Method and system for detecting human injury claim data risk

A risk detection and data technology, applied in the field of personal injury claim data risk detection, can solve problems such as disrupting social insurance order, irrational drug use, and expansion of disability ratings, and achieve the effect of improving prediction accuracy and generalization performance

Active Publication Date: 2018-04-13
KAITAIMING BEIJING TECH
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AI Technical Summary

Problems solved by technology

[0002] Many criminals use insurance claims to create false traffic accidents and obtain illegal compensation; at the same time, in real traffic accidents, there are a large number of unreasonable treatment plans, over-treatment, unreasonable medication, and unreasonable disabilities because of insurance companies’ claims. Appraisal and unreasonable compensation requirements, etc.; using traffic accidents to treat one's own original diseases also occurs from time to time; in disability accidents, it is very common for the disability appraisal ma

Method used

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  • Method and system for detecting human injury claim data risk
  • Method and system for detecting human injury claim data risk
  • Method and system for detecting human injury claim data risk

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Embodiment Construction

[0037] Below in conjunction with accompanying drawing, technical scheme of the present invention is described in further detail:

[0038] like figure 1 As shown, the present invention is a personal injury claim risk detection system, the system includes: a data acquisition module, a feature building module, a data processing module, an evaluation model building module, an evaluation model application module and a personal injury claim risk result processing module;

[0039] Wherein, the data collection module is used to collect claimant information data and original data of personal injury claims cases;

[0040] The feature building module is used to establish a feature system for risk assessment of personal injury claims;

[0041] The data processing module is used to clean and sample the collected raw data in combination with the constructed personal injury claim risk assessment feature system, and first perform missing value processing, outlier value processing and data no...

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Abstract

The invention relates to a method and a system for detecting human injury claim data risk. The method comprises steps that at least one type of the claimant information, medical data, disability identification data and claim data of human claim data is acquired, a prebuilt human injury claim risk detection modeling algorithm is utilized to carry out data processing, and false frauds and unreasonable expense item results in the claim process are discovered. The method is combined with all the characteristics of human injury claims to construct a human injury claim risk evaluation characteristicsystem, and the unified evaluation standard foundation is laid, moreover, for problems of low evaluation accuracy and incapability of guaranteeing rights of insurance companies and most of normal customers and maintaining the normal social order existing in a system in the prior art, the improved BP neural network algorithm is further constructed as a human injury claim risk evaluation model, andprediction accuracy and generalization performance are improved.

Description

technical field [0001] The invention relates to a risk detection method and system for personal injury claims data. Background technique [0002] Many criminals use insurance claims to create false traffic accidents and obtain illegal compensation; at the same time, in real traffic accidents, there are a large number of unreasonable treatment plans, excessive treatment, unreasonable medication, and unreasonable disabilities because of insurance companies’ claims. Appraisal and unreasonable compensation requirements, etc.; using traffic accidents to treat one's own original diseases also occurs from time to time; in disability accidents, it is very common for the disability appraisal materials to be falsified and the disability rating to be seriously expanded. More than 60% of the appraisal institutions participate in the appraisal materials Fraud, even more than 90% in developed coastal areas; scalpers involved in traffic accidents and personal injury cases in coastal areas ...

Claims

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Application Information

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IPC IPC(8): G06Q10/06G06Q40/08
CPCG06Q10/0635G06Q40/08
Inventor 王辉艾永梅王桂元
Owner KAITAIMING BEIJING TECH
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