WO2020062326A1 - Système intelligent de gestion de santé et d'assurance de sécurité des personnes, et procédé de mise en œuvre associé - Google Patents

Système intelligent de gestion de santé et d'assurance de sécurité des personnes, et procédé de mise en œuvre associé Download PDF

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Publication number
WO2020062326A1
WO2020062326A1 PCT/CN2018/109642 CN2018109642W WO2020062326A1 WO 2020062326 A1 WO2020062326 A1 WO 2020062326A1 CN 2018109642 W CN2018109642 W CN 2018109642W WO 2020062326 A1 WO2020062326 A1 WO 2020062326A1
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data
health
insured
platform
module
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PCT/CN2018/109642
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English (en)
Chinese (zh)
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朱继平
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上海笛乐护斯健康科技有限公司
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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
    • G16INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR SPECIFIC APPLICATION FIELDS
    • G16HHEALTHCARE INFORMATICS, i.e. INFORMATION AND COMMUNICATION TECHNOLOGY [ICT] SPECIALLY ADAPTED FOR THE HANDLING OR PROCESSING OF MEDICAL OR HEALTHCARE DATA
    • G16H50/00ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics
    • G16H50/30ICT specially adapted for medical diagnosis, medical simulation or medical data mining; ICT specially adapted for detecting, monitoring or modelling epidemics or pandemics for calculating health indices; for individual health risk assessment

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  • the invention relates to an insurance system, in particular to an intelligent health management and life safety insurance system; in addition, the invention also relates to a method for implementing the intelligent health management and life safety insurance system.
  • the current health insurance products have a great workload for insurance, underwriting and claims settlement.
  • underwriting insurance companies usually need the insured to provide their health status (requires the insured to issue a specific inspection report), and verify that the information provided is consistent and authentic, and provide a certificate issued by a third-party medical institution if necessary.
  • the insured is required to provide relevant claim materials (including medical records, medical status (social security / own expense); details of accidents, original bills for medical expenses, etc.).
  • the insurance company's claims focus review the doctor's diagnosis of the disease name, the date of the first diagnosis, the visiting hospital and its address, phone number, medical status (social security / own expense), details of the accident, etc., and appraisal or opinions of relevant departments.
  • the current workload of underwriting and claims for health insurance products is very large, the procedures are complex, time-consuming, and labor costs are high. For the insured, a large number of materials need to be provided and the procedures are cumbersome.
  • Chinese invention patent CN201410121802.8 discloses a health management system and method based on the Internet of Things and cloud computing.
  • the drawbacks are: its data source is to be collected through another instrument (health testing equipment), the health testing The device is not a wearable smart terminal, and still needs to manually collect data manually, and not real-time data collection, which has certain limitations; the system is only data feedback, no data analysis and targeted services; the system is not specifically targeted at Design for problems in the insurance industry.
  • the insurance client involved in this system is used to assist medical insurance and social security units in grasping the health status of participating users, and only solves the problem of data interaction with medical insurance units and social security units.
  • existing health insurance products have strict requirements on users, and most potential users are rejected.
  • the current workload of underwriting and claims for health insurance products is very large, the procedures are complex, time-consuming, and labor costs are high. For the insured, a large number of materials need to be provided and the procedures are cumbersome.
  • One of the technical problems to be solved by the present invention is to provide an intelligent health management and life safety insurance system, which can solve the above technical problems existing in current health insurance products, and provide customers with an intelligent health management and life safety monitoring system.
  • Carry out real-time monitoring provide targeted feedback, and use big data as the support to dynamically adjust the rate or / and the sum insured according to the monitoring results.
  • combine insurance management with health management, medical rehabilitation, emergency rescue, and financial services to make insurance services available in advance and in advance.
  • realizing insurance service + real-time and improving user experience the system can simplify underwriting and claims procedures, reduce labor costs, and expand sales channels.
  • the second technical problem to be solved by the present invention is to provide an implementation method of an intelligent health management and life safety insurance system.
  • the present invention adopts the following technical solutions:
  • an intelligent health management and life safety insurance system including: a wearable intelligent terminal, a big data server, a monitoring service center, a third-party service platform, and an insurance company platform; the big data server is respectively connected with Wearable smart terminals, monitoring service centers, third-party service platforms, and insurance company platforms are connected through the network; third-party service platforms include medical institutions, fitness institutions, diet and nutrition institutions, and psychological consulting agencies;
  • the wearable smart terminal is used to automatically detect and collect the health data of the insured in real time, and transmit the health data and other information of the insured (such as age, gender, blood type, medical history, allergy history, etc.) to the institute. Describe the big data server.
  • the third-party service platform transmits diagnostic data of the insured in the medical institution to the big data server;
  • the big data server receives real-time health data of the insured collected from the wearable smart terminal and diagnostic data collected from the third-party service platform, stores the data, and analyzes the data to form an insured health report;
  • the insurance company platform receives the insured's health report from the big data server, and can automatically underwrite or settle claims based on the report;
  • the monitoring service center receives the health report of the insured from the big data server, and provides services to the wearable smart terminal user, the insured, according to the situation.
  • the system further includes a volunteer platform including a volunteer network, social public resources, a community property platform, a nursing home, and the like.
  • the wearable smart terminal includes a positioning module, a communication module, a detection module, an intelligent classification module, and a sending module;
  • the positioning module is used to intelligently locate the user of the wearable smart terminal, that is, the insured;
  • the communication module is used for wired or wireless connection to the network
  • the detection module is used to automatically detect and collect the life and health signs data of the wearable smart terminal user and the insured; the life and health signs data includes: 1. vital signs data, such as body temperature, heart rate, breathing Frequency, blood pressure, etc .; 2. Behavioral habits data, including diet, sleep, mood, exercise, etc .; 3. Medical index data, including blood glucose, blood oxygen, and so on.
  • vital signs data such as body temperature, heart rate, breathing Frequency, blood pressure, etc .
  • Behavioral habits data including diet, sleep, mood, exercise, etc .
  • Medical index data including blood glucose, blood oxygen, and so on.
  • the intelligent classification module is used to receive and classify the life and health signs data collected by the detection module; the intelligent classification module classifies the life and health signs data into the following 5 categories: A, normal; B, health consultation; C, See your doctor as soon as possible; D. See your doctor immediately; E. First aid.
  • the sending module is used to distributed, encrypted, and securely send the user's health classification status received from the intelligent classification module to the user himself, contacts, monitoring service center, third-party service platform, insurance company platform, volunteer platform , And other participants in the ecosystem.
  • the present invention adopts blockchain technology.
  • the wearable smart terminal, the monitoring service center, the third-party service platform, the insurance company platform, and the volunteer platform will collect The data is distributed to each of the big data servers, and all participants are scored with tokens, which can be transferred and used.
  • the invention adopts the application of the blockchain technology, which is specifically: 1. There is a reward for logging in every day; 2. There is a reward for the authentication of other people's data; 3. If there is an abnormality in the user, provide help and reward; 4. Share with others. Reward; all participants (wearable smart end users, third-party service platforms, insurance company platforms, monitoring service centers, volunteer platforms, big data servers) are scored with tokens, which can be transferred and used; its advantages are: 1. Once the data is tampered, all participants will know that it can avoid data tampering and ensure the authenticity and credibility of the data; 2. The data is real-time and can dynamically monitor the collected data.
  • the big data server includes a data acquisition module, a data storage module, and a data analysis module;
  • the data collection module is configured to receive and collect real-time health data of users from the wearable smart terminal and diagnostic data from the third-party service platform;
  • the data storage module is configured to store data from the data acquisition module and the data analysis module;
  • the data analysis module is configured to perform calculation analysis on real-time health data and diagnosis data of users from the data collection module.
  • the wearable smart terminal uses wearable bracelets, watches, necklaces, clothes, shoes, socks, belts and other clothing, clothing, or sports protective gear.
  • the services provided by the monitoring service center include health reports, health consultations, medical consultations, green channels, automatic alarms, manual alarms, emergency rescues, and the like.
  • the present invention also provides a method for implementing the intelligent health management and life safety insurance system, including the following steps:
  • the insurance company provides the wearable smart terminal to the insured, and the wearable smart terminal detects the health status of the insured in real time;
  • the big data server receives real-time health data of the insured collected from the wearable smart terminal and diagnostic data collected from the third-party service platform. After analyzing the data, artificial intelligence automatically forms an insured health assessment analysis report. , Can be transmitted to the insurance company;
  • the insurance company refuses the insurance if the evaluation results do not meet the required conditions. If the required conditions are met, the insurance contract takes effect, and the wearable smart terminal continues to be carried out on the insured.
  • the evaluation is based on the daily real-time detection data of the wearable smart terminal. If it is found that the health conditions are not met, timely feedback to the following objects: the insured himself, the contact person, the monitoring service center, the third-party service platform, and the insurance company Platforms, volunteer platforms, etc .;
  • the system provides services such as health reports, health consultations, medical consultations, green channels, automatic alarms, manual alarms, emergency rescues and other services to the insured, and urges the insured and its contacts to self-adjust for different health conditions 2. Go to the designated service agency or other agencies and deal with it in time to restore the health status as soon as possible;
  • the insurance company can dynamically adjust the sum insured, premium, refusal, fixed loss, and automatic claims settlement. If the insured does not respond in time and fails to meet the health conditions for more than N times (for example, 3 times), the insurance company can dynamically adjust the rate, sum insured or denial of insurance; the system is based on the behavior and health status of the insured. Artificial intelligence evaluates, determines damages and informs insurance companies for automatic claims settlement.
  • step (3) when the insurance contract becomes effective, the insurance contract can be used for bank mortgage and loan.
  • the present invention adopts blockchain technology. Once the data is tampered, all participants will know that it can avoid data tampering and ensure the authenticity and credibility of the data. In addition, the data is real-time and can dynamically monitor the collected data.
  • FIG. 1 is a schematic structural diagram of an intelligent health management and life safety insurance system according to the present invention.
  • FIG. 2 is a schematic structural diagram of a wearable smart terminal in the system of the present invention.
  • FIG. 3 is a structural framework diagram of a big data server in the system of the present invention.
  • FIG. 4 is a program flowchart of a method for implementing an intelligent health management and life safety insurance system according to the present invention.
  • an intelligent health management and life safety insurance system of the present invention includes: a wearable intelligent terminal, a big data server, a monitoring service center, a third-party service platform, a volunteer platform, and an insurance company platform; a third-party service
  • the platforms include medical institutions, fitness institutions, diet and nutrition institutions, psychological counseling institutions, etc .
  • the volunteer platforms include volunteer networks, social public resources, community property platforms, nursing homes, etc.
  • the big data server is connected to a wearable smart terminal, a monitoring service center, a third-party service platform, and an insurance company platform through a network; the wearable smart terminal is used to automatically detect and collect health data of the insured in real time, and The health data and other information of the insured (for example, information such as age, gender, blood type, medical history, allergy history, etc.) are distributed to each of the big data servers; the third-party service platform distributes the insured's diagnostic data To each of the big data servers; the big data servers receive real-time health data collected from the wearable smart terminal and diagnostic data collected from the third-party service platform, store the data, and Analyze the data to form an insured health report; the insurance company platform receives the insured health reports from the various big data servers, and automatically underwrites or claims based on the reports; the monitoring service center receives The insured health report of each big data server
  • the wearable intelligent terminal user ie insurers to provide health reporting, health advice, seek medical inquiry, the green channel, automatic alarm, manual alarm, emergency and rescue services
  • the present invention adopts blockchain technology, and the wearable intelligent terminal, the monitoring service center, the third-party service platform, the insurance company platform, and the volunteer platform distribute the collected data to each of the distributed
  • the big data server scores tokens for all participants, and the tokens can be transferred and used.
  • the invention adopts the application of the blockchain technology, which is specifically: 1. There is a reward for logging in every day; 2. There is a reward for the authentication of other people's data; 3. If there is an abnormality in the user, provide help and reward; 4. Share with others. Reward; all participants (wearable smart end users, third-party service platforms, insurance company platforms, monitoring service centers, volunteer platforms, big data servers) are scored with tokens, which can be transferred and used; its advantages are: 1. Once the data is tampered, all participants will know that it can avoid data tampering and ensure the authenticity and credibility of the data; 2. The data is real-time and can dynamically monitor the collected data.
  • the wearable smart terminal includes a positioning module, a communication module, a detection module, a smart classification module, and a sending module; the positioning module is used to intelligently locate a user of the wearable smart terminal, that is, an insured person. Location; the communication module is used for wired or wireless connection to the network; the detection module is used to automatically detect and collect the life and health signs data of the wearable smart terminal user, ie, the insured, in real time Including: 1. Vital signs data, such as body temperature, heart rate, breathing frequency, blood pressure, etc .; 2. Behavioral habits data, including diet, sleep, mood, exercise, etc .; 3. Medical index data, including blood glucose, blood oxygen, and so on.
  • Vital signs data such as body temperature, heart rate, breathing frequency, blood pressure, etc .
  • Behavioral habits data including diet, sleep, mood, exercise, etc .
  • Medical index data including blood glucose, blood oxygen, and so on.
  • the intelligent classification module is used to receive and classify the life and health signs data collected by the detection module; the intelligent classification module classifies the life and health signs data into the following 5 categories: A, normal; B, health consultation; C, See your doctor as soon as possible; D. See your doctor immediately; E. First aid.
  • the sending module is used to distributed, encrypted, and securely send the user's health classification status received from the intelligent classification module to the user himself, contacts, monitoring service center, third-party service platform, insurance company platform, volunteer platform , And other participants in the ecosystem.
  • the wearable smart terminal may use wearable bracelets, watches, necklaces, clothes, shoes, socks, belts and other clothing, clothing, or sports protective gear.
  • the big data server includes a data acquisition module, a data storage module, and a data analysis module;
  • the data acquisition module is configured to receive and collect real-time health data of users from the wearable smart terminal and from the user Diagnostic data of a third-party service platform;
  • the data storage module is configured to store data from the data acquisition module and the data analysis module;
  • the data analysis module is used to real-time users from the data acquisition module Health data and diagnostic data are calculated and analyzed.
  • the present invention also provides a method for implementing an intelligent health management and life safety insurance system, including the following steps:
  • the insurance company provides the wearable smart terminal to the insured, and the wearable smart terminal detects the health status of the insured in real time;
  • the big data server receives real-time health data of the insured collected from the wearable smart terminal and diagnostic data collected from the third-party service platform, and analyzes the data to automatically form an insured health assessment analysis report.
  • the insurance company To the insurance company;
  • the insurance company refuses the insurance if the evaluation results do not meet the required conditions. If the required conditions are met, the insurance contract takes effect, and the wearable smart terminal continues to be carried out on the insured. Daily real-time detection; when the insurance contract takes effect, the insurance contract can be used for bank mortgages and loans;
  • the evaluation is based on the daily real-time detection data of the wearable smart terminal. If it is found that the health conditions are not met, timely feedback to the following objects: the insured himself, the contact person, the monitoring service center, the third-party service platform, and the insurance company Platforms, volunteer platforms, etc .;
  • the system provides services such as health reports, health consultations, medical consultations, green channels, automatic alarms, manual alarms, emergency rescue and other services to the insured; and urges the insured and its contacts to self-adjust for different health conditions 2. Go to the designated service agency or other agencies and deal with it in time to restore the health status as soon as possible;
  • the insurance company can dynamically adjust the sum insured, premium, refusal, fixed loss, and automatic claims settlement. If it is found that the feedback from the insured is not processed in time and the health conditions are not met 3 times or more, the insurance company may dynamically adjust the rate, sum insured or deny the insurance; if the feedback that does not meet the health conditions is less than 3 times, the system will The insurer's behavior and health status, artificial intelligence to assess, determine the damage and inform the insurance company to make automatic claims.

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Abstract

L'invention concerne un système intelligent de gestion de santé et d'assurance de sécurité des personnes, et un procédé de mise en œuvre dudit système. Ledit système comprend : un terminal portable intelligent, un serveur de mégadonnées, un centre de service de surveillance, une plateforme de service tierce (comprenant une institution médicale, etc.) et une plateforme de compagnie d'assurance ; le serveur de mégadonnées reçoit des données de santé en temps réel d'une personne assurée acquises par le terminal portable intelligent et des données de diagnostic acquises par la plate-forme de service tierce, stocke et analyse les données, et produit un rapport de santé de la personne assurée ; la plateforme de compagnie d'assurance reçoit le rapport de santé de la personne assurée depuis le serveur de mégadonnées, et réalise une sélection des risques ou un règlement des sinistres ; et le centre de service de surveillance reçoit le rapport de santé de la personne assurée depuis le serveur de mégadonnées, et fournit un service à un utilisateur, c'est-à-dire, la personne assurée, du terminal portable intelligent selon les situations. Ainsi, la présente invention réalise une surveillance en temps réel pour un utilisateur, fournit un retour ciblé, améliore l'expérience de l'utilisateur, simplifie les procédures de sélection des risques et de règlement des sinistres, et réduit le coût de main-d'œuvre.
PCT/CN2018/109642 2018-09-30 2018-10-10 Système intelligent de gestion de santé et d'assurance de sécurité des personnes, et procédé de mise en œuvre associé WO2020062326A1 (fr)

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CN201811154803.7A CN110969534A (zh) 2018-09-30 2018-09-30 智能健康管理和生命安全保险系统及其实现方法
CN201811154803.7 2018-09-30

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