WO2019041912A1

WO2019041912A1 - Method and apparatus for assigning claim settlement case, computer device, and storage medium

Info

Publication number: WO2019041912A1
Application number: PCT/CN2018/088567
Authority: WO
Inventors: 王雯; 朱晓宇
Original assignee: 平安科技（深圳）有限公司
Priority date: 2017-08-28
Filing date: 2018-05-27
Publication date: 2019-03-07
Also published as: CN107909232B; CN107909232A

Abstract

A method for assigning a claim settlement case, comprising: receiving a claim settlement case review request initiated by a first management terminal, the claim settlement case review request carrying a first user identifier corresponding to the first management terminal, and the first user identifier being used for uniquely identifying the user initiating the claim settlement case review request; searching a claim settlement case queue to be assigned for a first claim settlement case, wherein the first claim settlement case has the same application type and insurant identifier as a queue head claim settlement case, and the difference between the claim settlement application time of the first claim settlement case and the claim settlement application time of the queue head claim settlement case does not exceed a first preset time threshold; and assigning the first claim settlement case to the first management terminal corresponding to the first user identifier.

Description

Claim case allocation method, device, computer device and storage medium

This application claims to be filed on August 28, 2017, the Chinese Patent Office, the application number is 2017107519855, the priority of the Chinese patent application entitled "Methods, Apparatus, Storage Media and Computer Equipment for Claims Case Assignment", the entire contents of which are incorporated by reference. Combined in this application.

Technical field

The present application relates to a claim case allocation method, apparatus, computer device and storage medium.

Background technique

The same customer may involve multiple types of insurance policies, such as the same type of insurance that the same customer purchased multiple insurance institutions in the same company, such as the customer who purchased the medical insurance of the Ping An Insurance Company in Shanghai and the medical insurance of the Shenzhen Insurance Company. The customer has a personal medical insurance policy from a Shanghai institution and a Shenzhen institution, or the company in which the customer is located has uniformly purchased medical insurance for the employee. All employees have a group policy, and each employee (including the employee) also corresponds to A group sub-policy.

Due to the 7*24-hour service provided by the self-service claims system, customers can apply for multiple claims within one day. When a customer frequently makes a claim for a short period of time, the traditional claim case processing method distributes the received claims case concurrently, and it is easy to assign multiple types of claims cases involving the same customer to different reviewers at the same time, and Because of the relevance of these claims cases, such as the cost of hospitalization for customers 2,000 yuan, the Shanghai organization of Ping An Insurance Company has already paid 1,000 yuan, the amount of compensation for the Shenzhen Insurance Company of Ping An Insurance Company shall not exceed 1,000 yuan, and the amount of compensation paid by each institution shall not be Exceeding the total amount of insurance, etc., these claims cases are cross-interlocked, resulting in inefficient processing of claims.

Summary of the invention

According to various embodiments disclosed herein, a claim case allocation method, apparatus, computer device, and storage medium are provided.

A method for allocating claims cases, including:

Receiving, by the first management terminal, a claims case review request, where the claim case review request carries a first user identifier corresponding to the first management terminal, where the first user identifier is used to uniquely identify the claim for initiating the claim case user;

Finding, in the queue of claims to be distributed, the first claim case that is the same as the application type and the risk person identification of the team leader claim case and the claim application time does not exceed the first preset time threshold; and

And assigning the first claim case to the first management terminal corresponding to the first user identifier.

A claim case distribution device comprising:

The claim case review request receiving module receives the claim case review request initiated by the first management terminal, and the claim case review request carries a first user identifier corresponding to the first management terminal, where the first user identifier is used for unique identifier initiation The user of the claims review request;

The claim case finding module is configured to search for a first claim case in which the application type and the risk person identification of the team leader claim case are the same and the claim application time differs by no more than the first preset time threshold in the queue to be distributed claims;

The claim case allocation module allocates the first claim case to the first management terminal corresponding to the first user identifier.

A computer device comprising a memory and one or more processors having stored therein computer readable instructions, the computer readable instructions being executable by the processor to cause the one or more processors to execute The following steps:

One or more non-volatile storage media storing computer readable instructions, when executed by one or more processors, cause one or more processors to perform the following steps:

Details of one or more embodiments of the present application are set forth in the accompanying drawings and description below. Other features and advantages of the present invention will be apparent from the description, drawings and claims.

DRAWINGS

In order to more clearly illustrate the technical solutions in the embodiments of the present application, the drawings to be used in the embodiments will be briefly described below. Obviously, the drawings in the following description are only some embodiments of the present application, Those skilled in the art can also obtain other drawings based on these drawings without any creative work.

1 is an application environment diagram of a claim case allocation method in accordance with one or more embodiments.

2 is a block diagram of a computer device in accordance with one or more embodiments.

3 is a flow diagram of a method of assigning a claim case in accordance with one or more embodiments.

4 is a flowchart of a method for assigning a first claim case to the first management terminal corresponding to the first user identifier of FIG. 3 according to one or more embodiments.

FIG. 5 is a flowchart of a method for allocating a first claim case to the first management terminal corresponding to the first user identifier of FIG. 3 in another embodiment.

6 is a flow chart of a method for assigning claim cases in another embodiment.

7 is a block diagram of a claim case assigning device in accordance with one or more embodiments.

Detailed ways

In order to make the technical solutions and advantages of the present application more clear, the present application will be further described in detail below with reference to the accompanying drawings and embodiments. It is understood that the specific embodiments described herein are merely illustrative of the application and are not intended to be limiting.

The transaction rollback method provided by the embodiment of the present application can be applied to the environment as shown in FIG. 1. Server 102 communicates with terminal 104 over a network. The server 102 receives the claim case review request sent by the terminal 104, and distributes the found claim case to the terminal 104. Specifically, the server 102 communicates with the terminal 104 through the network, and the server 102 receives the claim case review request sent by the terminal 104, and finds the same application type and the claimant identification as the claim type of the team leader claim case in the queue to be distributed claims case The first claim case is assigned to the terminal 104 in a claim case in which the time difference does not exceed the preset time threshold. The terminal 104 is operated by an auditor for reviewing the claim case, and the auditor is a user who has the authority to review the claim case. Server 102 can be implemented as a standalone server or as a server cluster of multiple servers. Terminals 104 can be, but are not limited to, various personal computers, notebook computers, smart phones, tablets, portable wearable devices, and the like.

In one of the embodiments, a computer device is provided, the internal structure of which may be as shown in FIG. 2, which may be the server shown in FIG. 1. The computer device includes a processor connected by a system bus, a non-volatile storage medium, an internal memory, and a network connection port. The non-volatile storage medium can be a non-transitory computer readable storage medium. An operating system and computer readable instructions are stored in the non-volatile storage medium for implementing the medical service reservation method applicable to the server provided in the embodiments of the present application. This processor is used to improve computing and control capabilities and support the operation of the entire server. The internal memory is used to provide an environment for the operation of operating systems and computer readable instructions in a non-volatile storage medium. The network interface is used for network communication with the terminal. It will be understood by those skilled in the art that the structure shown in FIG. 2 is only a block diagram of a part of the structure related to the solution of the present application, and does not constitute a limitation on the server to which the solution of the present application is applied. Specifically, the server may include a ratio. More or fewer components are shown in the figures, or some components are combined, or have different component arrangements.

In one embodiment, as shown in FIG. 3, a claim case allocation method is provided. The method is applied to the server in FIG. 1 as an example, and includes the following steps:

Step 302: Receive a claim for reviewing a claim case initiated by the first management terminal, where the claim for reviewing the case carries a first user identifier corresponding to the first management terminal, where the first user identifier is used to uniquely identify the user who initiated the claim for reviewing the claim case.

The claim case is a case for compensation processing according to the claim materials provided by the customer and the purchased insurance; the first management terminal is a terminal used by the auditor who sends the request for the claim case stored in the audit database to the server; the first user identifier is used for unique Identify the user who initiated the claim for review of the claims case.

The claim case review request received by the server is a claim case review request sent by the first management terminal to the server through the first user identifier.

Step 304: Find a first claim case in which the application type and the risk person identification of the team leader claim case are the same and the claim application time does not exceed the first preset time threshold in the queue to be assigned claims.

The claim to be distributed is a claim case that is awaiting review in the received claims case; the team first claim case is a claim case located at the head of the queue to be assigned the claim case; the application type is the type of insurance on the policy corresponding to the claim case For example, the application type of the claim case is property insurance or personal insurance; the risk person identification is used to uniquely identify the claimant of the claim case, specifically, it may be a logo composed of a custom string, or may be a user's ID number, etc. The first preset time threshold is a time interval, such as 5 hours, calculated by the same customer to frequently apply for claims by analyzing data such as the application time of a large number of received claims cases.

In the first claim case in which the claimant ID and the application type of the team settlement claim case are the same and the claim application time differs by no more than the first preset time threshold, the search order is from the to-be-distributed claim. The team leader of the case queue starts, and then searches backwards until the end of the queue of the claims case to be assigned, that is, the first claim case found includes the team leader claim case.

Step 306: Assign the first claim case to the first management terminal corresponding to the first user identifier.

After finding the different claims cases associated with the same insured person, the found claims are assigned to the management terminal where the same user ID is located, so that the management terminal sequentially reviews the assigned claims cases through the user identification.

In the above-mentioned claim case allocation method, since the found claim case is the same type of insurance corresponding to the same type of insurance in the preset time range and different types of claims, the case is assigned to the same reviewer for review. It effectively reduces the probability of interlocking claims cases due to the concurrent allocation of claims cases, thus improving the processing efficiency of claims cases.

In one embodiment, step 306 includes: if the number of the first claim cases is less than or equal to the preset number of case processing, assigning the first claim case to the first management terminal corresponding to the first user identifier.

The preset number of cases handled is the maximum number of pre-configured auditors to handle claims. Specifically, the number of default claims cases can be the same value shared by all auditors, such as the default claims case corresponding to the auditor. The number is 80, or it can be dynamically set according to the default number of cases in which the default case reviewer is within the preset time range. For example, the average number of auditors per auditor A in the first quarter is 100. In the first quarter, the average number of audits per day in the first quarter is 90. In the first quarter, the average number of audits per day in the first quarter is 80. The number of default claims cases corresponding to A, B, and C is 100, 90 and 80.

In this embodiment, the efficiency of the claim settlement is improved by limiting the number of claims assigned to the auditor.

In one embodiment, as shown in FIG. 4, step 306 includes:

Step 316: Obtain a processing status of the second claim case in the assigned claim case that is the same as the application type and the issuer identifier of the first claim case.

The processing status of claims cases includes: five statuses to be reviewed, reviewed, pending, adjusted, and closed. When the server receives the claim case entered by the user, the claim case is marked as pending review, and the claim case is placed in the task pool, and the server then puts the claim case into the queue of the claim settlement case according to the application time; The person sends a review request for the claim case, and the server assigns the case set including the claim case to the auditor according to the method of step 304 to step 306, and the auditor sends a review request to the claim case, and then changes the review status of the claim case to During the audit; when the server receives the audit result sent by the terminal where the auditor is located (such as whether the audit material is complete and valid, whether the policy corresponding to the claim case has a payable amount, etc.), (if the audit materials are homogeneous and valid, the claim case If the corresponding policy has a compensable amount, the processing status of the claim case is modified to be adjusted; the server periodically detects the claim case to be settled, and when the claim case is detected, according to the claim type corresponding to the claim type Set a claim rule to adjust the claim case and change the claim case The audit status of the item is the settlement; when the adjustment result is successfully calculated (that is, the claim amount is calculated), the audit status of the claim case is changed to be closed.

Step 326: If the processing status of the second claim case is a closed case, assign the first claim case to the first management terminal corresponding to the first user identifier.

If the processing status of the claim case that is the same as the application type and the risk person identification of the found claim case in the case of the assigned claim case is closed, it indicates that the claim case that is currently not associated with the found claim case is being processed. Then, the found claim case can be assigned to the management terminal corresponding to the foregoing user identifier.

Under the premise of ensuring that the assigned claims cases associated with the claims to be distributed have been processed, it is ensured that the related claims to be assigned within the preset time range are allocated to the same individual, completely avoiding the intersection of the related claims cases. The issue of interlocking has further improved the efficiency of processing claims.

In one embodiment, after step 326, the method further includes: if the processing status of the second claim case is open, acquiring the second user identifier corresponding to the second claim case; and assigning the first claim case to the second user Identify the corresponding second management terminal.

The second user identifier is used to uniquely identify the auditor of the assigned claim case that is the same as the search type and the claimant identification of the found claim case; the second management terminal is the application type and the risk person identification of the found claim case The auditors who have the same assigned claims case review the terminal used in the assigned claims case; the unfinished processing status refers to any of the three processing states in the audit, pending adjustment, and adjustment.

After knowing that the assigned claims case associated with the claim to be distributed is in the open status (in process), the related claims to be assigned within the preset time range are assigned to the auditor who is reviewing the claim case, and is also completely The problem of cross-interlocking in interrelated claims cases is avoided, and the processing efficiency of claims cases is further improved.

In one embodiment, after step 306, the method further includes: detecting whether the audit result of the first claim case is received within the third preset time threshold; if yes, saving the audit result to the database, and if not, the A claim case is recycled to the task pool for redistribution.

The third preset time threshold is calculated by the server assigning the claim case to the auditing user. If the preset time range is 1 day, the detecting server receives the claim case and the claimant within 24 hours after receiving the claim case. If the result of the audit of the assigned claim case is confirmed, the result of the review will be saved to the database. If not, the claim case will be recycled to the task pool, and then the claim case will be placed according to the application time of the claim case in the task pool. Into the queue of claims to be assigned, these claims cases are then distributed according to the methods of steps 302 to 306 above.

In one embodiment, as shown in FIG. 5, after step 306, the method further includes:

Step 502: Acquire a policy type corresponding to the first compensation claim of the queue to be assigned to the claim case.

Policy types include personal policies, group policies, and group sub-policies. Among them, the personal insurance policy is the insurance policy corresponding to the insurance purchased by the customer in the name of the individual. For example, Zhang San purchased a medical insurance for himself. The insurance policy corresponding to the medical insurance purchased by Zhang San is a personal insurance policy; the group insurance policy is the customer’s name in the group. The policy corresponding to the purchased insurance, for example, if the company purchases a commercial insurance for each employee, then all employees of the company have a group policy that is differentiated by the company; the group sub-policy is for each individual corresponding to the group policy. The policies that are owned, such as each employee of the company, have a policy corresponding to commercial insurance.

Step 504: If the policy type is a group sub-policy, the policy type is a group sub-policy in the to-be-allocated claims case queue, and has the same group policy as the team-first claim case, and the difference is not the same as the claim application time of the team-first claim case. A third claim case that exceeds a second predetermined time threshold.

The second preset time threshold is a time for applying for claim settlement under different claims of the same group policy according to the claim application time data of different claims cases of the same type of insurance corresponding to different insured persons of the same group policy. Interval, such as 8 hours.

Step 506: Assign a third claim case to the first user terminal corresponding to the first user identifier.

After finding the claims case corresponding to the other risk-shooters on the policy corresponding to the team leader claim case in the queue of claims to be distributed, the claim cases corresponding to the other risk-shooters are associated with the previously found case-resolved cases. Claim cases are assigned to the same auditor.

By assigning the claims of the same type of insurance corresponding to different insured persons under the same group policy within the preset time period to the same auditor for review, the claims of the same type of insurance corresponding to different insurers under the same group policy The material verification method of the case is the same as the settlement calculation method, so that the auditor can quickly complete the review of the claim case and improve the processing efficiency of the claim case.

In one embodiment, as shown in FIG. 6, another method for assigning claims cases is provided, including:

Step 602: Receive a claim for reviewing a claims case initiated by the first management terminal, where the claim for reviewing claims carries a first user identifier corresponding to the first management terminal, where the first user identifier is used to uniquely identify the user who initiated the claim for reviewing the claim case.

Similarly, the first management terminal is a terminal used by an auditor who sends a request for a claim in the audit database to the server; the first user identifier is used to uniquely identify the user who initiated the claim review request.

Step 604: Find, in the queue to be assigned a claim, a first claim case that is the same as the application type and the risk person identification of the team leader claim case and the claim application time does not exceed the first preset time threshold.

Similarly, the claim settlement case is a claim case that is awaiting review in the received claims case; the team leader claim case is a claim case located at the head of the queue to be assigned the claim case; the application type is the policy corresponding to the claim case The type of insurance, such as the application type of the claim case is property insurance or personal insurance; the risk person identification is used to uniquely identify the claimant of the claim case, specifically, it may be a logo composed of a custom string, or may be the identity of the user. The first preset time threshold is the time interval after the same customer frequently makes a claim for claim by analyzing the application time of a large number of received claims cases.

Step 606: Obtain a processing status of a second claim case in which the application type and the risk person identification of the first claim case are the same in the assigned claim case,

Similarly, the processing status of claims cases includes: five statuses to be reviewed, reviewed, pending, adjusted, and closed.

In step 608, it is determined whether the processing status of the second claim case is a settlement, and if yes, the process proceeds to step 610, otherwise, the process proceeds to step 611.

In this embodiment, the processing status of the claim case is an open case, which means that the current processing status of the claim case is any one of the review status in the review, the settlement, and the adjustment.

Step 610: If the number of the first claim case is less than the preset case processing quantity, obtain the policy type corresponding to the team first claim case.

Similarly, policy types include personal policies, group policies, and group sub-policies. Among them, the personal insurance policy is the insurance policy corresponding to the insurance purchased by the customer in the name of the individual. For example, Zhang San purchased a medical insurance for himself. The insurance policy corresponding to the medical insurance purchased by Zhang San is a personal insurance policy; the group insurance policy is the customer’s name in the group. The policy corresponding to the purchased insurance, for example, if the company purchases a commercial insurance for each employee, then all employees of the company have a group policy that is differentiated by the company; the group sub-policy is for each individual corresponding to the group policy. The policies that are owned, such as each employee of the company, have a policy corresponding to commercial insurance.

Step 611: Acquire a second user identifier corresponding to the second claim case, and assign the first claim case to the second management terminal corresponding to the second user identifier.

Similarly, the second user identifier is used to uniquely identify the auditor of the assigned claim case that is the same as the search type and the claimant identification of the found claim case; the second management terminal is the type of the application with the found claim case and The auditor of the assigned claim case with the same claim of the insurer reviews the terminal used in the assigned claim case.

Step 612: If the policy type is a group sub-policy, the policy type is a group sub-policy in the to-be-allocated claims case queue, and has the same group policy as the team first claim case, and is different from the claim application time of the team leader claim case. A third claim case that exceeds a second predetermined time threshold.

The second preset time threshold is a time for applying for claim settlement under different claims of the same group policy according to the claim application time data of different claims cases of the same type of insurance corresponding to different insured persons of the same group policy. interval.

Step 614: If the sum of the number of the first claim case and the third claim case is less than or equal to the preset case processing quantity, assign the first claim case and the third claim case to the first user terminal corresponding to the first user identifier.

Step 616: If the number of the first claim cases is equal to the preset number of cases, the first claim case is allocated to the first management terminal corresponding to the first user identifier.

If the number of claims cases associated with the team leader claim case in the queue to be assigned claims reaches the preset number of cases, the directly found claims are directly assigned to the management terminal that initiated the case review request.

Under the premise of ensuring that the assigned claims cases associated with the claims to be distributed have been processed, it is ensured that the related claims to be assigned within the preset time range are assigned to the same auditor, completely avoiding the occurrence of interrelated claims cases. The cross-interlock problem effectively improves the processing efficiency of claims cases; and limits the number of claims cases assigned to auditors, further improving the processing efficiency of claims cases; and ensuring the number of claims assigned to auditors Within the scope of their auditing ability, the claims cases corresponding to other group sub-policies (and other risk-shooters) with the same group policy in the related claims cases are assigned to the same auditor as the above-mentioned related claims, because The material review method is the same as the claim calculation rule, which further improves the processing efficiency of claims.

It should be understood that although the various steps in the flowcharts of FIGS. 3-6 are sequentially displayed as indicated by the arrows, these steps are not necessarily performed in the order indicated by the arrows. Except as explicitly stated herein, the execution of these steps is not strictly limited, and the steps may be performed in other orders. Moreover, at least some of the steps in FIGS. 3-6 may include multiple sub-steps or multiple stages, which are not necessarily performed at the same time, but may be performed at different times, these sub-steps or stages The order of execution is not necessarily performed sequentially, but may be performed alternately or alternately with at least a portion of other steps or sub-steps or stages of other steps.

In one embodiment, as shown in FIG. 7, a claim case allocation device is provided, including a claim case review request receiving module 702, a claim case finding module 704, and a claim case assigning module 706, wherein:

The claim case review request receiving module 702 receives the claim case review request initiated by the first management terminal, and the claim case review request carries the first user identifier corresponding to the first management terminal, and the first user identifier is used to uniquely identify the initiate claim claim review request. user;

The claim case finding module 704 is configured to search, in the to-be-allocated claims case queue, the first claim case that is the same as the application type and the insured person identification of the team leader claim case and the claims application time does not exceed the first preset time threshold;

The claim case assigning module 706 allocates the first claim case to the first management terminal corresponding to the first user identifier.

In one embodiment, the claim case allocation module 706 is configured to determine whether the number of the first claim case is less than or equal to the preset case processing quantity; if yes, assign the first claim case to the first management corresponding to the first user ID terminal.

In one embodiment, the claim case assignment module 706 is configured to obtain the processing status of the second claim case in the assigned claim case that is the same as the application type and the issuer ID of the first claim case; if the second claim case is processed If the status is closed, the first claim case is assigned to the first management terminal corresponding to the first user identifier.

In one embodiment, the claim case assignment module 706 is configured to obtain a second user identifier corresponding to the second claim case if the processing status of the second claim case is open, and assign the first claim case to the second user identifier. Corresponding second management terminal.

In one embodiment, the claim case assignment module 706 is configured to obtain a policy type corresponding to the team leader claim case; if the policy type is a group sub-policy, the policy type is found as a group sub-policy in the queue to be assigned claims case, and the team The first claim case has the same group policy, and the third claim case that differs from the claim application time of the team leader claim case by a second preset time threshold; the third claim case is assigned to the first user corresponding to the first user ID terminal.

For the specific definition of the claim settlement device, refer to the above definition of the claim case allocation method, and details are not described herein. Each module in the above claims settlement configuration may be implemented in whole or in part by software, hardware, and combinations thereof. Each of the above modules may be embedded in or independent of the processor in the computer device, or may be stored in a memory in the computer device in a software form, so that the processor invokes the operations corresponding to the above modules.

A computer device comprising a memory and one or more processors having stored therein computer readable instructions, the computer readable instructions being executed by the processor such that the one or more processors perform the following steps:

Receiving a claim for reviewing a claims case initiated by the first management terminal, the claim for reviewing the claim case carrying the first user identifier corresponding to the first management terminal, where the first user identifier is used to uniquely identify the user who initiated the claim for reviewing the claim case;

Assigning the first claim case to the first management terminal corresponding to the first user identifier.

In one embodiment, the first control terminal corresponding to the first user identifier that is executed by the processor includes: determining whether the number of the first claim case is less than or equal to the preset number of cases processed; And assigning the first claim case to the first management terminal corresponding to the first user identifier.

In one embodiment, the first control terminal corresponding to the first user identifier is executed by the processor, and includes: acquiring the application type and the risk person identifier of the first claim case in the assigned claim case. The processing status of the second claim case is the same; and if the processing status of the second claim case is closed, the first claim case is assigned to the first management terminal corresponding to the first user identifier.

In one embodiment, when the processor executes the computer readable instructions, the following steps are further implemented: if the processing status of the second claim case is open, acquiring the second user identifier corresponding to the second claim case; and the first claim The case is assigned to the second management terminal corresponding to the second user identifier.

In one embodiment, when the processor executes the computer readable instructions, the following steps are further performed: obtaining a policy type corresponding to the team first claim case; if the policy type is a group sub-policy, searching for the policy type in the queue to be assigned claims case The group sub-policy, which has the same group policy as the team leader claim case, and the third claim case that differs from the claim settlement time of the team leader claim case by a second preset time threshold; and assigns the third claim case to the first First user terminal corresponding to the user identifier

In one embodiment, the computer readable instructions are further executed by the processor to: determine whether the number of first claims cases is less than or equal to a predetermined number of case processing; and if so, assign the first claim case to the first A first management terminal corresponding to a user identifier.

In one embodiment, the computer readable instructions are further executed by the processor to: obtain a processing status of the second claim case in the assigned claim case that is the same as the application type and the issuer identifier of the first claim case; And if the processing status of the second claim case is closed, the first claim case is allocated to the first management terminal corresponding to the first user identifier.

In one embodiment, when the computer readable instructions are executed by the processor, the following steps are further implemented: if the processing status of the second claim case is open, acquiring the second user identifier corresponding to the second claim case; and The claim case is assigned to the second management terminal corresponding to the second user identifier.

In one embodiment, when the computer readable instructions are executed by the processor, the following steps are further performed: obtaining a policy type corresponding to the team first claim case; if the policy type is a group sub-policy, searching for the policy type in the queue to be assigned claims case For the group sub-policy, the same group policy as the team first claim case, and the third claim case that differs from the claim settlement time of the team first claim case by a second preset time threshold; and the third claim case is assigned to the first claim case A first user terminal corresponding to a user identifier.

One of ordinary skill in the art can understand that all or part of the process of implementing the above embodiments can be completed by computer readable instructions, which can be stored in a non-volatile computer. The readable storage medium, which when executed, may include the flow of an embodiment of the methods as described above. Any reference to a memory, storage, database or other medium used in the various embodiments provided herein may include non-volatile and/or volatile memory. Non-volatile memory can include read only memory (ROM), programmable ROM (PROM), electrically programmable ROM (EPROM), electrically erasable programmable ROM (EEPROM), or flash memory. Volatile memory can include random access memory (RAM) or external cache memory. By way of illustration and not limitation, RAM is available in a variety of formats, such as static RAM (SRAM), dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDRSDRAM), enhanced SDRAM (ESDRAM), synchronization chain. Synchlink DRAM (SLDRAM), Memory Bus (Rambus) Direct RAM (RDRAM), Direct Memory Bus Dynamic RAM (DRDRAM), and Memory Bus Dynamic RAM (RDRAM).

It should be noted that “first”, “second”, “third” and the like in the various embodiments of the present application are only used as a distinction, and are not used as a limitation on size, subordination, sequence, and the like. For example, the first management terminal and the second management terminal are only used to distinguish different management terminals. The first management terminal may be referred to as a second management terminal without departing from the scope of the present application. Similarly, The second management terminal is referred to as a first management terminal, and both the first management terminal and the second management terminal are management terminals, but are not the same management terminal.

The technical features of the above-described embodiments may be arbitrarily combined. For the sake of brevity of description, all possible combinations of the technical features in the above embodiments are not described. However, as long as there is no contradiction between the combinations of these technical features, All should be considered as the scope of this manual.

The above-mentioned embodiments are merely illustrative of several embodiments of the present application, and the description thereof is more specific and detailed, but is not to be construed as limiting the scope of the claims. It should be noted that a number of variations and modifications may be made by those skilled in the art without departing from the spirit and scope of the present application. Therefore, the scope of the invention should be determined by the appended claims.

Claims

A method for allocating claims cases, including:

Receiving, by the first management terminal, a claims case review request, where the claim case review request carries a first user identifier corresponding to the first management terminal, where the first user identifier is used to uniquely identify the claim for initiating the claim case user;

Finding, in the queue of claims to be distributed, the first claim case that is the same as the application type and the risk person identification of the team leader claim case and the claim application time does not exceed the first preset time threshold; and

And assigning the first claim case to the first management terminal corresponding to the first user identifier.
The method according to claim 1, wherein the allocating the first claim case to the first management terminal corresponding to the first user identifier comprises:

Determining whether the number of the first claim cases is less than or equal to the number of preset cases processed; and

If yes, the first claim case is allocated to the first management terminal corresponding to the first user identifier.
The method according to claim 1, wherein the allocating the first claim case to the first management terminal corresponding to the first user identifier comprises:

Obtaining a processing status of the second claim case in the assigned claim case that is the same as the application type and the risk issuer identifier of the first claim case; and

If the processing status of the second claim case is a settlement, the first claim case is allocated to the first management terminal corresponding to the first user identifier.
The method of claim 3, wherein the method further comprises:

If the processing status of the second claim case is an open case, acquiring a second user identifier corresponding to the second claim case; and

And assigning the first claim case to the second management terminal corresponding to the second user identifier.
The method of claim 1 further comprising:

Obtaining a policy type corresponding to the first claim case of the team;

If the policy type is a group sub-policy, the policy type is a group sub-policy in the to-be-allocated claims case queue, and has the same group policy as the team leader claim case, and the claim for the team leader claims a third claim case in which the claim application time differs by no more than the second preset time threshold; and

And assigning the third claim case to the first user terminal corresponding to the first user identifier.
A claim case distribution device comprising:

The claim case review request receiving module receives the claim case review request initiated by the first management terminal, and the claim case review request carries a first user identifier corresponding to the first management terminal, where the first user identifier is used for unique identifier initiation The user of the claims review request;

The claim case finding module is configured to search for a first claim case in which the application type and the risk person identification of the team leader claim case are the same and the claim application time differs by no more than the first preset time threshold in the queue to be distributed claims;

The claim case allocation module allocates the first claim case to the first management terminal corresponding to the first user identifier.
The apparatus according to claim 6, wherein the claim case assigning module is further configured to determine whether the number of the first claim cases is less than or equal to a preset number of case processing; and if so, the first The claim case is allocated to the first management terminal corresponding to the first user identifier.
The device according to claim 6, wherein the claim case assigning module is further configured to acquire a second claim case in the assigned claim case that is the same as the application type and the issuer identifier of the first claim case. And processing the status; and if the processing status of the second claim case is a settlement, assigning the first claim case to the first management terminal corresponding to the first user identifier.
The apparatus according to claim 8, wherein the claim case assigning module is further configured to acquire a second user identifier corresponding to the second claim case if the processing status of the second claim case is an open case And assigning the first claim case to the second management terminal corresponding to the second user identifier.
The apparatus according to claim 6, wherein the claim case assigning module is further configured to acquire a policy type corresponding to the team head claim case; and if the policy type is a group sub-policy, the to-be-allocated In the claim case queue, the third type of claim for the policy type is a group sub-policy, which has the same group policy as the team leader claim case, and the claim application time of the team leader claim case does not exceed the second preset time threshold. a case; and assigning the third claim case to the first user terminal corresponding to the first user identifier.
A computer device comprising a memory and one or more processors having stored therein computer readable instructions, the computer readable instructions being executed by the one or more processors to cause the one or more The processors perform the following steps:

Receiving, by the first management terminal, a claims case review request, where the claim case review request carries a first user identifier corresponding to the first management terminal, where the first user identifier is used to uniquely identify the claim for initiating the claim case user;

Finding, in the queue of claims to be distributed, the first claim case that is the same as the application type and the risk person identification of the team leader claim case and the claim application time does not exceed the first preset time threshold; and

And assigning the first claim case to the first management terminal corresponding to the first user identifier.
The computer device according to claim 10, wherein the step of the processor performing the first claim case assignment to the first management terminal corresponding to the first user identifier comprises: determining the Whether the number of claims is less than or equal to the number of preset cases processed; and if so, assigning the first claim case to the first management terminal corresponding to the first user identifier.
The computer device according to claim 10, wherein the step of the processor performing the first claim case assignment to the first management terminal corresponding to the first user identifier comprises: acquiring an assigned claim The processing status of the second claim case in the case that is the same as the application type and the identity of the first claim case; and

If the processing status of the second claim case is a settlement, the first claim case is allocated to the first management terminal corresponding to the first user identifier.
A computer apparatus according to claim 13, wherein said processor, when said computer readable instructions are executed, further performing the step of: acquiring said first if said processing status of said second claim case is open a second user identifier corresponding to the second claim case; and

And assigning the first claim case to the second management terminal corresponding to the second user identifier.
The computer device according to claim 10, wherein the processor further executes the step of: acquiring a policy type corresponding to the team leader claim case when executing the computer readable instruction;

If the policy type is a group sub-policy, the policy type is a group sub-policy in the to-be-allocated claims case queue, and has the same group policy as the team leader claim case, and the claim for the team leader claims a third claim case in which the claim application time differs by no more than the second preset time threshold; and

And assigning the third claim case to the first user terminal corresponding to the first user identifier.
One or more non-transitory computer readable storage mediums storing computer readable instructions, when executed by one or more processors, cause the one or more processors to perform the following steps:

Receiving, by the first management terminal, a claims case review request, where the claim case review request carries a first user identifier corresponding to the first management terminal, where the first user identifier is used to uniquely identify the claim for initiating the claim case user;

Finding, in the queue of claims to be distributed, the first claim case that is the same as the application type and the risk person identification of the team leader claim case and the claim application time does not exceed the first preset time threshold; and

And assigning the first claim case to the first management terminal corresponding to the first user identifier.
A storage medium according to claim 16, wherein said computer readable instructions, when executed by said processor, further perform the step of determining whether the number of said first claims cases is less than or equal to a predetermined number of case processing And if yes, assigning the first claim case to the first management terminal corresponding to the first user identifier.
A storage medium according to claim 16, wherein said computer readable instructions, when executed by said processor, further perform the steps of: obtaining an application type and a risk in said first claim case in the assigned claim case The processing status of the second claim case with the same person identification; and

If the processing status of the second claim case is a settlement, the first claim case is allocated to the first management terminal corresponding to the first user identifier.
A storage medium according to claim 18, wherein said computer readable instructions are further executed by said processor, said step of: obtaining said said if said processing status of said second claim case is open a second user identifier corresponding to the second claim case; and

And assigning the first claim case to the second management terminal corresponding to the second user identifier.
The storage medium according to claim 16, wherein said computer readable instructions are further executed by said processor to: obtain a policy type corresponding to said team head claims case;

If the policy type is a group sub-policy, the policy type is a group sub-policy in the to-be-allocated claims case queue, and has the same group policy as the team leader claim case, and the claim for the team leader claims a third claim case in which the claim application time differs by no more than the second preset time threshold; and

And assigning the third claim case to the first user terminal corresponding to the first user identifier.