Case claim settlement method, server and computer readable storage medium

A case and processor technology, applied in the insurance field, can solve the problems of long insurance claim settlement cycle, achieve the effect of shortening the claim settlement cycle, achieving a win-win situation, and saving time.

Inactive Publication Date: 2018-07-27
PING AN TECH (SHENZHEN) CO LTD
3 Cites 9 Cited by

AI-Extracted Technical Summary

Problems solved by technology

[0005] The main purpose of the present invention is to provide a case claim settlement method, server and com...
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Method used

In the present embodiment, when receiving the claim settlement application that investigator inputs, obtain the insured person's identity that carries in the claim settlement application; Then, according to the insured person's identity search all insurance policies of the insured person, configure the policy list for The investigator selects the policy for which the claim is currently applied; then, obtains the policy selected by the investigator based on the policy list, configures the corresponding claim case, and sends the investigation task of generating the claim case to the investigator. In this embodiment, when the investigator files an application for claim settlement, a policy list that records all the policies of the insured is provided for the investigator to choose, so that the investigator can filter out inappropriate insurance policies that cannot apply for compensation this time, and only select the policies based on the investigator's selection. The insurance policy is filed for claim settlement, which reduces the workload of the review node, speeds up the review speed of claim settlement cases, and shortens the insurance claim settlement cycle, which can improve customer experience.
In the present embodiment, when receiving the claim settlement application that the investigator inputs, the corresponding configuration claim case and generate investigation tasks are issued to the investigator, and the investigator reports the case and investigates the case; then, the investigator receives the investigation based on The investigation report submitted by the invest...
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Abstract

The invention discloses a case claim settlement method, which comprises: when receiving a claim settlement application input by an investigator, correspondingly configuring a claim settlement case andgenerating and sending an investigation task to the investigator; receiving an investigation report submitted by the investigator based on the investigation task and submitting the claim settlement case and the investigation report to an audit node; and when receiving a compensation instruction fed back by the audit node, paying for the claim settlement case according to the compensation instruction. The invention also discloses a server and a computer readable storage medium. According to the invention, the time spent by a customer on the process is greatly saved and the claim settlement period is shortened.

Application Domain

Technology Topic

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  • Case claim settlement method, server and computer readable storage medium
  • Case claim settlement method, server and computer readable storage medium
  • Case claim settlement method, server and computer readable storage medium

Examples

  • Experimental program(1)

Example

[0110] Further, refer to Figure 5 The second embodiment of the case settlement method of the present invention provides a case settlement method. Based on the above-mentioned first embodiment of the case settlement method of the present invention, the step S10 includes:
[0111] Step S13: Upon receiving the claim settlement application input by the investigator, obtain the insured identity carried in the claim settlement application.
[0112] When the investigator arrives at the scene of the accident, the investigator determines the identity of the insured customer, and then enters this customer as the insured into the claim application. Among them, the claim application contains the identity of the insured, such as name, ID number, age and other information.
[0113] After receiving the claim settlement application from the investigator, the server obtains the identity of the insured person carried in the claim settlement application.
[0114] Step S14: Search for all insurance policies of the insured according to the identity of the insured, and configure a list of insurance policies for the investigator to select.
[0115] After obtaining the identity of the insured, the server searches the database for all the insurance policies of the insured according to the identity of the insured, and configures all the insurance policies found into the policy list. The insurance policies in the form list can be sorted according to the time of purchase.
[0116] Then, the server displays a list of insurance policies for the investigator to select the insurance policy currently applying for claims.
[0117] The investigator can select the insurance policy by checking on the policy list page to filter out unsuitable insurance policies. For example, if the accident is a car accident, the investigator may need to select a car insurance policy, accident insurance policy, etc.
[0118] When it is necessary to explain, the policy list can only display the purchase time and insurance type of each policy. Of course, it can also display other information in the policy, which can be flexibly configured according to actual needs.
[0119] Step S15: Obtain the insurance policy selected by the investigator based on the insurance policy list, configure the claim case correspondingly, and generate an investigation task to issue to the investigator.
[0120] When the investigator selects the insurance policy that needs to apply for a claim in the policy list and confirms it, the server obtains the insurance policy selected by the investigator, configures the corresponding claim case, and generates the investigation task of the claim case and sends it to the investigator. Investigate.
[0121] In this embodiment, upon receiving the claim settlement application input by the investigator, the identity of the insured person carried in the claim settlement application is obtained; then, all insurance policies of the insured person are searched according to the identity of the insured person, and the policy list is configured for the investigator to choose The insurance policy currently applying for claims; then, obtain the insurance policy selected by the investigator based on the policy list, configure the corresponding claim case, and generate the investigation task of the claim case and send it to the investigator. In this embodiment, when the investigator files a claim settlement application, it provides a list of policies that record all the insurance policies of the insured for the investigator to choose, so that the investigator can filter out the unsuitable policies that cannot apply for claims this time, based only on the investigator’s selection The insurance policy issued for filing claims has reduced the workload of the review nodes, accelerated the review of claims cases, shortened the cycle of insurance claims, and improved customer experience.
[0122] Further, refer to Image 6 The third embodiment of the claim settlement method of the present invention provides an insurance policy claim settlement method. Based on the above-mentioned second embodiment of the claim settlement method of the present invention, the step S15 includes:
[0123] Step S151: When receiving the policy selected by the surveyor based on the policy list, display the terms of the selected policy for selection.
[0124] Step S152: Obtain the insurance policy and terms selected by the investigator, configure the claim case correspondingly, and generate an investigation task and send it to the investigator.
[0125] When the server configures the policy list and displays it to the investigator for selection, if it receives a policy selected by the investigator based on the policy list, the terms of the selected policy will be displayed for the investigator to choose. Among them, the terms of the insurance policy include items such as insurance liability, insurance amount, additional clauses, etc., for the investigator to choose.
[0126] The investigator selected and determined the corresponding clauses based on the actual situation of the accident.
[0127] After receiving the terms of the insurance policy selected by the investigator, the server configures the claim case corresponding to the insurance policy and terms selected by the investigator, and generates an investigation task and sends it to the investigator.
[0128] Specifically, the investigator can select the insurance policy for this claim based on the insurance type of the insurance policy and other information. After the server receives the insurance policy selected by the investigator, it searches the database for the policy content of this policy and displays the various terms of the policy content. At the same time, the server can also extract preset fields from the content of the policy to obtain the policy number, the identity information of the insured, and the beneficiary information.
[0129] The investigator selects the terms on which the claim is based, such as insurance liability, insurance amount, additional clauses, etc., based on the insurance policy provided by the server, to determine the claim liability and the amount of the claim. The investigator will confirm after completing the selection of terms.
[0130] After the server receives the terms selected by the investigator, it fills in the fields of the policy number, the insured’s identity information, the beneficiary information and other information, as well as the fields of the terms selected by the investigator, according to the preset filling rules. In the case configuration template set, a claim case is generated. The policy recorded in the claim case is the policy on which the claim is settled, the terms recorded are the terms on which the claim is settled, and the insured recorded is the insured who needs to apply for a claim for the accident.
[0131] The server also configures the case number of this claim case according to the preset numbering rules. Then, the server configures the investigation task corresponding to this claim case, obtains the investigator who configures this claim case, and sends the configured investigation task to the investigator's system for the investigator to perform the investigation task. The investigation task includes various information about the claim settlement case, including the insurance policy on which the claim settlement is based, the insured, and the clause on which the claim settlement is based, for the investigator to conduct a purposeful investigation.
[0132] It should be noted that the investigator can select multiple insurance policies and corresponding clauses respectively, and then the server configures a claim case, and generates an investigation task and sends it to the investigator.
[0133] In this embodiment, when receiving the insurance policy selected by the investigator based on the policy list, the terms of the selected insurance policy are displayed for the investigator to choose; the insurance policy and terms selected by the investigator are obtained, the claim case is configured correspondingly, and the corresponding investigation is generated The task is issued to the investigator. In this embodiment, when the investigator chooses an insurance policy, the terms of the insurance policy are provided for the investigator to choose, so that the investigator can select the terms on which the claim is based, etc., making the claim settlement more targeted and reducing the workload of the review node , Shortening the claim cycle.
[0134] Further, refer to Figure 7 , The fourth embodiment of the case settlement method of the present invention provides a case settlement method based on the above-mentioned second or third embodiment of the case settlement method of the present invention (this embodiment takes the second embodiment of the case settlement method of the present invention as an example), so The step S14 includes:
[0135] Step S141: Search all insurance policies of the insured according to the identity of the insured;
[0136] Step S142: Filter out the insurance policies within the insurance period from all the insurance policies of the insured, and configure them as a list of insurance policies for the investigator to select.
[0137] After obtaining the identity of the insured, the server searches the database for all insurance policies of the insured according to the identity of the insured.
[0138] Then, the server performs preliminary filtering, selects the policies that are still within the insurance period from all the policies, and filters out the policies that have expired. Among them, the insurance period is also called the insurance period. According to the insurance contract, the insurance company is liable for the agreed insured event within the agreed time, and this agreed time becomes the insurance period.
[0139] Then, the server uses the policy that is still within the insurance period and configures it into a policy list for the investigator to select the policy for this claim.
[0140] In this embodiment, all the insurance policies of the insured are searched according to the identity of the insured; the insurance policies within the insurance period are selected from all the insurance policies of the insured and configured as a list of insurance policies for the investigator to choose. Therefore, this embodiment automatically filters out policies that have expired. Since the insurance company does not pay for policies that are not within the insurance period, there is no need to file a case for these policies that are not within the insurance period, which can reduce the work of investigators and review nodes. Increase the speed of claims settlement.
[0141] Further, refer to Figure 8 The fifth embodiment of the case settlement method of the present invention provides a case settlement method. Based on the foregoing third embodiment of the case settlement method of the present invention, the step S30 includes:
[0142] Step S33: Upon receiving the compensation instruction fed back by the review node, determine the approved insurance policy and terms according to the compensation instruction;
[0143] Step S34: Obtain the amount of compensation payment according to the approved terms, and obtain the beneficiary account bound to the approved insurance policy;
[0144] Step S35: Use electronic payment to transfer the compensation payment to the beneficiary account.
[0145] When the server receives the compensation instruction fed back by the review node, it parses the compensation instruction and obtains the currently approved insurance policy and terms.
[0146] Then, the server obtains the compensation payment amount agreed upon with the insurance company when the customer signs the insurance policy according to the approved terms. For example, if the auto insurance policy passes the review, the liability amount clause in the policy also passes the audit. The default field in the clause is the value of the compensation amount. Therefore, the auto insurance policy can be obtained by reading the default field in the liability amount clause The amount of compensation.
[0147] At the same time, the server queries the customer's reservation information and obtains the beneficiary account bound to the approved insurance policy.
[0148] Further, if there are multiple insurance policies and their clauses that have passed the review, the server will compensate each policy according to the beneficiary account of each policy and the compensation amount in each policy clause.
[0149] Then, the server uses electronic payment to transfer the compensation payment to the beneficiary's account for compensation.
[0150] In this embodiment, upon receiving the compensation instruction fed back by the review node, the approved policy and terms are determined according to the compensation instruction; the amount of compensation payment is obtained according to the approved terms, and the benefits bound to the approved policy are obtained Then, use electronic payment to transfer the compensation to the beneficiary’s account. In this embodiment, there is no need to review the node's designated compensation payment amount and beneficiary account, which realizes the automatic extraction of the compensation payment amount for compensation according to the approved insurance policy and terms, which improves the intelligence of the case settlement.
[0151] In addition, the embodiment of the present invention also provides a computer-readable storage medium, the computer-readable storage medium stores a case settlement program, and when the case settlement program is executed by a processor, the following operations are implemented:
[0152] Upon receiving the claim settlement application input by the investigator, correspondingly configure the claim settlement case and generate an investigation task and send it to the investigator;
[0153] Receiving the investigation report submitted by the investigator based on the investigation task, and submitting the claim settlement case and the investigation report to an audit node;
[0154] Upon receiving the compensation instruction fed back by the review node, the compensation of the claim settlement case is performed according to the compensation instruction.
[0155] Further, the following operations are also implemented when the case claims procedure is executed by the processor:
[0156] Upon receiving the claim settlement application input by the investigator, obtain the identity of the insured person carried in the claim settlement application;
[0157] Search for all insurance policies of the insured according to the identity of the insured, and configure a list of insurance policies for the investigator to choose;
[0158] Obtain the insurance policy selected by the investigator based on the insurance policy list, configure the claim case correspondingly, and generate an investigation task to issue to the investigator.
[0159] Further, the following operations are also implemented when the case claims procedure is executed by the processor:
[0160] When receiving the policy selected by the investigator based on the policy list, display the terms of the selected policy for selection;
[0161] Obtain the insurance policy and terms selected by the investigator, configure the claim case correspondingly, and generate an investigation task and send it to the investigator.
[0162] Further, the following operations are also implemented when the case claims procedure is executed by the processor:
[0163] Search for all insurance policies of the insured according to the identity of the insured;
[0164] From all the insurance policies of the insured, the insurance policies within the insurance period are screened out and configured as a list of insurance policies for the investigator to select.
[0165] Further, the following operations are also implemented when the case claims procedure is executed by the processor:
[0166] When receiving the compensation instruction fed back by the review node, obtain the compensation payment amount and the beneficiary account according to the compensation instruction;
[0167] Using electronic payment, transfer the compensation payment to the beneficiary account.
[0168] Further, the following operations are also implemented when the case claims procedure is executed by the processor:
[0169] When receiving the compensation instruction fed back by the review node, determine the approved insurance policy and terms according to the compensation instruction;
[0170] Obtain the amount of compensation payment according to the approved terms, and obtain the beneficiary account bound to the approved insurance policy;
[0171] Using electronic payment, transfer the compensation payment to the beneficiary account.
[0172] Further, the following operations are also implemented when the case claims procedure is executed by the processor:
[0173] Upon receiving the claim settlement application input by the investigator, determine whether the investigator has the authority to accept claims;
[0174] If the investigator has the authority to accept claims, configure a claim case corresponding to the claims application and generate an investigation task and send it to the investigator.
[0175] Further, the following operations are also implemented when the case claims procedure is executed by the processor:
[0176] Reverse the survey task.
[0177] The specific embodiments of the computer-readable storage medium of the present invention are basically the same as the embodiments of the above-mentioned case settlement method, and will not be repeated here.
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