WO2019090982A1 - 保险理赔流程的处理方法及装置 - Google Patents

保险理赔流程的处理方法及装置 Download PDF

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Publication number
WO2019090982A1
WO2019090982A1 PCT/CN2018/074618 CN2018074618W WO2019090982A1 WO 2019090982 A1 WO2019090982 A1 WO 2019090982A1 CN 2018074618 W CN2018074618 W CN 2018074618W WO 2019090982 A1 WO2019090982 A1 WO 2019090982A1
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Prior art keywords
insurance
post node
current
node
dictionary
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PCT/CN2018/074618
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English (en)
French (fr)
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李响
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平安科技(深圳)有限公司
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Publication of WO2019090982A1 publication Critical patent/WO2019090982A1/zh

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    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06QINFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q40/00Finance; Insurance; Tax strategies; Processing of corporate or income taxes
    • G06Q40/08Insurance
    • GPHYSICS
    • G06COMPUTING; CALCULATING OR COUNTING
    • G06QINFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES; SYSTEMS OR METHODS SPECIALLY ADAPTED FOR ADMINISTRATIVE, COMMERCIAL, FINANCIAL, MANAGERIAL OR SUPERVISORY PURPOSES, NOT OTHERWISE PROVIDED FOR
    • G06Q10/00Administration; Management
    • G06Q10/10Office automation; Time management
    • G06Q10/103Workflow collaboration or project management

Definitions

  • the present application relates to the field of insurance claims technology, and in particular, to an insurance claim processing method and apparatus.
  • Insurance claims refer to the insurance company's performance of compensation or payment according to the contract when the insured's property is damaged or the insured's property is damaged or the life of the insured is damaged, or other insurance accidents stipulated in the insurance policy are required to pay the insurance premium.
  • the act of responsibility is the work that directly reflects the insurance function and fulfills the insurance liability.
  • the insurance claims process is divided into different claims process post nodes from case acceptance, bill entry, claims review, claims sampling, claims notification, claims negotiation, etc. Each claim process post node is defined according to the operation authority of the salesperson.
  • the insurance claims process is promoted manually. Specifically, on a claim process post node in the insurance claims process, after the salesperson completes the claim process related node claim process operation, the salesperson manually selects and submits to the next claim process post node, and proceeds to the next stage of the insurance claim. Process flow.
  • this manual method of advancing the insurance claims process is time consuming and error prone, which in turn affects the efficiency and accuracy of insurance claims.
  • the present application provides a method and a device for processing an insurance claims process, and the main purpose thereof is to solve the problem that the current process of manually advancing the insurance claims is time-consuming and error-prone, thereby affecting the efficiency and accuracy of the insurance claims. problem.
  • a method for processing an insurance claims process comprising:
  • the claim process dictionary is included in different claim process types, and corresponds to the claim process post node respectively.
  • the insurance claim case task is pushed to the next claim center node corresponding to the current claim process post node for processing.
  • a processing apparatus for an insurance claims process comprising:
  • the obtaining unit is configured to obtain a current claim process post node where the insurance claim case task is located, and a type of claim process corresponding to the insurance claim case task;
  • a query unit configured to query a pre-defined claims process dictionary according to the current claim process post node and the claim process type acquired by the obtaining unit, where the claim process dictionary is included in different claim process types, and the claim process
  • the post nodes respectively correspond to the next claim process post node that needs to flow to;
  • a pushing unit configured to: after the processing of the claim process related to the current claim process post node, the insurance claim case task is pushed to the next claim corresponding to the current claims process post node that is queried by the query unit Process post nodes are processed.
  • a storage device having stored thereon a computer program, the program being implemented by the processor to implement the processing method of the insurance claims process.
  • a physical device for processing an insurance claims process including a storage device, a processor, and a computer program stored on the storage device and executable on the processor, the processor executing the program
  • the processing method of the above insurance claims process is realized.
  • the method and device for processing the insurance claims process provided by the present application can be compared with the current claim process node of the insurance claims case task and the current claim.
  • the corresponding claim process type of the task query the pre-defined claims process dictionary, find the next claim process post node that needs to flow to, and automatically push the task to the query after the claim process related to the current claims process post node is processed.
  • the next claim process post node is processed, which saves the promotion time of the insurance claims process, speeds up the processing progress of the insurance claims process, saves human resources, and can accurately find the next claim process post node through the claims process dictionary, and then Can improve the efficiency and accuracy of insurance claims.
  • FIG. 1 is a schematic flow chart of a method for processing an insurance claims process provided by an embodiment of the present application
  • FIG. 2 is a schematic flowchart diagram of another method for processing an insurance claims process provided by an embodiment of the present application
  • FIG. 3 is a schematic structural diagram of a processing apparatus for an insurance claims process according to an embodiment of the present application
  • FIG. 4 is a schematic structural diagram of another processing apparatus for an insurance claim flow provided by an embodiment of the present application.
  • the embodiment of the present application provides a method for processing an insurance claims process, which can improve the timeliness and accuracy of the insurance claims process. As shown in FIG. 1, the method includes:
  • the claim process post node can be the case acceptance post node, the bill entry post node, the claims review post node, the claims check check post node, the claims negotiation negotiation post node, etc.;
  • the claim process type can be the regular process type, the appeal process type, the member process type Etc.
  • the content of the claim process post node and the claim process type can be determined according to different insurance claims business processes.
  • the execution entity of the embodiment of the present application may be a processing device for the insurance claims process, and in the process of the insurance claims process, automatic push between the insurance claims process post nodes is implemented.
  • the claim process dictionary is included in the different claims process type, and corresponds to the next claim process post node that needs to flow to the claim process post node.
  • the claim process dictionary can be used to query the next claim process post node that needs to flow to the corresponding claim settlement process node of the insurance claim case task corresponding to the claim settlement process type.
  • the insurance claim case task is pushed to the next claim process post node corresponding to the current claim process post node for processing.
  • the current post node of the insurance claims case task is the case acceptance post node
  • the corresponding claim process type is the normal process type
  • the only record in the claim process dictionary is queried, and the next post node to which the current post node needs to flow is billed.
  • the insurance claim case task is automatically pushed to the bill entry post node for the next stage of processing after the current claim node related claim process is processed.
  • the similar method of the insurance claim process provided in this embodiment can be applied to other business process scenarios, such as business process approval, document processing, and provident fund procedures.
  • the process of the process such as the process of the process, involves a different number of post nodes, and the flow of the first-level one is required, which is not limited in this embodiment.
  • the method and device for processing the insurance claims process provided by the embodiment of the present application can be insured after the claim settlement process related to the current claim process post node is completed, compared with the current process of manually advancing the insurance claims process.
  • the claims case task is automatically pushed to the next claim process post node for processing, which saves the advancement time of the insurance claims process, speeds up the processing progress of the insurance claims process, saves human resources, and can be accurately found through the claims process dictionary. Going to the next claims process post node can improve the efficiency and accuracy of insurance claims.
  • the method includes:
  • the claim process post nodes respectively correspond to the next claim process post node that needs to be transferred to meet different flow conditions.
  • steps 201 to 202 describe the process of predefining the claims process dictionary.
  • steps 201 to 202 describe the process of predefining the claims process dictionary.
  • the next claim process post node can be automatically transferred to which process conditions are satisfied, and the specific content of the transfer condition can be based on actual conditions. Depending on the needs.
  • the mapping relationship between the claims process type, the claims process post node, the flow condition, and the next claim process post node that needs to be flowed to is saved in a predefined claim process dictionary.
  • the pre-defined claims process dictionary includes a mapping relationship between the "claim process type”, the "current claims process post node”, the "flow condition”, and the "next claims process post node”.
  • the claim process dictionary includes four types of claims process type, current claim process post node, flow condition, and next claim process post node, which can accurately find the corresponding needs of the current claim process of the insurance claim task.
  • the next claim process post node, through the flow condition matching, can find the only next claim process post node, and can also meet various business needs.
  • the current claim process post node where the insurance claim case task is located, and the type of claim process corresponding to the insurance claim case task are obtained in real time.
  • the current claims process post node where the insurance claim case is located is the claim review post node, and the corresponding claim process type of the insurance claim case task is the appeal process type.
  • the related information may include billing information of the user to be claimed, insurance policy information, and the like; the billing information may include personal information of the user to be claimed (such as age, gender, ID number, work unit, etc.), and items to be paid. Cost information (such as fee name, fee amount, etc.); insurance policy information may include policy identification information (such as policy number, name, etc.), policy type information, policy type information (such as personal life insurance, group insurance, etc.), policy Insured amount information, policy liability details (such as the proportion of claims for various expenses, claims scope, claims limits, claims conditions, etc.).
  • the method may further include: updating information according to the received claims process dictionary. And updating the claims process dictionary, wherein the update information may be obtained from the cloud server periodically or irregularly, or the related technical personnel manually write the update information according to the business needs and input; correspondingly, the step 205 may specifically include: after the update by the query
  • the mapping relationship saved in the claims process dictionary determines each flow condition corresponding to the current claim process post node under the acquired claim process type, and the next claim process post node corresponding to each flow condition.
  • the relevant information of the insurance claims case task it is determined that the user to be claimed is a member user, and the member circulation condition is met, that is, a jump mechanism can be adopted to speed up the processing progress of the claims process; and, according to the relevant information of the insurance claim case task, the query is
  • the corresponding insurance products support direct service, that is, enjoy the insurance company's direct claims service, in line with the direct transfer conditions; if the corresponding insurance products are inquired to cooperate with other companies, in line with the cooperative product transfer conditions; Abnormal information appears in the insurance claims case task, which meets the exception handling conditions.
  • the method before the step 206, further includes: according to the step of the step 206, in order to enable the next claim flow node to be found in the claim process dictionary.
  • the relevant information of the insurance claims case task detecting whether there are circulation conditions in the insurance circulation case in which the insurance claims case task meets; if not, the insurance claim case task is classified and classified, and the query is obtained in the current claim
  • a reference insurance claim case task having a similarity degree to the insurance claim case that is greater than a predetermined threshold and having a transfer condition in the claims process dictionary; and then referencing the insurance claim case task in the claim process dictionary to the current claim process post node
  • the corresponding flow condition is determined as a flow condition that the insurance claim case task meets, wherein the predetermined threshold of the similarity may be determined according to actual conditions.
  • the flow condition of the task on the current post node cannot be queried in the claim process dictionary, and in order to find a suitable next claim process post node, the query may also be At the current post node, a reference insurance claim case task having a similarity degree to the task greater than a certain threshold and having a transfer condition in the claim process dictionary, and then the reference insurance claim case task in the claim process dictionary is on the current post node
  • the corresponding flow condition is determined as the flow condition that the task meets; if there are multiple reference insurance claim cases, the one with the highest similarity to the task is taken as the corresponding reference insurance claim task.
  • the current post node of the insurance claims case task is the case acceptance post node
  • the corresponding claim process type is the appeal process type
  • the task meets the normal claim appeal condition
  • the next claim process post node that needs to be transferred to the case is the case review post. node.
  • the current post node is the case acceptance post node
  • the corresponding claim process type is the normal process type. If the insurance claim case task meets the direct flow transfer condition, the next claim process post node that needs to flow to is determined to be the straightforward adjustment. The post node is reviewed; if the insurance claim case task meets the abnormal processing conditions, it is determined that the next claim process post node to be flowed to is an abnormal check post node.
  • the insurance claim case task is pushed to the next claim process post node corresponding to the current claim process post node for processing.
  • the method may further include : obtaining the communication mode information of the service processing module corresponding to the next claim process post node; and using the obtained communication mode information, sending the processing reminding information of the insurance claim case task to the service processing module.
  • the service processing module may be configured to process the unit module of the corresponding service in the case according to the related information of the claim case. For the specific processing, refer to the processing method in the prior art, and details are not described herein; Email that can contain business processing modules (Electronic MAIL, E-mail) address, IP address, phone number, account number of instant messaging tool, etc.
  • the processing reminder information may be sent to the service processing module responsible for the post node, so that the service processing module processes in time to ensure the processing efficiency of the insurance claim.
  • the method may further include: recording the claim node of each claim process to the insurance claim case The processing progress information of the task; according to the recorded processing progress information, by comparing the average processing progress information, counting the abnormal claim process post node and the insurance claim case task with abnormal handling, and obtaining the corresponding suspected reason from the predetermined reason analysis library And solution information; based on the statistical results, the suspected reasons obtained, and the solution information, generate an analysis report processed by the insurance claims process.
  • the suspected reason corresponding to the different abnormal conditions and the corresponding solution information are stored in the predetermined reason analysis library, and may be pre-edited by the relevant technical personnel and saved in the predetermined reason analysis library.
  • the post node whose processing duration is greater than a certain threshold is counted, and the claim node is determined to be an abnormal claim process post node, and the corresponding suspected cause and solution information are obtained from the predetermined reason analysis library.
  • the work efficiency of the staff member A on the post node 1 is much lower than that of the other staff members on the post node 1, indicating that the worker A has an abnormality, and the corresponding suspect can be obtained from the predetermined reason analysis library.
  • the reason and solution information that is, the lack of experience of staff A, etc., the solution is to strengthen the corresponding training, based on this information can generate corresponding analysis report to show the performance personnel or superior leaders.
  • the corresponding suspected causes and solution information can be obtained from the predetermined reason analysis library according to the processing status of each post node. That is, it may be caused by too much billing information that needs to be entered in the insurance claim case of type A.
  • the solution is to increase the processing progress by adding the number of staff members to the billing entry node, and based on the information, a corresponding analysis report can be generated for display.
  • the report can be in the form of a chart, a table, and the like.
  • Another method for processing the insurance claims process provided by the embodiment of the present application can speed up the processing progress of the insurance claims process, save human resources, improve the efficiency and accuracy of the insurance claims, and can find unique through the matching of the flow conditions.
  • the next claim process post node can also meet various business needs; in the claim process dictionary, there is no insurance claims case task that meets the transfer conditions, and can also find the appropriate next claim process post node;
  • the staff on the node of the claims process timely handles the tasks of insurance claims in their positions and speeds up the efficiency of insurance claims.
  • the embodiment of the present application provides a processing device for an insurance claims process.
  • the device includes: an obtaining unit 31, an inquiring unit 32, Push unit 33.
  • the obtaining unit 31 may be configured to obtain a current claim process post node where the insurance claim case task is located, and a claim process type corresponding to the insurance claim case task;
  • the query unit 32 may be configured to query a pre-defined claims process dictionary according to the current claim process post node and the claim process type acquired by the obtaining unit 31, wherein the claim process dictionary is included in different claim process types Corresponding to the claims processing post node corresponding to the next claim process post node that needs to flow to;
  • the pushing unit 33 may be configured to: after the processing of the claim process related to the current claim process post node is completed, push the insurance claim case task to the next corresponding to the current claims process post node that is queried by the query unit A claim process post node is processed.
  • the device further includes: a configuration unit 34, a saving unit 35;
  • the configuration unit 34 can be configured to be configured in different claims process types, and the claim process post nodes respectively correspond to the next claim process post node that needs to flow to the flow when the different flow conditions are met;
  • the saving unit 35 may be configured to save the mapping relationship between the claims process type, the claims process post node, the flow condition, and the next claim process post node that needs to be flowed according to the configuration result of the configuration unit 34.
  • the claims process in the dictionary. Through the matching of the flow conditions, the only next claim process post node can be found, and can also meet various business needs.
  • the query unit 32 specifically includes: an obtaining module 321 and a determining module 322;
  • the obtaining module 321 is configured to obtain information about the task of the insurance claim case
  • the determining module 322 is configured to determine, by querying the mapping relationship, each flow condition corresponding to the current claims process post node and the next claim corresponding to each flow condition under the acquired claim process type Process post node;
  • the obtaining module 321 is further configured to obtain, according to the related information, a flow condition that the insurance claim case task meets from the respective flow conditions;
  • the determining module 322 is further configured to determine, by the next claim flow station node corresponding to the matching flow condition, a next claim flow process node that needs to flow to correspond to the current claim flow station node.
  • the query unit 32 specifically includes: Detection module 323, query module 324;
  • the detecting module 323 may be configured to detect, according to the related information, whether a flow condition that matches the insurance claim case task exists in each of the flow conditions;
  • the query module 324 can be configured to: if the detecting module 323 detects the flow condition that the insurance claim case task does not exist, classify the insurance claim case task, and query the obtained node in the current claim process node, a reference insurance claim case task having a similarity degree to the insurance claim case that is greater than a predetermined threshold and having a transfer condition in the claims process dictionary;
  • the determining module 322 is further configured to determine, in the claim process dictionary, a corresponding transfer condition of the reference insurance claim case task on the current claim process post node, as a flow condition that the insurance claim case task meets;
  • the obtaining module 321 may be specifically configured to: if yes, obtain, according to the related information, a flow condition that is met by the insurance claim case task from the respective flow condition.
  • the obtaining unit 31 may be further configured to: after the processing of the claims process related to the current claim process post node is completed, the insurance claim case task is pushed to the queried and current claim process posts. After processing the next claim process post node corresponding to the node, obtaining the communication mode information of the service processing module corresponding to the service node of the next claim flow process node;
  • the pushing unit 33 is further configured to send the processing reminding information of the insurance claim case task to the service processing module by using the communication mode information.
  • the device in order to analyze and process the abnormally generated post node, and perform timely maintenance processing on the abnormally generated post node, in an optional embodiment of the present application, as shown in FIG. 4, the device further includes : recording unit 36, statistical unit 37, generating unit 38;
  • the recording unit 36 can be used to record processing progress information of each claim process post node for the insurance claim case task
  • the statistic unit 37 may be configured to: according to the processing progress information, compare the average processing progress information, and calculate the abnormal claim process post node and the insurance claim case task with abnormal handling, and obtain the corresponding suspect from the predetermined reason analysis library.
  • Reason and solution information
  • the generating unit 38 is configured to generate an analysis report processed by the insurance claims process according to the statistical result, the suspected cause, and the solution information.
  • the apparatus further includes: an update unit 39;
  • the updating unit 39 may be configured to update the claims process dictionary according to the received update information of the claims flow dictionary;
  • the query unit 32 is specifically configured to query the updated claims process dictionary according to the current claim process post node and the claim process type.
  • the embodiment of the present application further provides a storage device, where a computer program is stored, and when the program is executed by the processor, the foregoing FIG. 1 and FIG. 2 are implemented.
  • the method of handling the insurance claims process
  • the embodiment of the present application further provides a physical device for processing an insurance claim process
  • the physical device includes a storage device and a processor; the storage device is configured to store a computer program; the processor is configured to execute the computer program to implement the processing method of the insurance claims process as shown in FIGS. 1 and 2 .
  • the processing progress of the insurance claims process can be accelerated, the human resources can be saved, the efficiency and accuracy of the insurance claims can be improved, and the only next claim process post node can be found through the matching of the flow conditions.
  • the present application can be implemented by hardware, or by software plus a necessary general hardware platform.
  • the technical solution of the present application may be embodied in the form of a software product, which may be stored in a non-volatile storage medium (which may be a CD-ROM, a USB flash drive, a mobile hard disk, etc.), including several The instructions are for causing a computer device (which may be a personal computer, server, or network device, etc.) to perform the methods described in various implementation scenarios of the present application.
  • modules in the apparatus in the implementation scenario may be distributed in the apparatus for implementing the scenario according to the implementation scenario description, or may be correspondingly changed in one or more devices different from the implementation scenario.
  • the modules of the above implementation scenarios may be combined into one module, or may be further split into multiple sub-modules.

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Abstract

本申请公开了一种保险理赔流程的处理方法及装置,涉及保险理赔技术领域,可以提高保险理赔的效率以及准确性,所述方法包括:获取保险理赔案件任务所在的当前理赔流程岗位节点,以及与所述保险理赔案件任务相应的理赔流程类型;根据所述当前理赔流程岗位节点和所述理赔流程类型,查询预先定义的理赔流程字典,所述理赔流程字典中包含在不同的理赔流程类型下,与理赔流程岗位节点分别对应需要流转到的下一个理赔流程岗位节点;在所述当前理赔流程岗位节点相关的理赔流程处理完毕后,将所述保险理赔案件任务推送给查询到的与所述当前理赔流程岗位节点对应的下一个理赔流程岗位节点进行处理。本申请适用于保险理赔流程的处理。

Description

保险理赔流程的处理方法及装置
本申请要求与2017年11月10日提交中国专利局、申请号为201711110995.7、发明名称为“保险理赔流程的处理方法及装置”的中国专利申请的优先权,其全部内容通过引用结合在申请中。
技术领域
本申请涉及保险理赔技术领域,特别是涉及一种保险理赔处理方法及装置。
背景技术
保险理赔是指在保险标的发生保险事故而使被保险人财产受到损失或人身生命受到损害时,或保单约定的其它保险事故出现而需要给付保险金时,保险公司根据合同规定,履行赔偿或给付责任的行为,是直接体现保险职能和履行保险责任的工作。保险理赔流程从案件受理、账单录入、理赔审核、理赔抽检、理赔通知、理赔协商等分成不同的理赔流程岗位节点,每个理赔流程岗位节点是根据业务员的操作权限来定义的。
目前,保险理赔流程是通过人工方式推进的。具体的,在保险理赔流程中的一个理赔流程岗位节点上,业务员完成该理赔流程岗位节点相关理赔流程操作后,会手动选择提交给下一个理赔流程岗位节点,继续进行下一阶段的保险理赔处理流程。然而这种人工方式推进保险理赔流程相当耗时,并且容易出错,进而影响了保险理赔的效率以及准确性。
发明内容
有鉴于此,本申请提供了一种保险理赔流程的处理方法及装置,主要目的在于解决目前通过人工方式推进保险理赔流程相当耗时,并且容易出错,进而影响了保险理赔的效率以及准确性的问题。
依据本申请一个方面,提供了一种保险理赔流程的处理方法,该方法包括:
获取保险理赔案件任务所在的当前理赔流程岗位节点,以及与所述保险理赔案件任务相应的理赔流程类型;
根据所述当前理赔流程岗位节点和所述理赔流程类型,查询预先定义的理赔流程字典,所述理赔流程字典中包含在不同的理赔流程类型下,与理赔流程岗位节点分别对应需要流转到的下一个理赔流程岗位节点;
在所述当前理赔流程岗位节点相关的理赔流程处理完毕后,将所述保险理赔案件任务推送给查询到的与所述当前理赔流程岗位节点对应的下一个理赔流程岗位节点进行处理。
依据本申请另一个方面,提供了一种保险理赔流程的处理装置,该装置包括:
获取单元,用于获取保险理赔案件任务所在的当前理赔流程岗位节点,以及与所述保险理赔案件任务相应的理赔流程类型;
查询单元,用于根据所述获取单元获取的当前理赔流程岗位节点和所述理赔流程类型,查询预先定义的理赔流程字典,所述理赔流程字典中包含在不同的理赔流程类型下,与理赔流程岗位节点分别对应需要流转到的下一个理赔流程岗位节点;
推送单元,用于在所述当前理赔流程岗位节点相关的理赔流程处理完毕后,将所述保险理赔案件任务推送给所述查询单元查询到的与所述当前理赔流程岗位节点对应的下一个理赔流程岗位节点进行处理。
依据本申请又一个方面,提供了一种存储设备,其上存储有计算机程序,所述程序被处理器执行时实现上述保险理赔流程的处理方法。
依据本申请再一个方面,提供了一种保险理赔流程处理的实体装置,包括存储设备、处理器及存储在存储设备上并可在处理器上运行的计算机程序,所述处理器执行所述程序时实现上述保险理赔流程的处理方法。
借由上述技术方案,本申请提供的一种保险理赔流程的处理方法及装置,与目前通过人工方式推进保险理赔流程相比,本申请可以根据保险理赔案件任务所在的当前理赔流程岗位节点以及该任务相应的理赔流程类型,查询预先定义的理赔流程字典,找到需要流转到的下一个理赔流程岗位节点,在当前理赔流程岗位节点相关的理赔流程处理完毕后,将该任务自动推送给查询到的下一个理赔流程岗位节点进行处理,节省了保险理赔流程的推进时间,加快了保险理赔流程的处理进度,也节省了人力资源,并且通过理赔流程字典可以准确查找到下一个理赔流程岗位节点,进而可以提高保险理赔的效率以及准确性。
上述说明仅是本申请技术方案的概述,为了能够更清楚了解本申请的技术手段,而可依照说明书的内容予以实施,并且为了让本申请的上述和其它目的、特征和优点能够更明显易懂,以下特举本申请的具体实施方式。
附图说明
通过阅读下文优选实施方式的详细描述,各种其他的优点和益处对于本领域普通技术人员将变得清楚明了。附图仅用于示出优选实施方式的目的,而并不认为是对本申请的限制。而且在整个附图中,用相同的参考符号表示相同的部件。在附图中:
图1示出了本申请实施例提供的一种保险理赔流程的处理方法流程示意图;
图2示出了本申请实施例提供的另一种保险理赔流程的处理方法流程示意图;
图3示出了本申请实施例提供的一种保险理赔流程的处理装置的结构示意图;
图4示出了本申请实施例提供的另一种保险理赔流程的处理装置的结构示意图。
具体实施方式
下面将参照附图更详细地描述本公开的示例性实施例。虽然附图中显示了本公开的示例性实施例,然而应当理解,可以以各种形式实现本公开而不应被这里阐述的实施例所限制。相反,提供这些实施例是为了能够更透彻地理解本公开,并且能够将本公开的范围完整的传达给本领域的技术人员。
本申请实施例提供了一种保险理赔流程的处理方法,可以提高保险理赔流程的处理时效性和准确性,如图1所示,该方法包括:
101、获取保险理赔案件任务所在的当前理赔流程岗位节点,以及与保险理赔案件任务相应的理赔流程类型。
其中,理赔流程岗位节点可以为案件受理岗位节点、账单录入岗位节点、理赔审核岗位节点、理赔抽检岗位节点、理赔协商岗位节点等;理赔流程类型可以为常规流程类型、申诉流程类型、会员流程类型等;理赔流程岗位节点和理赔流程类型的内容具体可以根据不同的保险理赔业务流程而定。
对于本申请实施例的执行主体可以为用于保险理赔流程的处理装置,在保险理赔流程的处理过程中,实现保险理赔流程岗位节点之间的自动推送。
102、根据获取到的当前理赔流程岗位节点和理赔流程类型,查询预先定义的理赔流程字典。
其中,理赔流程字典中包含在不同的理赔流程类型下,与理赔流程岗位节点分别对应需要流转到的下一个理赔流程岗位节点。
利用理赔流程字典可以查询得到在保险理赔案件任务相应的理赔流程类型下,与该保险理赔案件任务当前所在理赔流程岗位节点相应需要流转到的下一个理赔流程岗位节点。
103、在当前理赔流程岗位节点相关的理赔流程处理完毕后,将保险理赔案件任务推送给查询到的与当前理赔流程岗位节点对应的下一个理赔流程岗位节点进行处理。
例如,保险理赔案件任务所在的当前岗位节点是案件受理岗位节点,相应的理赔流程类型为常规流程类型,查询到了理赔流程字典中唯一一条记录,当前岗位节点需要流转至的下一个岗位节点为账单录入岗位节点,根据查询结果,该保险理赔案件任务在当前岗位节点相关的理赔流程处理完毕后,自动推送到账单录入岗位节点进行下一阶段的处理操作。
需要说明的是,本实施例提供的保险理赔流程的处理方法除了应用在保险理赔流程的场景以外,其类似方法还可以应用在其他业务流程场景中,如业务流程审批、证件办理流程、公积金手续办理流程等涉及不同岗位节点、且需要一级一级的流转进行的场景,对此本实施例不做限定。
本申请实施例提供的一种保险理赔流程的处理方法及装置,与目前通过人工方式推进保险理赔流程相比,本申请实施例在当前理赔流程岗位节点相关的理赔流程处理完毕后,可以将保险理赔案件任务自动推送给查询到的下一个理赔流程岗位节点进行处理,节省了保险理赔流程的推进时间,加快了保险理赔流程的处理进度,也节省了人力资源,并且通过理赔流程字典可以准确查找到下一个理赔流程岗位节点,进而可以提高保险理赔的效率以及准确性。
进一步的,作为上述实施例具体实施方式的细化和扩展,提供了另一种保险理赔流程的处理方法,如图2所示,该方法包括:
201、配置在不同的理赔流程类型下,理赔流程岗位节点在符合不同流转条件时分别对应需要流转到的下一个理赔流程岗位节点。
在本实施例中,步骤201至202所述的是预先定义理赔流程字典的过程。首先参照不同保险理赔业务流程结构(如理赔流程图或表等),确定每个理赔流程类型下,不同的理赔流程岗位节点。
在不同的理赔流程类型下,配置每个理赔流程岗位节点作为当前理赔流程岗位节点时,在满足哪些流程条件下分别可以自动流转至的下一个理赔流程岗位节点,流转条件的具体内容可以根据实际需求而定。
202、依据配置结果,将理赔流程类型、理赔流程岗位节点、流转条件、以及需要流转到的下一个理赔流程岗位节点四者之间的映射关系保存在预先定义的理赔流程字典中。
例如,预先定义后的理赔流程字典中包含‘理赔流程类型’、‘当前理赔流程岗位节点’、‘流转条件’、‘下一个理赔流程岗位节点’四者之间存在的映射关系。
在本实施例中,理赔流程字典包含了理赔流程类型、当前理赔流程岗位节点、流转条件、下一个理赔流程岗位节点四种元素,可以准确找到符合保险理赔任务当前理赔流程岗位节点对应需要流转到的下一个理赔流程岗位节点,通过流转条件匹配,可以找到唯一的下一个理赔流程岗位节点,还可以满足各种不同的业务需求。
203、在保险理赔流程的处理过程中,实时获取保险理赔案件任务所在的当前理赔流程岗位节点,以及与保险理赔案件任务相应的理赔流程类型。
例如,获取得到保险理赔案件任务所在的当前理赔流程岗位节点是理赔审核岗位节点,该保险理赔案件任务相应的理赔流程类型为申诉流程类型。
204、获取保险理赔案件任务的相关信息。
其中,相关信息可以包括待理赔用户的账单信息、保险保单信息等;账单信息中可以包含待理赔用户的用户个人信息(如年龄、性别、身份证号、工作单位等)、需要缴纳的各项费用信息(如费用名称、费用金额等)等内容;保险保单信息中可以包含保单标识信息(如保单编号、名称等)、保单险种信息、保单类型信息(如个人寿险、团险等)、保单投保金额信息、保单责任明细信息(如各项费用的理赔比例、理赔范围、理赔限额、理赔条件等)等内容。
205、通过查询理赔流程字典中保存的映射关系,确定在获取到的理赔流程类型下,当前理赔流程岗位节点所对应的各个流转条件,以及每个流转条件对应的下一个理赔流程岗位节点。
进一步的,为了满足对理赔流程字典的更新需求,得到更加准确或更贴近业务需要的查询结果,在本申请的一个可选实施例中,还可以包括:根据接收到的理赔流程字典的更新信息,对理赔流程字典进行更新,其中更新信息可以从云端服务器中定时或不定时获取,或者由于相关技术人员根据业务需要手动编写更新信息并输入;相应的,步骤205具体可以包括:通过查询更新后的理赔流程字典中保存的映射关系,确定在获取到的理赔流程类型下,当前理赔流程岗位节点所对应的各个流转条件,以及每个流转条件对应的下一个理赔流程岗位节点。
206、根据获取到的相关信息,从各个流转条件中获取保险理赔案件任务符合的流转条件。
对于本实施例,首先根据预先定义的理赔流程字典中包含的‘理赔流程类型’、‘当前理赔流程岗位节点’、‘流转条件’、‘下一个理赔流程岗位节点’四者之间存在的映射关系,可以查询得到在保险理赔案件任务对应的理赔流程类型下,当前所在的理赔流程岗位节点所对应的各个流程条件,以及每个流转条件对应的下一个理赔流程岗位节点;然后根据该保险理赔案件任务的相关信息,判断当前满足上述各个流转条件中的哪一个流转条件。
例如,根据保险理赔案件任务的相关信息,确定待理赔用户为会员用户,符合会员流转条件,即可以采用跳转机制,加快理赔流程处理进度;再如根据保险理赔案件任务的相关信息,查询到相应的保险产品支持直结服务,即享受保险公司直结理赔服务,符合直结流转条件;又如查询到相应的保险产品为与其他公司的合作产品,符合合作产品流转条件;再如查询到保险理赔案件任务出现异常信息,符合异常处理条件。
为了使得在理赔流程字典中不存在保险理赔案件任务所符合流转条件时也能够找到合适的下一个理赔流程岗位节点,在本申请的一个可选实施例中,在步骤206之前,还包括:根据保险理赔案件任务的相关信息,检测在理赔流程字典内各个流转条件中是否存在保险理赔案件任务符合的流转条件;若不存在,则对该保险理赔案件任务进行归类划分,查询得到在当前理赔流程岗位节点上,与保险理赔案件相似度大于预定阈值的、且在理赔流程字典中存在流转条件的参考保险理赔案件任务;然后将理赔流程字典中参考保险理赔案件任务在该当前理赔流程岗位节点上对应的流转条件,确定为该保险理赔案件任务符合的流转条件,其中,相似度的预定阈值可以根据实际情况而定。
例如,根据保险理赔案件任务的相关信息,在理赔流程字典中查询不到在当前岗位节点上该任务所符合的流转条件,这时为了找到合适的下一个理赔流程岗位节点,可以查询也是在该当前岗位节点上,与该任务相似度大于一定阈值的、且在该理赔流程字典中存在流转条件的参考保险理赔案件任务,然后将理赔流程字典中该参考保险理赔案件任务在该当前岗位节点上对应的流转条件确定为该任务所符合的流转条件;如果存在多个参考保险理赔案件任务,则从中取与该任务相似度最大的一个任务作为相应的参考保险理赔案件任务。
207、将与符合的流转条件对应的下一个理赔流程岗位节点,确定为与当前理赔流程岗位节点对应需要流转到的下一个理赔流程岗位节点。
例如,保险理赔案件任务当前的岗位节点为案件受理岗位节点,相应的理赔流程类型为申诉流程类型,并且该任务符合正常理赔申诉条件,确定需要流转到的下一个理赔流程岗位节点为案件审核岗位节点。
再例如,当前的岗位节点为案件受理岗位节点,相应的理赔流程类型为常规流程类型,如果保险理赔案件任务符合直结流转条件,确定需要流转到的下一个理赔流程岗位节点为直结理算审核岗位节点;如果保险理赔案件任务符合异常处理条件,确定需要流转到的下一个理赔流程岗位节点为异常检查岗位节点。
208、在当前理赔流程岗位节点相关的理赔流程处理完毕后,将保险理赔案件任务推送给查询到的与当前理赔流程岗位节点对应的下一个理赔流程岗位节点进行处理。
进一步的,为了通知每个理赔流程岗位节点上的工作人员及时处理自己岗位上的保险理赔案件任务,加快保险理赔的效率,在本申请的一个可选实施例中,在步骤208之后还可以包括:获取查询到的下一个理赔流程岗位节点对应业务处理模块的通信方式信息;利用获取到的通信方式信息,向业务处理模块发送保险理赔案件任务的处理提醒信息。其中,业务处理模块可以为根据理赔案件的相关信息,处理所在本岗位节点上该案件相应业务的单元模块,具体处理过程可以参见现有技术中的处理方式,在此不再赘述;通信方式信息可以包含业务处理模块的电子邮箱(Electronic MAIL,E-mail)地址、IP地址、电话号码、即时通信工具的账号等。
在本实施例中,在理赔案件任务到达一个岗位节点时,可以向负责该岗位节点的业务处理模块发送处理提醒信息,以便业务处理模块及时进行处理,保证保险理赔的处理效率。
进一步的,为了分析处理出现异常的岗位节点,并对出现异常的岗位节点进行及时维护处理,在本申请的一个可选实施例中,还可以包括:记录每个理赔流程岗位节点对保险理赔案件任务的处理进度信息;根据记录的处理进度信息,通过比较平均处理进度信息,统计存在异常的理赔流程岗位节点和存在处理异常的保险理赔案件任务,并从预定原因分析库中获取相应的疑似原因以及解决方案信息;依据统计结果、获取的疑似原因以及解决方案信息,生成保险理赔流程处理的分析报告。其中,预定原因分析库中保存有不同的异常状况分别对应的疑似原因以及相应的解决方案信息,可以由相关技术人员预先编辑,并保存在预定原因分析库中。
根据每个岗位节点的平均处理进度,统计出处理时长大于一定阈值的岗位节点,将其确定为存在异常的理赔流程岗位节点,并从预定原因分析库中获取相应的疑似原因以及解决方案信息,如统计得到工作人员A在岗位节点1上的工作效率相比于其他工作人员在岗位节点1上的工作效率要低很多,说明工作人员A存在异常,可以从预定原因分析库中获取相应的疑似原因以及解决方案信息,即可能是工作人员A的经验不足等原因,解决方案是需要加强相应的培训,基于这些信息可以生成相应的分析报告展示给绩效人员或上级领导。
再例如,通过统计得出A类型的保险理赔案件相对其他类型的案件处理起来进度较慢,可以根据相关每个岗位节点的处理状况,从预定原因分析库中获取相应的疑似原因以及解决方案信息,即可能是A类型的保险理赔案件需要录入的账单信息过多造成的,解决方案是加派账单录入节点的工作人员人数以加快处理进度,基于这些信息可以生成相应的分析报告进行展示,该报告可以为图、表等形式。
本申请实施例提供的另一种保险理赔流程的处理方法,可以加快保险理赔流程的处理进度,节省了人力资源,可以提高保险理赔的效率以及准确性;并且通过流转条件匹配,可以找到唯一的下一个理赔流程岗位节点,还可以满足各种不同的业务需求;在理赔流程字典中不存在保险理赔案件任务所符合流转条件时也能够找到合适的下一个理赔流程岗位节点;而且还能通知每个理赔流程岗位节点上的工作人员及时处理自己岗位上的保险理赔案件任务,加快保险理赔的效率。
进一步的,作为图1和图2所述方法的具体实现,本申请实施例提供了一种保险理赔流程的处理装置,如图3所示,所述装置包括:获取单元31、查询单元32、推送单元33。
获取单元31,可以用于获取保险理赔案件任务所在的当前理赔流程岗位节点,以及与所述保险理赔案件任务相应的理赔流程类型;
查询单元32,可以用于根据所述获取单元31获取的当前理赔流程岗位节点和所述理赔流程类型,查询预先定义的理赔流程字典,其中所述理赔流程字典中包含在不同的理赔流程类型下,与理赔流程岗位节点分别对应需要流转到的下一个理赔流程岗位节点;
推送单元33,可以用于在所述当前理赔流程岗位节点相关的理赔流程处理完毕后,将所述保险理赔案件任务推送给所述查询单元查询到的与所述当前理赔流程岗位节点对应的下一个理赔流程岗位节点进行处理。
在具体的应用场景中,如图4所示,所述装置还包括:配置单元34、保存单元35;
配置单元34,可以用于配置在不同的理赔流程类型下,理赔流程岗位节点在符合不同流转条件时分别对应需要流转到的下一个理赔流程岗位节点;
保存单元35,可以用于依据配置单元34的配置结果,将理赔流程类型、理赔流程岗位节点、流转条件、以及需要流转到的下一个理赔流程岗位节点四者之间的映射关系保存在预先定义的理赔流程字典中。通过流转条件匹配,可以找到唯一的下一个理赔流程岗位节点,还可以满足各种不同的业务需求。
在具体的应用场景中,如图4所示,查询单元32具体包括:获取模块321、确定模块322;
获取模块321,可以用于获取所述保险理赔案件任务的相关信息;
确定模块322,可以用于通过查询所述映射关系,确定在获取到的所述理赔流程类型下,所述当前理赔流程岗位节点所对应的各个流转条件,以及每个流转条件对应的下一个理赔流程岗位节点;
获取模块321,还可以用于根据所述相关信息,从所述各个流转条件中获取所述保险理赔案件任务符合的流转条件;
确定模块322,还可以用于将与所述符合的流转条件对应的下一个理赔流程岗位节点,确定为与所述当前理赔流程岗位节点对应需要流转到的下一个理赔流程岗位节点。
在具体的应用场景中,为了使得在理赔流程字典中不存在保险理赔案件任务所符合流转条件时也能够找到合适的下一个理赔流程岗位节点,如图4所示,查询单元32具体还包括:检测模块323、查询模块324;
检测模块323,可以用于根据所述相关信息,检测在所述各个流转条件中是否存在所述保险理赔案件任务符合的流转条件;
查询模块324,可以用于若检测模块323检测出不存在保险理赔案件任务符合的流转条件,则对所述保险理赔案件任务进行归类划分,并查询得到在所述当前理赔流程岗位节点上,与所述保险理赔案件相似度大于预定阈值的、且在所述理赔流程字典中存在流转条件的参考保险理赔案件任务;
确定模块322,还可以用于将所述理赔流程字典中所述参考保险理赔案件任务在所述当前理赔流程岗位节点上对应的流转条件,确定为所述保险理赔案件任务符合的流转条件;
获取模块321,具体可以用于若存在,则根据所述相关信息,从所述各个流转条件中获取所述保险理赔案件任务符合的流转条件。
在具体的应用场景中,获取单元31,还可以用于在所述当前理赔流程岗位节点相关的理赔流程处理完毕后,将所述保险理赔案件任务推送给查询到的与所述当前理赔流程岗位节点对应的下一个理赔流程岗位节点进行处理之后,获取查询到的下一个理赔流程岗位节点对应业务处理模块的通信方式信息;
推送单元33,还可以用于利用所述通信方式信息,向所述业务处理模块发送所述保险理赔案件任务的处理提醒信息。
在具体的应用场景中,为了分析处理出现异常的岗位节点,并对出现异常的岗位节点进行及时维护处理,在本申请的一个可选实施例中,如图4所示,所述装置还包括:记录单元36、统计单元37、生成单元38;
记录单元36,可以用于记录每个理赔流程岗位节点对保险理赔案件任务的处理进度信息;
统计单元37,可以用于根据所述处理进度信息,通过比较平均处理进度信息,统计存在异常的理赔流程岗位节点和存在处理异常的保险理赔案件任务,并从预定原因分析库中获取相应的疑似原因以及解决方案信息;
生成单元38,可以用于依据所述统计结果、所述疑似原因以及解决方案信息,生成保险理赔流程处理的分析报告。
在具体的应用场景中,为了满足对理赔流程字典的更新需求,得到更加准确或更贴近业务需要的查询结果,如图4所示,所述装置还包括:更新单元39;
更新单元39,可以用于根据接收到的所述理赔流程字典的更新信息,对所述理赔流程字典进行更新;
查询单元32,具体可以用于根据所述当前理赔流程岗位节点和所述理赔流程类型,查询更新后的理赔流程字典。
需要说明的是,本申请实施例提供的一种保险理赔流程的处理装置所涉及各功能单元的其他相应描述,可以参考图1和图2中的对应描述,在此不再赘述。
基于上述如图1和图2所示方法,相应的,本申请实施例还提供了一种存储设备,其上存储有计算机程序,该程序被处理器执行时实现上述如图1和图2所示的保险理赔流程的处理方法。
基于上述如图1和图2所示方法和如图3和如图4所示虚拟装置的实施例,为了实现上述目的,本申请实施例还提供了一种保险理赔流程处理的实体装置,该实体装置包括存储设备和处理器;所述存储设备,用于存储计算机程序;所述处理器,用于执行所述计算机程序以实现上述如图1和图2所示的保险理赔流程的处理方法。
通过应用本申请的技术方案,可以加快保险理赔流程的处理进度,节省了人力资源,可以提高保险理赔的效率以及准确性;并且通过流转条件匹配,可以找到唯一的下一个理赔流程岗位节点,还可以满足各种不同的业务需求;在理赔流程字典中不存在保险理赔案件任务所符合流转条件时也能够找到合适的下一个理赔流程岗位节点;而且还能通知每个理赔流程岗位节点上的工作人员及时处理自己岗位上的保险理赔案件任务,加快保险理赔的效率。
通过以上的实施方式的描述,本领域的技术人员可以清楚地了解到本申请可以通过硬件实现,也可以借助软件加必要的通用硬件平台的方式来实现。基于这样的理解,本申请的技术方案可以以软件产品的形式体现出来,该软件产品可以存储在一个非易失性存储介质(可以是CD-ROM,U盘,移动硬盘等)中,包括若干指令用以使得一台计算机设备(可以是个人计算机,服务器,或者网络设备等)执行本申请各个实施场景所述的方法。
本领域技术人员可以理解附图只是一个优选实施场景的示意图,附图中的模块或流程并不一定是实施本申请所必须的。
本领域技术人员可以理解实施场景中的装置中的模块可以按照实施场景描述进行分布于实施场景的装置中,也可以进行相应变化位于不同于本实施场景的一个或多个装置中。上述实施场景的模块可以合并为一个模块,也可以进一步拆分成多个子模块。
上述本申请序号仅仅为了描述,不代表实施场景的优劣。
以上公开的仅为本申请的几个具体实施场景,但是,本申请并非局限于此,任何本领域的技术人员能思之的变化都应落入本申请的保护范围。

Claims (28)

  1. 一种保险理赔流程的处理方法,其特征在于,包括:
    获取保险理赔案件任务所在的当前理赔流程岗位节点,以及与所述保险理赔案件任务相应的理赔流程类型;
    根据所述当前理赔流程岗位节点和所述理赔流程类型,查询预先定义的理赔流程字典,所述理赔流程字典中包含在不同的理赔流程类型下,与理赔流程岗位节点分别对应需要流转到的下一个理赔流程岗位节点;
    在所述当前理赔流程岗位节点相关的理赔流程处理完毕后,将所述保险理赔案件任务推送给查询到的与所述当前理赔流程岗位节点对应的下一个理赔流程岗位节点进行处理。
  2. 根据权利要求1所述的方法,其特征在于,所述根据所述当前理赔流程岗位节点和所述理赔流程类型,查询预先定义的理赔流程字典之前,所述方法还包括:
    配置在不同的理赔流程类型下,理赔流程岗位节点在符合不同流转条件时分别对应需要流转到的下一个理赔流程岗位节点;
    依据配置结果,将理赔流程类型、理赔流程岗位节点、流转条件、以及需要流转到的下一个理赔流程岗位节点四者之间的映射关系保存在预先定义的理赔流程字典中。
  3. 根据权利要求2所述的方法,其特征在于,所述根据所述当前理赔流程岗位节点和所述理赔流程类型,查询预先定义的理赔流程字典,包括:
    获取所述保险理赔案件任务的相关信息;
    通过查询所述映射关系,确定在获取到的所述理赔流程类型下,所述当前理赔流程岗位节点所对应的各个流转条件,以及每个流转条件对应的下一个理赔流程岗位节点;
    根据所述相关信息,从所述各个流转条件中获取所述保险理赔案件任务符合的流转条件;
    将与所述符合的流转条件对应的下一个理赔流程岗位节点,确定为与所述当前理赔流程岗位节点对应需要流转到的下一个理赔流程岗位节点。
  4. 根据权利要求3所述的方法,其特征在于,所述根据所述相关信息,从所述各个流转条件中获取所述保险理赔案件任务符合的流转条件之前,所述方法还包括:
    根据所述相关信息,检测在所述各个流转条件中是否存在所述保险理赔案件任务符合的流转条件;
    若不存在,则对所述保险理赔案件任务进行归类划分,并查询得到在所述当前理赔流程岗位节点上,与所述保险理赔案件相似度大于预定阈值的、且在所述理赔流程字典中存在流转条件的参考保险理赔案件任务;
    将所述理赔流程字典中所述参考保险理赔案件任务在所述当前理赔流程岗位节点上对应的流转条件,确定为所述保险理赔案件任务符合的流转条件;
    所述根据所述相关信息,从所述各个流转条件中获取所述保险理赔案件任务符合的流转条件,包括:
    若存在,则根据所述相关信息,从所述各个流转条件中获取所述保险理赔案件任务符合的流转条件。
  5. 根据权利要求1所述的方法,其特征在于,在所述当前理赔流程岗位节点相关的理赔流程处理完毕后,将所述保险理赔案件任务推送给查询到的与所述当前理赔流程岗位节点对应的下一个理赔流程岗位节点进行处理之后,所述方法还包括:
    获取查询到的下一个理赔流程岗位节点对应业务处理模块的通信方式信息;
    利用所述通信方式信息,向所述业务处理模块发送所述保险理赔案件任务的处理提醒信息。
  6. 根据权利要求1所述的方法,其特征在于,所述方法还包括:
    记录每个理赔流程岗位节点对保险理赔案件任务的处理进度信息;
    根据所述处理进度信息,通过比较平均处理进度信息,统计存在异常的理赔流程岗位节点和存在处理异常的保险理赔案件任务,并从预定原因分析库中获取相应的疑似原因以及解决方案信息;
    依据所述统计结果、所述疑似原因以及解决方案信息,生成保险理赔流程处理的分析报告。
  7. 根据权利要求1所述的方法,其特征在于,所述方法还包括:
    根据接收到的所述理赔流程字典的更新信息,对所述理赔流程字典进行更新;
    所述根据所述当前理赔流程岗位节点和所述理赔流程类型,查询预先定义的理赔流程字典,包括:
    根据所述当前理赔流程岗位节点和所述理赔流程类型,查询更新后的理赔流程字典。
  8. 一种保险理赔流程的处理装置,其特征在于,包括:
    获取单元,用于获取保险理赔案件任务所在的当前理赔流程岗位节点,以及与所述保险理赔案件任务相应的理赔流程类型;
    查询单元,用于根据所述获取单元获取的当前理赔流程岗位节点和所述理赔流程类型,查询预先定义的理赔流程字典,所述理赔流程字典中包含在不同的理赔流程类型下,与理赔流程岗位节点分别对应需要流转到的下一个理赔流程岗位节点;
    推送单元,用于在所述当前理赔流程岗位节点相关的理赔流程处理完毕后,将所述保险理赔案件任务推送给所述查询单元查询到的与所述当前理赔流程岗位节点对应的下一个理赔流程岗位节点进行处理。
  9. 根据权利要求8所述的装置,其特征在于,所述装置还包括:
    配置单元,用于配置在不同的理赔流程类型下,理赔流程岗位节点在符合不同流转条件时分别对应需要流转到的下一个理赔流程岗位节点;
    保存单元,用于依据配置结果,将理赔流程类型、理赔流程岗位节点、流转条件、以及需要流转到的下一个理赔流程岗位节点四者之间的映射关系保存在预先定义的理赔流程字典中。
  10. 根据权利要求9所述的装置,其特征在于,所述查询单元包括:
    获取模块,用于获取所述保险理赔案件任务的相关信息;
    确定模块,用于通过查询所述映射关系,确定在获取到的所述理赔流程类型下,所述当前理赔流程岗位节点所对应的各个流转条件,以及每个流转条件对应的下一个理赔流程岗位节点;
    获取模块,用于根据所述相关信息,从所述各个流转条件中获取所述保险理赔案件任务符合的流转条件;
    确定模块,用于将与所述符合的流转条件对应的下一个理赔流程岗位节点,确定为与所述当前理赔流程岗位节点对应需要流转到的下一个理赔流程岗位节点。
  11. 根据权利要求10所述的装置,其特征在于,所述查询单元还包括:检测模块、查询模块;
    检测模块,用于根据所述相关信息,检测在所述各个流转条件中是否存在所述保险理赔案件任务符合的流转条件;
    查询模块,用于若检测模块检测出在所述各个流转条件中不存在所述保险理赔案件任务符合的流转条件,则对所述保险理赔案件任务进行归类划分,并查询得到在所述当前理赔流程岗位节点上,与所述保险理赔案件相似度大于预定阈值的、且在所述理赔流程字典中存在流转条件的参考保险理赔案件任务;
    确定模块,还用于将所述理赔流程字典中所述参考保险理赔案件任务在所述当前理赔流程岗位节点上对应的流转条件,确定为所述保险理赔案件任务符合的流转条件;
    获取模块,还用于若检测模块检测出在所述各个流转条件中存在所述保险理赔案件任务符合的流转条件,则根据所述相关信息,从所述各个流转条件中获取所述保险理赔案件任务符合的流转条件。
  12. 根据权利要求8所述的装置,其特征在于,所述获取单元,还用于获取查询到的下一个理赔流程岗位节点对应业务处理模块的通信方式信息;
    所述推送单元,还用于利用所述通信方式信息,向所述业务处理模块发送所述保险理赔案件任务的处理提醒信息。
  13. 根据权利要求8所述的装置,其特征在于,所述装置还包括:
    记录单元,用于记录每个理赔流程岗位节点对保险理赔案件任务的处理进度信息;
    统计单元,用于根据所述处理进度信息,通过比较平均处理进度信息,统计存在异常的理赔流程岗位节点和存在处理异常的保险理赔案件任务,并从预定原因分析库中获取相应的疑似原因以及解决方案信息;
    生成单元,用于依据所述统计结果、所述疑似原因以及解决方案信息,生成保险理赔流程处理的分析报告。
  14. 根据权利要求8所述的装置,其特征在于,所述装置还包括:更新单元;
    所述更新单元,用于根据接收到的所述理赔流程字典的更新信息,对所述理赔流程字典进行更新;
    所述查询单元,具体用于根据所述当前理赔流程岗位节点和所述理赔流程类型,查询更新后的理赔流程字典。
  15. 一种存储设备,其上存储有计算机程序,其特征在于,所述程序被处理器执行时实现保险理赔流程的处理方法,包括:
    获取保险理赔案件任务所在的当前理赔流程岗位节点,以及与所述保险理赔案件任务相应的理赔流程类型;
    根据所述当前理赔流程岗位节点和所述理赔流程类型,查询预先定义的理赔流程字典,所述理赔流程字典中包含在不同的理赔流程类型下,与理赔流程岗位节点分别对应需要流转到的下一个理赔流程岗位节点;
    在所述当前理赔流程岗位节点相关的理赔流程处理完毕后,将所述保险理赔案件任务推送给查询到的与所述当前理赔流程岗位节点对应的下一个理赔流程岗位节点进行处理。
  16. 根据权利要求15所述的存储设备,其特征在于,所述程序被处理器执行时实现根据所述当前理赔流程岗位节点和所述理赔流程类型,查询预先定义的理赔流程字典之前,还包括:
    配置在不同的理赔流程类型下,理赔流程岗位节点在符合不同流转条件时分别对应需要流转到的下一个理赔流程岗位节点;
    依据配置结果,将理赔流程类型、理赔流程岗位节点、流转条件、以及需要流转到的下一个理赔流程岗位节点四者之间的映射关系保存在预先定义的理赔流程字典中。
  17. 根据权利要求16所述的存储设备,其特征在于,所述程序被处理器执行时实现根据所述当前理赔流程岗位节点和所述理赔流程类型,查询预先定义的理赔流程字典,包括:
    获取所述保险理赔案件任务的相关信息;
    通过查询所述映射关系,确定在获取到的所述理赔流程类型下,所述当前理赔流程岗位节点所对应的各个流转条件,以及每个流转条件对应的下一个理赔流程岗位节点;
    根据所述相关信息,从所述各个流转条件中获取所述保险理赔案件任务符合的流转条件;
    将与所述符合的流转条件对应的下一个理赔流程岗位节点,确定为与所述当前理赔流程岗位节点对应需要流转到的下一个理赔流程岗位节点。
  18. 根据权利要求17所述的存储设备,其特征在于,所述程序被处理器执行时实现根据所述相关信息,从所述各个流转条件中获取所述保险理赔案件任务符合的流转条件之前,还包括:
    根据所述相关信息,检测在所述各个流转条件中是否存在所述保险理赔案件任务符合的流转条件;
    若不存在,则对所述保险理赔案件任务进行归类划分,并查询得到在所述当前理赔流程岗位节点上,与所述保险理赔案件相似度大于预定阈值的、且在所述理赔流程字典中存在流转条件的参考保险理赔案件任务;
    将所述理赔流程字典中所述参考保险理赔案件任务在所述当前理赔流程岗位节点上对应的流转条件,确定为所述保险理赔案件任务符合的流转条件;
    所述程序被处理器执行时实现根据所述相关信息,从所述各个流转条件中获取所述保险理赔案件任务符合的流转条件,包括:
    若存在,则根据所述相关信息,从所述各个流转条件中获取所述保险理赔案件任务符合的流转条件。
  19. 根据权利要求15所述的存储设备,其特征在于,所述程序被处理器执行时实现在所述当前理赔流程岗位节点相关的理赔流程处理完毕后,将所述保险理赔案件任务推送给查询到的与所述当前理赔流程岗位节点对应的下一个理赔流程岗位节点进行处理之后,还包括:
    获取查询到的下一个理赔流程岗位节点对应业务处理模块的通信方式信息;
    利用所述通信方式信息,向所述业务处理模块发送所述保险理赔案件任务的处理提醒信息。
  20. 根据权利要求15所述的存储设备,其特征在于,所述程序被处理器执行时实现所述方法还包括:
    记录每个理赔流程岗位节点对保险理赔案件任务的处理进度信息;
    根据所述处理进度信息,通过比较平均处理进度信息,统计存在异常的理赔流程岗位节点和存在处理异常的保险理赔案件任务,并从预定原因分析库中获取相应的疑似原因以及解决方案信息;
    依据所述统计结果、所述疑似原因以及解决方案信息,生成保险理赔流程处理的分析报告。
  21. 根据权利要求15所述的存储设备,其特征在于,所述程序被处理器执行时实现所述方法还包括:
    根据接收到的所述理赔流程字典的更新信息,对所述理赔流程字典进行更新;
    所述程序被处理器执行时实现根据所述当前理赔流程岗位节点和所述理赔流程类型,查询预先定义的理赔流程字典,包括:
    根据所述当前理赔流程岗位节点和所述理赔流程类型,查询更新后的理赔流程字典。
  22. 一种保险理赔流程的处理装置,包括存储设备、处理器及存储在存储设备上并可在处理器上运行的计算机程序,其特征在于,所述处理器执行所述程序时实现保险理赔流程的处理方法,包括:
    获取保险理赔案件任务所在的当前理赔流程岗位节点,以及与所述保险理赔案件任务相应的理赔流程类型;
    根据所述当前理赔流程岗位节点和所述理赔流程类型,查询预先定义的理赔流程字典,所述理赔流程字典中包含在不同的理赔流程类型下,与理赔流程岗位节点分别对应需要流转到的下一个理赔流程岗位节点;
    在所述当前理赔流程岗位节点相关的理赔流程处理完毕后,将所述保险理赔案件任务推送给查询到的与所述当前理赔流程岗位节点对应的下一个理赔流程岗位节点进行处理。
  23. 根据权利要求22所述的装置,其特征在于,所述处理器执行所述程序时实现根据所述当前理赔流程岗位节点和所述理赔流程类型,查询预先定义的理赔流程字典之前,还包括:
    配置在不同的理赔流程类型下,理赔流程岗位节点在符合不同流转条件时分别对应需要流转到的下一个理赔流程岗位节点;
    依据配置结果,将理赔流程类型、理赔流程岗位节点、流转条件、以及需要流转到的下一个理赔流程岗位节点四者之间的映射关系保存在预先定义的理赔流程字典中。
  24. 根据权利要求23所述的装置,其特征在于,所述处理器执行所述程序时实现根据所述当前理赔流程岗位节点和所述理赔流程类型,查询预先定义的理赔流程字典,包括:
    获取所述保险理赔案件任务的相关信息;
    通过查询所述映射关系,确定在获取到的所述理赔流程类型下,所述当前理赔流程岗位节点所对应的各个流转条件,以及每个流转条件对应的下一个理赔流程岗位节点;
    根据所述相关信息,从所述各个流转条件中获取所述保险理赔案件任务符合的流转条件;
    将与所述符合的流转条件对应的下一个理赔流程岗位节点,确定为与所述当前理赔流程岗位节点对应需要流转到的下一个理赔流程岗位节点。
  25. 根据权利要求24所述的装置,其特征在于,所述处理器执行所述程序时实现根据所述相关信息,从所述各个流转条件中获取所述保险理赔案件任务符合的流转条件之前,还包括:
    根据所述相关信息,检测在所述各个流转条件中是否存在所述保险理赔案件任务符合的流转条件;
    若不存在,则对所述保险理赔案件任务进行归类划分,并查询得到在所述当前理赔流程岗位节点上,与所述保险理赔案件相似度大于预定阈值的、且在所述理赔流程字典中存在流转条件的参考保险理赔案件任务;
    将所述理赔流程字典中所述参考保险理赔案件任务在所述当前理赔流程岗位节点上对应的流转条件,确定为所述保险理赔案件任务符合的流转条件;
    所述程序被处理器执行时实现根据所述相关信息,从所述各个流转条件中获取所述保险理赔案件任务符合的流转条件,包括:
    若存在,则根据所述相关信息,从所述各个流转条件中获取所述保险理赔案件任务符合的流转条件。
  26. 根据权利要求22所述的装置,其特征在于,所述处理器执行所述程序时实现在所述当前理赔流程岗位节点相关的理赔流程处理完毕后,将所述保险理赔案件任务推送给查询到的与所述当前理赔流程岗位节点对应的下一个理赔流程岗位节点进行处理之后,还包括:
    获取查询到的下一个理赔流程岗位节点对应业务处理模块的通信方式信息;
    利用所述通信方式信息,向所述业务处理模块发送所述保险理赔案件任务的处理提醒信息。
  27. 根据权利要求22所述的装置,其特征在于,所述处理器执行所述程序时实现所述方法还包括:
    记录每个理赔流程岗位节点对保险理赔案件任务的处理进度信息;
    根据所述处理进度信息,通过比较平均处理进度信息,统计存在异常的理赔流程岗位节点和存在处理异常的保险理赔案件任务,并从预定原因分析库中获取相应的疑似原因以及解决方案信息;
    依据所述统计结果、所述疑似原因以及解决方案信息,生成保险理赔流程处理的分析报告。
  28. 根据权利要求22所述的装置,其特征在于,所述处理器执行所述程序时实现所述方法还包括:
    根据接收到的所述理赔流程字典的更新信息,对所述理赔流程字典进行更新;
    所述处理器执行所述程序时实现根据所述当前理赔流程岗位节点和所述理赔流程类型,查询预先定义的理赔流程字典,包括:
    根据所述当前理赔流程岗位节点和所述理赔流程类型,查询更新后的理赔流程字典。
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