WO2019001087A1 - Case claim method, device, server and computer readable storage medium - Google Patents

Case claim method, device, server and computer readable storage medium Download PDF

Info

Publication number
WO2019001087A1
WO2019001087A1 PCT/CN2018/082622 CN2018082622W WO2019001087A1 WO 2019001087 A1 WO2019001087 A1 WO 2019001087A1 CN 2018082622 W CN2018082622 W CN 2018082622W WO 2019001087 A1 WO2019001087 A1 WO 2019001087A1
Authority
WO
WIPO (PCT)
Prior art keywords
case
investigator
policy
investigation
receiving
Prior art date
Application number
PCT/CN2018/082622
Other languages
French (fr)
Chinese (zh)
Inventor
候彦如
Original Assignee
平安科技(深圳)有限公司
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by 平安科技(深圳)有限公司 filed Critical 平安科技(深圳)有限公司
Publication of WO2019001087A1 publication Critical patent/WO2019001087A1/en

Links

Classifications

    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06QINFORMATION 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
    • G06Q40/00Finance; Insurance; Tax strategies; Processing of corporate or income taxes
    • G06Q40/08Insurance

Definitions

  • the present application relates to the field of insurance technology, and in particular, to a case claim method, apparatus, server, and computer readable storage medium.
  • the staff of the insurance company accepts the claim case on the PC side and enters the relevant report information.
  • the case acceptance system then sends the case to the case investigation system, and the case investigation system assigns the investigator to conduct the case investigation.
  • the investigator's investigation is completed, the investigation needs to be reported to the auditor, and the auditor can pass the audit before the compensation can be made.
  • the claims settlement process is complicated, the progress is slow, and the cycle is very long. Especially in the case of a major accident, it may happen that the insured person urgently needs funds, but the settlement process is slow and cannot be paid in time.
  • the main purpose of the present application is to provide a case claim method, a server, and a computer readable storage medium, aiming at solving the technical problem of long insurance claim period.
  • the present application provides a method for claim settlement, and the method for claim settlement includes the following steps:
  • the corresponding claim settlement case is generated and an investigation task is generated and sent to the investigator;
  • the present application further provides a case claim device, and the case claim device includes:
  • the matching module is configured to send a survey claim to the investigator when the claim for the claim entered by the investigator is received;
  • a reporting module configured to receive an investigation report submitted by the investigator based on the investigation task, and submit the claim case and the investigation report to an audit node;
  • the claim module is configured to perform the payment of the claim case according to the claim instruction when receiving the payout instruction fed back by the audit node.
  • the present invention also provides a server, the server comprising: a memory, a processor, and a case claim program stored on the memory and operable on the processor, the case claim program The step of implementing the case claim method of any of the above, when executed by the processor.
  • the present application further provides a computer readable storage medium, wherein the computer readable storage medium stores a case claim program, and the case claim program is executed by the processor to implement any of the above The steps of the method of claim settlement.
  • a case claim method, device, server, and computer readable storage medium which are provided by the embodiment of the present application, are sent to the investigator by correspondingly configuring a claim case and generating an investigation task when receiving the claim application input by the investigator.
  • the investigator conducts the report and the case investigation; then, receives the investigation report submitted by the investigator based on the investigation task, submits the claim case and the investigation report to the audit node, and the audit node performs the audit to ensure the authenticity of the claim and prevent fraudulent insurance;
  • the compensation order is returned by the review node, the claim is paid according to the claim.
  • the customer report is saved, and the insurance company accepts and distributes the process of the investigator.
  • the investigator can directly file a claim for claim settlement, and when the investigator completes the investigation and passes the audit of the audit node, the customer can directly pay for the claim.
  • the time spent by the customer on the process is greatly saved, the claim period is shortened, and the customer can quickly get the payment, especially in the event of a major accident; and, by reviewing the control of the node, the claim is reduced.
  • the risk of fraud protects the interests of insurance companies, thereby achieving a win-win situation for both customers and insurance companies.
  • FIG. 1 is a schematic structural diagram of a terminal structure of a hardware operating environment involved in an embodiment of the present application
  • FIG. 2 is a schematic flow chart of a first embodiment of a claim settlement method of the present application
  • FIG. 3 is a schematic diagram showing the refinement process of the steps of the claim compensation case and the step of generating the investigation task to be sent to the investigator when receiving the claim application input by the investigator in FIG. 2;
  • FIG. 4 is a schematic diagram showing a refinement flow of the steps of performing the payment of the claim case according to the claim instruction when receiving the payout instruction fed back by the audit node in FIG. 2;
  • FIG. 5 is a schematic flow chart of a second embodiment of a claim settlement method of the present application.
  • FIG. 6 is a schematic flow chart of a third embodiment of a claim settlement method of the present application.
  • FIG. 7 is a schematic flow chart of a fourth embodiment of a claim settlement method of the present application.
  • FIG. 8 is a schematic flow chart of a fifth embodiment of a claim settlement method of the present application.
  • FIG. 1 is a schematic structural diagram of a terminal in a hardware operating environment involved in an embodiment of the present application.
  • the server in this embodiment may be a terminal device such as a PC.
  • the terminal may include a processor 1001, such as a CPU, a communication bus 1002, a user interface 1003, and a memory 1004.
  • the communication bus 1002 is used to implement connection communication between these components.
  • the user interface 1003 can include a display, an input unit such as a keyboard, and the optional user interface 1003 can also include a standard wired interface, a wireless interface.
  • the memory 1004 may be a high speed RAM memory or a stable memory (non-volatile) Memory), such as disk storage.
  • the memory 1004 can also optionally be a storage device independent of the aforementioned processor 1001.
  • the terminal may further include a camera, RF (Radio) Frequency, RF) circuits, sensors, audio circuits, WiFi modules, and more.
  • RF Radio
  • FIG. 1 does not constitute a limitation to the server, and may include more or less components than those illustrated, or some components may be combined, or different component arrangements.
  • an operating system, a network communication module, a user interface module, and a case claims program may be included in the memory 1004 as a computer storage medium.
  • the user interface 1003 is mainly used to connect a client (user end) to perform data communication with the client; and the processor 1001 can be used to call a case claim program stored in the memory 1004, and execute the present.
  • a first embodiment of a claim settlement method of the present application provides a case claim method, and the case claim method includes:
  • Step S10 When receiving the claim application input by the investigator, correspondingly configuring the claim case and generating a survey task is sent to the surveyor.
  • the investigator can directly file a claim for claim, and the case investigation can be started without reporting the case, and the progress of the claim can be accelerated.
  • the investigator obtains the customer after arriving at the scene of the accident.
  • Identity and accident situation use the server to access the claims system, select the customer's policy to apply for claims, and enter the claims application.
  • the investigator can also enter the customer's policy number, determine the policy to apply for claims, and then enter the claim application.
  • the server After receiving the claim, the server obtains the policy for the current claim settlement, and files the case for the corresponding claims. Then, the investigation task of the server configuration claim case is sent to the investigator.
  • the investigator After receiving the investigation task issued by the server, the investigator locates at the scene of the accident to confirm that it has conducted an investigation at the scene of the accident, and can also take pictures of the scene of the accident, obtain relevant image data, and conduct investigations on current claims cases. task.
  • the step S10 includes:
  • Step S11 When receiving the claim application input by the investigator, determining whether the investigator has the claim acceptance right;
  • Step S12 If the investigator has the claim accepting authority, the claims claim is configured according to the claims application, and a survey task is generated and sent to the surveyor.
  • the server determines whether the investigator has a claim based on the pre-determined permission filing information when receiving the claim for the claim entered by the investigator. Acceptance authority.
  • the respondent case is configured according to the claim application instruction and the corresponding investigation task is generated and sent to the investigator; if the investigator does not have the claim acceptance right, the claim is rejected, prompting the investigator to Open the claims application permission.
  • Step S20 Receive the investigation report submitted by the surveyor based on the investigation task, and submit the claim case and the investigation report to the audit node.
  • the investigator After completing the investigation, the investigator inputs the investigation report writing instruction, enters the investigation conclusion in the investigation report writing interface of the server configuration, and submits the positioning information and the collected image data together as the investigation report corresponding to the investigation task.
  • the investigation report submitted by the investigator is also the investigation report of the current claim case.
  • the server receives the investigation report submitted by the investigator, and obtains the investigation result, the positioning information, and the image data obtained by the investigation. Then, the server submits the claim case and the investigation report to the audit node, and the audit node checks and confirms the investigation report of the claim case to prevent the case from being misreported or misrepresented.
  • the audit node After receiving the investigation report, the audit node will review whether the policy in the claim case can be paid; if the payment can be made, the amount of the payment and the beneficiary need to be determined according to the agreement in the policy, and the beneficiary's account is determined.
  • the beneficiary's account may be an account that can collect money, such as a bank card account or an electronic account.
  • Step S30 When receiving the compensation instruction fed back by the auditing node, the payment of the case is performed according to the claim.
  • the payment instruction is sent to the server to notify that the claim case has passed the review and can be paid.
  • the server receives the compensation instruction feedback from the audit node, it executes the compensation instruction and pays the beneficiary.
  • the step S30 includes:
  • Step S31 when receiving the payment instruction fed back by the auditing node, acquiring the payment amount and the beneficiary account according to the claim instruction;
  • Step S32 Transfer the claim payment to the beneficiary account by using electronic payment.
  • the server parses the claim instruction, and obtains the payment amount and the beneficiary account of the case. Specifically, the server can read the code of the claim instruction, extract the preset field in the code, obtain the payment amount and the beneficiary account of the case, and store it in a text format.
  • the preset field may be a field of a preset location, a field after the preset identifier, or the like.
  • the server then uses electronic payment to transfer the payment to the beneficiary's account based on the amount of the payment and the beneficiary's account. It should be noted that if the insured has multiple policies to be paid, the server obtains multiple claims of the audit node and compensates separately; or, the server according to the multi-pair payment amount and the beneficiary account in the configuration instruction, Pay separately.
  • the method further includes:
  • the server configures the processing status of the investigation task to be closed or completed, and may also delete the investigation task in the investigation system or the investigation task list of the investigator, and complete the verification of the investigation task. Through the verification of the investigation task, the investigation personnel's investigation task execution cycle is ended, and the influence of the investigator's work time is avoided.
  • the corresponding claim settlement case is generated and an investigation task is generated and sent to the investigator, and the investigator reports and investigates the case; and then, the receiving surveyor submits the report based on the survey task.
  • the investigation report submits the claims case and the investigation report to the auditing node, and the auditing node conducts the audit to ensure the authenticity of the claim and prevent fraudulent insurance; when receiving the compensation order feedback from the auditing node, the claims are paid according to the claim.
  • the customer report is saved, and the insurance company accepts and distributes the process of the investigator.
  • the investigator can directly file the claim for claim settlement, and when the investigator completes the investigation and passes the audit of the audit node, the customer can directly conduct the settlement.
  • the payment process greatly saves the time spent by the customer on the process, shortens the claim cycle, and enables the customer to get the payment quickly, especially in the event of a major accident; and, by reviewing the control of the node, the reduction is reduced.
  • the risk of fraud in claims is protected by the interests of insurance companies, thereby achieving a win-win situation for both customers and insurance companies.
  • the second embodiment of the claim settlement method of the present application provides a method for claim settlement, which is based on the first embodiment of the claim settlement method of the present application, and the step S10 includes:
  • Step S13 When receiving the claim application input by the investigator, obtain the identity of the insured person carried in the claim application.
  • the investigator determines the identity of the insured customer and then enters the claim as the insured.
  • the claims application contains the identity of the insured, such as name, ID number, age and other information.
  • the server After receiving the claim form of the investigator, the server obtains the identity of the insured person carried in the claim application.
  • Step S14 Search all the policies of the insured according to the insured identity, and configure a policy list for the surveyor to select.
  • the server After obtaining the insured status, the server searches the database for all policies of the insured according to the insured status, and configures all the policies found as a policy list.
  • the policies in the form list can be sorted according to the purchase time and the like.
  • the server displays a list of policies for the investigator to select the policy for which the claim is currently applied.
  • Investigators can select the policy by checking the policy list page and filter out the inappropriate policy. For example, if the accident is a car accident, the investigator may need to choose a car insurance policy, an accident insurance policy, and the like.
  • the policy list can display only the purchase time and insurance type of each policy. Of course, other information in the policy can also be displayed, which can be flexibly configured according to actual needs.
  • Step S15 Acquire a policy selected by the surveyor based on the policy list, correspondingly configure a claim case, and generate a survey task and send the survey task to the surveyor.
  • the server obtains the policy selected by the investigator, correspondingly configures the claim case, and generates an investigation task for the claim case and sends it to the investigator, thereby the investigator Conduct an investigation.
  • the list of policies that record all the policies of the insured is provided for the investigator to select, so that the investigator can filter out the policy that is inappropriate and cannot apply for claim, only according to the survey candidate.
  • the issued insurance policy is filed, which reduces the workload of the audit node, speeds up the review of claims, and shortens the period of insurance claims, which can enhance the customer experience.
  • the third embodiment of the claim settlement method of the present application provides a policy claim method, based on the second embodiment of the claim settlement method of the present application, the step S15 includes:
  • Step S151 When the policy selected by the surveyor based on the policy list is received, the terms of the selected policy are displayed for selection.
  • Step S152 Obtain a policy and a clause selected by the investigator, correspondingly configure a claim case, and generate an investigation task and send the investigation task to the investigator.
  • the server When the server is configured with the policy list and displayed to the investigator for selection, if the policy selected by the surveyor based on the policy list is received, the terms of the selected policy are displayed for the investigator to select.
  • the terms of the policy include the insurance liability of the policy, the amount of insurance, additional terms and other items for the investigator to choose. According to the actual situation of the accident, the investigator selects the corresponding terms and determines. After receiving the policy clause of the investigator, the server correspondingly configures the claim case according to the policy and terms selected by the investigator, and generates an investigation task and sends it to the investigator.
  • the investigator can select the policy for this claim based on the insurance policy and other information.
  • the server looks up the policy content of the policy in the database and displays the terms of the policy.
  • the server can also extract the preset field in the policy content, and obtain the policy number, the insured identity information, the beneficiary information, and the like.
  • the investigator selects the terms of the claim basis, such as insurance liability, insurance amount, additional clauses, etc., to determine the claims liability and the amount of claims. The investigator confirms the selection of the terms.
  • the server After the server receives the terms selected by the investigator, the fields of the policy number, the insured identity information, the beneficiary information, and the fields of the terms selected by the investigator are filled in according to the preset filling rules.
  • a claim case is generated.
  • the policy written in the claim case is the policy on which the claim is based, and the written terms are the terms of the claim, and the insured person who is required to apply for the claim in this accident.
  • the server also configures the case number of the claim case according to a preset numbering rule. Then, the server configures the investigation task corresponding to the claim case, and obtains the investigator who configures the claim case, and distributes the configured survey task to the surveyer's system for the surveyor to perform the survey task.
  • the investigation task includes all the information of the claim case, including the policy on which the claim is based, the insured, the terms of the claim, etc., for the investigator to conduct the investigation purposefully.
  • the investigator can separately select multiple policies and corresponding terms, and then the server configures the claim case and generates a survey task to be sent to the surveyor.
  • the terms of the policy are provided for the investigator to select, so that the investigator can select the terms of the claim, so that the claim is more targeted and the workload of the audit node is reduced. , shortened the claims cycle.
  • the fourth embodiment of the claim settlement method of the present application provides a method for claim settlement, based on the second or third embodiment of the claim settlement method of the present application (the second embodiment of the claim settlement method of the present application)
  • the step S14 includes:
  • Step S141 Search for all policies of the insured according to the insured identity
  • Step S142 Filter out the policy within the insurance period in all the policies of the insured, and configure the policy as a policy list for the investigator to select.
  • the server After obtaining the insured status, the server searches the database for all policies of the insured according to the insured status. Then, the server performs preliminary filtering and screening, selects the policies that are still in the insurance period in all the policies, and filters out the policies that have expired. Among them, the insurance period is also called the insurance period. According to the insurance contract, the insurance company is insured for the agreed insurance accident within the agreed time, and the agreed time becomes the insurance period. The server then uses the policy that is currently in the insurance period to be configured as a policy list for the investigator to choose the policy for the claim.
  • the policy that has expired is automatically filtered out. Since the insurance company does not pay the insurance policy that is not within the insurance period, it is not necessary to file a policy for these insurance policies, which can reduce the workload of the investigator and the audit node, and improve the workload. Claim speed.
  • the fifth embodiment of the claim settlement method of the present application provides a method for claim settlement, which is based on the third embodiment of the claim settlement method of the present application, and the step S30 includes:
  • Step S33 when receiving the compensation instruction fed back by the auditing node, determining the policy and terms of the approved audit according to the claim instruction;
  • Step S34 Obtain an amount of the payment payment according to the terms of the review, and obtain the beneficiary account bound to the policy that has passed the review;
  • Step S35 Transfer the claim payment to the beneficiary account by using electronic payment.
  • the server When the server receives the compensation instruction feedback from the audit node, it parses the claim and obtains the policy and terms that are currently approved. Then, according to the terms of the audit, the server obtains the payment amount agreed with the insurance company when the customer signs the policy. For example, if the auto insurance policy is approved, the liability amount clause in the policy is also approved. The default field in the clause is the value of the payment payment amount. Therefore, the auto insurance policy can be obtained by reading the preset field in the liability amount clause. The amount of the payment. At the same time, the server queries the customer's reservation information and obtains the beneficiary account bound by the approved policy. Further, if there are multiple policies and their terms passed the review, the server will pay for each policy according to the beneficiary account of each policy and the payment amount in each policy clause.
  • the server then uses the electronic payment to transfer the payment to the beneficiary's account for payment.
  • the embodiment of the present application further provides a case claim device, where the claim claim device includes:
  • the matching module is configured to send a survey claim to the investigator when the claim for the claim entered by the investigator is received;
  • a reporting module configured to receive an investigation report submitted by the investigator based on the investigation task, and submit the claim case and the investigation report to an audit node;
  • the claim module is configured to perform the payment of the claim case according to the claim instruction when receiving the payout instruction fed back by the audit node.
  • the matching module is further used,
  • the matching module is further used,
  • the matching module is further used,
  • the claim module is further configured to:
  • the claim payment amount and the beneficiary account are obtained according to the claim instruction; and the claim payment is transferred to the beneficiary account using the electronic payment.
  • the claim module is further configured to:
  • the claim payment is transferred to the beneficiary account.
  • the matching module is further used,
  • the investigator When receiving the claim for the claim entered by the investigator, determining whether the investigator has the claim accepting authority; if the investigator has the claim accepting authority, the claims claim is configured according to the claims request and the survey task is generated. To the investigator.
  • reporting module is further configured to:
  • the embodiment of the present application further provides a computer readable storage medium, where the computer claim storage medium stores a case claim program, and when the case claim program is executed by the processor, the following operations are implemented:
  • the corresponding claim settlement case is generated and an investigation task is generated and sent to the investigator;
  • the policy of the insured person is selected in the policy of the insured person, and is configured as a policy list for the investigator to select.
  • the electronic payment is used to transfer the payment to the beneficiary account.
  • the electronic payment is used to transfer the payment to the beneficiary account.
  • the claim settlement case is correspondingly configured according to the claims application, and an investigation task is generated and sent to the investigator.
  • the technical solution of the present application which is essential or contributes to the prior art, may be embodied in the form of a software product stored in a storage medium (such as ROM/RAM as described above). , a disk, an optical disk, including a number of instructions for causing a terminal device (which may be a mobile phone, a computer, a server, an air conditioner, or a network device, etc.) to perform the methods described in the various embodiments of the present application.
  • a terminal device which may be a mobile phone, a computer, a server, an air conditioner, or a network device, etc.

Landscapes

  • Business, Economics & Management (AREA)
  • Accounting & Taxation (AREA)
  • Finance (AREA)
  • Engineering & Computer Science (AREA)
  • Development Economics (AREA)
  • Economics (AREA)
  • Marketing (AREA)
  • Strategic Management (AREA)
  • Technology Law (AREA)
  • Physics & Mathematics (AREA)
  • General Business, Economics & Management (AREA)
  • General Physics & Mathematics (AREA)
  • Theoretical Computer Science (AREA)
  • Financial Or Insurance-Related Operations Such As Payment And Settlement (AREA)

Abstract

The present application discloses a case claim method, which comprises: when a claim application input by an investigator is received, accordingly configuring a claim case, generating an investigation task and sending the same to the investigator; receiving an investigation report submitted by the investigator on the basis of the investigation task, and submitting the claim case and the investigation report to an examination node; and when a compensation instruction fed back by the examination node is received, carrying out the compensation on the claim case according to the compensation instruction. Also disclosed in the present application are a case claim device, a server, and a computer readable storage medium. The application greatly saves the time spent by the customer on the process and shortens the claim period.

Description

案件理赔方法、装置、服务器及计算机可读存储介质  Case claim method, device, server and computer readable storage medium
本申请要求于2017年6月26日提交中国专利局、申请号为201710497417.7、发明名称为“案件理赔方法、服务器及计算机可读存储介质”的中国专利申请的优先权,其全部内容通过引用结合在申请中。This application claims the priority of the Chinese Patent Application filed on June 26, 2017, the Chinese Patent Application No. 201710497417.7, entitled "Case Claim Method, Server and Computer Readable Storage Media", the entire contents of which are incorporated by reference. In the application.
技术领域Technical field
本申请涉及保险技术领域,尤其涉及一种案件理赔方法、装置、服务器及计算机可读存储介质。The present application relates to the field of insurance technology, and in particular, to a case claim method, apparatus, server, and computer readable storage medium.
背景技术Background technique
目前,保险业务的理赔都是报案人提出理赔申请后,保险公司的工作人员在PC端受理理赔案件,录入相关的报案信息。然后,案件受理系统将案件发给案件调查系统,再由案件调查系统指派调查人进行案件调查。当调查人调查完成后,需要将调查报告给审核人,由审核人审核通过后才能进行赔偿。经过案件受理、分配调查人、调查人调查、审核等多个步骤,导致理赔案件的理赔流程复杂、进度缓慢,周期十分漫长。尤其当发生重大事故时,可能发生被保人急需资金,但是理赔流程较慢无法及时支付的情况。At present, after the claims of the insurance business are submitted by the informant, the staff of the insurance company accepts the claim case on the PC side and enters the relevant report information. The case acceptance system then sends the case to the case investigation system, and the case investigation system assigns the investigator to conduct the case investigation. When the investigator's investigation is completed, the investigation needs to be reported to the auditor, and the auditor can pass the audit before the compensation can be made. After multiple steps such as case acceptance, distribution of investigators, investigators' investigations, and audits, the claims settlement process is complicated, the progress is slow, and the cycle is very long. Especially in the case of a major accident, it may happen that the insured person urgently needs funds, but the settlement process is slow and cannot be paid in time.
发明内容Summary of the invention
本申请的主要目的在于提供一种案件理赔方法、服务器及计算机可读存储介质,旨在解决保险理赔周期长的技术问题。The main purpose of the present application is to provide a case claim method, a server, and a computer readable storage medium, aiming at solving the technical problem of long insurance claim period.
为实现上述目的,本申请提供一种案件理赔方法,所述案件理赔方法包括以下步骤:To achieve the above object, the present application provides a method for claim settlement, and the method for claim settlement includes the following steps:
在收到调查人输入的理赔申请时,对应配置理赔案件并生成调查任务下发给所述调查人;When receiving the claim application input by the investigator, the corresponding claim settlement case is generated and an investigation task is generated and sent to the investigator;
接收所述调查人基于所述调查任务提交的调查报告,将所述理赔案件及所述调查报告提交给审核节点;Receiving the investigation report submitted by the investigator based on the investigation task, and submitting the claim case and the investigation report to the audit node;
在收到所述审核节点反馈的赔付指令时,根据所述赔付指令进行所述理赔案件的赔付。When receiving the compensation instruction fed back by the auditing node, the claims of the claim case are paid according to the claim.
此外,为实现上述目的,本申请还提供一种案件理赔装置,所述案件理赔装置包括:In addition, in order to achieve the above object, the present application further provides a case claim device, and the case claim device includes:
配案模块,用于在收到调查人输入的理赔申请时,对应配置理赔案件并生成调查任务下发给所述调查人;The matching module is configured to send a survey claim to the investigator when the claim for the claim entered by the investigator is received;
报告模块,用于接收所述调查人基于所述调查任务提交的调查报告,将所述理赔案件及所述调查报告提交给审核节点;a reporting module, configured to receive an investigation report submitted by the investigator based on the investigation task, and submit the claim case and the investigation report to an audit node;
赔付模块,用于在收到所述审核节点反馈的赔付指令时,根据所述赔付指令进行所述理赔案件的赔付。The claim module is configured to perform the payment of the claim case according to the claim instruction when receiving the payout instruction fed back by the audit node.
此外,为实现上述目的,本发明还提供一种服务器,所述服务器包括:存储器、处理器及存储在所述存储器上并可在所述处理器上运行的案件理赔程序,所述案件理赔程序被所述处理器执行时实现如上述任一项所述的案件理赔方法的步骤。In addition, in order to achieve the above object, the present invention also provides a server, the server comprising: a memory, a processor, and a case claim program stored on the memory and operable on the processor, the case claim program The step of implementing the case claim method of any of the above, when executed by the processor.
此外,为实现上述目的,本申请还提供一种计算机可读存储介质,所述计算机可读存储介质上存储有案件理赔程序,所述案件理赔程序被处理器执行时实现如上述任一项所述的案件理赔方法的步骤。In addition, in order to achieve the above object, the present application further provides a computer readable storage medium, wherein the computer readable storage medium stores a case claim program, and the case claim program is executed by the processor to implement any of the above The steps of the method of claim settlement.
本申请实施例提出的一种案件理赔方法、装置、服务器和计算机可读存储介质,通过在收到调查人输入的理赔申请时,对应配置理赔案件并生成调查任务下发给此调查人,由调查人进行报案及案件调查;然后,接收调查人基于调查任务提交的调查报告,将理赔案件及调查报告提交给审核节点,由审核节点进行审核,保障理赔的真实性,防止骗保;在收到审核节点反馈的赔付指令时,根据赔付指令进行理赔案件的赔付。本申请中节省了客户报案,以及保险公司受理、分配调查人的流程,调查人可直接提起理赔申请,进行理赔立案,当调查人完成调查并通过审核节点的审核后,可直接对客户进行赔付,相对于传统的理赔流程大大节省了客户在流程上耗费的时间,缩短了理赔周期,使得客户可以快速拿到赔付款,尤其是发生重大事故时;并且,通过审核节点的管控,减少了理赔的欺诈风险,保障了保险公司的利益,由此,实现了客户与保险公司的双赢。A case claim method, device, server, and computer readable storage medium, which are provided by the embodiment of the present application, are sent to the investigator by correspondingly configuring a claim case and generating an investigation task when receiving the claim application input by the investigator. The investigator conducts the report and the case investigation; then, receives the investigation report submitted by the investigator based on the investigation task, submits the claim case and the investigation report to the audit node, and the audit node performs the audit to ensure the authenticity of the claim and prevent fraudulent insurance; When the compensation order is returned by the review node, the claim is paid according to the claim. In this application, the customer report is saved, and the insurance company accepts and distributes the process of the investigator. The investigator can directly file a claim for claim settlement, and when the investigator completes the investigation and passes the audit of the audit node, the customer can directly pay for the claim. Compared with the traditional claims process, the time spent by the customer on the process is greatly saved, the claim period is shortened, and the customer can quickly get the payment, especially in the event of a major accident; and, by reviewing the control of the node, the claim is reduced. The risk of fraud protects the interests of insurance companies, thereby achieving a win-win situation for both customers and insurance companies.
附图说明DRAWINGS
图1是本申请实施例方案涉及的硬件运行环境的终端置结构示意图;1 is a schematic structural diagram of a terminal structure of a hardware operating environment involved in an embodiment of the present application;
图2为本申请案件理赔方法第一实施例的流程示意图;2 is a schematic flow chart of a first embodiment of a claim settlement method of the present application;
图3为图2中在收到调查人输入的理赔申请时,对应配置理赔案件并生成调查任务下发给所述调查人的步骤的细化流程示意图;FIG. 3 is a schematic diagram showing the refinement process of the steps of the claim compensation case and the step of generating the investigation task to be sent to the investigator when receiving the claim application input by the investigator in FIG. 2;
图4为图2中在收到所述审核节点反馈的赔付指令时,根据所述赔付指令进行所述理赔案件的赔付的步骤的细化流程示意图;4 is a schematic diagram showing a refinement flow of the steps of performing the payment of the claim case according to the claim instruction when receiving the payout instruction fed back by the audit node in FIG. 2;
图5为本申请案件理赔方法第二实施例的流程示意图;5 is a schematic flow chart of a second embodiment of a claim settlement method of the present application;
图6为本申请案件理赔方法第三实施例的流程示意图;6 is a schematic flow chart of a third embodiment of a claim settlement method of the present application;
图7为本申请案件理赔方法第四实施例的流程示意图;7 is a schematic flow chart of a fourth embodiment of a claim settlement method of the present application;
图8为本申请案件理赔方法第五实施例的流程示意图。FIG. 8 is a schematic flow chart of a fifth embodiment of a claim settlement method of the present application.
本申请目的的实现、功能特点及优点将结合实施例,参照附图做进一步说明。The implementation, functional features and advantages of the present application will be further described with reference to the accompanying drawings.
具体实施方式Detailed ways
应当理解,此处所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。It is understood that the specific embodiments described herein are merely illustrative of the application and are not intended to be limiting.
如图1所示,图1是本申请实施例方案涉及的硬件运行环境的终端结构示意图。本申请实施例服务器可以是PC等终端设备。如图1所示,该终端可以包括:处理器1001,例如CPU,通信总线1002,用户接口1003,存储器1004。其中,通信总线1002用于实现这些组件之间的连接通信。用户接口1003可以包括显示屏(Display)、输入单元比如键盘(Keyboard),可选的用户接口1003还可以包括标准的有线接口、无线接口。存储器1004可以是高速RAM存储器,也可以是稳定的存储器(non-volatile memory),例如磁盘存储器。存储器1004可选的还可以是独立于前述处理器1001的存储装置。可选地,终端还可以包括摄像头、RF(Radio Frequency,射频)电路,传感器、音频电路、WiFi模块等等。本领域技术人员可以理解,图1中示出的终端结构并不构成对服务器的限定,可以包括比图示更多或更少的部件,或者组合某些部件,或者不同的部件布置。As shown in FIG. 1 , FIG. 1 is a schematic structural diagram of a terminal in a hardware operating environment involved in an embodiment of the present application. The server in this embodiment may be a terminal device such as a PC. As shown in FIG. 1, the terminal may include a processor 1001, such as a CPU, a communication bus 1002, a user interface 1003, and a memory 1004. Among them, the communication bus 1002 is used to implement connection communication between these components. The user interface 1003 can include a display, an input unit such as a keyboard, and the optional user interface 1003 can also include a standard wired interface, a wireless interface. The memory 1004 may be a high speed RAM memory or a stable memory (non-volatile) Memory), such as disk storage. The memory 1004 can also optionally be a storage device independent of the aforementioned processor 1001. Optionally, the terminal may further include a camera, RF (Radio) Frequency, RF) circuits, sensors, audio circuits, WiFi modules, and more. It will be understood by those skilled in the art that the terminal structure shown in FIG. 1 does not constitute a limitation to the server, and may include more or less components than those illustrated, or some components may be combined, or different component arrangements.
如图1所示,作为一种计算机存储介质的存储器1004中可以包括操作系统、网络通信模块、用户接口模块以及案件理赔程序。在图1所示的终端中,用户接口1003主要用于连接客户端(用户端),与客户端进行数据通信;而处理器1001可以用于调用存储器1004中存储的案件理赔程序,并执行本发明任一实施例所述的案件理赔方法。As shown in FIG. 1, an operating system, a network communication module, a user interface module, and a case claims program may be included in the memory 1004 as a computer storage medium. In the terminal shown in FIG. 1, the user interface 1003 is mainly used to connect a client (user end) to perform data communication with the client; and the processor 1001 can be used to call a case claim program stored in the memory 1004, and execute the present. The claim settlement method described in any of the embodiments of the invention.
本申请服务器的具体实施例与下述案件理赔方法各实施例基本相同,在此不作赘述。The specific embodiment of the server of the present application is basically the same as the embodiments of the following claims claim method, and details are not described herein.
参照图2,本申请案件理赔方法第一实施例提供一种案件理赔方法,所述案件理赔方法包括:Referring to FIG. 2, a first embodiment of a claim settlement method of the present application provides a case claim method, and the case claim method includes:
步骤S10、在收到调查人输入的理赔申请时,对应配置理赔案件并生成调查任务下发给所述调查人。Step S10: When receiving the claim application input by the investigator, correspondingly configuring the claim case and generating a survey task is sent to the surveyor.
本实施例中调查人可以直接提起理赔申请,无需报案人报案即可开始进行案件的调查,加快理赔进度。In this embodiment, the investigator can directly file a claim for claim, and the case investigation can be started without reporting the case, and the progress of the claim can be accelerated.
具体的,作为一种应用场景,当发生重大事故时,例如连环车祸、重大火灾等,由于灾情严重且事实清楚,为了使客户尽快收到赔付款,调查人在到达事故现场后,获取客户的身份及事故情况,使用服务器接入理赔系统,选择客户的保单申请理赔,输入理赔申请。当然,调查人也可以输入客户的保单号,确定申请理赔的保单,然后,输入理赔申请。Specifically, as an application scenario, when a major accident occurs, such as a serial car accident or a major fire, due to the seriousness of the disaster and the facts are clear, in order to enable the customer to receive the payment as soon as possible, the investigator obtains the customer after arriving at the scene of the accident. Identity and accident situation, use the server to access the claims system, select the customer's policy to apply for claims, and enter the claims application. Of course, the investigator can also enter the customer's policy number, determine the policy to apply for claims, and then enter the claim application.
服务器在收到理赔申请后,获取当前申请理赔的保单,对应配置理赔案件进行立案。然后,服务器配置理赔案件的调查任务下发给此调查人。After receiving the claim, the server obtains the policy for the current claim settlement, and files the case for the corresponding claims. Then, the investigation task of the server configuration claim case is sent to the investigator.
调查人在收到服务器下发的调查任务后,在事故现场进行定位以证实其在事故现场进行了调查,并且,还可以对事故现场进行拍摄,获取相关的影像资料,执行当前理赔案件的调查任务。After receiving the investigation task issued by the server, the investigator locates at the scene of the accident to confirm that it has conducted an investigation at the scene of the accident, and can also take pictures of the scene of the accident, obtain relevant image data, and conduct investigations on current claims cases. task.
进一步地,作为一种实施方式,参照图3,所述步骤S10包括:Further, as an implementation manner, referring to FIG. 3, the step S10 includes:
步骤S11、在收到所述调查人输入的理赔申请时,判断所述调查人是否具有理赔受理权限;Step S11: When receiving the claim application input by the investigator, determining whether the investigator has the claim acceptance right;
步骤S12、若所述调查人具有理赔受理权限,则根据所述理赔申请对应配置理赔案件并生成调查任务下发给所述调查人。Step S12: If the investigator has the claim accepting authority, the claims claim is configured according to the claims application, and a survey task is generated and sent to the surveyor.
由于保险理赔涉及的金额可能较大,尤其是重大事故时,为了管控调查人的权限,服务器在收到调查人输入的理赔申请时,根据预设的权限备案信息,判断此调查人是否具有理赔受理权限。Since the amount involved in the insurance claims may be large, especially in the case of a major accident, in order to control the authority of the investigator, the server determines whether the investigator has a claim based on the pre-determined permission filing information when receiving the claim for the claim entered by the investigator. Acceptance authority.
若此调查人具有理赔受理权限,则根据理赔申请指令对应配置理赔案件并生成对应的调查任务下发给调查人;若调查人不具有理赔受理权限,则驳回其理赔申请,提示此调查人需要开通理赔申请权限。If the investigator has the right to claim compensation, the respondent case is configured according to the claim application instruction and the corresponding investigation task is generated and sent to the investigator; if the investigator does not have the claim acceptance right, the claim is rejected, prompting the investigator to Open the claims application permission.
步骤S20、接收所述调查人基于所述调查任务提交的调查报告,将所述理赔案件及所述调查报告提交给审核节点。Step S20: Receive the investigation report submitted by the surveyor based on the investigation task, and submit the claim case and the investigation report to the audit node.
调查人完成调查后,输入调查报告撰写指令,在服务器配置的调查报告撰写界面中录入调查结论,并将其定位信息以及搜集得到的影像资料一起作为调查任务对应的调查报告提交。需要说明的是,调查人提交的调查报告也即当前理赔案件的调查报告。服务器接收调查人提交的调查报告,获取调查人的调查结论、定位信息及其搜集得到的影像资料。然后,服务器将理赔案件及此调查报告提交给审核节点,由审核节点对理赔案件的调查报告进行审核确认,防止出现案件误报、误赔。After completing the investigation, the investigator inputs the investigation report writing instruction, enters the investigation conclusion in the investigation report writing interface of the server configuration, and submits the positioning information and the collected image data together as the investigation report corresponding to the investigation task. It should be noted that the investigation report submitted by the investigator is also the investigation report of the current claim case. The server receives the investigation report submitted by the investigator, and obtains the investigation result, the positioning information, and the image data obtained by the investigation. Then, the server submits the claim case and the investigation report to the audit node, and the audit node checks and confirms the investigation report of the claim case to prevent the case from being misreported or misrepresented.
审核节点在收到调查报告后,审核理赔案件中的保单是否能够进行赔付;若能够进行赔付,则需要根据保单中的协议确定赔付款金额及受益人,并确定受益人的账户。需要说明的是,受益人的账户可以是银行卡账户、电子账户等能够收款的账户。After receiving the investigation report, the audit node will review whether the policy in the claim case can be paid; if the payment can be made, the amount of the payment and the beneficiary need to be determined according to the agreement in the policy, and the beneficiary's account is determined. It should be noted that the beneficiary's account may be an account that can collect money, such as a bank card account or an electronic account.
步骤S30、在收到所述审核节点反馈的赔付指令时,根据所述赔付指令进行所述案件的赔付。Step S30: When receiving the compensation instruction fed back by the auditing node, the payment of the case is performed according to the claim.
若审核节点审核确定当前理赔案件能够进行赔付,则向服务器发出赔付指令,通知此理赔案件已经通过审核,可以赔付。服务器收到审核节点反馈的赔付指令时,执行赔付指令,对受益人进行赔付。If the audit node audit determines that the current claim case can be paid, the payment instruction is sent to the server to notify that the claim case has passed the review and can be paid. When the server receives the compensation instruction feedback from the audit node, it executes the compensation instruction and pays the beneficiary.
具体的,作为一种实施方式,参照图4,所述步骤S30包括:Specifically, as an implementation manner, referring to FIG. 4, the step S30 includes:
步骤S31、在收到所述审核节点反馈的赔付指令时,根据所述赔付指令获取赔付款金额及受益人账户;Step S31, when receiving the payment instruction fed back by the auditing node, acquiring the payment amount and the beneficiary account according to the claim instruction;
步骤S32、使用电子支付,将所述赔付款转账至所述受益人账户。Step S32: Transfer the claim payment to the beneficiary account by using electronic payment.
服务器在收到审核节点反馈的赔付指令时,解析赔付指令,获取赔付指令中携带的赔付款金额以及案件的受益人账户。具体的,服务器可以读取赔付指令的代码,提取代码中的预设字段,得到赔付款金额以及案件的受益人账户,并以文本格式存储。其中,预设字段可以是预设位置的字段,或预设标识符后的字段等。然后,服务器使用电子支付,根据得到的赔付款金额和受益人账户,将赔付款转账给受益人账户。需要说明的是,若被保人有多张保单需要进行赔付,则服务器获取审核节点的多个赔付指令,分别进行赔偿;或,服务器根据配置指令中的多对赔付款金额以及受益人账户,分别进行赔付。When receiving the compensation instruction fed back by the auditing node, the server parses the claim instruction, and obtains the payment amount and the beneficiary account of the case. Specifically, the server can read the code of the claim instruction, extract the preset field in the code, obtain the payment amount and the beneficiary account of the case, and store it in a text format. The preset field may be a field of a preset location, a field after the preset identifier, or the like. The server then uses electronic payment to transfer the payment to the beneficiary's account based on the amount of the payment and the beneficiary's account. It should be noted that if the insured has multiple policies to be paid, the server obtains multiple claims of the audit node and compensates separately; or, the server according to the multi-pair payment amount and the beneficiary account in the configuration instruction, Pay separately.
由此,完整了理赔案件的赔付。Thus, the payment of the claims case is completed.
进一步地,所述步骤S20之后还包括:Further, after the step S20, the method further includes:
核销所述调查任务。Write off the investigation task.
具体的,服务器将调查任务的处理状态配置为结案或已完成,同时,还可以在调查人的调查系统或调查任务列表中删除此调查任务,完成调查任务的核销。通过调查任务的核销,结束调查人的调查任务执行周期,避免影响调查人的工作时效。Specifically, the server configures the processing status of the investigation task to be closed or completed, and may also delete the investigation task in the investigation system or the investigation task list of the investigator, and complete the verification of the investigation task. Through the verification of the investigation task, the investigation personnel's investigation task execution cycle is ended, and the influence of the investigator's work time is avoided.
在本实施例中,在收到调查人输入的理赔申请时,对应配置理赔案件并生成调查任务下发给此调查人,由调查人进行报案及案件调查;然后,接收调查人基于调查任务提交的调查报告,将理赔案件及调查报告提交给审核节点,由审核节点进行审核,保障理赔的真实性,防止骗保;在收到审核节点反馈的赔付指令时,根据赔付指令进行理赔案件的赔付。本实施例中节省了客户报案,以及保险公司受理、分配调查人的流程,调查人可直接提起理赔申请,进行理赔立案,当调查人完成调查并通过审核节点的审核后,可直接对客户进行赔付,相对于传统的理赔流程大大节省了客户在流程上耗费的时间,缩短了理赔周期,使得客户可以快速拿到赔付款,尤其是发生重大事故时;并且,通过审核节点的管控,减少了理赔的欺诈风险,保障了保险公司的利益,由此,实现了客户与保险公司的双赢。In this embodiment, when receiving the claim application input by the investigator, the corresponding claim settlement case is generated and an investigation task is generated and sent to the investigator, and the investigator reports and investigates the case; and then, the receiving surveyor submits the report based on the survey task. The investigation report submits the claims case and the investigation report to the auditing node, and the auditing node conducts the audit to ensure the authenticity of the claim and prevent fraudulent insurance; when receiving the compensation order feedback from the auditing node, the claims are paid according to the claim. . In this embodiment, the customer report is saved, and the insurance company accepts and distributes the process of the investigator. The investigator can directly file the claim for claim settlement, and when the investigator completes the investigation and passes the audit of the audit node, the customer can directly conduct the settlement. Compared with the traditional claims process, the payment process greatly saves the time spent by the customer on the process, shortens the claim cycle, and enables the customer to get the payment quickly, especially in the event of a major accident; and, by reviewing the control of the node, the reduction is reduced. The risk of fraud in claims is protected by the interests of insurance companies, thereby achieving a win-win situation for both customers and insurance companies.
进一步的,参照图5,本申请案件理赔方法第二实施例提供一种案件理赔方法,基于上述本申请案件理赔方法第一实施例,所述步骤S10包括:Further, referring to FIG. 5, the second embodiment of the claim settlement method of the present application provides a method for claim settlement, which is based on the first embodiment of the claim settlement method of the present application, and the step S10 includes:
步骤S13、在收到所述调查人输入的理赔申请时,获取理赔申请中携带的被保人身份。Step S13: When receiving the claim application input by the investigator, obtain the identity of the insured person carried in the claim application.
当调查人到达事故现场后,调查人确定出险客户的身份,然后,将此客户作为被保人输入理赔申请。其中,理赔申请中包含此被保人的身份,例如姓名、身份证号、年龄等信息。服务器在收到调查人的理赔申请后,获取理赔申请中携带的被保人身份。When the investigator arrives at the scene of the accident, the investigator determines the identity of the insured customer and then enters the claim as the insured. Among them, the claims application contains the identity of the insured, such as name, ID number, age and other information. After receiving the claim form of the investigator, the server obtains the identity of the insured person carried in the claim application.
步骤S14、根据所述被保人身份查找所述被保人的全部保单,配置保单列表供所述调查人选择。Step S14: Search all the policies of the insured according to the insured identity, and configure a policy list for the surveyor to select.
在得到被保人身份后,服务器在数据库中,根据被保人身份查找被保人的全部保单,并将找到的全部保单配置成保单列表。表单列表中保单可以根据购买时间等进行排序。然后,服务器显示保单列表供调查人选择当前申请理赔的保单。调查人可以在保单列表页面通过勾选的方式进行保单的选择,过滤掉不合适的保单。例如,本次事故为车祸,则可能需要调查人选出车险保单、意外险保单等。需要说明的时,保单列表中可以仅显示各保单的购买时间、险种等信息,当然,还可以显示保单中的其他信息,可根据实际需要灵活配置。After obtaining the insured status, the server searches the database for all policies of the insured according to the insured status, and configures all the policies found as a policy list. The policies in the form list can be sorted according to the purchase time and the like. The server then displays a list of policies for the investigator to select the policy for which the claim is currently applied. Investigators can select the policy by checking the policy list page and filter out the inappropriate policy. For example, if the accident is a car accident, the investigator may need to choose a car insurance policy, an accident insurance policy, and the like. When it is necessary to explain, the policy list can display only the purchase time and insurance type of each policy. Of course, other information in the policy can also be displayed, which can be flexibly configured according to actual needs.
步骤S15、获取所述调查人基于所述保单列表选择的保单,对应配置理赔案件,并生成调查任务下发给所述调查人。Step S15: Acquire a policy selected by the surveyor based on the policy list, correspondingly configure a claim case, and generate a survey task and send the survey task to the surveyor.
当调查人在保单列表中选出需要申请理赔的保单,并确认后,服务器获取调查人选择的保单,对应配置理赔案件,并生成理赔案件的调查任务下发给此调查人,由此调查人进行调查。When the investigator selects the policy that needs to apply for the claim in the policy list, and confirms, the server obtains the policy selected by the investigator, correspondingly configures the claim case, and generates an investigation task for the claim case and sends it to the investigator, thereby the investigator Conduct an investigation.
本实施例在调查人提起理赔申请时,提供记载了被保人全部保单的保单列表供调查人选择,从而使调查人可以过滤掉不合适、本次不能申请理赔的保单,仅根据调查人选出的保单进行理赔立案,减轻了审核节点的工作量,加快了理赔案件的审核速度,也缩短了保险理赔的周期,能够提升客户体验。In this embodiment, when the investigator files a claim for claim, the list of policies that record all the policies of the insured is provided for the investigator to select, so that the investigator can filter out the policy that is inappropriate and cannot apply for claim, only according to the survey candidate. The issued insurance policy is filed, which reduces the workload of the audit node, speeds up the review of claims, and shortens the period of insurance claims, which can enhance the customer experience.
进一步地,参照图6,本申请案件理赔方法第三实施例提供一种保单理赔方法,基于上述本申请案件理赔方法第二实施例,所述步骤S15包括:Further, referring to FIG. 6, the third embodiment of the claim settlement method of the present application provides a policy claim method, based on the second embodiment of the claim settlement method of the present application, the step S15 includes:
步骤S151、在收到所述调查人基于所述保单列表选择的保单时,展示所述被选保单的条款以供选择。Step S151: When the policy selected by the surveyor based on the policy list is received, the terms of the selected policy are displayed for selection.
步骤S152、获取所述调查人选择的保单及条款,对应配置理赔案件,并生成调查任务下发给所述调查人。Step S152: Obtain a policy and a clause selected by the investigator, correspondingly configure a claim case, and generate an investigation task and send the investigation task to the investigator.
当服务器配置好保单列表,并展示给调查人选择时,若收到调查人基于保单列表选择的保单,则展示此被选保单的条款,供调查人选择。其中,保单的条款包括保单的保险责任、保险金额、附加条款等条目,以供调查人选择。调查人根据本次事故的实际情况,选择对应的条款,并确定。服务器在收到调查人选择保单条款后,根据调查人选择的保单及条款,对应配置理赔案件,并生成调查任务下发给所述调查人。When the server is configured with the policy list and displayed to the investigator for selection, if the policy selected by the surveyor based on the policy list is received, the terms of the selected policy are displayed for the investigator to select. Among them, the terms of the policy include the insurance liability of the policy, the amount of insurance, additional terms and other items for the investigator to choose. According to the actual situation of the accident, the investigator selects the corresponding terms and determines. After receiving the policy clause of the investigator, the server correspondingly configures the claim case according to the policy and terms selected by the investigator, and generates an investigation task and sends it to the investigator.
具体的,调查人可以根据保单的险种等信息选择本次理赔的保单。服务器在收到调查人选择的保单后,在数据库中查找此保单的保单内容,展示此保单内容的各项条款。同时,服务器还可以在保单内容中提取预设字段,得到保单编号、被保人身份信息、受益人信息等。调查人根据服务器提供的保单条款,选择本次进行理赔依据的条款,例如保险责任、保险金额、附加条款等,用于确定理赔责任和理赔金额等事项。调查人完成条款选择后进行确认。Specifically, the investigator can select the policy for this claim based on the insurance policy and other information. After receiving the policy selected by the investigator, the server looks up the policy content of the policy in the database and displays the terms of the policy. At the same time, the server can also extract the preset field in the policy content, and obtain the policy number, the insured identity information, the beneficiary information, and the like. According to the policy terms provided by the server, the investigator selects the terms of the claim basis, such as insurance liability, insurance amount, additional clauses, etc., to determine the claims liability and the amount of claims. The investigator confirms the selection of the terms.
服务器收到调查人选择的条款后,将保单编号、被保人身份信息、受益人信息等信息的字段,以及调查人选择的条款内容的字段,根据预设的填充规则,分别对应填入预设的案件配置模板中,生成理赔案件。理赔案件中记载的保单即为本次理赔依据的保单、记载的条款即为本次理赔依据的条款、记载的被保人也即本次发生事故需要申请理赔的被保人。After the server receives the terms selected by the investigator, the fields of the policy number, the insured identity information, the beneficiary information, and the fields of the terms selected by the investigator are filled in according to the preset filling rules. In the case configuration template, a claim case is generated. The policy written in the claim case is the policy on which the claim is based, and the written terms are the terms of the claim, and the insured person who is required to apply for the claim in this accident.
服务器还根据预设的编号规则,对应配置此理赔案件的案件编号。然后,服务器配置此理赔案件对应的调查任务,并获取配置此理赔案件的调查人,将配置的调查任务下发到此调查人的系统中,以供调查人执行调查任务。调查任务中包括理赔案件的各项信息,包括理赔依据的保单、被保人、理赔依据的条款等,以供调查人有目的的进行调查。The server also configures the case number of the claim case according to a preset numbering rule. Then, the server configures the investigation task corresponding to the claim case, and obtains the investigator who configures the claim case, and distributes the configured survey task to the surveyer's system for the surveyor to perform the survey task. The investigation task includes all the information of the claim case, including the policy on which the claim is based, the insured, the terms of the claim, etc., for the investigator to conduct the investigation purposefully.
需要说明的是,调查人可以分别选择多个保单及对应的条款,然后由服务器配置理赔案件,并生成调查任务下发给所述调查人。It should be noted that the investigator can separately select multiple policies and corresponding terms, and then the server configures the claim case and generates a survey task to be sent to the surveyor.
本实施例在调查人选择保单时,提供保单的条款供调查人选择,使调查人可以选出本次赔付依据的条款等,使得本此理赔更加有针对性,也减轻了审核节点的工作量,缩短了理赔周期。In this embodiment, when the investigator selects the policy, the terms of the policy are provided for the investigator to select, so that the investigator can select the terms of the claim, so that the claim is more targeted and the workload of the audit node is reduced. , shortened the claims cycle.
进一步地,参照图7,本申请案件理赔方法第四实施例提供一种案件理赔方法,基于上述本申请案件理赔方法第二或第三实施例(本实施例以本申请案件理赔方法第二实施例为例),所述步骤S14包括:Further, referring to FIG. 7, the fourth embodiment of the claim settlement method of the present application provides a method for claim settlement, based on the second or third embodiment of the claim settlement method of the present application (the second embodiment of the claim settlement method of the present application) For example, the step S14 includes:
步骤S141、根据所述被保人身份查找所述被保人的全部保单;Step S141: Search for all policies of the insured according to the insured identity;
步骤S142、在所述被保人的全部保单中筛选出在保险期限内保单,配置成保单列表供所述调查人选择。Step S142: Filter out the policy within the insurance period in all the policies of the insured, and configure the policy as a policy list for the investigator to select.
服务器在得到被保人身份后,在数据库中根据被保人身份查找被保人的全部保单。然后,服务器进行初步的过滤筛选,在全部保单内选出目前仍在保险期限内的保单,过滤掉已经过期的保单。其中,保险期限也称保险期间。根据保险合同,保险公司在约定的时间内对约定的保险事故负保险责任,这一约定时间就成为保险期限。然后,服务器使用目前仍在保险期限内的保单,配置成保单列表,供调查人选择本次申请理赔的保单。After obtaining the insured status, the server searches the database for all policies of the insured according to the insured status. Then, the server performs preliminary filtering and screening, selects the policies that are still in the insurance period in all the policies, and filters out the policies that have expired. Among them, the insurance period is also called the insurance period. According to the insurance contract, the insurance company is insured for the agreed insurance accident within the agreed time, and the agreed time becomes the insurance period. The server then uses the policy that is currently in the insurance period to be configured as a policy list for the investigator to choose the policy for the claim.
本实施例自动过滤掉了已经过期的保单,由于保险公司不赔付不在保险期限内的保单,因此,无需对这些不在保险期限内的保单进行立案,可以减少调查人和审核节点的工作量,提升理赔速度。In this embodiment, the policy that has expired is automatically filtered out. Since the insurance company does not pay the insurance policy that is not within the insurance period, it is not necessary to file a policy for these insurance policies, which can reduce the workload of the investigator and the audit node, and improve the workload. Claim speed.
进一步地,参照图8,本申请案件理赔方法第五实施例提供一种案件理赔方法,基于上述本申请案件理赔方法第三实施例,所述步骤S30包括:Further, referring to FIG. 8, the fifth embodiment of the claim settlement method of the present application provides a method for claim settlement, which is based on the third embodiment of the claim settlement method of the present application, and the step S30 includes:
步骤S33、在收到所述审核节点反馈的赔付指令时,根据所述赔付指令确定通过审核的保单及条款;Step S33, when receiving the compensation instruction fed back by the auditing node, determining the policy and terms of the approved audit according to the claim instruction;
步骤S34、根据所述通过审核的条款获取赔付款的金额,并获取所述通过审核的保单所绑定的受益人账户;Step S34: Obtain an amount of the payment payment according to the terms of the review, and obtain the beneficiary account bound to the policy that has passed the review;
步骤S35、使用电子支付,将所述赔付款转账至所述受益人账户。Step S35: Transfer the claim payment to the beneficiary account by using electronic payment.
服务器在收到审核节点反馈的赔付指令时,解析赔付指令,获取当前通过审核的保单和条款。然后,服务器根据通过审核的条款,获取客户签订保单时与保险公司约定的赔付款金额。例如,若车险保单通过审核,保单中的责任金额条款也通过审核,该条款中的预设字段即为赔付款金额的数值,因此通过读取责任金额条款中的预设字段可以获取此车险保单的赔付款金额。同时,服务器查询客户的预留信息,获取通过审核的保单所绑定的受益人账户。进一步地,若有多个保单及其条款通过了审核,则服务器分别根据各保单的受益人账户和各保单条款中的赔付款金额,对各保单进行赔付。When the server receives the compensation instruction feedback from the audit node, it parses the claim and obtains the policy and terms that are currently approved. Then, according to the terms of the audit, the server obtains the payment amount agreed with the insurance company when the customer signs the policy. For example, if the auto insurance policy is approved, the liability amount clause in the policy is also approved. The default field in the clause is the value of the payment payment amount. Therefore, the auto insurance policy can be obtained by reading the preset field in the liability amount clause. The amount of the payment. At the same time, the server queries the customer's reservation information and obtains the beneficiary account bound by the approved policy. Further, if there are multiple policies and their terms passed the review, the server will pay for each policy according to the beneficiary account of each policy and the payment amount in each policy clause.
然后,服务器使用电子支付,将赔付款转账到受益人账户中,进行赔付。The server then uses the electronic payment to transfer the payment to the beneficiary's account for payment.
本实施例中无需审核节点指定赔付款金额和受益人账户,实现了自动根据审核通过的保单及条款提取赔付款金额进行赔付,提高了案件理赔的智能化程度。In this embodiment, it is not necessary to audit the node to specify the payment amount and the beneficiary account, and realize the payment of the payment amount automatically according to the policy and terms passed the examination, thereby improving the intelligence degree of the case settlement.
此外,本申请实施例还提出一种案件理赔装置,所述案件理赔装置包括:In addition, the embodiment of the present application further provides a case claim device, where the claim claim device includes:
配案模块,用于在收到调查人输入的理赔申请时,对应配置理赔案件并生成调查任务下发给所述调查人;The matching module is configured to send a survey claim to the investigator when the claim for the claim entered by the investigator is received;
报告模块,用于接收所述调查人基于所述调查任务提交的调查报告,将所述理赔案件及所述调查报告提交给审核节点;a reporting module, configured to receive an investigation report submitted by the investigator based on the investigation task, and submit the claim case and the investigation report to an audit node;
赔付模块,用于在收到所述审核节点反馈的赔付指令时,根据所述赔付指令进行所述理赔案件的赔付。The claim module is configured to perform the payment of the claim case according to the claim instruction when receiving the payout instruction fed back by the audit node.
可选地,所述配案模块还用于,Optionally, the matching module is further used,
在收到所述调查人输入的理赔申请时,获取理赔申请中携带的被保人身份;根据所述被保人身份查找所述被保人的全部保单,配置保单列表供所述调查人选择;获取所述调查人基于所述保单列表选择的保单,对应配置理赔案件,并生成调查任务下发给所述调查人。Obtaining the identity of the insured person carried in the claim application when receiving the claim application input by the investigator; searching for all the policies of the insured person according to the insured person's identity, and configuring the policy list for the investigator to select Obtaining a policy selected by the surveyor based on the policy list, correspondingly configuring a claim case, and generating a survey task to be sent to the surveyor.
可选地,所述配案模块还用于,Optionally, the matching module is further used,
在收到所述调查人基于所述保单列表选择的保单时,展示所述被选保单的条款以供选择;获取所述调查人选择的保单及条款,对应配置理赔案件,并生成调查任务下发给所述调查人。Upon receiving the policy selected by the investigator based on the policy list, displaying the terms of the selected policy for selection; obtaining the policy and terms selected by the investigator, correspondingly configuring the claim case, and generating an investigation task Issued to the investigator.
可选地,所述配案模块还用于,Optionally, the matching module is further used,
根据所述被保人身份查找所述被保人的全部保单;在所述被保人的全部保单中筛选出在保险期限内保单,配置成保单列表供所述调查人选择。Finding all the policies of the insured according to the insured person's identity; screening out the policy within the insurance period in all the policies of the insured, and configuring the policy as a list of policies for the investigator to select.
可选地,所述赔付模块还用于,Optionally, the claim module is further configured to:
在收到所述审核节点反馈的赔付指令时,根据所述赔付指令获取赔付款金额及受益人账户;使用电子支付,将所述赔付款转账至所述受益人账户。Upon receiving the payment instruction fed back by the auditing node, the claim payment amount and the beneficiary account are obtained according to the claim instruction; and the claim payment is transferred to the beneficiary account using the electronic payment.
可选地,所述赔付模块还用于,Optionally, the claim module is further configured to:
在收到所述审核节点反馈的赔付指令时,根据所述赔付指令确定通过审核的保单及条款;根据所述通过审核的条款获取赔付款的金额,并获取所述通过审核的保单所绑定的受益人账户;使用电子支付,将所述赔付款转账至所述受益人账户。Upon receiving the payment instruction fed back by the auditing node, determining the policy and terms of the approved review according to the claim, and obtaining the amount of the payment according to the terms of the review, and obtaining the policy of the approved policy Beneficiary account; using electronic payment, the claim payment is transferred to the beneficiary account.
可选地,所述配案模块还用于,Optionally, the matching module is further used,
在收到所述调查人输入的理赔申请时,判断所述调查人是否具有理赔受理权限;若所述调查人具有理赔受理权限,则根据所述理赔申请对应配置理赔案件并生成调查任务下发给所述调查人。When receiving the claim for the claim entered by the investigator, determining whether the investigator has the claim accepting authority; if the investigator has the claim accepting authority, the claims claim is configured according to the claims request and the survey task is generated. To the investigator.
可选地,所述报告模块还用于,Optionally, the reporting module is further configured to:
回销所述调查任务。Resell the investigation task.
本申请案件理赔装置的具体实施例与上述案件理赔方法各实施例基本相同,在此不作赘述。The specific embodiment of the claim settlement device of the present application is substantially the same as the embodiment of the claim settlement method, and is not described herein.
此外,本申请实施例还提出一种计算机可读存储介质,所述计算机可读存储介质上存储有案件理赔程序,所述案件理赔程序被处理器执行时实现如下操作:In addition, the embodiment of the present application further provides a computer readable storage medium, where the computer claim storage medium stores a case claim program, and when the case claim program is executed by the processor, the following operations are implemented:
在收到调查人输入的理赔申请时,对应配置理赔案件并生成调查任务下发给所述调查人;When receiving the claim application input by the investigator, the corresponding claim settlement case is generated and an investigation task is generated and sent to the investigator;
接收所述调查人基于所述调查任务提交的调查报告,将所述理赔案件及所述调查报告提交给审核节点;Receiving the investigation report submitted by the investigator based on the investigation task, and submitting the claim case and the investigation report to the audit node;
在收到所述审核节点反馈的赔付指令时,根据所述赔付指令进行所述理赔案件的赔付。When receiving the compensation instruction fed back by the auditing node, the claims of the claim case are paid according to the claim.
进一步地,所述案件理赔程序被处理器执行时还实现如下操作:Further, when the case claim program is executed by the processor, the following operations are also implemented:
在收到所述调查人输入的理赔申请时,获取理赔申请中携带的被保人身份;Obtaining the identity of the insured person carried in the claim application when receiving the claim for the claim entered by the investigator;
根据所述被保人身份查找所述被保人的全部保单,配置保单列表供所述调查人选择;Finding all the policies of the insured according to the insured identity, and configuring a policy list for the investigator to select;
获取所述调查人基于所述保单列表选择的保单,对应配置理赔案件,并生成调查任务下发给所述调查人。Obtaining a policy selected by the surveyor based on the policy list, correspondingly configuring a claim case, and generating a survey task to be sent to the surveyor.
进一步地,所述案件理赔程序被处理器执行时还实现如下操作:Further, when the case claim program is executed by the processor, the following operations are also implemented:
在收到所述调查人基于所述保单列表选择的保单时,展示所述被选保单的条款以供选择;When the policy selected by the surveyor based on the policy list is received, the terms of the selected policy are displayed for selection;
获取所述调查人选择的保单及条款,对应配置理赔案件,并生成调查任务下发给所述调查人。Obtaining the policy and terms selected by the investigator, correspondingly configuring the claim case, and generating a survey task to be sent to the surveyor.
进一步地,所述案件理赔程序被处理器执行时还实现如下操作:Further, when the case claim program is executed by the processor, the following operations are also implemented:
根据所述被保人身份查找所述被保人的全部保单;Finding all the policies of the insured according to the insured person's identity;
在所述被保人的全部保单中筛选出在保险期限内保单,配置成保单列表供所述调查人选择。The policy of the insured person is selected in the policy of the insured person, and is configured as a policy list for the investigator to select.
进一步地,所述案件理赔程序被处理器执行时还实现如下操作:Further, when the case claim program is executed by the processor, the following operations are also implemented:
在收到所述审核节点反馈的赔付指令时,根据所述赔付指令获取赔付款金额及受益人账户;Upon receiving the payment instruction fed back by the auditing node, obtaining the payment amount and the beneficiary account according to the claim instruction;
使用电子支付,将所述赔付款转账至所述受益人账户。The electronic payment is used to transfer the payment to the beneficiary account.
进一步地,所述案件理赔程序被处理器执行时还实现如下操作:Further, when the case claim program is executed by the processor, the following operations are also implemented:
在收到所述审核节点反馈的赔付指令时,根据所述赔付指令确定通过审核的保单及条款;Upon receiving the payment instruction fed back by the auditing node, determining the policy and terms of the approved review according to the claim;
根据所述通过审核的条款获取赔付款的金额,并获取所述通过审核的保单所绑定的受益人账户;Obtaining the amount of the payment in accordance with the terms of the review, and obtaining the beneficiary account bound by the approved policy;
使用电子支付,将所述赔付款转账至所述受益人账户。The electronic payment is used to transfer the payment to the beneficiary account.
进一步地,所述案件理赔程序被处理器执行时还实现如下操作:Further, when the case claim program is executed by the processor, the following operations are also implemented:
在收到所述调查人输入的理赔申请时,判断所述调查人是否具有理赔受理权限;When receiving the claim for input by the investigator, determining whether the investigator has the right to claim compensation;
若所述调查人具有理赔受理权限,则根据所述理赔申请对应配置理赔案件并生成调查任务下发给所述调查人。If the investigator has the claim accepting authority, the claim settlement case is correspondingly configured according to the claims application, and an investigation task is generated and sent to the investigator.
进一步地,所述案件理赔程序被处理器执行时还实现如下操作:Further, when the case claim program is executed by the processor, the following operations are also implemented:
回销所述调查任务。Resell the investigation task.
本申请计算机可读存储介质的具体实施例与上述案件理赔方法各实施例基本相同,在此不作赘述。The specific embodiment of the computer readable storage medium of the present application is substantially the same as the embodiment of the method for claim settlement, and is not described herein.
需要说明的是,在本文中,术语“包括”、“包含”或者其任何其他变体意在涵盖非排他性的包含,从而使得包括一系列要素的过程、方法、物品或者系统不仅包括那些要素,而且还包括没有明确列出的其他要素,或者是还包括为这种过程、方法、物品或者系统所固有的要素。在没有更多限制的情况下,由语句“包括一个……”限定的要素,并不排除在包括该要素的过程、方法、物品或者系统中还存在另外的相同要素。It is to be understood that the term "comprises", "comprising", or any other variants thereof, is intended to encompass a non-exclusive inclusion, such that a process, method, article, or It also includes other elements that are not explicitly listed, or elements that are inherent to such a process, method, item, or system. An element defined by the phrase "comprising a ..." does not exclude the presence of additional equivalent elements in a process, method, article, or system that includes the element, without further limitation.
上述本申请实施例序号仅仅为了描述,不代表实施例的优劣。The serial numbers of the embodiments of the present application are merely for the description, and do not represent the advantages and disadvantages of the embodiments.
通过以上的实施方式的描述,本领域的技术人员可以清楚地了解到上述实施例方法可借助软件加必需的通用硬件平台的方式来实现,当然也可以通过硬件,但很多情况下前者是更佳的实施方式。基于这样的理解,本申请的技术方案本质上或者说对现有技术做出贡献的部分可以以软件产品的形式体现出来,该计算机软件产品存储在如上所述的一个存储介质(如ROM/RAM、磁碟、光盘)中,包括若干指令用以使得一台终端设备(可以是手机,计算机,服务器,空调器,或者网络设备等)执行本申请各个实施例所述的方法。Through the description of the above embodiments, those skilled in the art can clearly understand that the foregoing embodiment method can be implemented by means of software plus a necessary general hardware platform, and of course, can also be through hardware, but in many cases, the former is better. Implementation. Based on such understanding, the technical solution of the present application, which is essential or contributes to the prior art, may be embodied in the form of a software product stored in a storage medium (such as ROM/RAM as described above). , a disk, an optical disk, including a number of instructions for causing a terminal device (which may be a mobile phone, a computer, a server, an air conditioner, or a network device, etc.) to perform the methods described in the various embodiments of the present application.
以上仅为本申请的可选实施例,并非因此限制本申请的专利范围,凡是利用本申请说明书及附图内容所作的等效结构或等效流程变换,或直接或间接运用在其他相关的技术领域,均同理包括在本申请的专利保护范围内。The above is only an alternative embodiment of the present application, and thus does not limit the scope of the patent application, and the equivalent structure or equivalent process transformation made by the specification and the drawings of the present application, or directly or indirectly applied to other related technologies. The fields are all included in the scope of patent protection of this application.

Claims (20)

  1. 一种案件理赔方法,其特征在于,所述案件理赔方法包括以下步骤: A case claim method, characterized in that the claim claim method comprises the following steps:
    在收到调查人输入的理赔申请时,对应配置理赔案件并生成调查任务下发给所述调查人;When receiving the claim application input by the investigator, the corresponding claim settlement case is generated and an investigation task is generated and sent to the investigator;
    接收所述调查人基于所述调查任务提交的调查报告,将所述理赔案件及所述调查报告提交给审核节点;Receiving the investigation report submitted by the investigator based on the investigation task, and submitting the claim case and the investigation report to the audit node;
    在收到所述审核节点反馈的赔付指令时,根据所述赔付指令进行所述理赔案件的赔付。When receiving the compensation instruction fed back by the auditing node, the claims of the claim case are paid according to the claim.
  2. 如权利要求1所述的案件理赔方法,其特征在于,所述在收到调查人输入的理赔申请时,对应配置理赔案件并生成调查任务下发给所述调查人的步骤包括:The method for claim settlement according to claim 1, wherein when the claim for the claim entered by the investigator is received, the step of assigning the claim case and generating the survey task to the investigator includes:
    在收到所述调查人输入的理赔申请时,获取理赔申请中携带的被保人身份;Obtaining the identity of the insured person carried in the claim application when receiving the claim for the claim entered by the investigator;
    根据所述被保人身份查找所述被保人的全部保单,配置保单列表供所述调查人选择;Finding all the policies of the insured according to the insured identity, and configuring a policy list for the investigator to select;
    获取所述调查人基于所述保单列表选择的保单,对应配置理赔案件,并生成调查任务下发给所述调查人。Obtaining a policy selected by the surveyor based on the policy list, correspondingly configuring a claim case, and generating a survey task to be sent to the surveyor.
  3. 如权利要求2所述的案件理赔方法,其特征在于,所述获取所述调查人基于所述保单列表选择的保单,对应配置理赔案件,并生成调查任务下发给所述调查人的步骤包括:The method for claim settlement according to claim 2, wherein the obtaining the policy selected by the surveyor based on the policy list, corresponding to configuring the claim case, and generating the survey task to be sent to the surveyor includes: :
    在收到所述调查人基于所述保单列表选择的保单时,展示所述被选保单的条款以供选择;When the policy selected by the surveyor based on the policy list is received, the terms of the selected policy are displayed for selection;
    获取所述调查人选择的保单及条款,对应配置理赔案件,并生成调查任务下发给所述调查人。Obtaining the policy and terms selected by the investigator, correspondingly configuring the claim case, and generating a survey task to be sent to the surveyor.
  4. 如权利要求2所述的案件理赔方法,其特征在于,所述根据所述被保人身份查找所述被保人的全部保单,配置保单列表供所述调查人选择的步骤包括:The method for claim settlement according to claim 2, wherein the step of searching for the policy of the insured according to the insured person's identity and configuring the policy list for the surveyor to select includes:
    根据所述被保人身份查找所述被保人的全部保单;Finding all the policies of the insured according to the insured person's identity;
    在所述被保人的全部保单中筛选出在保险期限内保单,配置成保单列表供所述调查人选择。The policy of the insured person is selected in the policy of the insured person, and is configured as a policy list for the investigator to select.
  5. 如权利要求1所述的案件理赔方法,其特征在于,所述在收到所述审核节点反馈的赔付指令时,根据所述赔付指令进行所述理赔案件的赔付的步骤包括:The method for claim settlement according to claim 1, wherein the step of performing payment of the claim case according to the claim instruction when receiving the payout instruction fed back by the audit node comprises:
    在收到所述审核节点反馈的赔付指令时,根据所述赔付指令获取赔付款金额及受益人账户;Upon receiving the payment instruction fed back by the auditing node, obtaining the payment amount and the beneficiary account according to the claim instruction;
    使用电子支付,将所述赔付款转账至所述受益人账户。The electronic payment is used to transfer the payment to the beneficiary account.
  6. 如权利要求3所述的案件理赔方法,其特征在于,所述在收到所述审核节点反馈的赔付指令时,根据所述赔付指令进行所述理赔案件的赔付的步骤包括:The method for claim settlement according to claim 3, wherein the step of performing the claim of the claim case according to the claim instruction when receiving the payout instruction fed back by the audit node comprises:
    在收到所述审核节点反馈的赔付指令时,根据所述赔付指令确定通过审核的保单及条款;Upon receiving the payment instruction fed back by the auditing node, determining the policy and terms of the approved review according to the claim;
    根据所述通过审核的条款获取赔付款的金额,并获取所述通过审核的保单所绑定的受益人账户;Obtaining the amount of the payment in accordance with the terms of the review, and obtaining the beneficiary account bound by the approved policy;
    使用电子支付,将所述赔付款转账至所述受益人账户。The electronic payment is used to transfer the payment to the beneficiary account.
  7. 如权利要求1所述的案件理赔方法,其特征在于,所述在收到调查人输入的理赔申请时,对应配置理赔案件并生成调查任务下发给所述调查人的步骤包括:The method for claim settlement according to claim 1, wherein when the claim for the claim entered by the investigator is received, the step of assigning the claim case and generating the survey task to the investigator includes:
    在收到所述调查人输入的理赔申请时,判断所述调查人是否具有理赔受理权限;When receiving the claim for input by the investigator, determining whether the investigator has the right to claim compensation;
    若所述调查人具有理赔受理权限,则根据所述理赔申请对应配置理赔案件并生成调查任务下发给所述调查人。If the investigator has the claim accepting authority, the claim settlement case is correspondingly configured according to the claims application, and an investigation task is generated and sent to the investigator.
  8. 如权利要求1所述的案件理赔方法,其特征在于,所述接收所述调查人基于所述调查任务提交的调查报告,将所述理赔案件及所述调查报告提交给审核节点的步骤之后,还包括:The method for claim settlement according to claim 1, wherein the receiving the investigation person submits the claim report and the investigation report to the audit node based on the investigation report submitted by the investigation task, Also includes:
    回销所述调查任务。Resell the investigation task.
  9. 一种案件理赔装置,其特征在于,所述案件理赔装置包括:A case claim device, characterized in that the case claim device comprises:
    配案模块,用于在收到调查人输入的理赔申请时,对应配置理赔案件并生成调查任务下发给所述调查人;The matching module is configured to send a survey claim to the investigator when the claim for the claim entered by the investigator is received;
    报告模块,用于接收所述调查人基于所述调查任务提交的调查报告,将所述理赔案件及所述调查报告提交给审核节点;a reporting module, configured to receive an investigation report submitted by the investigator based on the investigation task, and submit the claim case and the investigation report to an audit node;
    赔付模块,用于在收到所述审核节点反馈的赔付指令时,根据所述赔付指令进行所述理赔案件的赔付。The claim module is configured to perform the payment of the claim case according to the claim instruction when receiving the payout instruction fed back by the audit node.
  10. 如权利要求9所述的案件理赔装置,其特征在于,所述配案模块还用于,The case claim apparatus according to claim 9, wherein said matching module is further used for
    在收到所述调查人输入的理赔申请时,获取理赔申请中携带的被保人身份;根据所述被保人身份查找所述被保人的全部保单,配置保单列表供所述调查人选择;获取所述调查人基于所述保单列表选择的保单,对应配置理赔案件,并生成调查任务下发给所述调查人。Obtaining the identity of the insured person carried in the claim application when receiving the claim application input by the investigator; searching for all the policies of the insured person according to the insured person's identity, and configuring the policy list for the investigator to select Obtaining a policy selected by the surveyor based on the policy list, correspondingly configuring a claim case, and generating a survey task to be sent to the surveyor.
  11. 如权利要求10所述的案件理赔装置,其特征在于,所述配案模块还用于,The case claim apparatus according to claim 10, wherein said matching module is further configured to:
    在收到所述调查人基于所述保单列表选择的保单时,展示所述被选保单的条款以供选择;获取所述调查人选择的保单及条款,对应配置理赔案件,并生成调查任务下发给所述调查人。Upon receiving the policy selected by the investigator based on the policy list, displaying the terms of the selected policy for selection; obtaining the policy and terms selected by the investigator, correspondingly configuring the claim case, and generating an investigation task Issued to the investigator.
  12. 如权利要求10所述的案件理赔装置,其特征在于,所述配案模块还用于,The case claim apparatus according to claim 10, wherein said matching module is further configured to:
    根据所述被保人身份查找所述被保人的全部保单;在所述被保人的全部保单中筛选出在保险期限内保单,配置成保单列表供所述调查人选择。Finding all the policies of the insured according to the insured person's identity; screening out the policy within the insurance period in all the policies of the insured, and configuring the policy as a list of policies for the investigator to select.
  13. 一种服务器,其特征在于,所述服务器包括:存储器、处理器及存储在所述存储器上并可在所述处理器上运行的案件理赔程序,所述案件理赔程序被所述处理器执行时实现如下步骤:A server, comprising: a memory, a processor, and a case claim program stored on the memory and operable on the processor, when the case claim program is executed by the processor Implement the following steps:
    在收到调查人输入的理赔申请时,对应配置理赔案件并生成调查任务下发给所述调查人;When receiving the claim application input by the investigator, the corresponding claim settlement case is generated and an investigation task is generated and sent to the investigator;
    接收所述调查人基于所述调查任务提交的调查报告,将所述理赔案件及所述调查报告提交给审核节点;Receiving the investigation report submitted by the investigator based on the investigation task, and submitting the claim case and the investigation report to the audit node;
    在收到所述审核节点反馈的赔付指令时,根据所述赔付指令进行所述理赔案件的赔付。When receiving the compensation instruction fed back by the auditing node, the claims of the claim case are paid according to the claim.
  14. 如权利要求13所述的服务器,其特征在于,所述案件理赔程序被所述处理器执行时还实现如下步骤:The server according to claim 13, wherein said case claim program is further executed as follows when said processor is executed by said processor:
    在收到所述调查人输入的理赔申请时,获取理赔申请中携带的被保人身份;Obtaining the identity of the insured person carried in the claim application when receiving the claim for the claim entered by the investigator;
    根据所述被保人身份查找所述被保人的全部保单,配置保单列表供所述调查人选择;Finding all the policies of the insured according to the insured identity, and configuring a policy list for the investigator to select;
    获取所述调查人基于所述保单列表选择的保单,对应配置理赔案件,并生成调查任务下发给所述调查人。Obtaining a policy selected by the surveyor based on the policy list, correspondingly configuring a claim case, and generating a survey task to be sent to the surveyor.
  15. 如权利要求14所述的服务器,其特征在于,所述案件理赔程序被所述处理器执行时还实现如下步骤:The server according to claim 14, wherein said case claim program is further executed as follows when said processor is executed by said processor:
    在收到所述调查人基于所述保单列表选择的保单时,展示所述被选保单的条款以供选择;When the policy selected by the surveyor based on the policy list is received, the terms of the selected policy are displayed for selection;
    获取所述调查人选择的保单及条款,对应配置理赔案件,并生成调查任务下发给所述调查人。Obtaining the policy and terms selected by the investigator, correspondingly configuring the claim case, and generating a survey task to be sent to the surveyor.
  16. 如权利要求14所述的服务器,其特征在于,所述案件理赔程序被所述处理器执行时还实现如下步骤:The server according to claim 14, wherein said case claim program is further executed as follows when said processor is executed by said processor:
    根据所述被保人身份查找所述被保人的全部保单;Finding all the policies of the insured according to the insured person's identity;
    在所述被保人的全部保单中筛选出在保险期限内保单,配置成保单列表供所述调查人选择。The policy of the insured person is selected in the policy of the insured person, and is configured as a policy list for the investigator to select.
  17. 一种计算机可读存储介质,其特征在于,所述计算机可读存储介质上存储有案件理赔程序,所述案件理赔程序被处理器执行时实现如下步骤:A computer readable storage medium, wherein the computer readable storage medium stores a case claim program, and when the case claim program is executed by the processor, the following steps are implemented:
    在收到调查人输入的理赔申请时,对应配置理赔案件并生成调查任务下发给所述调查人;When receiving the claim application input by the investigator, the corresponding claim settlement case is generated and an investigation task is generated and sent to the investigator;
    接收所述调查人基于所述调查任务提交的调查报告,将所述理赔案件及所述调查报告提交给审核节点;Receiving the investigation report submitted by the investigator based on the investigation task, and submitting the claim case and the investigation report to the audit node;
    在收到所述审核节点反馈的赔付指令时,根据所述赔付指令进行所述理赔案件的赔付。When receiving the compensation instruction fed back by the auditing node, the claims of the claim case are paid according to the claim.
  18. 如权利要求17所述的计算机可读存储介质,其特征在于,所述案件理赔程序被所述处理器执行时还实现如下步骤:The computer readable storage medium of claim 17, wherein the case claim program is further executed by the processor to:
    在收到所述调查人输入的理赔申请时,获取理赔申请中携带的被保人身份;Obtaining the identity of the insured person carried in the claim application when receiving the claim for the claim entered by the investigator;
    根据所述被保人身份查找所述被保人的全部保单,配置保单列表供所述调查人选择;Finding all the policies of the insured according to the insured identity, and configuring a policy list for the investigator to select;
    获取所述调查人基于所述保单列表选择的保单,对应配置理赔案件,并生成调查任务下发给所述调查人。Obtaining a policy selected by the surveyor based on the policy list, correspondingly configuring a claim case, and generating a survey task to be sent to the surveyor.
  19. 如权利要求18所述的计算机可读存储介质,其特征在于,所述案件理赔程序被所述处理器执行时还实现如下步骤:The computer readable storage medium of claim 18, wherein the case claim program is further executed by the processor to:
    在收到所述调查人基于所述保单列表选择的保单时,展示所述被选保单的条款以供选择;When the policy selected by the surveyor based on the policy list is received, the terms of the selected policy are displayed for selection;
    获取所述调查人选择的保单及条款,对应配置理赔案件,并生成调查任务下发给所述调查人。Obtaining the policy and terms selected by the investigator, correspondingly configuring the claim case, and generating a survey task to be sent to the surveyor.
  20. 如权利要求18所述的计算机可读存储介质,其特征在于,所述案件理赔程序被所述处理器执行时还实现如下步骤:The computer readable storage medium of claim 18, wherein the case claim program is further executed by the processor to:
    根据所述被保人身份查找所述被保人的全部保单;Finding all the policies of the insured according to the insured person's identity;
    在所述被保人的全部保单中筛选出在保险期限内保单,配置成保单列表供所述调查人选择。 The policy of the insured person is selected in the policy of the insured person, and is configured as a policy list for the investigator to select.
PCT/CN2018/082622 2017-06-26 2018-04-11 Case claim method, device, server and computer readable storage medium WO2019001087A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
CN201710497417.7A CN108335215A (en) 2017-06-26 2017-06-26 Case Claims Resolution method, server and computer readable storage medium
CN201710497417.7 2017-06-26

Publications (1)

Publication Number Publication Date
WO2019001087A1 true WO2019001087A1 (en) 2019-01-03

Family

ID=62922323

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CN2018/082622 WO2019001087A1 (en) 2017-06-26 2018-04-11 Case claim method, device, server and computer readable storage medium

Country Status (2)

Country Link
CN (1) CN108335215A (en)
WO (1) WO2019001087A1 (en)

Families Citing this family (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN110033227A (en) * 2018-11-28 2019-07-19 阿里巴巴集团控股有限公司 Data processing method, calculates equipment and storage medium at device
CN111260480A (en) * 2018-11-30 2020-06-09 重庆小雨点小额贷款有限公司 Claims settlement method, server, terminal device and storage medium
CN109360113B (en) * 2018-12-14 2021-04-13 泰康保险集团股份有限公司 Automatic policy adjustment method, device, medium and electronic equipment
CN110163005B (en) * 2019-04-10 2023-06-06 创新先进技术有限公司 Block chain-based service processing method, system, computing device and storage medium
CN111401831A (en) * 2020-03-04 2020-07-10 平安医疗健康管理股份有限公司 Task progress display method, device and equipment and readable storage medium
CN111967999A (en) * 2020-08-27 2020-11-20 平安养老保险股份有限公司 Investigation processing method, device, computer equipment and storage medium
CN112581078A (en) * 2020-12-02 2021-03-30 五八到家有限公司 Method and device for processing violation data of worker and storage medium
CN112767180A (en) * 2021-01-06 2021-05-07 大童保险销售服务有限公司 Method and device for generating insurance case public estimation report and storage medium
CN114092120A (en) * 2021-12-01 2022-02-25 广州品唯软件有限公司 Method, device, equipment and readable storage medium for paying and determining responsibility

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104240130A (en) * 2013-10-14 2014-12-24 王升 Investment and financing method using venture investment and financing system and venture investment and financing system
CN106022998A (en) * 2016-05-05 2016-10-12 重庆法云科技有限公司 Legal transaction processing method and device
CN106682987A (en) * 2016-11-21 2017-05-17 中国平安财产保险股份有限公司 Property insurance claim settlement realization method and realization system thereof
CN106709696A (en) * 2016-11-21 2017-05-24 中国平安财产保险股份有限公司 Self-service claim settlement realization method and system

Family Cites Families (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN105354743A (en) * 2015-12-07 2016-02-24 中国建设银行股份有限公司 Data processing method and device
CN105847376A (en) * 2016-04-11 2016-08-10 深圳市永兴元科技有限公司 Vehicle insurance assessment system and method
CN106529896B (en) * 2016-09-26 2018-06-22 平安科技(深圳)有限公司 The method and Claims Resolution server surveyed based on Claims Resolution

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN104240130A (en) * 2013-10-14 2014-12-24 王升 Investment and financing method using venture investment and financing system and venture investment and financing system
CN106022998A (en) * 2016-05-05 2016-10-12 重庆法云科技有限公司 Legal transaction processing method and device
CN106682987A (en) * 2016-11-21 2017-05-17 中国平安财产保险股份有限公司 Property insurance claim settlement realization method and realization system thereof
CN106709696A (en) * 2016-11-21 2017-05-24 中国平安财产保险股份有限公司 Self-service claim settlement realization method and system

Also Published As

Publication number Publication date
CN108335215A (en) 2018-07-27

Similar Documents

Publication Publication Date Title
WO2019001087A1 (en) Case claim method, device, server and computer readable storage medium
WO2018233351A1 (en) Self-service claim method and device, server, and computer readable storage medium
WO2019037396A1 (en) Account clearing method, device and equipment and storage medium
WO2018107610A1 (en) Service data processing method, system and device, and computer-readable storage medium
WO2019019493A1 (en) Data sharing method and device, and computer readable storage medium
WO2019109521A1 (en) Identity approval method, apparatus and device for video interview, and readable storage medium
WO2019090986A1 (en) Adjustment method and device for insurance claim settlement case
WO2019104876A1 (en) Insurance product pushing method and system, terminal, client terminal, and storage medium
WO2018166314A1 (en) Limit approval method, apparatus and device, and computer-readable storage medium
WO2019061612A1 (en) Loan product promotion method and apparatus, and computer-readable storage medium
WO2019061614A1 (en) Loan product matching method, apparatus and computer-readable storage medium
WO2019061613A1 (en) Loan qualification screening method, device and computer readable storage medium
WO2019015232A1 (en) Remittance processing method and system, and computer-readable storage medium
WO2019090984A1 (en) Policy liability detail checking method and device
WO2019109520A1 (en) Video interview work assignment method, apparatus and device, and readable storage medium
WO2019140804A1 (en) Suspicious transaction monitoring method, device, and apparatus, and storage medium
WO2018036151A1 (en) Insurance policy processing method, apparatus, device, and computer readable storage medium
WO2018155846A1 (en) Agency payment system, server and controlling method thereof
WO2019000800A1 (en) Credential preparation method, apparatus, and device and computer readable storage medium
WO2018233301A1 (en) Product recommendation method, apparatus, and device, and computer readable storage medium
WO2019100604A1 (en) Account inquiry method, apparatus, device, and computer readable storage medium
WO2018201699A1 (en) Customer evaluation method, device, and apparatus, and computer readable storage medium
WO2018080264A1 (en) Real estate transaction service providing method and server
WO2019051866A1 (en) Right and interest information management method, device, and apparatus, and computer-readable storage medium
WO2017012198A1 (en) Electronic examination letter-based examination institution automatic matching method and network hospital platform

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 18823806

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

32PN Ep: public notification in the ep bulletin as address of the adressee cannot be established

Free format text: NOTING OF LOSS OF RIGHTS PURSUANT TO RULE 112(1) EPC (EPO FORM 1205A DATED 20/05/2020)

122 Ep: pct application non-entry in european phase

Ref document number: 18823806

Country of ref document: EP

Kind code of ref document: A1