WO2019052222A1 - 保单处理方法、装置、计算机设备及可读存储介质 - Google Patents

保单处理方法、装置、计算机设备及可读存储介质 Download PDF

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Publication number
WO2019052222A1
WO2019052222A1 PCT/CN2018/088722 CN2018088722W WO2019052222A1 WO 2019052222 A1 WO2019052222 A1 WO 2019052222A1 CN 2018088722 W CN2018088722 W CN 2018088722W WO 2019052222 A1 WO2019052222 A1 WO 2019052222A1
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information
case
policy
insurance
date
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PCT/CN2018/088722
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English (en)
French (fr)
Inventor
王雯
莫瑞海
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平安科技（深圳）有限公司
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Publication of WO2019052222A1 publication Critical patent/WO2019052222A1/zh

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    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q10/00—Administration; Management
    • G06Q10/10—Office automation; Time management
    • G06Q10/103—Workflow collaboration or project management
    • G—PHYSICS
    • G06—COMPUTING; CALCULATING OR COUNTING
    • G06Q—INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q40/00—Finance; Insurance; Tax strategies; Processing of corporate or income taxes
    • G06Q40/08—Insurance

Definitions

  • the present application relates to a policy processing method, apparatus, computer device, and readable storage medium.
  • the insurance claims processing process includes reporting, accepting, reviewing, and closing the case.
  • the traditional insurance acceptance method is manual acceptance, that is, the counter personnel receive the user's report, and receive the acceptance claims submitted by the user.
  • the counter personnel receive the acceptance claims materials.
  • the acceptance claims materials are directly handed over to the auditors. The auditors need to manually determine which type of insurance the claims materials are subject to, and whether they can be settled, etc., which will result in high audit pressure and high labor costs. .
  • a policy processing method, apparatus, computer device, and readable storage medium are provided.
  • a policy processing method comprising:
  • the third insurance information corresponding to the policy warranty period including the billing date is selected, and the third insurance information is added to the The second case acceptance information is described.
  • a policy processing device comprising:
  • a receiving module configured to receive a user identifier and policy information sent by the terminal
  • An insurance information obtaining module configured to acquire insurance information corresponding to the user identifier
  • the policy warranty selection module is configured to select a policy warranty period from the obtained insurance information
  • An expiration date selection module for selecting an expiration date from the received policy information
  • a case acceptance module configured to: when the date of the insurance is within the time limit of the policy warranty period, select the first insurance information corresponding to the policy warranty period including the date of the insurance; and according to the policy information and the The selected first insurance information generates first case acceptance information; when the risk date is not within the time limit of the policy warranty period, generating second case acceptance information according to the policy information, and from the policy information Selecting billing information; when the billing date in the billing information is within the time range of the policy warranty period, selecting third insurance information corresponding to the policy warranty period including the billing date, and selecting the third The insurance information is added to the second case acceptance information.
  • 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:
  • the third insurance information corresponding to the policy warranty period including the billing date is selected, and the third insurance information is added to the The second case acceptance information is described.
  • One or more non-transitory computer readable instruction storage media storing computer readable instructions, when executed by one or more processors, cause one or more processors to perform the steps of:
  • the third insurance information corresponding to the policy warranty period including the billing date is selected, and the third insurance information is added to the The second case acceptance information is described.
  • FIG. 1 is an application scenario diagram of a policy processing method in accordance with one or more embodiments.
  • FIG. 2 is a flow diagram of a policy processing method in accordance with one or more embodiments.
  • FIG. 3 is a flow diagram of a case adjustment step in accordance with one or more embodiments.
  • FIG. 4 is a flow diagram of a pre-audit step in accordance with one or more embodiments.
  • FIG. 5 is a block diagram showing the structure of a policy processing apparatus in accordance with one or more embodiments.
  • FIG. 6 is a block diagram of a computer device in accordance with one or more embodiments.
  • FIG. 1 is an application scenario diagram of a policy processing method in an embodiment, including a user terminal and a computer device, where the computer device is a policy acceptance server, and is configured to process insurance data submitted by the user terminal.
  • the user terminal may be a terminal of a user who purchases insurance, or may be a terminal of a salesperson who assists the user in purchasing insurance, and the user terminal may be a mobile phone, a tablet computer, a desktop computer, a laptop computer, or the like.
  • the computer device determines whether to accept the claim request based on the insurance data submitted by the user terminal.
  • a policy processing method is provided. This embodiment is exemplified by applying the method to the computer device in FIG. 1 above.
  • a policy processing program is run on the computer device, and the policy processing method is implemented by the policy processing program.
  • the method specifically includes the following steps:
  • S202 Receive user identifier and policy information sent by the terminal.
  • the user identifier is an identifier that can uniquely determine the identity of a certain user, such as an identity card number, a policy number, and the like.
  • the policy information is information provided by the user when reporting the case, and may include information such as the date of the insurance, the type of risk, and the type of treatment.
  • the user terminal sends the user identification and policy information to the computer device, that is, the policy acceptance server.
  • the computer device can detect the policy information, for example, whether the mandatory field is sent to the computer device, and the format of the mandatory field sent to the computer device is correct, and only the mandatory field is correct to proceed to the next step. .
  • S204 Acquire insurance information corresponding to the user identifier.
  • the computer device may obtain the insurance information according to the user identifier.
  • the insurance information is the insurance information purchased by the user.
  • a user may purchase multiple insurances.
  • user A may have both personal insurance and medical insurance purchased by himself, and personal insurance and medical insurance purchased by the company for user A.
  • all the insurances purchased by the user that is, the insurance information of the user A can be called up. If there is no insurance information corresponding to the user ID, it means that the user has not bought the insurance, so the claim can be directly rejected, that is, it is not accepted.
  • the user's insurance information includes not only the type of insurance purchased by the user, but also the policy life of each insurance, policy liability, and the like.
  • the policy period is the period of protection for the insurance purchased, for example, only the risk that occurs during the policy period will be reimbursed.
  • the policy liability is the scope of claims for the insurance purchased.
  • the major illness insurance can only claim for the 25 major diseases listed in the country affected by the insured, and the amount of claims is also limited.
  • the computer device selects a risk date from the received policy information, such as a risk date entered by the user when making a claim through the user terminal.
  • the first insurance information when the date of the insurance is within the time limit of the policy warranty period, the user claims to make a claim, so the first insurance information corresponding to the policy warranty period including the date of the insurance is selected; and according to the policy information and the selected policy
  • the first insurance information generates the first case acceptance information, so as to issue the claim payment after the subsequent review of the case, wherein when the date of the insurance is located in the time range of the policy, the policy information corresponding to the date of the insurance may be cached.
  • the first case acceptance information may be sent to the user terminal to prompt the user that the current claim request has been accepted.
  • the computer device first accepts the claim and then acquires the user terminal.
  • the billing information in the policy information sent, the billing date is selected from the billing information, and when the billing date is within a certain policy period, the third insurance information including the policy period of the billing date is selected, and then generated
  • the third case acceptance information includes the third insurance information including the policy period of the bill date, so as to reduce the pressure for subsequent case review.
  • the user sends the claim material, that is, the policy information to the server through the terminal, and the server can query the insurance that the user has bought according to the user identifier, that is, the insurance information, and the server can query according to the date of the insurance in the received policy information.
  • the corresponding policy can be used to associate the policy information with the insurance information to generate the first case acceptance information, so that the subsequent case review process can be directly performed according to the first case acceptance information, without requiring the auditor to determine one by one, thereby reducing the cost. .
  • the method further includes: selecting the first risk type and the first treatment type from the received policy information
  • the first type of insurance and the first type of treatment may be selected from the policy information sent by the user through the user terminal, and the type of insurance, ie, personal insurance, automobile insurance, etc., the type of treatment is hospitalization, emergency department , surgery, etc.
  • the insurance purchased by the user also includes the type of insurance and the type of treatment, and the first insurance information corresponding to the policy period including the date of the insurance is selected, and then the second type of insurance and the second treatment are selected from the first insurance information.
  • Type, matching the first type of risk and the second type of risk, the first type of treatment and the second type of treatment are matched, and if the match is successful, the first case acceptance information is generated according to the policy information and the second insurance information that is successfully matched.
  • the computer device may first determine whether the policy of the user in the insurance information is a standard order or a protocol form, the standard list refers to a personal policy, and the agreement form refers to a group list, such as a company group list, a family group list, a school group list, and the like.
  • the user's policy is a standard order
  • the first risk type and the second type of risk are matched, and the first type of treatment and the second type of treatment are matched.
  • the second information is based on the policy information and the second successful match.
  • the insurance information generates the first case acceptance information.
  • the second risk type and the second type of treatment are first queried according to the policy number, level, etc., and then the first type of insurance and the second type of risk are matched, the first type of treatment and the second type of treatment. Matching is performed, and if the matching is successful, the first case acceptance information is generated according to the policy information and the second insurance information that is successfully matched.
  • the policy number is the agreement number of the agreement, and the level can refer to different levels. For example, when the agreement is a company group, the level can include the manager, the secretary, the ordinary employee, etc.; when the agreement is a school group, the level It can include principals, directors, teachers, students, etc.
  • the claim insurance policy is screened by the date of the insurance, and the responsibility is matched according to the reason of the customer application, that is, the type of the insurance and the type of treatment, and the policy is matched on the policy, and the invalid policy is automatically removed, thereby avoiding the late reviewer.
  • the auditor's labor intensity is greatly reduced, and the time limit for claims is effectively improved.
  • the step of generating the first case acceptance information according to the policy information and the selected first insurance information may further include: querying whether there is an open case corresponding to the user identifier; when there is a corresponding to the user identifier In the case of an unfinished case, the first complexity of the unresolved case is obtained; the second complexity of the case corresponding to the currently generated first case acceptance information is calculated; when the first complexity is greater than the first threshold, and the second complexity is When the value is less than the second threshold, the priority of the case corresponding to the currently generated first case acceptance information is higher than the review priority of the open case; and the case after the first case acceptance information is generated according to the audit priority Review.
  • the step of calculating the second complexity of the case corresponding to the currently generated first case acceptance information may include: obtaining the claim amount, the number of visits, and the hospitalization time from the received policy information; obtaining and the policy The original delivery time corresponding to the information and the credit degree corresponding to the user identification; and the second complexity of the case corresponding to the currently generated first case acceptance information is calculated according to the settlement amount, the number of visits, the hospitalization time, the original delivery time, and the credit.
  • FIG. 3 is a flowchart of a case adjustment step according to one or more embodiments, and the case adjustment step may include:
  • S302 Query whether there is an open case corresponding to the user identifier.
  • case B since a user may have applied for a case claim in advance, assuming case A, but the case A claim has not been completed, the user has applied for another case claim, which is assumed to be case B, because in order to avoid duplicate claims, Only one case of the user is allowed to be in the claim phase at a time, so case B can only wait for the case A settlement to be completed before proceeding with the claim. Therefore, in order to guarantee the claim period of case B, first check whether there is an open case corresponding to the user ID, that is, case A above.
  • the complexity of the case must be calculated to determine whether the case can be processed in advance.
  • the calculation of the complexity of the case is detailed below.
  • S306 Obtain a claim amount, a number of visits, and a hospital stay time from the received policy information.
  • the amount of the claim is the amount of the user's application for the claim; the number of visits refers to the number of times the user goes to the hospital. For example, the number of times the user can go to the hospital within a certain period of time, for example, the number of visits to the hospital within three months; Hospital stay after the date of the accident.
  • S308 Obtain an original sending time corresponding to the policy information and a credit corresponding to the user identifier.
  • the user since there is a case where the user himself sends the policy information through the user terminal to make a claim, since the photo is prone to fraud, the user needs to send the original of the policy information to a specific place after accepting the user's claim request. For example, if the user is restricted to send the original to the claim center within one month, if the user sends the original to the claim center within 1.5 months, the original delivery time is 1.5 months, which exceeds the preset time by one month. The user sends the original to the Claims Center within 0.5 months, and the original delivery time is 0.5 months, less than the default time of 1 month.
  • the credit degree refers to the credit status of the user.
  • the computer device may store the credit degree of the user in advance.
  • the calculation of the credit degree may include: obtaining the user's loan record according to the user identifier, the time for the user to handle other bank cards, and the e-commerce and public accumulation fund such as qq and Taobao. Wait for the data, and select the part of the data to calculate to get the user's credit, and store it in real time.
  • the selected part may be selected according to a preset priority, for example, the fixed asset is taken as the first priority, the provident fund, the salary, the stock, etc.
  • the third priority is then assigned a certain weight to each priority, and finally the user's credit is obtained according to the amount of assets and weights in each priority.
  • the assets of a user's fixed assets are 3 million
  • the weight is 0.5
  • the provident fund is 100,000
  • the weight is 0.3
  • the Alipay is 200,000
  • the weight is 0.2.
  • S310 Calculate a second complexity of the case corresponding to the currently generated first case acceptance information according to the claim amount, the number of visits, the hospitalization time, the original delivery time, and the credit.
  • the second complexity is calculated by the five dimensions of the claim amount, the number of visits, the hospital stay, the original delivery time, and the credit, and other indicators may be introduced in other embodiments. This is not a limitation.
  • the first threshold is a division threshold of a complex case, and the complexity is greater than the first threshold.
  • the case is a complex case, that is, a case with a long review period
  • the second threshold is a division threshold of a simple case, and the complexity is less than the second threshold.
  • the case is a simple case, that is, a case with a short review period. Since each user can only have one case at a time to process the claims review cycle, if the case is currently in the review cycle, for example, case A in the above is a complex case, it will take a long time to wait for case B.
  • case B Being able to enter the audit cycle, assuming that case B is a simple case, this will result in a shorter review cycle for simple case B, which will make the user experience worse.
  • the complexity of the case is set. The priority of the case is reviewed. If the case corresponding to the first case acceptance information generated is a simple case and the case currently in the review cycle is a complex case, the review priority of the simple case is set higher than the complexity. The priority of the case is reviewed, so that the simple case can be reviewed and settled, and after the simple case is reviewed, the complex case can be further settled.
  • S314 Review the case after the first case acceptance information is generated according to the audit priority.
  • the computer device will review the accepted cases according to the audit priority, for example, the case with higher priority is reviewed first, and after the case with higher priority is reviewed, Continue to review cases with lower priority.
  • the priority of the case is set by the complexity of the case, and the simple case locked by the complicated case can be first settled, and the claim settlement time is improved; and the order of the case is not caused by the customer.
  • the timeliness of all customer cases is lengthened to improve customer satisfaction.
  • FIG. 4 is a flowchart of a pre-audit step, which may be performed after step S210 in the embodiment shown in FIG. 2, in accordance with one or more embodiments.
  • the method may further include:
  • S402 Detect whether the case in which the first case acceptance information is currently generated is a pre-review case.
  • a pre-review case refers to a case that has not been resold. After the policy is signed, the customer's payment is successful. The policy that takes effect at this time should be signed and confirmed by the customer. This is called a resale. The purpose of the initial resale is to prevent the salesman from violating the rules, and at the same time to explain the rights and obligations to the customer again to prevent misleading sales.
  • the computer device can determine whether the case is a pre-examination case according to the insurance information of the case in which the first case acceptance information is currently generated. For example, when the case is a pre-review case, the pre-examination flag of the case is set to 1, when the case is not In the case of a pre-review case, the pre-review flag of the case is set to zero.
  • the pre-examination flag is added to the case in which the first case acceptance information is currently generated, for example, the pre-review flag is set to 1.
  • the case when there is a pre-examination identification in the case, the case is pre-examined, so that the time limit for the settlement of the case can be prevented.
  • the auxiliary entry during the case promotion process, if the case is not resold at the moment, The original logic does not pay attention to whether or not to sell back, and still pushes the case down and flows. This caused the case to not be resold before the review.
  • reviewing it can't be adjusted, and it can only be adjusted after the resale, which is a serious delay.
  • the case can be resold first, and only the case of completing the resale will enter the claim section, which can shorten the length of the claim link, that is, in the case of pre-investigation cases, the case is completed.
  • the workflow is transferred, if the pre-investigation is initiated on the case, the workflow will not be pushed to the audit node at this moment, but the case will be pushed to the audit investigation, and will not be acquired and distributed by the user. Users are allowed to obtain and distribute only after the case investigation is resold.
  • the case in which the first case acceptance information is currently generated has no pre-review identifier, that is, the case can directly enter the audit node, the case after the first case acceptance information is currently generated can be directly examined.
  • the case is directly examined by detecting whether the case in which the first case acceptance information is currently generated is a pre-review case. If the case has not been pre-examined, the case needs to be pre-examined first. Only the cases that have undergone pre-review will enter the claim stage, which will prevent the case from being investigated and not resold before the review, and the case can not be adjusted when the case is reviewed, and can only be adjusted after the resale. The occurrence has shortened the review time.
  • FIGS. 2-4 are sequentially displayed as indicated by the arrows, these steps are not necessarily performed in the order indicated by the arrows. Except as explicitly stated herein, the execution of these steps is not strictly limited, and the steps may be performed in other orders. Moreover, at least some of the steps in FIGS. 2-4 may include a plurality of sub-steps or stages, which are not necessarily performed at the same time, but may be executed at different times, these sub-steps or stages The order of execution is not necessarily performed sequentially, but may be performed alternately or alternately with at least a portion of other steps or sub-steps or stages of other steps.
  • FIG. 5 is a schematic structural diagram of a policy processing apparatus according to an embodiment.
  • the policy processing apparatus may include:
  • the receiving module 510 is configured to receive user identifier and policy information sent by the terminal.
  • the insurance information obtaining module 520 is configured to acquire the insurance information corresponding to the user identifier.
  • the policy retention period selection module 530 is configured to select a policy warranty period from the acquired insurance information.
  • the expiration date selection module 540 is configured to select an expiration date from the received policy information.
  • the case acceptance module 550 is configured to: when the date of the insurance is within the time limit of the policy warranty period, select the first insurance information corresponding to the policy warranty period including the insurance date; and generate the first insurance information according to the policy information and the selected first insurance information.
  • the first case acceptance information when the date of the insurance is not within the time limit of the policy period, the second case acceptance information is generated according to the policy information, and the billing information is selected from the policy information; when the billing date in the billing information is located in the policy During the time range of the period, the third insurance information corresponding to the policy warranty period including the billing date is selected, and the third insurance information is added to the second case acceptance information.
  • the policy processing apparatus may further include:
  • the policy information selection module is configured to select the first type of insurance and the first type of treatment from the received policy information; and select the second type of insurance and the second type of treatment from the insurance information corresponding to the policy period including the date of the insurance.
  • the case acceptance module is further configured to select, from the selected first insurance information, second insurance information that matches the second risk type with the first type of insurance and the second type of treatment matches the first type of treatment; according to the policy information and The second insurance information generates the first case acceptance information.
  • the policy processing apparatus may further include:
  • the query module is configured to query whether there is an open case corresponding to the user identifier; when there is an open case corresponding to the user identifier, the first complexity of the open case is obtained.
  • the calculation module is configured to calculate a second complexity of the case corresponding to the currently generated first case acceptance information.
  • a priority configuration module configured to: when the first complexity is greater than the first threshold, and the second complexity is less than the second threshold, setting a case corresponding to the currently generated first case acceptance information has a higher priority than an open case The priority of the case review.
  • the audit module is used to review the case after the first case acceptance information is generated according to the audit priority.
  • the computing module can include:
  • the parameter obtaining unit is configured to obtain the claim amount, the number of visits, and the hospital stay time from the received policy information; and obtain an original sending time corresponding to the policy information and a credit corresponding to the user identifier.
  • the calculating unit is configured to calculate a second complexity of the case corresponding to the currently generated first case acceptance information according to the claim amount, the number of visits, the hospital stay, the original delivery time, and the credit.
  • the policy processing apparatus may further include:
  • the detecting module is configured to detect whether the current case for generating the first case acceptance information is a pre-review case.
  • the identifier adding module is configured to add a pre-examination identifier to the case in which the first case acceptance information is currently generated if the case in which the first case acceptance information is currently generated is a pre-review case.
  • the pre-audit module is configured to perform pre-review on the case in which the first case acceptance information is currently generated if there is a pre-review indicator in the case where the first case acceptance information is currently generated.
  • the audit module is also used to review the case in which the first case acceptance information is currently generated if there is no pre-review indicator in the case where the first case acceptance information is currently generated.
  • Each of the above-described policy processing devices may be implemented in whole or in part by software, hardware, and combinations thereof.
  • Each of the above modules may be embedded in or independent of the processor in the computer device, or may be stored in a memory in the computer device in a software form, so that the processor invokes the operations corresponding to the above modules.
  • a computer device which may be a server, and its internal structure diagram may be as shown in FIG. 6.
  • the computer device includes a processor, memory, network interface, and database connected by a system bus.
  • the processor of the computer device is used to provide computing and control capabilities.
  • the memory of the computer device includes a non-transitory computer readable instruction storage medium, an internal memory.
  • the non-transitory computer readable instruction storage medium stores an operating system, computer readable instructions, and a database.
  • the internal memory provides an environment for the operation of an operating system and computer readable instructions in a non-transitory computer readable instruction storage medium.
  • the network interface of the computer device is used to communicate with an external terminal via a network connection.
  • the computer readable instructions are executed by the processor to implement a policy processing method.
  • FIG. 6 is only a block diagram of a part of the structure related to the solution of the present application, and does not constitute a limitation of the computer device to which the solution of the present application is applied.
  • the specific computer device may It includes more or fewer components than those shown in the figures, or some components are combined, or have different component arrangements.
  • a computer device comprising a memory and one or more processors, the memory storing computer readable instructions, the computer readable instructions being executed by the processor, causing the one or more processors to perform the following steps: receiving the transmission by the terminal User identification and policy information; obtaining insurance information corresponding to the user identification; selecting the policy insurance period from the obtained insurance information; selecting the insurance date from the received policy information; when the insurance date is within the time range of the policy warranty period And selecting the first insurance information corresponding to the policy warranty period including the date of the insurance; and generating the first case acceptance information according to the policy information and the selected first insurance information; when the risk date is not within the time limit of the policy warranty period , generating second case acceptance information according to the policy information, and selecting billing information from the policy information; and when the billing date in the billing information is within the time range of the policy warranty period, selecting the policy period corresponding to the billing date including the billing date
  • the third insurance information is added, and the third insurance information is added to the second case acceptance information.
  • the processor may further implement the following steps: selecting the first type of insurance and the first type of treatment from the received policy information; and from the insurance information corresponding to the policy period including the date of the insurance. Selecting the second risk type and the second treatment type; and generating the first case acceptance information according to the policy information and the selected first insurance information, comprising: selecting the second risk type from the selected first insurance information a second insurance information matching the type of risk and matching the second type of treatment with the first type of treatment; and generating the first case acceptance information based on the policy information and the second insurance information.
  • the processor may further implement the following steps: query whether there is an open case corresponding to the user identifier; and when there is an open case corresponding to the user identifier, obtain the first of the open case Complexity; calculating a second complexity of the case corresponding to the currently generated first case acceptance information; when the first complexity is greater than the first threshold and the second complexity is less than the second threshold, setting the currently generated first
  • the priority of the case corresponding to the case acceptance information is higher than the review priority of the open case; and the case for generating the first case acceptance information is reviewed according to the audit priority.
  • the processor may further implement the following steps: obtaining the claim amount, the number of visits, and the hospital stay time from the received policy information; acquiring the original delivery time corresponding to the policy information and corresponding to the user identifier The credit level; and the second complexity of the case corresponding to the currently generated first case acceptance information based on the amount of the claim, the number of visits, the length of the hospital stay, the time of the original delivery, and the credit rating.
  • the processor executes the program, the following steps may be implemented: detecting whether the case in which the first case acceptance information is currently generated is a pre-review case; if the case in which the first case acceptance information is currently generated is a pre-review case , adding a pre-examination identifier to the case in which the first case acceptance information is currently generated; if there is a pre-review indicator in the case where the first case acceptance information is currently generated, the case after the current case reception information is generated is pre-positioned If there is no pre-review mark in the case where the first case acceptance information is currently generated, the case in which the first case acceptance information is currently generated is reviewed.
  • 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 steps of: receiving a user identification sent by the terminal And insurance policy information; obtaining insurance information corresponding to the user identification; selecting the policy insurance period from the obtained insurance information; selecting the insurance date from the received policy information; when the risk date is within the time range of the policy warranty period, Selecting the first insurance information corresponding to the policy warranty period including the date of the insurance; and generating the first case acceptance information according to the policy information and the selected first insurance information; when the date of the insurance is not within the time limit of the policy warranty period, Generating the second case acceptance information according to the policy information, and selecting the billing information from the policy information; and when the billing date in the billing information is within the time range of the policy warranty period, selecting the third corresponding to the policy warranty period including the billing date Insured information, and the third insurance information is added to the second case acceptance information.
  • the following steps may be further implemented: selecting the first type of insurance and the first type of treatment from the received policy information; and insuring the insurance policy corresponding to the policy including the date of the insurance.
  • the second risk type and the second treatment type are selected in the information;
  • the step of generating the first case acceptance information according to the policy information and the selected first insurance information comprises: selecting the second risk type from the selected first insurance information The second insurance information matching the first risk type and the second treatment type matching the first treatment type; and generating the first case acceptance information according to the policy information and the second insurance information.
  • the following steps may be further implemented: querying whether there is an open case corresponding to the user identifier; and when there is an open case corresponding to the user identifier, obtaining an open case a first complexity; calculating a second complexity of the case corresponding to the currently generated first case acceptance information; when the first complexity is greater than the first threshold, and the second complexity is less than the second threshold, setting the currently generated
  • the priority of the case corresponding to the first case acceptance information is higher than the review priority of the open case; and the case for generating the first case acceptance information is reviewed according to the audit priority.
  • the following steps may be further implemented: obtaining the claim amount, the number of visits, and the hospital stay time from the received policy information; obtaining the original delivery time corresponding to the policy information and the user Identifying the corresponding credit degree; and calculating the second complexity of the case corresponding to the currently generated first case acceptance information according to the claim amount, the number of visits, the hospital stay, the original delivery time, and the credit.
  • the following steps may be further implemented: detecting whether the case in which the first case acceptance information is currently generated is a pre-review case; if the case in which the first case acceptance information is currently generated is a pre-position When reviewing the case, the pre-examination mark is added to the case in which the first case acceptance information is currently generated; if the pre-examination mark is present in the case where the first case acceptance information is currently generated, the case in which the first case acceptance information is currently generated is performed. Pre-review; and if there is no pre-review indicator in the case where the first case acceptance information is currently generated, the case in which the first case acceptance information is currently generated is reviewed.
  • Non-volatile memory can include read only memory (ROM), programmable ROM (PROM), electrically programmable ROM (EPROM), electrically erasable programmable ROM (EEPROM), or flash memory.
  • Volatile memory can include random access memory (RAM) or external cache memory.
  • RAM is available in a variety of formats, such as static RAM (SRAM), dynamic RAM (DRAM), synchronous DRAM (SDRAM), double data rate SDRAM (DDRSDRAM), enhanced SDRAM (ESDRAM), synchronization chain.
  • SRAM static RAM
  • DRAM dynamic RAM
  • SDRAM synchronous DRAM
  • DDRSDRAM double data rate SDRAM
  • ESDRAM enhanced SDRAM
  • Synchlink DRAM SLDRAM
  • Memory Bus Radbus
  • RDRAM Direct RAM
  • DRAM Direct Memory Bus Dynamic RAM
  • RDRAM Memory Bus Dynamic RAM

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Abstract

一种保单处理方法，该方法包括接收终端发送的用户标识和保单信息；获取与用户标识对应的投保信息；从投保信息中选取保单保期；从保单信息中选取出险日期；当出险日期位于保单保期的时间范围时，则选取与包含出险日期的保单保期对应的第一投保信息；并根据保单信息与所选取的第一投保信息生成第一案件受理信息；当出险日期不位于保单保期的时间范围时，根据保单信息生成第二案件受理信息，并从保单信息中选取账单信息；当账单信息中的账单日期位于保单保期的时间范围内，选取与包含账单日期的保单保期对应的第三投保信息，将第三投保信息添加至第二案件受理信息。

Description

保单处理方法、装置、计算机设备及可读存储介质
相关申请的交叉引用
本申请要求于2017年9月13日提交中国专利局，申请号为2017108243289，申请名称为“保单处理方法、装置、计算机设备及可读存储介质”的中国专利申请的优先权，其全部内容通过引用结合在本申请中。
技术领域
本申请涉及一种保单处理方法、装置、计算机设备及可读存储介质。
背景技术
一般的，保险理赔处理流程包括报案、受理、审核和结案等环节，传统保险受理方式为人工受理，即柜台人员接收用户报案，同时接收用户提交的受理理赔材料，柜台人员在接收受理理赔材料后，将该受理理赔材料直接交给审核人员，审核人员需要人工来确定所受理的理赔材料是属于用户所买的哪一种保险，以及是否可以理赔等，从而会导致审核压力大，人力成本高。
发明内容
根据本申请公开的各种实施例，提供一种保单处理方法、装置、计算机设备及可读存储介质。
一种保单处理方法，包括：
接收终端发送的用户标识和保单信息；
获取与所述用户标识对应的投保信息；
从获取到的投保信息中选取保单保期；
从所接收的保单信息中选取出险日期；
当所述出险日期位于所述保单保期的时间范围内时，则选取与包含所述出险日期的保单保期对应的第一投保信息；并根据所述保单信息与所选取的第一投保信息生成第一案件受理信息；
当所述出险日期不位于所述保单保期的时间范围内时，则根据所述保单信息生成第二案件受理信息，并从所述保单信息中选取账单信息；及
当所述账单信息中的账单日期位于所述保单保期的时间范围内，则选取与包含所述账单日期的保单保期对应的第三投保信息，并将所述第三投保信息添加至所述第二案件受理信息中。
一种保单处理装置，包括：
接收模块，用于接收终端发送的用户标识和保单信息；
投保信息获取模块，用于获取与所述用户标识对应的投保信息；
保单保期选取模块，用于从获取到的投保信息中选取保单保期；
出险日期选取模块，用于从所接收的保单信息中选取出险日期；及
案件受理模块，用于当所述出险日期位于所述保单保期的时间范围内时，则选取与包含所述出险日期的保单保期对应的第一投保信息；并根据所述保单信息与所选取的第一投保信息生成第一案件受理信息；当所述出险日期不位于所述保单保期的时间范围内时，则根据所述保单信息生成第二案件受理信息，并从所述保单信息中选取账单信息；当所述账单信息中的账单日期位于所述保单保期的时间范围内，则选取与包含所述账单日期的保单保期对应的第三投保信息，并将所述第三投保信息添加至所述第二案件受理信息中。
一种计算机设备，包括存储器和一个或多个处理器，所述存储器中储存有计算机可读指令，所述计算机可读指令被所述处理器执行时，使得所述一个或多个处理器执行以下步骤：
接收终端发送的用户标识和保单信息；
获取与所述用户标识对应的投保信息；
从获取到的投保信息中选取保单保期；
从所接收的保单信息中选取出险日期；
当所述出险日期位于所述保单保期的时间范围内时，则选取与包含所述出险日期的保单保期对应的第一投保信息；并根据所述保单信息与所选取的第一投保信息生成第一案件受理信息；
当所述出险日期不位于所述保单保期的时间范围内时，则根据所述保单信息生成第二案件受理信息，并从所述保单信息中选取账单信息；及
当所述账单信息中的账单日期位于所述保单保期的时间范围内，则选取与包含所述账单日期的保单保期对应的第三投保信息，并将所述第三投保信息添加至所述第二案件受理信息中。
一个或多个存储有计算机可读指令的非易失性计算机可读指令存储介质，计算机可读指令被一个或多个处理器执行时，使得一个或多个处理器执行以下步骤：
接收终端发送的用户标识和保单信息；
获取与所述用户标识对应的投保信息；
从获取到的投保信息中选取保单保期；
从所接收的保单信息中选取出险日期；
当所述出险日期位于所述保单保期的时间范围内时，则选取与包含所述出险日期的保单保期对应的第一投保信息；并根据所述保单信息与所选取的第一投保信息生成第一案件受理信息；
当所述出险日期不位于所述保单保期的时间范围内时，则根据所述保单信息生成第二 案件受理信息，并从所述保单信息中选取账单信息；及
当所述账单信息中的账单日期位于所述保单保期的时间范围内，则选取与包含所述账单日期的保单保期对应的第三投保信息，并将所述第三投保信息添加至所述第二案件受理信息中。
本申请的一个或多个实施例的细节在下面的附图和描述中提出。本申请的其它特征和优点将从说明书、附图以及权利要求书变得明显。
附图说明
为了更清楚地说明本申请实施例中的技术方案，下面将对实施例中所需要使用的附图作简单地介绍，显而易见地，下面描述中的附图仅仅是本申请的一些实施例，对于本领域普通技术人员来讲，在不付出创造性劳动的前提下，还可以根据这些附图获得其它的附图。
图1为根据一个或多个实施例中保单处理方法的应用场景图。
图2为根据一个或多个实施例中的保单处理方法的流程图。
图3为根据一个或多个实施例中案件调整步骤的流程图。
图4为根据一个或多个实施例中的前置审核步骤的流程图。
图5为根据一个或多个实施例中的保单处理装置的结构示意图。
图6为根据一个或多个实施例中的计算机设备的结构示意图。
具体实施方式
为了使本申请的技术方案及优点更加清楚明白，以下结合附图及实施例，对本申请进行进一步详细说明。应当理解，此处所描述的具体实施例仅仅用于解释本申请，并不用于限定本申请。
参阅图1，图1为一实施例中保单处理方法的应用场景图，包括用户终端和计算机设备，该计算机设备为保单受理服务器，用于处理用户终端提交的保险数据。用户终端可以是购买保险的用户的终端，也可以是协助用户购买保险的业务员的终端，该用户终端可以是手机、平板电脑、台式电脑、手提电脑等设备。当用户终端将发起理赔请求时，计算机设备根据用户终端提交的保险数据确定是否受理该理赔请求。
请参阅图2，在其中一个实施例中，提供一种保单处理方法，本实施例以该方法应用到上述图1中的计算机设备来举例说明。该计算机设备上运行有保单处理程序，通过该保单处理程序来实施保单处理方法。该方法具体包括如下步骤：
S202：接收终端发送的用户标识和保单信息。
具体地，用户标识是可以唯一确定某一用户的身份的标识，例如，身份证号码、保单号等。保单信息是用户报案时所提供的信息，其可以包括出险日期、出险类型以及治疗类型等信息。
用户在发生险情后，可能去医院等地方进行治疗从而产生账单，当用户通过用户终端 发起理赔请求时，则通过用户终端向计算机设备，即保单受理服务器发送用户标识和保单信息。其中，计算机设备可以对保单信息进行检测，例如检测必传字段是否都发送到了计算机设备，且发送到计算机设备的必传字段的格式是否正确等，只有必传字段均正确才会进行下一步等。
S204：获取与用户标识对应的投保信息。
具体地，当计算机设备接收到用户终端发送的用户标识和保单信息后，可以根据用户标识获取投保信息。投保信息即用户所买的保险信息，例如一个用户可能购买了多份保险，例如用户甲可能既存在自己购买的人身保险、医疗保险，又存在公司给用户甲购买的人身保险和医疗保险等，通过用户标识可以调出其所购买的所有的保险，即用户甲的投保信息。其中若没有与用户标识对应的投保信息，则表示用户没有买过保险，因此可以直接拒绝理赔，即不受理。
S206：从获取到的投保信息中选取保单保期。
具体地，用户的投保信息不仅包含用户所购买的保险的类型，还包括每一保险的保单保期、保单责任等。保单保期即所购买的保险的保障期限，例如只有发生在保单保期内的险情才会进行理赔报销。保单责任即所购买的保险的理赔范围，例如大病保险只能是针对被保险人所患的国家所列出的25类大病进行理赔，且理赔金额也有所限制。
S208：从所接收的保单信息中选取出险日期。
具体地，计算机设备从所接收的保单信息中选取出险日期，例如用户在通过用户终端进行理赔时输入的出险日期。
S210：当出险日期位于保单保期的时间范围内时，则选取与包含出险日期的保单保期对应的第一投保信息；并根据保单信息与所选取的第一投保信息生成第一案件受理信息。
具体地，当出险日期位于保单保期的时间范围时，才会用户本次理赔请求进行理赔，因此选取与包含出险日期的保单保期对应的第一投保信息；并根据保单信息与所选取的第一投保信息生成第一案件受理信息，以便于后续对该案件进行审核后发放理赔款，其中，当出险日期位于保单保期的时间范围时，可以将与该出险日期对应的保单信息进行缓存。此外，当计算机设备生成第一案件受理信息后，可以将该第一案件受理信息发送到用户终端，以提示用户本次理赔请求已经被受理。
S212：当出险日期不位于所述保单保期的时间范围内时，则根据保单信息生成第二案件受理信息，并从保单信息中选取账单信息。
S214：当账单信息中的账单日期位于保单保期的时间范围内，则选取与包含账单日期的保单保期对应的第三投保信息，并将第三投保信息添加至第二案件受理信息中。
具体地，当出险日期不位于保单保期的时间范围内时，为了提高用户的体验，也将该理赔请求受理下来，即根据保单信息生成第二案件受理信息，并将该第二案件受理信息发送到用户终端。但是由于用户填写的出险日期可能不是真正出险日期，因此如果不受理该理赔请求，则会导致用户体验变差，因此为了防止该种情况的发生，计算机设备首先受理 该理赔请求，然后获取用户终端发送的保单信息中的账单信息，从该账单信息中选取账单日期，当该账单日期在某一保单保期内时，则选取包含账单日期的保单保期的第三投保信息，然后在所生成的第二案件受理信息中添加该包含账单日期的保单保期的第三投保信息，以为后续案件审核减轻压力。
上述保单处理方法，用户通过终端将理赔材料，即保单信息发送到服务器，服务器根据用户标识可以查询到用户已经买的保险，即投保信息，服务器根据所接收的保单信息中的出险日期可以查询到相应的保单，从而可以将保单信息和投保信息进行关联，生成第一案件受理信息，从而后续案件审核过程可以直接根据该第一案件受理信息进行，不需要审核人员来一一确定，减少了成本。
在其中一个实施例中，选取与包含出险日期的保单保期对应的第一投保信息的步骤之后，还可以包括从所接收的保单信息中选取第一出险类型和第一治疗类型从与包含出险日期的保单保期对应的投保信息中选取第二出险类型和第二治疗类型。从而根据保单信息与所选取的第一投保信息生成第一案件受理信息的步骤可以包括：从所选取的第一投保信息中，选取第二出险类型与第一出险类型相匹配且第二治疗类型与第一治疗类型相匹配的第二投保信息；根据保单信息以及第二投保信息生成第一案件受理信息。
具体地，根据客户的出险日期受理上所有的保单，其中会包括很多保期内责任不匹配的保单，仍然需要后期审核人员在理算时进行审核删除，导致后期人员审核时效低下，且增加系统的负载消耗。因此为了进一步减少后期审核人员的负担，可以从用户通过用户终端发送的保单信息中选取第一出险类型和第一治疗类型，出险类型即险种，例如人身保险、车险等，治疗类型即住院、急诊、手术等。用户所买的保险中也会包括出险类型和治疗类型，选取出包含出险日期的保单保期所对应的第一投保信息，然后从该些第一投保信息中选取第二出险类型和第二治疗类型，将第一出险类型和第二出险类型进行匹配，第一治疗类型和第二治疗类型进行匹配，如果匹配成功，则根据保单信息和匹配成功的的第二投保信息生成第一案件受理信息。
具体地，计算机设备可以先判断投保信息中用户的保单是标准单还是协议单，标准单是指个人保单，协议单是指团体单，例如公司团体单、家庭团体单、学校团体单等。当用户的保单为标准单时，则将第一出险类型和第二出险类型进行匹配，第一治疗类型和第二治疗类型进行匹配，如果匹配成功，则根据保单信息和匹配成功的的第二投保信息生成第一案件受理信息。当用户的保单为协议单时，首先根据保单号、层级等查询第二出险类型和第二治疗类型，再将第一出险类型和第二出险类型进行匹配，第一治疗类型和第二治疗类型进行匹配，如果匹配成功，则根据保单信息和匹配成功的的第二投保信息生成第一案件受理信息。其中保单号即协议单的协议号，层级可以是指不同的等级，例如当协议当为公司团体单时，其层级可以包括经理、秘书、普通职工等；当协议单为学校团体单时，层级可以包括校长、主任、老师、学生等。
上述实施例中，通过出险日期对理赔保单进行筛选，并结合客户申请原因，即出险类 型以及治疗类型进行责任匹配，将责任匹配上的保单受理上，自动去除无效保单，从而尽量避免后期审核人员在理算时理算场景复杂的情况发生，大大降低审核人员劳动强度，有效提升理赔时效。
在其中一个实施例中，根据保单信息与所选取的第一投保信息生成第一案件受理信息的步骤之后还可以包括：查询是否存在与用户标识对应的未结案案件；当存在与用户标识对应的未结案案件时，则获取未结案案件的第一复杂度；计算当前生成的第一案件受理信息所对应的案件的第二复杂度；当第一复杂度大于第一阈值，且第二复杂度小于第二阈值时，则设置当前生成的第一案件受理信息所对应的案件的审核优先级高于未结案案件的审核优先级；根据审核优先级，对生成第一案件受理信息后的案件进行审核。
在其中一个实施例中，计算当前生成的第一案件受理信息所对应的案件的第二复杂度的步骤可以包括：从所接收的保单信息中获取理赔金额、就诊次数以及住院时间；获取与保单信息对应的原件寄送时间以及与用户标识对应的信用度；根据理赔金额、就诊次数、住院时间、原件寄送时间以及信用度计算与当前生成的第一案件受理信息对应的案件的第二复杂度。
参阅图3，图3为根据一个或多个实施例中案件调整步骤的流程图，该案件调整步骤可以包括：
S302：查询是否存在与用户标识对应的未结案案件。
具体地，由于某一用户可能事先已经申请了一个案件理赔，假设为案件A，但是该案件A理赔还未结束，用户又申请了另外一个案件理赔，假设为案件B，由于为了避免重复理赔，每次只允许用户的一个案件处于理赔阶段，因此案件B只能等待案件A理赔结束后才能继续进行理赔。因此为了保证案件B的理赔期限，首先查询是否存在与用户标识对应的未结案案件，即上文中的案件A。
S304：当存在与用户标识对应的未结案案件时，则获取未结案案件的第一复杂度。
具体地，在每个案件进行理赔前，均要计算案件的复杂度，以便于确定该案件是否可以预先处理，案件复杂度的计算方式具体参见下文。
S306：从所接收的保单信息中获取理赔金额、就诊次数以及住院时间。
具体地，理赔金额是指用户申请理赔的金额；就诊次数是指用户去医院的次数，例如可以选取用户一定时间内去医院的次数，例如三个月内去医院的次数；住院时间即用户在出险日期后的住院时间。
S308：获取与保单信息对应的原件寄送时间以及与用户标识对应的信用度。
具体地，由于存在用户自己通过用户终端发送保单信息以进行理赔的情况，由于照片很容易出现造假的情况，所以在受理用户的理赔请求后，需要让用户将保单信息的原件寄送到特定地方，例如限制用户在一个月内将原件寄送到理赔中心，如果用户在1.5个月才将原件寄送到理赔中心，则原件寄送时间为1.5个月，超过预设时间1个月，如果用户在0.5个月就将原件寄送到理赔中心，则原件寄送时间为0.5个月，少于预设时间1个月。
信用度是指用户的信用情况，例如计算机设备可以事先存储用户的信用度，该信用度的计算可以包括：根据用户标识获取用户的贷款记录，用户办理其他银行卡的时间以及qq、淘宝等电商、公积金等数据，并选取这些数据中感兴趣的部分进行计算以获得用户的信用度，并实时进行存储。具体地，选取感兴趣的部分可以是根据预设的优先级进行选取，例如将固定资产作为第一优先级，将公积金、工资、股票等作为第二优先级，将qq、淘宝等电商作为第三优先级，然后给每一个优先级分配一定的权重，最后根据各个优先级中的资产额和权重获取用户的信用度。例如某个用户固定资产房产的资产额为300万，权重0.5，公积金为10万，权重0.3，支付宝20万，权重0.2，则经过计算300×0.5+10×0.3+20×0.2＝157，则其信用度可以根据157来计算。
S310：根据理赔金额、就诊次数、住院时间、原件寄送时间以及信用度计算与当前生成的第一案件受理信息对应的案件的第二复杂度。
具体地，在本实施例中，通过理赔金额、就诊次数、住院时间、原件寄送时间以及信用度这五个维度来计算第二复杂度，在其他的实施例中还可以引入其他的指标，在此不做限制。
可选地，第二复杂度＝a1×理赔金额+a2×信用度+a3×就诊次数+a4×住院时间+a5×原件寄送时间，其中a1、a2、a3、a4和a5为权值，可以根据不同的理赔类型进行调整，且a1+a2+a3+a4+a5＝1。
S312：当第一复杂度大于第一阈值，且第二复杂度小于第二阈值时，则设置当前生成的第一案件受理信息所对应的案件的审核优先级高于未结案案件的审核优先级。
具体地，第一阈值为复杂案件的划分阈值，复杂度大于第一阈值的案件，其为复杂案件，即审核周期长的案件，第二阈值为简单案件的划分阈值，复杂度小于第二阈值的案件，其为简单案件，即审核周期短的案件。由于每一用户在一个时间点只能有一个案件处理理赔审核周期中，如果当前处于审核周期中的案件，例如上文中的案件A为复杂案件时，则需要等待较长的时间，案件B才能够进入审核周期，假设案件B为简单案件，这样就会导致简单案件B的审核周期也会较长，从而使得用户体验变差，为了避免该种情况的发生，通过计算案件的复杂度来设置案件的审核优先级，若当前生成的第一案件受理信息所对应的案件的为简单案件，且当前处于审核周期中的案件为复杂案件，则会设置该简单案件的审核优先级高于该复杂案件的审核优先级，从而可以先对简单案件进行审核理赔，在简单案件审核理赔后，再对复杂案件进行进一步的理赔。
S314：根据审核优先级，对生成第一案件受理信息后的案件进行审核。
具体地，当设置好审核优先级后，则计算机设备会根据该审核优先级，对已经受理的案件进行审核，例如先审优先级较高的案件，待优先级较高的案件审核完毕后，再继续审核优先级低的案件。
上述实施例中，通过案件的复杂度来设置案件的审核优先级，被复杂前案锁住的简单后案可以先进行理赔，提高后案的理赔时效；且不因客户提交案件顺序原因导致该客户所 有案件时效都拉长，提高客户满意度。
参阅图4，图4为根据一个或多个实施例中的前置审核步骤的流程图，该前置审查步骤可以是在图2所示的实施例中的步骤S210的之后被执行，即在根据保单信息与所选取的第一投保信息生成第一案件受理信息的步骤之后，还可以包括：
S402：检测当前生成第一案件受理信息的案件是否为前置审查案件。
具体地，前置审查案件是指没有经过回销的案件。其中保单签订以后，客户付款成功，这个时候生效的保单要拿给客户签字确认，这个过叫做回销。最开始回销的目的是防止业务员的违规行为，同时再次向客户说明权利和义务，防止销售误导。
计算机设备可以根据当前生成第一案件受理信息的案件的投保信息来确定案件是否为前置审查案件，例如当案件为前置审查案件时，则将案件的前置审查标识置1，当案件不为前置审查案件时，则将案件的前置审查标识置0。
S404：若当前生成第一案件受理信息的案件为前置审查案件，则对当前生成第一案件受理信息的案件增加前置审查标识。
具体地，当前生成第一案件受理信息的案件为前置审查案件时，则对当前生成第一案件受理信息的案件增加前置审查标识，例如将前置审查标识置1。
S406：若当前生成第一案件受理信息的案件存在前置审查标识时，则对当前生成第一案件受理信息后的案件进行前置审查。
具体地，当案件存在前置审查标识时，则对案件进行前置审查，从而可以防止案件理赔时效的增加，例如在辅助录入之后，案件推动过程中，如果案件在此刻仍未进行回销，原有的逻辑并不关注是否回销，仍然将案件向下推动，流转。这就造成了案件在审核之前仍没有回销。而且审核时候，不能理算，只能等到回销之后方能够理算，这样严重的拖长了时效。但是将前置审查放在案件理赔之前，可以首先对案件进行回销，只有完成回销的案件才会进入理赔环节，这样可以缩短理赔环节的时长，即在针对前置调查案件，案件完成审核录入后，流转工作流的时候，对案件如果发起过前置调查，则在此刻不将工作流推向到审核节点，而是将案件推到审核调查，同时不被用户获取和分配。只有待案件调查回销后才允许用户获取和分配。
S408：若当前生成第一案件受理信息的案件无前置审查标识时，则对当前生成第一案件受理信息后的案件进行审核。
具体地，若当前生成第一案件受理信息的案件无前置审查标识，即该案件可以直接进入审核节点，则可以直接对当前生成第一案件受理信息后的案件进行审核。
上述实施例中，通过检测当前生成第一案件受理信息的案件是否为前置审查案件来确定是否直接对案件进行审核，如果案件还未进行过前置审查，则需要首先对案件进行前置审查，只有经过前置审查的案件才会进入理赔阶段，这样可以防止案件在审核之前的仍有调查没有回销，而且案件审核时候，不能理算，只能等到回销之后方能够理算的情况的发生，缩短了审核时效。
应该理解的是，虽然图2-4的流程图中的各个步骤按照箭头的指示依次显示，但是这些步骤并不是必然按照箭头指示的顺序依次执行。除非本文中有明确的说明，这些步骤的执行并没有严格的顺序限制，这些步骤可以以其它的顺序执行。而且，图2-4中的至少一部分步骤可以包括多个子步骤或者多个阶段，这些子步骤或者阶段并不必然是在同一时刻执行完成，而是可以在不同的时刻执行，这些子步骤或者阶段的执行顺序也不必然是依次进行，而是可以与其它步骤或者其它步骤的子步骤或者阶段的至少一部分轮流或者交替地执行。
参阅图5，图5为一实施例中的保单处理装置的结构示意图，该保单处理装置可以包括：
接收模块510，用于接收终端发送的用户标识和保单信息。
投保信息获取模块520，用于获取与用户标识对应的投保信息。
保单保期选取模块530，用于从获取到的投保信息中选取保单保期。
出险日期选取模块540，用于从所接收的保单信息中选取出险日期。
案件受理模块550，用于当出险日期位于保单保期的时间范围内时，则选取与包含出险日期的保单保期对应的第一投保信息；并根据保单信息与所选取的第一投保信息生成第一案件受理信息；当出险日期不位于保单保期的时间范围内时，则根据保单信息生成第二案件受理信息，并从保单信息中选取账单信息；当账单信息中的账单日期位于保单保期的时间范围内，则选取与包含账单日期的保单保期对应的第三投保信息，并将第三投保信息添加至第二案件受理信息中。
在其中一个实施例中，该保单处理装置还可以包括：
保单信息选取模块，用于从所接收的保单信息中选取第一出险类型和第一治疗类型；从与包含出险日期的保单保期对应的投保信息中选取第二出险类型和第二治疗类型。
案件受理模块还用于从所选取的第一投保信息中，选取第二出险类型与第一出险类型相匹配且第二治疗类型与第一治疗类型相匹配的第二投保信息；根据保单信息以及第二投保信息生成第一案件受理信息。
在其中一个实施例中，该保单处理装置还可以包括：
查询模块，用于查询是否存在与用户标识对应的未结案案件；当存在与用户标识对应的未结案案件时，则获取未结案案件的第一复杂度。
计算模块，用于计算当前生成的第一案件受理信息所对应的案件的第二复杂度。
优先级配置模块，用于当第一复杂度大于第一阈值，且第二复杂度小于第二阈值时，则设置当前生成的第一案件受理信息所对应的案件的审核优先级高于未结案案件的审核优先级。
审核模块，用于根据审核优先级，对生成第一案件受理信息后的案件进行审核。
在其中一个实施例中，该计算模块可以包括：
参数获取单元，用于从所接收的保单信息中获取理赔金额、就诊次数以及住院时间； 以及获取与保单信息对应的原件寄送时间以及与用户标识对应的信用度。
计算单元，用于根据理赔金额、就诊次数、住院时间、原件寄送时间以及信用度计算与当前生成的第一案件受理信息对应的案件的第二复杂度。
在其中一个实施例中，该保单处理装置还可以包括：
检测模块，用于检测当前生成第一案件受理信息的案件是否为前置审查案件。
标识添加模块，用于若当前生成第一案件受理信息的案件为前置审查案件，则对当前生成第一案件受理信息的案件增加前置审查标识。
前置审核模块，用于若当前生成第一案件受理信息的案件存在前置审查标识时，则对当前生成第一案件受理信息后的案件进行前置审查。
审核模块还用于若当前生成第一案件受理信息的案件无前置审查标识时，则对当前生成第一案件受理信息的案件进行审核。
关于保单处理装置的具体限定可以参见上文中对于保单处理方法的限定，在此不再赘述。上述保单处理装置中的各个模块可全部或部分通过软件、硬件及其组合来实现。上述各模块可以硬件形式内嵌于或独立于计算机设备中的处理器中，也可以以软件形式存储于计算机设备中的存储器中，以便于处理器调用执行以上各个模块对应的操作。
在一个实施例中，提供了一种计算机设备，该计算机设备可以是服务器，其内部结构图可以如图6所示。该计算机设备包括通过系统总线连接的处理器、存储器、网络接口和数据库。其中，该计算机设备的处理器用于提供计算和控制能力。该计算机设备的存储器包括非易失性计算机可读指令存储介质、内存储器。该非易失性计算机可读指令存储介质存储有操作系统、计算机可读指令和数据库。该内存储器为非易失性计算机可读指令存储介质中的操作系统和计算机可读指令的运行提供环境。该计算机设备的网络接口用于与外部的终端通过网络连接通信。该计算机可读指令被处理器执行时以实现一种保单处理方法。
本领域技术人员可以理解，图6中示出的结构，仅仅是与本申请方案相关的部分结构的框图，并不构成对本申请方案所应用于其上的计算机设备的限定，具体的计算机设备可以包括比图中所示更多或更少的部件，或者组合某些部件，或者具有不同的部件布置。一种计算机设备，包括存储器和一个或多个处理器，存储器中储存有计算机可读指令，计算机可读指令被处理器执行时，使得一个或多个处理器执行以下步骤：：接收终端发送的用户标识和保单信息；获取与用户标识对应的投保信息；从获取到的投保信息中选取保单保期；从所接收的保单信息中选取出险日期；当出险日期位于保单保期的时间范围内时，则选取与包含出险日期的保单保期对应的第一投保信息；并根据保单信息与所选取的第一投保信息生成第一案件受理信息；当出险日期不位于保单保期的时间范围内时，则根据保单信息生成第二案件受理信息，并从保单信息中选取账单信息；及当账单信息中的账单日期位于保单保期的时间范围内，则选取与包含账单日期的保单保期对应的第三投保信息，并将第三投保信息添加至第二案件受理信息中。
在其中一个实施例中，处理器执行程序时还可以实现以下步骤：从所接收的保单信息中选取第一出险类型和第一治疗类型；从与包含出险日期的保单保期对应的投保信息中选取第二出险类型和第二治疗类型；根据保单信息与所选取的第一投保信息生成第一案件受理信息的步骤，包括：从所选取的第一投保信息中，选取第二出险类型与第一出险类型相匹配且第二治疗类型与第一治疗类型相匹配的第二投保信息；及根据保单信息以及第二投保信息生成第一案件受理信息。
在其中一个实施例中，处理器执行程序时还可以实现以下步骤：查询是否存在与用户标识对应的未结案案件；当存在与用户标识对应的未结案案件时，则获取未结案案件的第一复杂度；计算当前生成的第一案件受理信息所对应的案件的第二复杂度；当第一复杂度大于第一阈值，且第二复杂度小于第二阈值时，则设置当前生成的第一案件受理信息所对应的案件的审核优先级高于未结案案件的审核优先级；及根据审核优先级，对生成第一案件受理信息的案件进行审核。
在其中一个实施例中，处理器执行程序时还可以实现以下步骤：从所接收的保单信息中获取理赔金额、就诊次数以及住院时间；获取与保单信息对应的原件寄送时间以及与用户标识对应的信用度；及根据理赔金额、就诊次数、住院时间、原件寄送时间以及信用度计算与当前生成的第一案件受理信息对应的案件的第二复杂度。
在其中一个实施例中，处理器执行程序时还可以实现以下步骤：检测当前生成第一案件受理信息的案件是否为前置审查案件；若当前生成第一案件受理信息的案件为前置审查案件，则对当前生成第一案件受理信息的案件增加前置审查标识；若当前生成第一案件受理信息的案件存在前置审查标识时，则对当前生成第一案件受理信息后的案件进行前置审查；及若当前生成第一案件受理信息的案件无前置审查标识时，则对当前生成第一案件受理信息的案件进行审核。
一个或多个存储有计算机可读指令的非易失性存储介质，计算机可读指令被一个或多个处理器执行时，使得一个或多个处理器执行以下步骤：：接收终端发送的用户标识和保单信息；获取与用户标识对应的投保信息；从获取到的投保信息中选取保单保期；从所接收的保单信息中选取出险日期；当出险日期位于保单保期的时间范围内时，则选取与包含出险日期的保单保期对应的第一投保信息；并根据保单信息与所选取的第一投保信息生成第一案件受理信息；当出险日期不位于保单保期的时间范围内时，则根据保单信息生成第二案件受理信息，并从保单信息中选取账单信息；及当账单信息中的账单日期位于保单保期的时间范围内，则选取与包含账单日期的保单保期对应的第三投保信息，并将第三投保信息添加至第二案件受理信息中。
在其中一个实施例中，该程序被处理器执行时还可以实现以下步骤：从所接收的保单信息中选取第一出险类型和第一治疗类型；从与包含出险日期的保单保期对应的投保信息中选取第二出险类型和第二治疗类型；根据保单信息与所选取的第一投保信息生成第一案件受理信息的步骤，包括：从所选取的第一投保信息中，选取第二出险类型与第一出险类 型相匹配且第二治疗类型与第一治疗类型相匹配的第二投保信息；及根据保单信息以及第二投保信息生成第一案件受理信息。
在其中一个实施例中，该程序被处理器执行时还可以实现以下步骤：查询是否存在与用户标识对应的未结案案件；当存在与用户标识对应的未结案案件时，则获取未结案案件的第一复杂度；计算当前生成的第一案件受理信息所对应的案件的第二复杂度；当第一复杂度大于第一阈值，且第二复杂度小于第二阈值时，则设置当前生成的第一案件受理信息所对应的案件的审核优先级高于未结案案件的审核优先级；及根据审核优先级，对生成第一案件受理信息的案件进行审核。
在其中一个实施例中，该程序被处理器执行时还可以实现以下步骤：从所接收的保单信息中获取理赔金额、就诊次数以及住院时间；获取与保单信息对应的原件寄送时间以及与用户标识对应的信用度；及根据理赔金额、就诊次数、住院时间、原件寄送时间以及信用度计算与当前生成的第一案件受理信息对应的案件的第二复杂度。
在其中一个实施例中，该程序被处理器执行时还可以实现以下步骤：检测当前生成第一案件受理信息的案件是否为前置审查案件；若当前生成第一案件受理信息的案件为前置审查案件，则对当前生成第一案件受理信息的案件增加前置审查标识；若当前生成第一案件受理信息的案件存在前置审查标识时，则对当前生成第一案件受理信息后的案件进行前置审查；及若当前生成第一案件受理信息的案件无前置审查标识时，则对当前生成第一案件受理信息的案件进行审核。
本领域普通技术人员可以理解实现上述实施例方法中的全部或部分流程，是可以通过计算机可读指令来指令相关的硬件来完成，所述的计算机可读指令可存储于一非易失性计算机可读取存储介质中，该计算机可读指令在执行时，可包括如上述各方法的实施例的流程。其中，本申请所提供的各实施例中所使用的对存储器、存储、数据库或其它介质的任何引用，均可包括非易失性和/或易失性存储器。非易失性存储器可包括只读存储器(ROM)、可编程ROM(PROM)、电可编程ROM(EPROM)、电可擦除可编程ROM(EEPROM)或闪存。易失性存储器可包括随机存取存储器(RAM)或者外部高速缓冲存储器。作为说明而非局限，RAM以多种形式可得，诸如静态RAM(SRAM)、动态RAM(DRAM)、同步DRAM(SDRAM)、双数据率SDRAM(DDRSDRAM)、增强型SDRAM(ESDRAM)、同步链路(Synchlink)DRAM(SLDRAM)、存储器总线(Rambus)直接RAM(RDRAM)、直接存储器总线动态RAM(DRDRAM)、以及存储器总线动态RAM(RDRAM)等。
以上所述实施例的各技术特征可以进行任意的组合，为使描述简洁，未对上述实施例中的各个技术特征所有可能的组合都进行描述，然而，只要这些技术特征的组合不存在矛盾，都应当认为是本说明书记载的范围。
以上所述实施例仅表达了本申请的几种实施方式，其描述较为具体和详细，但并不能因此而理解为对发明专利范围的限制。应当指出的是，对于本领域的普通技术人员来说， 在不脱离本申请构思的前提下，还可以做出若干变形和改进，这些都属于本申请的保护范围。因此，本申请专利的保护范围应以所附权利要求为准。

Claims (20)

  1. 一种保单处理方法，包括：
    接收终端发送的用户标识和保单信息；
    获取与所述用户标识对应的投保信息；
    从获取到的投保信息中选取保单保期；
    从所接收的保单信息中选取出险日期；
    当所述出险日期位于所述保单保期的时间范围内时，则选取与包含所述出险日期的保单保期对应的第一投保信息；并根据所述保单信息与所选取的第一投保信息生成第一案件受理信息；
    当所述出险日期不位于所述保单保期的时间范围内时，则根据所述保单信息生成第二案件受理信息，并从所述保单信息中选取账单信息；及
    当所述账单信息中的账单日期位于所述保单保期的时间范围内，则选取与包含所述账单日期的保单保期对应的第三投保信息，并将所述第三投保信息添加至所述第二案件受理信息中。
  2. 根据权利要求1所述的方法，其特征在于，所述选取与包含所述出险日期的保单保期对应的第一投保信息之后，还包括：
    从所接收的保单信息中选取第一出险类型和第一治疗类型；
    从与包含所述出险日期的保单保期对应的投保信息中选取第二出险类型和第二治疗类型；及
    所述根据所述保单信息与所选取的第一投保信息生成第一案件受理信息，包括：
    从所选取的第一投保信息中，选取所述第二出险类型与所述第一出险类型相匹配且所述第二治疗类型与所述第一治疗类型相匹配的第二投保信息；
    根据所述保单信息以及所述第二投保信息生成第一案件受理信息。
  3. 根据权利要求2所述的方法，其特征在于，所述根据所述保单信息与所选取的第一投保信息生成第一案件受理信息之后，还包括：
    查询是否存在与所述用户标识对应的未结案案件；
    当存在与所述用户标识对应的未结案案件时，则获取所述未结案案件的第一复杂度；
    计算当前生成的第一案件受理信息所对应的案件的第二复杂度；
    当所述第一复杂度大于第一阈值，且所述第二复杂度小于第二阈值时，则设置当前生成的第一案件受理信息所对应的案件的审核优先级高于所述未结案案件的审核优先级；及根据所述审核优先级，对生成第一案件受理信息的案件进行审核。
  4. 根据权利要求3所述的方法，其特征在于，所述计算当前生成的第一案件受理信息所对应的案件的第二复杂度，包括：
    从所接收的保单信息中获取理赔金额、就诊次数以及住院时间；
    获取与所述保单信息对应的原件寄送时间以及与所述用户标识对应的信用度；及
    根据所述理赔金额、就诊次数、住院时间、原件寄送时间以及信用度计算与当前生成的第一案件受理信息对应的案件的第二复杂度。
  5. 根据权利要求1所述的方法，其特征在于，所述根据所述保单信息与所选取的第一投保信息生成第一案件受理信息之后，还包括：
    检测当前生成第一案件受理信息的案件是否为前置审查案件；
    若当前生成第一案件受理信息的案件为前置审查案件，则对当前生成第一案件受理信息的案件增加前置审查标识；
    若当前生成第一案件受理信息的案件存在前置审查标识时，则对当前生成第一案件受理信息后的案件进行前置审查；及
    若当前生成第一案件受理信息的案件无前置审查标识时，则对当前生成第一案件受理信息的案件进行审核。
  6. 一种保单处理装置，包括：
    接收模块，用于接收终端发送的用户标识和保单信息；
    投保信息获取模块，用于获取与所述用户标识对应的投保信息；
    保单保期选取模块，用于从获取到的投保信息中选取保单保期；
    出险日期选取模块，用于从所接收的保单信息中选取出险日期；及
    案件受理模块，用于当所述出险日期位于所述保单保期的时间范围内时，则选取与包含所述出险日期的保单保期对应的第一投保信息；并根据所述保单信息与所选取的第一投保信息生成第一案件受理信息；当所述出险日期不位于所述保单保期的时间范围内时，则根据所述保单信息生成第二案件受理信息，并从所述保单信息中选取账单信息；当所述账单信息中的账单日期位于所述保单保期的时间范围内，则选取与包含所述账单日期的保单保期对应的第三投保信息，并将所述第三投保信息添加至所述第二案件受理信息中。
  7. 根据权利要求6所述的装置，其特征在于，所述装置还包括：
    保单信息选取模块，用于从所接收的保单信息中选取第一出险类型和第一治疗类型；从与包含所述出险日期的保单保期对应的投保信息中选取第二出险类型和第二治疗类型；及
    所述案件受理模块还用于从所选取的第一投保信息中，选取所述第二出险类型与所述第一出险类型相匹配且所述第二治疗类型与所述第一治疗类型相匹配的第二投保信息；根据所述保单信息以及所述第二投保信息生成第一案件受理信息。
  8. 根据权利要求7所述的装置，其特征在于，所述装置还包括：
    查询模块，用于查询是否存在与所述用户标识对应的未结案案件；当存在与所述用户标识对应的未结案案件时，则获取所述未结案案件的第一复杂度；
    计算模块，用于计算当前生成的第一案件受理信息所对应的案件的第二复杂度；
    优先级配置模块，用于当所述第一复杂度大于第一阈值，且所述第二复杂度小于第二阈值时，则设置当前生成的第一案件受理信息所对应的案件的审核优先级高于所述未结案 案件的审核优先级；及
    审核模块，用于根据所述审核优先级，对生成第一案件受理信息后的案件进行审核。
  9. 根据权利要求8所述的装置，其特征在于，所述计算模块包括：
    参数获取单元，用于从所接收的保单信息中获取理赔金额、就诊次数以及住院时间；获取与所述保单信息对应的原件寄送时间以及与所述用户标识对应的信用度；及
    计算单元，用于根据所述理赔金额、就诊次数、住院时间、原件寄送时间以及信用度计算与当前生成的第一案件受理信息对应的案件的第二复杂度。
  10. 根据权利要求6所述的装置，其特征在于，所述装置还包括：
    检测模块，用于检测当前生成第一案件受理信息的案件是否为前置审查案件；
    标识添加模块，用于若当前生成第一案件受理信息的案件为前置审查案件，则对当前生成第一案件受理信息的案件增加前置审查标识；
    前置审核模块，用于若当前生成第一案件受理信息的案件存在前置审查标识时，则对当前生成第一案件受理信息后的案件进行前置审查；及
    所述审核模块还用于若当前生成第一案件受理信息的案件无前置审查标识时，则对当前生成第一案件受理信息的案件进行审核。
  11. 一种计算机设备，包括存储器及一个或多个处理器，所述存储器中储存有计算机可读指令，所述计算机可读指令被所述一个或多个处理器执行时，使得所述一个或多个处理器执行以下步骤：
    接收终端发送的用户标识和保单信息；
    获取与所述用户标识对应的投保信息；
    从获取到的投保信息中选取保单保期；
    从所接收的保单信息中选取出险日期；
    当所述出险日期位于所述保单保期的时间范围内时，则选取与包含所述出险日期的保单保期对应的第一投保信息；并根据所述保单信息与所选取的第一投保信息生成第一案件受理信息；
    当所述出险日期不位于所述保单保期的时间范围内时，则根据所述保单信息生成第二案件受理信息，并从所述保单信息中选取账单信息；及
    当所述账单信息中的账单日期位于所述保单保期的时间范围内，则选取与包含所述账单日期的保单保期对应的第三投保信息，并将所述第三投保信息添加至所述第二案件受理信息中。
  12. 根据权利要求11所述的计算机设备，其特征在于，所述处理器执行所述计算机可读指令时所实现的所述选取与包含所述出险日期的保单保期对应的第一投保信息之后，还包括：
    从所接收的保单信息中选取第一出险类型和第一治疗类型；
    从与包含所述出险日期的保单保期对应的投保信息中选取第二出险类型和第二治疗 类型；及
    所述处理器执行所述计算机可读指令时所实现的所述根据所述保单信息与所选取的第一投保信息生成第一案件受理信息，包括：
    从所选取的第一投保信息中，选取所述第二出险类型与所述第一出险类型相匹配且所述第二治疗类型与所述第一治疗类型相匹配的第二投保信息；
    根据所述保单信息以及所述第二投保信息生成第一案件受理信息。
  13. 根据权利要求12所述的计算机设备，其特征在于，所述处理器执行所述计算机可读指令时所实现的所述根据所述保单信息与所选取的第一投保信息生成第一案件受理信息之后，还包括：
    查询是否存在与所述用户标识对应的未结案案件；
    当存在与所述用户标识对应的未结案案件时，则获取所述未结案案件的第一复杂度；
    计算当前生成的第一案件受理信息所对应的案件的第二复杂度；
    当所述第一复杂度大于第一阈值，且所述第二复杂度小于第二阈值时，则设置当前生成的第一案件受理信息所对应的案件的审核优先级高于所述未结案案件的审核优先级；及
    根据所述审核优先级，对生成第一案件受理信息的案件进行审核。
  14. 根据权利要求13所述的计算机设备，其特征在于，所述处理器执行所述计算机可读指令时所实现的所述计算当前生成的第一案件受理信息所对应的案件的第二复杂度，包括：
    从所接收的保单信息中获取理赔金额、就诊次数以及住院时间；
    获取与所述保单信息对应的原件寄送时间以及与所述用户标识对应的信用度；及
    根据所述理赔金额、就诊次数、住院时间、原件寄送时间以及信用度计算与当前生成的第一案件受理信息对应的案件的第二复杂度。
  15. 根据权利要求11所述的计算机设备，其特征在于，所述处理器执行所述计算机可读指令时所实现的所述根据所述保单信息与所选取的第一投保信息生成第一案件受理信息之后，还包括：
    检测当前生成第一案件受理信息的案件是否为前置审查案件；
    若当前生成第一案件受理信息的案件为前置审查案件，则对当前生成第一案件受理信息的案件增加前置审查标识；
    若当前生成第一案件受理信息的案件存在前置审查标识时，则对当前生成第一案件受理信息后的案件进行前置审查；及
    若当前生成第一案件受理信息的案件无前置审查标识时，则对当前生成第一案件受理信息的案件进行审核。
  16. 一个或多个存储有计算机可读指令的非易失性计算机可读存储介质，所述计算机可读指令被一个或多个处理器执行时，使得所述一个或多个处理器执行以下步骤：
    接收终端发送的用户标识和保单信息；
    获取与所述用户标识对应的投保信息；
    从获取到的投保信息中选取保单保期；
    从所接收的保单信息中选取出险日期；
    当所述出险日期位于所述保单保期的时间范围内时，则选取与包含所述出险日期的保单保期对应的第一投保信息；并根据所述保单信息与所选取的第一投保信息生成第一案件受理信息；
    当所述出险日期不位于所述保单保期的时间范围内时，则根据所述保单信息生成第二案件受理信息，并从所述保单信息中选取账单信息；及
    当所述账单信息中的账单日期位于所述保单保期的时间范围内，则选取与包含所述账单日期的保单保期对应的第三投保信息，并将所述第三投保信息添加至所述第二案件受理信息中。
  17. 根据权利要求16所述的存储介质，其特征在于，所述计算机可读指令被所述处理器执行时所实现的所述选取与包含所述出险日期的保单保期对应的第一投保信息之后，还包括：
    从所接收的保单信息中选取第一出险类型和第一治疗类型；
    从与包含所述出险日期的保单保期对应的投保信息中选取第二出险类型和第二治疗类型；及
    所述计算机可读指令被所述处理器执行时所实现的所述根据所述保单信息与所选取的第一投保信息生成第一案件受理信息，包括：
    从所选取的第一投保信息中，选取所述第二出险类型与所述第一出险类型相匹配且所述第二治疗类型与所述第一治疗类型相匹配的第二投保信息；
    根据所述保单信息以及所述第二投保信息生成第一案件受理信息。
  18. 根据权利要求17所述的存储介质，其特征在于，所述计算机可读指令被所述处理器执行时所实现的所述根据所述保单信息与所选取的第一投保信息生成第一案件受理信息之后，还包括：
    查询是否存在与所述用户标识对应的未结案案件；
    当存在与所述用户标识对应的未结案案件时，则获取所述未结案案件的第一复杂度；
    计算当前生成的第一案件受理信息所对应的案件的第二复杂度；
    当所述第一复杂度大于第一阈值，且所述第二复杂度小于第二阈值时，则设置当前生成的第一案件受理信息所对应的案件的审核优先级高于所述未结案案件的审核优先级；及
    根据所述审核优先级，对生成第一案件受理信息的案件进行审核。
  19. 根据权利要求18所述的存储介质，其特征在于，所述计算机可读指令被所述处理器执行时所实现的所述计算当前生成的第一案件受理信息所对应的案件的第二复杂度，包括：
    从所接收的保单信息中获取理赔金额、就诊次数以及住院时间；
    获取与所述保单信息对应的原件寄送时间以及与所述用户标识对应的信用度；及
    根据所述理赔金额、就诊次数、住院时间、原件寄送时间以及信用度计算与当前生成的第一案件受理信息对应的案件的第二复杂度。
  20. 根据权利要求16所述的存储介质，其特征在于，所述计算机可读指令被所述处理器执行时所实现的所述根据所述保单信息与所选取的第一投保信息生成第一案件受理信息之后，还包括：
    检测当前生成第一案件受理信息的案件是否为前置审查案件；
    若当前生成第一案件受理信息的案件为前置审查案件，则对当前生成第一案件受理信息的案件增加前置审查标识；
    若当前生成第一案件受理信息的案件存在前置审查标识时，则对当前生成第一案件受理信息后的案件进行前置审查；及
    若当前生成第一案件受理信息的案件无前置审查标识时，则对当前生成第一案件受理信息的案件进行审核。
PCT/CN2018/088722 2017-09-13 2018-05-28 保单处理方法、装置、计算机设备及可读存储介质 WO2019052222A1 (zh)

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CN108985945A (zh) * 2018-06-12 2018-12-11 中国平安人寿保险股份有限公司 一种保险的年金结算方法及服务器
CN108984754B (zh) * 2018-07-18 2023-04-18 平安科技（深圳）有限公司 客户信息更新方法、装置、计算机设备及存储介质
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CN109360113B (zh) * 2018-12-14 2021-04-13 泰康保险集团股份有限公司 一种保单的自动理算方法、装置、介质及电子设备
CN111489261B (zh) * 2020-04-16 2023-07-14 中国大地财产保险股份有限公司 一种再保险业务处理方法、装置、设备及可读存储介质
CN113283996A (zh) * 2021-05-27 2021-08-20 北京健康之家科技有限公司 一种保单筛选方法及存储介质
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