer service self. Expand the list of customers.
  • the various modules in the above policy data review device may be implemented in whole or in part by software, hardware, and combinations thereof.
  • Each of the above modules may be embedded in or independent of the processor in the computer device, or may be stored in a memory in the computer device in a software form, so that the processor invokes the operations corresponding to the above modules.
  • a computer device which may be a terminal, and its internal structure diagram may be as shown in FIG. 6.
  • the computer device includes a processor, memory, network interface, and database connected by a system bus.
  • the processor of the computer device is used to provide computing and control capabilities.
  • the memory of the computer device includes a non-volatile storage medium, an internal memory.
  • the non-volatile storage medium stores an operating system, computer readable instructions, and a database.
  • the internal memory provides an environment for operation of an operating system and computer readable instructions in a non-volatile storage medium.
  • the database of the computer device is used to store policy data audit data.
  • the network interface of the computer device is used to communicate with an external terminal via a network connection.
  • the computer readable instructions are executed by the processor to implement a policy data review method.
  • FIG. 6 is only a block diagram of a part of the structure related to the solution of the present application, and does not constitute a limitation of the computer device to which the solution of the present application is applied.
  • the specific computer device may It includes more or fewer components than those shown in the figures, or some components are combined, or have different component arrangements.
  • a computer device comprising a memory and one or more processors having stored therein computer readable instructions, the computer readable instructions being executed by the processor such that the one or more processors perform the following steps:
  • Obtain policy data which includes the basic information of the insured, the type of insurance and the amount of insurance coverage;
  • the product information of the insurance product is obtained, and the result of the insurance recommendation is generated according to the product information and the audit result of the sales insurance product.
  • One or more non-transitory computer readable instruction storage media storing computer readable instructions, when executed by one or more processors, cause one or more processors to perform the steps of:
  • Obtain policy data which includes the basic information of the insured, the type of insurance and the amount of insurance coverage;
  • the product information of the insurance product is obtained, and the result of the insurance recommendation is generated according to the product information and the audit result of the sales insurance product.
  • Non-volatile memory can include read only memory (ROM), programmable ROM (PROM), electrically programmable ROM (EPROM), electrically erasable programmable ROM (EEPROM), or flash memory.
  • Volatile memory can include random access memory (RAM) or external cache memory.
  • RAM is available in a variety of formats, such as static RAM (SRAM), dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDRSDRAM), enhanced SDRAM (ESDRAM), synchronization chain.
  • SRAM static RAM
  • DRAM dynamic RAM
  • SDRAM synchronous DRAM
  • DDRSDRAM double data rate SDRAM
  • ESDRAM enhanced SDRAM
  • Synchlink DRAM SLDRAM
  • Memory Bus Radbus
  • RDRAM Direct RAM
  • DRAM Direct Memory Bus Dynamic RAM
  • RDRAM Memory Bus Dynamic RAM

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Abstract

一种保单数据审核方法，包括：获取保单数据，保单数据包括被保人基本信息、险种和投保额度，根据被保人基本信息查询被保人历史保险信息，利用险种和被保人历史保险信息计算被保人投保保险可销售额度，将被保人投保保险可销售额度与投保额度进行比较生成审核结果，当审核结果为审核不通过时，获取在售险种产品信息，根据在售险种产品信息和审核结果生成投保建议结果。

Description

保单数据审核方法、装置、计算机设备和存储介质
相关申请的交叉引用
本申请要求于2017年06月16日提交中国专利局、申请号为2017104594746、发明名称为“保单数据审核方法、装置、计算机设备及存储介质”的中国专利申请的优先权，其全部内容通过引用结合在本申请中。
技术领域
本申请涉及一种保单数据审核方法、装置、计算机设备及存储介质。
背景技术
目前，在保险销售业务流程中，客服人员通过保险销售系统为客户投保时，在客服人员录入保单后，需要将录入的保单提交给保单审核人员，由保单审核人员对提交的保单中的投保额度、客户信息等投保数据进行人工审核，审核投保数据是否满足规定要求。
但是，上述保单数据的审核过程中存在以下问题：客服人员提交订单后，审核人员由于工作安排无法对保单数据进行及时处理和审核，客户无法及时获取投保审核结果，审核结果具有一定的延时性，其次，如果投保数据不满足规定要求，客户人员需要修改订单并重新提交，并需等待审核人员再次审核的审核结果，使得投保工作的返工率较高。综上所述，上述人工审核保单数据的方法存在审核周期长、投保工作返工率高的问题。
发明内容
根据本申请公开的各种实施例，提供一种保单数据审核方法、装置、计算机设备及存储介质。
一种保单数据审核方法，包括：
获取保单数据，所述保单数据包括被保人基本信息、险种和投保额度；
根据所述被保人基本信息查询被保人历史保险信息；
利用所述被保人基本信息、所述险种和所述被保人历史保险信息计算被保人投保保险可销售额度；
将所述被保人投保保险可销售额度与所述投保额度进行比较生成审核结果；及
当所述审核结果为审核不通过时，获取在售险种产品信息，根据所述在售险种产品信息和所述审核结果生成投保建议结果。
一种保单数据审核装置，包括：
保单获取模块，用于获取保单数据，所述保单数据包括被保人基本信息、险种和投保额度；
已购信息查询模块，用于根据所述被保人基本信息查询被保人历史保险信息；
额度计算模块，用于利用所述被保人基本信息、所述险种和所述被保人历史保险信息计算被保人投保保险可销售额度；
审核结果生成模块，用于将所述被保人投保保险可销售额度与所述投保额度进行比较生成审核结果；及
建议结果生成模块，用于当所述审核结果为审核不通过时，获取在售险种产品信息，根据所述在售险种产品信息和所述审核结果生成投保建议结果。
一种计算机设备，包括存储器和一个或多个处理器，存储器中存储有计算机可读指令，计算机可读指令被处理器执行时实现本申请任意一个实施例中提供的保单数据审核方法的步骤。
一个或多个存储有计算机可读指令的非易失性计算机可读指令存储介质，计算机可读指令被一个或多个处理器执行时，使得一个或多个处理器实现本申请任意一个实施例中提供的保单数据审核方法的步骤。
本申请的一个或多个实施例的细节在下面的附图和描述中提出。本申请的其它特征和优点将从说明书、附图以及权利要求书变得明显。
附图说明
为了更清楚地说明本申请实施例中的技术方案，下面将对实施例中所需要使用的附图作简单地介绍，显而易见地，下面描述中的附图仅仅是本申请的一些实施例，对于本领域普通技术人员来讲，在不付出创造性劳动的前提下，还可以根据这些附图获得其它的附图。
图1为根据一个或多个实施例中保单数据审核方法的应用环境图。
图2为根据一个或多个实施例中保单数据审核方法的流程图。
图3为根据一个或多个实施例中保单数据审核方法的可销售额度计算步骤的流程图。
图4为根据一个或多个实施例中保单数据审核方法的投保建议结果生成步骤的流程图。
图5为根据一个或多个实施例中保单数据审核装置的框图。
图6为根据一个或多个实施例中计算机设备的框图。
具体实施方式
为了使本申请的技术方案及优点更加清楚明白，以下结合附图及实施例，对本申请进行进一步详细说明。应当理解，此处描述的具体实施例仅仅用以解释本申请，并不用于限定本申请。
本申请实施例中所提供的保单数据审核方法可以应用于如图1所示的应用环境中。保险销售终端102与服务器104通过网络连接。服务器104上存储有所有客户的客户信息，以及客户已购所有保险的历史信息，其中，客户包括投保人和被保人。保险销售终端102将根据获取保单数据的被保人基本信息生成被保人历史保险信息请求，并将请求发送给服务器104，服务器104接收请求后，根据请求中的被保人标识信息在本地查找相对应的被保人历史保险信息，并将其返回给保险销售终端102。保险销售终端102接收到服务器104返回的被保人历史保险信息后，根据被保人历史保险信息计算被保人投保保险可销售额度并对保单进行审核。需要说明的是，上述保险销售终端102也可以是保险销售服务器。
如图2所示，在一个实施例中，提供了一种保单数据审核方法，该方法可以应用于终端，也可以应用于服务器。本实施例以该方法应用于终端来举例说明，该方法具体包括以下步骤：
步骤210，获取保单数据，保单数据包括被保人基本信息、险种和投保额度。
多种类型的保险产品可以通过电话销售、网络销售和柜台销售等多种销售方式和销售渠道进行销售，进一步的，每种销售渠道根据不同的销售平台、代理机构再细分为多个子销售渠道，客户可以根据自身的具体情况在不同的销售渠道购买保险。当保险订单意向达成时，座席销售人员或者客户自己可以将保单数据录入各销售渠道的终端，各销售渠道的终端获取录入的保单数据后对保单数据进行审核。在另一个实施例中，各销售渠道的终端获取录入的保单数据后统一发送给保单审核终端，由保单审核终端统一接收各销售渠道终端发送的保单数据并进行审核工作。
保单数据中包括被保人基本信息，所购保险的险种类型和投保额度。此外，保单数据中还包括保单的任务号、投保人基本信息和订单的投保渠道等。被保人或者投保人基本信息包括被保人或者投保人的姓名、性别、年龄、证件类型、证件号码、所在城市代码和省份代码等。险种类型包括重疾险、意外险和残疾险等等。
步骤220，根据被保人基本信息查询被保人历史保险信息。
被保人历史保险信息包括已投保的被保人作为保险受益人的所有历史保险订单的信息，其中，历史保险订单具体包括其他人或者被保人自己作为投保人、被保人自己作为受益人的订单，也包括被保人为他人投保、且被保人 与其共同受益的订单。终端接收保单数据后，根据被保人基本信息生成被保人历史保险信息请求，并将请求发送给服务器。例如，终端可以读取被保人基本信息中的被保人证件类别和证件号码，并将其与保单的任务号相结合生成被保人历史保险信息请求。在其他实施例中，终端也可以根据被保人的姓名、年龄、所在城市代码等信息生成请求，只要能够唯一确定被保人身份即可。
服务器接收请求后，根据请求中的被保人基本信息与系统中已存储的客户信息相匹配，当匹配成功时，获取与匹配成功的客户相对应的历史保险信息，并将查询到的历史保险信息返回给终端。当匹配失败时，服务器向终端返回“该客户不存在”或者“该客户为新增客户”等查询失败结果。
其中，被保人历史保险信息包括被保人已购买所有保险的险种类型，每种险种类型的投保额度，投保渠道，各投保渠道所购保险的总投保额度，已购所有保险的总投保额度等信息。
步骤230，利用被保人基本信息、险种和被保人历史保险信息计算被保人投保保险可销售额度。
被保人基本信息包括区域代码和被保人年龄。终端根据险种获取与险种相对应的投保保险可销售额度的计算总规则，计算总规则中又根据被保人年龄和区域的划分设置有不同的计算子规则。终端根据被保人的区域代码查询所属区域的区域计算规则，在根据被保人年龄在区域计算规则中查询与其年龄相对应的计算子规则。终端根据查询到的计算子规则和被保人历史保险信息计算出被保人投保保险可销售额度。
步骤240，将被保人投保保险可销售额度与投保额度进行比较生成审核结果。
终端将计算得到的被保人投保保险可销售额度与投保人的投保额度进行比较，当被保人投保保险可销售额度大于或等于投保额度数据时，投保险种的可销售额度可以满足被保人投保额度的需求，终端生成审核通过的审核结果。当被保人投保保险可销售额度与投保额度数据的差值小于或等于0时，投保险种的可销售额度不能满足被保人投保额度的需求，生成审核不通过的审核结果。将审核结果在显示界面进行展示。
步骤250，当审核结果为审核不通过时，获取在售险种产品信息，根据在售险种产品信息和审核结果生成投保建议结果。
终端生成审核不通过的审核结果之后，终端从本地或者从销售系统服务器上获取所有在售险种的产品信息，并获取在售各险种产品对应的投保保险可销售额度的计算规则，根据各险种的计算规则和被保人历史保险信息计算出在售险种产品的可销售额度，将各险种产品的可销售额度与审核结果进行 比较，汇总后生成投保建议结果，并将投保建议结果在展示在显示界面。
上述保单数据审核方法，终端在获取保单数据后，通过对保单数据进行解析能够自动获取保单中的被保人基本信息，投保保险的险种和投保额度，通过被保人基本信息可以查询到被保人的历史保险信息，且根据险种和历史保险信息计算出被保人所投保险的可销售额度，根据计算出的可销售额度能够判断投保额度是否满足投保要求并生成审核结果，从而实现对保单数据的及时地、自动化地处理和审核，能够提高保单审核工作的工作效率，减少审核时间，使得用户能够及时获得审核反馈。此外，终端根据审核结果和获取到的在售险种的产品信息，能够自动生成投保建议结果供用户参考，使用户可以根据建议结果修改保单，避免了因盲目修改造成不必要的重复投保审核工作，能够有效降低投保工作返工率。
在一些实施例中，被保人基本信息包括区域代码和被保人年龄，图3为保单数据审核方法的步骤230的流程图，具体包括以下步骤：
步骤2301，根据区域代码判定被保人所属的区域等级。
区域代码包括城市代码、省份代码等，终端根据区域代码查找出与其对应的产品配送区域机构码。终端获取区域等级划分表，并在区域等级划分表中查找与产品配送区域机构码对应的区域分类，从而判定被保人所属的区域等级。
不同的险种产品的区域等级划分可能相同也可能不同。不同的区域等级对应有不同的被保人年龄等级划分规则，并且保险产品在不同区域的投保保额上限值也不相同。
在一些实施例中，以产品险种类型为重疾险为例进行说明。重疾险对应的区域等级分为三个等级，分别为常规区域等级、特殊区域等级和其他区域等级，常规区域为经济水平较发达、医疗水平较好的区域，如北京、上海和江苏等区域；特殊区域为人口身体素质较好但经济水平一般的区域，如黑龙江、内蒙古、吉林和辽宁等区域；其他区域为除常规区域和特殊区域以外的区域。
步骤2303，查询与险种以及区域等级相对应的年龄划分等级，根据被保人年龄以及年龄划分等级判定被保人所属的年龄等级。
终端在判定出被保人所属的区域等级后，查询与区域等级相对应的年龄划分等级，将被保人年龄与每个年龄等级的上、下限值进行比较，判定出被保人所属的年龄等级。例如，重疾险险种的常规区域等级对应有5个级别的年龄等级，第一年龄等级为60岁以上，第二年龄等级为50岁到60岁，第三年龄等级为40岁到50岁，第四年龄等级为18岁到40岁，第五年龄等级为18岁以下。不同年龄所对应的可销售额度计算方法不同。在一些实施例中， 当判断出年龄等级属于第一年龄等级时，无需进行下述步骤，直接将被保人投保保险可销售额度记为0。
步骤2305，获取与年龄等级对应的总保额上限值和渠道保额上限值。
险种产品在不同区域、以及在同一区域的不同年龄阶层所投放的可售保险的总保额上限值和在各销售渠道投放的保额上限值可能相同，也可能不同。例如，重疾险在A省对于50岁到60岁年龄层投放的总保额上限值为1000万元，其中，网售渠道投放的渠道保额上限值为600万元，电销渠道投放的渠道保额上限值为300万元，其他销售渠道投放的渠道保额上限值为100万元。终端获取保额上限值配置表，并从中查找出与判定得到的年龄等级对应的总保额上限值和渠道保额上限值。
步骤2307，读取被保人历史保险信息中的已购总保额值和渠道已购保额值。
已购总保额值为被保人所购买的所有保险产品的投保额度值的总和，渠道已购保额值为被保人在相应的购买渠道所购买的保险产品的投保额度值的总和。终端根据保单数据中的渠道信息查找渠道已购保额值。这里的已购总保额值是指被保人作为受益人的所有相关保险订单中的投保总额，渠道已购保额值是指投保总额中通过具体销售渠道所购买的总保额值。
步骤2309，将总保额上限值与已购总保额值的差值作为第一差值，将渠道保额上限值与渠道已购保额值的差值作为第二差值，将第一差值与第二差值中取值较小的值作为被保人投保保险可销售额度。
终端计算的第一差值为总保额的可销售额度，第二差值为相应渠道保额的可销售额度，并取其中的较小值作为被保人投保保险可销售额度。以保证被保人投保保险可销售额度为最低限额额度。
上述实施例中的保单数据审核方法，根据被保人基本信息中的区域代码和被保人年龄，并利用险种类型，能够自动判断出被保人所属的区域等级，然后根据所属区域等级的年龄划分等级判定出被保人所属的年龄等级，并通过查找保额上限值配置表能够查找出与年龄等级对应的总保额上限值和渠道保额上限值，然后同被保人历史保险信息进行差值计算得到被保人投保保险可销售额度。终端通过将多种产品的区域划分规则、年龄划分规则以及保额上限制进行关联并统一配置，只需根据得到被保人信息就可以自动关联查找出与其相对应的计算参数信息并得到计算结果，从而能有效提高计算效率。
如图4所示，为一个实施例中保单数据审核方法中步骤250的流程图，具体包括以下步骤：
步骤2501，依次获取所述在售险种产品信息中各保险产品的保额上限值。
终端获取在售险种产品列表，列表中包括目前在售的所有险种的产品信 息，每个险种的产品信息中又包括区域等级的划分信息、每个区域等级对应的年龄等级的划分信息以及，每个年龄等级所对应的险种总保额上限值和每种销售渠道的渠道保额上限值。终端根据列表中险种产品的排列顺序依次读取每个险种的产品信息。
步骤2503，根据所述保险上限值和所述被保人历史保险信息计算所述保险产品的可销售额度。
终端从读取的险种的产品信息中查找与被保人的区域代码相对应的年龄划分等级，并根据被保人年龄判定出被保人在此险种中所属的年龄等级，最后终端从产品信息查找出与被保人所属年龄等级对应的险种总保额上限值，根据保单数据的渠道信息查找出与渠道、年龄等级相对应的渠道保额上限值。计算出总保额上限值与被保人已购总保额值的差值并将其作为第一差值，计算出将渠道保额上限值与被保人的渠道已购保额值的差值并将其作为第二差值，将第一差值与第二差值中取值较小的值作为被保人投保保险可销售额度。
步骤2505，当计算得到的所述可销售额度与投保额度的差值大于0时，将所述保险产品加入推荐列表，并在推荐列表中添加所述保险产品对应的可销售额度信息，根据所述推荐列表生成投保建议结果。
终端计算出被保人投保保险可销售额度与投保额度的差值，并判断差值是否大于0，当差值大于0时，将险种保险产品加入推荐列表，具体的，在推荐列表中至少记录保险产品的险种类型、产品代码等信息，同时，终端将计算出的可销售额度信息也与保险产品关联记录。当终端计算出在售险种产品列表中所有险种保险产品的被保人投保保险可销售额度，可销售额度与投保额度的差值之后，将所有差值大于0的保险产品信息汇总生成推荐列表，并根据推荐列表生成其他可够保险产品推荐投保建议结果，将投保建议结果在界面进行展示。
在一些实施例中，在生成推荐列表之前，按照计算出的差值额度从大到小的顺序对保险产品进行排序。优选的，终端上预先设置有差值额度的等级划分标准，如五星推荐等级、三星推荐等级和一星推荐等级等等。根据划分标准判断保险产品所属的等级，对符合可销售额度要求的保险产品分类推荐。方便用户选择。
在另一个实施例中，终端获取各保险产品与被保人所投险种的关联程度系数，将保险产品按照关联程度系数从大到小的顺序进行排列。在本实施例中，根据险种的关联性进行推荐，能够使用户更容易获取兴趣产品的可投保信息。
在本实施例中，终端在得到审核不通过的审核结果后，获取所有在售产品信息列表，计算出每种险种产品的可销售额度，并从中筛选出可销售额度 与投保额度差值大于0的产品，即被保人可进行购买的产品生成推荐建议投保结果。从而在客户所投险种不可购的情况下，为用户展示出其他可购的保险产品信息和备选投保方案，避免用户在投保审核失败后无目的性地修改保单，减小保单重复填写、审核以及返工的概率，降低审核工作量。同时，也能降低客户放弃投保的几率，尽可能避免客户资源流失。
在一些实施例中，当审核结果为审核不通过时，还包括以下步骤：根据保单数据中的险种类型获取同种险种所包含的所有种类产品的产品信息。同一种险种类型会对应有多款保险产品，多款保险产品之间的保额档次、缴费年限、保障年限、是否有社保以及是否有附加险等信息都存在差别，从而导致每款保险产品的实际投保额度也有差别，保额档次高，缴费年限长的产品的实际投保额度高，而保额档次低、缴费年限短的产品的实际投保额度低。终端获取除被保人所投产品之外的其他款产品的实际投保额度，并计算被保人投保保险可销售额度与实际投保额度的差值，将差值大于0的产品信息加入产品调整建议列表，产品信息至少包括险种类型、保额档次、缴费年限和保障年限等信息。在所有种类的产品的差值计算完成后，生成产品调整建议列表并在显示界面进行展示。
在本实施例中，用户可以根据产品调整建议列表中所列产品信息，通过降低保额档次、缴费年限等方式调整投保方案，能够够有效地购买到自己心仪的保险产品。
在一些实施例中，保单数据审核方法还包括：根据所述险种判断投保保险所属险种是否为豁免险，当所述投保保险所属险种为豁免险时，获取所述保单数据中的投保人基本信息，根据所述投保人基本信息查询投保人历史保险信息，根据所述风险保额计算规则和所述投保人历史保险信息计算投保人投保保险可销售额度，将所述投保人投保保险可销售额度与所述投保额度数据进行比较生成投保人数据审核结果。
豁免险是指与被保人和投保人的切身利益相关的险种，例如，意外身故险等。豁免险险种的产品除了要对被保人的可销售额度进行限额销售之外，也要对投保人的购买额度进行限制，避免投保人恶意购买、获得不当得利。因此，当险种类型为豁免险时，既需根据被保人的已购投保额度对保单的投保额度是否满足投保要求进行审核，也需要根据投保人的已购投保额度对保单的投保额度是否满足投保要求进行审核。投保人历史保险信息包括已投保的投保人作为保险受益人的所有历史保险订单的信息，其中，历史保险订单具体包括其他人或者投保人自己作为投保人、投保人自己作为受益人的订单，也包括投保人为他人投保、且投保人与其共同受益的订单。
终端获取豁免险险种列表，根据保单数据中的险种判断是否属于所投险 种是否属于豁免险，当属于豁免险时，对投保人的投保额度进行审核。终端对投保人的投保保险可销售额度的计算方法和审核结果的生成方法，均与上述实施例中描述的被保人投保保险可销售额度的计算方法和生成方法相同，在此不再赘述。当投保人和被保人的投保额度的审核结果均为审核通过时，将审核通过的结果进行展示。当投保人和被保人中至少一个的审核结果为审核不通过时，将审核不通过的结果进行展示。
在一些实施例中，当投保人的审核结果为不通过时，终端获取在售险种产品列表，并根据上述实施例中的各保险产品可销售额度的计算方法和投保人的已购保险信息计算出各产品的可销售额度，并将可销售额度与投保额度的差值大于0的产品加入到投保人可购产品推荐列表中，将投保人可购产品推荐列表中的产品信息与被保人可购产品列表中的产品信息进行匹配，将匹配成功的产品信息加入投保建议列表中，根据投保建议列表生成最终的投保建议结果并进行展示。
在本实施例中，当终端判断出所投险种为豁免险时，在对被保人的投保额度进行审核的同时，对投保人的投保额度也进行审核，从而能够对投保人的投保额度进行有效风险控制，降低恶意投保的可能性。
在一些实施例中，保单数据审核方法还包括以下步骤：读取被保人基本信息中的身份信息，将身份信息与已有客户列表中的客户身份信息进行匹配。当匹配失败时，返回审核成功的审核结果，读取保单数据中的客服编号，查找与客服编号对应的客服自拓客户列表，将被保人基本信息添加至客服自拓客户列表中。
客户信息可以存储在终端本地，也可以存储在服务器上。终端从本地获取客户列表，或者向服务器发送已有客户列表请求，服务器向终端返回已有客户列表。已有客户列表中包括客户的客户姓名、性别、出生日期、证件类型和证件号等基本信息。
终端读取被保人的姓名、证件号等身份信息，将读取的身份信息与已有客户列表中的客户身份信息进行匹配，当匹配失败时，说明被保人为首次投保，符合投保要求，不用进行下面的审核步骤，终端直接返回审核成功的审核结果。并且客户为新增客户，终端将客户信息添加至已有客户列表中。当匹配成功时，继续执行下面的审核步骤。
终端根据保单数据中的客服编号查找到对应客服的客服自拓客户列表，客服自拓客户列表中记录的客户均为通过此客服首次购买保险产品的客户。终端将被保人基本信息添加至客服自拓客户列表中。在一些实施例中，终端读取投保人的身份信息，并将投保人与已有客户列表中的客户身份信息进行匹配，当匹配失败时，将投保人基本信息添加至已有客户列表中，并同时添 加至客服自拓客户列表中。
在一些实施例中，当客户通过电话或网页等方式发起投保咨询请求时，客户输入身份信息，终端获取客户的身份信息后，根据身份信息在客服自拓客户列表中查询是否存在与客户相匹配的客服，当查找到时，获取客服编号，根据客服编号获取客服的联系方式，将客户的咨询请求转接至相应的客服。当查找不到时，随机选择客服进行咨询请求转接。
在一些实施例中，当判定出投保人为新建客户时，读取保单数据中的转介绍信息是否为空，当不为空时，读取转介绍信息中的介绍人身份信息，将介绍人身份信息在客服自拓客户列表中查询是否存在与介绍人相匹配的客服，当存在时，将投保人信息添加至相应客服的自拓客户列表中，今后由此客服经营投保人的相关业务。
在本实施例中，通过将客户身份信息与已有客户信息进行匹配，当判断出客户为新建客户时，可以直接反馈审核成功结果，无需进行多余的审核工作，节省审核时间，提高效率。并且通过将客户添加至客服的自拓客户列表中，可以使客户由同一客服经营，能够更快建立客户的信任感，降低客户的流失率，并且也能提高客服销售的积极性。
应该理解的是，虽然图2-4的流程图中的各个步骤按照箭头的指示依次显示，但是这些步骤并不是必然按照箭头指示的顺序依次执行。除非本文中有明确的说明，这些步骤的执行并没有严格的顺序限制，这些步骤可以以其它的顺序执行。而且，图2-4中的至少一部分步骤可以包括多个子步骤或者多个阶段，这些子步骤或者阶段并不必然是在同一时刻执行完成，而是可以在不同的时刻执行，这些子步骤或者阶段的执行顺序也不必然是依次进行，而是可以与其它步骤或者其它步骤的子步骤或者阶段的至少一部分轮流或者交替地执行
在一个实施例中，如图5所示，提供了一种保单数据审核装置，该装置包括：
保单获取模块510，用于获取保单数据，保单数据包括被保人基本信息、险种和投保额度.
已购信息查询模块520，用于根据被保人基本信息查询被保人历史保险信息。
额度计算模块530，用于利用被保人基本信息、险种和被保人历史保险信息计算被保人投保保险可销售额度。
审核结果生成模块540，用于将被保人投保保险可销售额度与投保额度进行比较生成审核结果。
建议结果生成模块550，用于当审核结果为审核不通过时，获取在售险 种产品信息，根据在售险种产品信息和审核结果生成投保建议结果。
在一些实施例中，被保人基本信息包括区域代码和被保人年龄，额度计算模块530包括：
区域等级判定模块，用于根据区域代码判定被保人所属的区域等级；
年龄等级判定模块，用于查询与险种以及区域等级相对应的年龄划分等级，根据被保人年龄以及年龄划分等级判定被保人所属的年龄等级；
保额上限值获取模块，用于获取与年龄等级对应的总保额上限值和渠道保额上限值；
已购保额值获取模块，用于读取被保人历史保险信息中的已购总保额值和渠道已购保额值；
差值计算比较模块，用于将总保额上限值与已购总保额值的差值作为第一差值，将渠道保额上限值与渠道已购保额值的差值作为第二差值，将第一差值与第二差值中取值较小的值作为被保人投保保险可销售额度。
在一些实施例中，建议结果生成模块550包括：
产品信息获取模块，用于依次获取在售险种产品信息中各保险产品的保额上限值。
产品可销额度计算模块，用于根据保险上限值和被保人历史保险信息计算保险产品的可销售额度。
推荐列表生成模块，用于当计算得到的可销售额度与投保额度的差值大于0时，将保险产品加入推荐列表，并在推荐列表中添加保险产品对应的可销售额度信息，根据推荐列表生成投保建议结果。
在一些实施例中，装置还包括：
险种判断模块，用于根据险种判断投保保险所属险种是否为豁免险。
投保人额度计算模块，用于当投保保险所属险种为豁免险时，获取保单数据中的投保人基本信息，根据投保人基本信息查询投保人历史保险信息，根据风险保额计算规则和投保人历史保险信息计算投保人投保保险可销售额度。
投保人审核结果生成模块，用于将投保人投保保险可销售额度与投保额度数据进行比较生成投保人数据审核结果。
在一些实施例中，装置还包括：
身份信息读取模块，用于读取被保人基本信息中的身份信息；
身份匹配模块，用于将身份信息与已有客户列表中的客户身份信息进行匹配；
列表信息添加模块，用于当匹配失败时，返回审核成功的审核结果，读取保单数据中的客服编号，查找与客服编号对应的客服自拓客户列表，将被 保人基本信息添加至客服自拓客户列表中。
关于保单数据审核装置的具体限定可以参见上文中对于保单数据审核方法的限定，在此不再赘述。上述保单数据审核装置中的各个模块可全部或部分通过软件、硬件及其组合来实现。上述各模块可以硬件形式内嵌于或独立于计算机设备中的处理器中，也可以以软件形式存储于计算机设备中的存储器中，以便于处理器调用执行以上各个模块对应的操作。
在一个实施例中，提供了一种计算机设备，该计算机设备可以是终端，其内部结构图可以如图6所示。该计算机设备包括通过系统总线连接的处理器、存储器、网络接口和数据库。其中，该计算机设备的处理器用于提供计算和控制能力。该计算机设备的存储器包括非易失性存储介质、内存储器。该非易失性存储介质存储有操作系统、计算机可读指令和数据库。该内存储器为非易失性存储介质中的操作系统和计算机可读指令的运行提供环境。该计算机设备的数据库用于存储保单数据审核数据。该计算机设备的网络接口用于与外部的终端通过网络连接通信。该计算机可读指令被处理器执行时以实现一种保单数据审核方法。
本领域技术人员可以理解，图6中示出的结构，仅仅是与本申请方案相关的部分结构的框图，并不构成对本申请方案所应用于其上的计算机设备的限定，具体的计算机设备可以包括比图中所示更多或更少的部件，或者组合某些部件，或者具有不同的部件布置。
一种计算机设备，包括存储器和一个或多个处理器，存储器中储存有计算机可读指令，计算机可读指令被处理器执行时，使得一个或多个处理器执行以下步骤：
获取保单数据，保单数据包括被保人基本信息、险种和投保额度；
根据被保人基本信息查询被保人历史保险信息；
利用被保人基本信息、险种和被保人历史保险信息计算被保人投保保险可销售额度；
将被保人投保保险可销售额度与投保额度进行比较生成审核结果；及
当审核结果为审核不通过时，获取在售险种产品信息，根据在售险种产品信息和审核结果生成投保建议结果。
一个或多个存储有计算机可读指令的非易失性计算机可读指令存储介质，计算机可读指令被一个或多个处理器执行时，使得一个或多个处理器执行以下步骤：
获取保单数据，保单数据包括被保人基本信息、险种和投保额度；
根据被保人基本信息查询被保人历史保险信息；
利用被保人基本信息、险种和被保人历史保险信息计算被保人投保保险 可销售额度；
将被保人投保保险可销售额度与投保额度进行比较生成审核结果；及
当审核结果为审核不通过时，获取在售险种产品信息，根据在售险种产品信息和审核结果生成投保建议结果。
本领域普通技术人员可以理解实现上述实施例方法中的全部或部分流程，是可以通过计算机可读指令来指令相关的硬件来完成，所述的计算机可读指令可存储于一非易失性计算机可读取存储介质中，该计算机可读指令在执行时，可包括如上述各方法的实施例的流程。其中，本申请所提供的各实施例中所使用的对存储器、存储、数据库或其它介质的任何引用，均可包括非易失性和/或易失性存储器。非易失性存储器可包括只读存储器(ROM)、可编程ROM(PROM)、电可编程ROM(EPROM)、电可擦除可编程ROM(EEPROM)或闪存。易失性存储器可包括随机存取存储器(RAM)或者外部高速缓冲存储器。作为说明而非局限，RAM以多种形式可得，诸如静态RAM(SRAM)、动态RAM(DRAM)、同步DRAM(SDRAM)、双数据率SDRAM(DDRSDRAM)、增强型SDRAM(ESDRAM)、同步链路(Synchlink)DRAM(SLDRAM)、存储器总线(Rambus)直接RAM(RDRAM)、直接存储器总线动态RAM(DRDRAM)、以及存储器总线动态RAM(RDRAM)等。
以上所述实施例的各技术特征可以进行任意的组合，为使描述简洁，未对上述实施例中的各个技术特征所有可能的组合都进行描述，然而，只要这些技术特征的组合不存在矛盾，都应当认为是本说明书记载的范围。
以上所述实施例仅表达了本申请的几种实施方式，其描述较为具体和详细，但并不能因此而理解为对发明专利范围的限制。应当指出的是，对于本领域的普通技术人员来说，在不脱离本申请构思的前提下，还可以做出若干变形和改进，这些都属于本申请的保护范围。因此，本申请专利的保护范围应以所附权利要求为准。

Claims (20)

  1. 一种保单数据审核方法，包括：
    获取保单数据，所述保单数据包括被保人基本信息、险种和投保额度；
    根据所述被保人基本信息查询被保人历史保险信息；
    利用所述被保人基本信息、所述险种和所述被保人历史保险信息计算被保人投保保险可销售额度；
    将所述被保人投保保险可销售额度与所述投保额度进行比较生成审核结果；及
    当所述审核结果为审核不通过时，获取在售险种产品信息，根据所述在售险种产品信息和所述审核结果生成投保建议结果。
  2. 根据权利要求1所述的保单数据审核方法，其特征在于，所述被保人基本信息包括区域代码和被保人年龄；所述利用所述被保人基本信息、所述险种和所述被保人历史保险信息计算被保人投保保险可销售额度，包括：
    根据所述区域代码判定被保人所属的区域等级；
    查询与所述险种以及所述区域等级相对应的年龄划分等级，根据所述被保人年龄以及所述年龄划分等级判定被保人所属的年龄等级；
    获取与所述年龄等级对应的总保额上限值和渠道保额上限值；
    读取所述被保人历史保险信息中的已购总保额值和渠道已购保额值；及
    将所述总保额上限值与所述已购总保额值的差值作为第一差值，将所述渠道保额上限值与所述渠道已购保额值的差值作为第二差值，将所述第一差值与所述第二差值中取值较小的值作为被保人投保保险可销售额度。
  3. 根据权利要求1或2所述的保单数据审核方法，其特征在于，所述根据所述在售险种产品信息和所述审核结果生成投保建议结果的步骤，包括：
    依次获取所述在售险种产品信息中各保险产品的保额上限值；
    根据所述保险上限值和所述被保人历史保险信息计算所述保险产品的可销售额度；及
    当计算得到的所述可销售额度与所述投保额度的差值大于0时，将所述保险产品加入推荐列表，并在推荐列表中添加所述保险产品对应的可销售额度信息，根据所述推荐列表生成投保建议结果。
  4. 根据权利要求1所述的保单数据审核方法，其特征在于，所述方法还包括：
    根据所述险种判断投保保险所属险种是否为豁免险；
    当所述投保保险所属险种为豁免险时，获取所述保单数据中的投保人基本信息，根据所述投保人基本信息查询投保人历史保险信息，根据所述风险保额计算规则和所述投保人历史保险信息计算投保人投保保险可销售额度； 及
    将所述投保人投保保险可销售额度与所述投保额度数据进行比较生成投保人数据审核结果。
  5. 根据权利要求1所述的保单数据审核方法，其特征在于，所述方法还包括：
    读取所述被保人基本信息中的身份信息；
    将所述身份信息与已有客户列表中的客户身份信息进行匹配；及
    当匹配失败时，返回审核成功的审核结果，读取所述保单数据中的客服编号，查找与所述客服编号对应的客服自拓客户列表，将所述被保人基本信息添加至所述客服自拓客户列表中。
  6. 一种保单数据审核装置，包括：
    保单获取模块，用于获取保单数据，所述保单数据包括被保人基本信息、险种和投保额度；
    已购信息查询模块，用于根据所述被保人基本信息查询被保人历史保险信息；
    额度计算模块，用于利用所述被保人基本信息、所述险种和所述被保人历史保险信息计算被保人投保保险可销售额度；
    审核结果生成模块，用于将所述被保人投保保险可销售额度与所述投保额度进行比较生成审核结果；及
    建议结果生成模块，用于当所述审核结果为审核不通过时，获取在售险种产品信息，根据所述在售险种产品信息和所述审核结果生成投保建议结果。
  7. 根据权利要求6所述的保单数据审核装置，其特征在于，所述被保人基本信息包括区域代码和被保人年龄；所述额度计算模块包括：
    区域等级判定模块，用于根据所述区域代码判定被保人所属的区域等级；
    年龄等级判定模块，用于查询与所述险种以及所述区域等级相对应的年龄划分等级，根据所述被保人年龄以及所述年龄划分等级判定被保人所属的年龄等级；
    保额上限值获取模块，用于获取与所述年龄等级对应的总保额上限值和渠道保额上限值；
    已购保额值获取模块，用于读取所述被保人历史保险信息中的已购总保额值和渠道已购保额值；及
    差值计算比较模块，用于将所述总保额上限值与所述已购总保额值的差值作为第一差值，将所述渠道保额上限值与所述渠道已购保额值的差值作为第二差值，将所述第一差值与所述第二差值中取值较小的值作为被保人投保保险可销售额度。
  8. 根据权利要求6或7所述的保单数据审核装置，其特征在于，所述建议结果生成模块包括：
    产品信息获取模块，用于依次获取所述在售险种产品信息中各保险产品的保额上限值；
    产品可销额度计算模块，用于根据所述保险上限值和所述被保人历史保险信息计算所述保险产品的可销售额度；及
    推荐列表生成模块，用于当计算得到的所述可销售额度与所述投保额度的差值大于0时，将所述保险产品加入推荐列表，并在推荐列表中添加所述保险产品对应的可销售额度信息，根据所述推荐列表生成投保建议结果。
  9. 根据权利要求6所述的保单数据审核装置，其特征在于，所述装置还包括：
    险种判断模块，用于根据所述险种判断投保保险所属险种是否为豁免险；
    投保人额度计算模块，用于当所述投保保险所属险种为豁免险时，获取所述保单数据中的投保人基本信息，根据所述投保人基本信息查询投保人历史保险信息，根据所述风险保额计算规则和所述投保人历史保险信息计算投保人投保保险可销售额度；及
    投保人审核结果生成模块，用于将所述投保人投保保险可销售额度与所述投保额度数据进行比较生成投保人数据审核结果。
  10. 根据权利要求6所述的保单数据审核装置，其特征在于，所述装置还包括：
    身份信息读取模块，用于读取所述被保人基本信息中的身份信息；
    身份匹配模块，用于将所述身份信息与已有客户列表中的客户身份信息进行匹配；
    列表信息添加模块，用于当匹配失败时，返回审核成功的审核结果，读取所述保单数据中的客服编号，查找与所述客服编号对应的客服自拓客户列表，将所述被保人基本信息添加至所述客服自拓客户列表中。
  11. 一种计算机设备，包括存储器及一个或多个处理器，所述存储器中储存有计算机可读指令，所述计算机可读指令被所述一个或多个处理器执行时，使得所述一个或多个处理器执行以下步骤：
    获取保单数据，所述保单数据包括被保人基本信息、险种和投保额度；
    根据所述被保人基本信息查询被保人历史保险信息；
    利用所述险种和所述被保人历史保险信息计算被保人投保保险可销售额度；
    将所述被保人投保保险可销售额度与所述投保额度进行比较生成审核结果；及
    当所述审核结果为审核不通过时，获取在售险种产品信息，根据所述在售险种产品信息和所述审核结果生成投保建议结果。
  12. 根据权利要求11所述的计算机设备，其特征在于，所述被保人基本信息包括区域代码和被保人年龄；所述处理器执行所述计算机可读指令时实现所述利用所述被保人基本信息、所述险种和所述被保人历史保险信息计算被保人投保保险可销售额度，还包括：
    根据所述区域代码判定被保人所属的区域等级；
    查询与所述险种以及所述区域等级相对应的年龄划分等级，根据所述被保人年龄以及所述年龄划分等级判定被保人所属的年龄等级；
    获取与所述年龄等级对应的总保额上限值和渠道保额上限值；
    读取所述被保人历史保险信息中的已购总保额值和渠道已购保额值；及
    将所述总保额上限值与所述已购总保额值的差值作为第一差值，将所述渠道保额上限值与所述渠道已购保额值的差值作为第二差值，将所述第一差值与所述第二差值中取值较小的值作为被保人投保保险可销售额度。
  13. 根据权利要求11或12所述的计算机设备，其特征在于，所述处理器执行所述计算机可读指令时实现根据所述在售险种产品信息和所述审核结果生成投保建议结果，还包括：
    依次获取所述在售险种产品信息中各保险产品的保额上限值；
    根据所述保险上限值和所述被保人历史保险信息计算所述保险产品的可销售额度；及
    当计算得到的所述可销售额度与所述投保额度的差值大于0时，将所述保险产品加入推荐列表，并在推荐列表中添加所述保险产品对应的可销售额度信息，根据所述推荐列表生成投保建议结果。
  14. 根据权利要求11所述的计算机设备，其特征在于，所述处理器执行所述计算机可读指令时还执行以下步骤：
    根据所述险种判断投保保险所属险种是否为豁免险；
    当所述投保保险所属险种为豁免险时，获取所述保单数据中的投保人基本信息，根据所述投保人基本信息查询投保人历史保险信息，根据所述风险保额计算规则和所述投保人历史保险信息计算投保人投保保险可销售额度；及
    将所述投保人投保保险可销售额度与所述投保额度数据进行比较生成投保人数据审核结果。
  15. 根据权利要求11所述的计算机设备，其特征在于，所述处理器执行所述计算机可读指令时还执行以下步骤：
    读取所述被保人基本信息中的身份信息；
    将所述身份信息与已有客户列表中的客户身份信息进行匹配；及
    当匹配失败时，返回审核成功的审核结果，读取所述保单数据中的客服编号，查找与所述客服编号对应的客服自拓客户列表，将所述被保人基本信息添加至所述客服自拓客户列表中。
  16. 一个或多个存储有计算机可读指令的非易失性计算机可读存储介质，所述计算机可读指令被一个或多个处理器执行时，使得所述一个或多个处理器执行以下步骤：
    获取保单数据，所述保单数据包括被保人基本信息、险种和投保额度；
    根据所述被保人基本信息查询被保人历史保险信息；
    利用所述被保人基本信息、所述险种和所述被保人历史保险信息计算被保人投保保险可销售额度；
    将所述被保人投保保险可销售额度与所述投保额度进行比较生成审核结果；及
    当所述审核结果为审核不通过时，获取在售险种产品信息，根据所述在售险种产品信息和所述审核结果生成投保建议结果。
  17. 根据权利要求16所述的存储介质，其特征在于，所述被保人基本信息包括区域代码和被保人年龄；所述计算机可读指令被所述处理器实现所述利用所述被保人基本信息、所述险种和所述被保人历史保险信息计算被保人投保保险可销售额度，还包括：
    根据所述区域代码判定被保人所属的区域等级；
    查询与所述险种以及所述区域等级相对应的年龄划分等级，根据所述被保人年龄以及所述年龄划分等级判定被保人所属的年龄等级；
    获取与所述年龄等级对应的总保额上限值和渠道保额上限值；
    读取所述被保人历史保险信息中的已购总保额值和渠道已购保额值；及
    将所述总保额上限值与所述已购总保额值的差值作为第一差值，将所述渠道保额上限值与所述渠道已购保额值的差值作为第二差值，将所述第一差值与所述第二差值中取值较小的值作为被保人投保保险可销售额度。
  18. 根据权利要求16或17所述的存储介质，其特征在于，所述计算机可读指令被所述处理器实现所述根据所述在售险种产品信息和所述审核结果生成投保建议结果，还包括：
    依次获取所述在售险种产品信息中各保险产品的保额上限值；
    根据所述保险上限值和所述被保人历史保险信息计算所述保险产品的可销售额度；及
    当计算得到的所述可销售额度与所述投保额度的差值大于0时，将所述保险产品加入推荐列表，并在推荐列表中添加所述保险产品对应的可销售额 度信息，根据所述推荐列表生成投保建议结果。
  19. 根据权利要求16所述的存储介质，其特征在于，所述计算机可读指令被所述处理器执行时还执行以下步骤：
    根据所述险种判断投保保险所属险种是否为豁免险；
    当所述投保保险所属险种为豁免险时，获取所述保单数据中的投保人基本信息，根据所述投保人基本信息查询投保人历史保险信息，根据所述风险保额计算规则和所述投保人历史保险信息计算投保人投保保险可销售额度；及
    将所述投保人投保保险可销售额度与所述投保额度数据进行比较生成投保人数据审核结果。
  20. 根据权利要求16所述的存储介质，其特征在于，所述计算机可读指令被所述处理器执行时还执行以下步骤：
    读取所述被保人基本信息中的身份信息；
    将所述身份信息与已有客户列表中的客户身份信息进行匹配；及
    当匹配失败时，返回审核成功的审核结果，读取所述保单数据中的客服编号，查找与所述客服编号对应的客服自拓客户列表，将所述被保人基本信息添加至所述客服自拓客户列表中。
PCT/CN2018/084800 2017-06-16 2018-04-27 保单数据审核方法、装置、计算机设备和存储介质 Ceased WO2018228065A1 (zh)

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