The invention relates to the technical field of
big data and the technical field of financial science and technology, and discloses a claim
knowledge base construction method, which constructs a claim
knowledge extraction sub-base by obtaining insurance claim data, analyzing the data by using a big
language model, generating a claim dictionary and clause paraphrasing. Analyzing adjustment standards of different insurance types, constructing an adjustment standard sub-
library in combination with claim settlement standards and claim
payment conditions, obtaining historical claim settlement cases, performing tagging management, constructing a claim settlement case sub-
library, and pushing similar cases to form a similar case recommendation sub-
library. The expert opinions are used for generating a standard operation process and establishing a standard operation process sub-library. And all the sub-libraries are integrated to form a complete claim
knowledge base, and new insurance claim data are regularly acquired to realize dynamic updating of the sub-libraries. Through structured and modularized
knowledge integration, intelligence and
standardization of the claim settlement process are realized, the claim settlement
processing efficiency is remarkably improved, the operation complexity is reduced, the fraud risk is reduced, and the customer experience is improved.