Claim settlement decision method, device, computer device and storage medium

Abstract

The present application relates to machine learning techniques in the field of artificial intelligence, and provides a Claim settlement decision method, device, computer device and storage medium. Themethod comprises the following steps of: receiving a claim decision request sent by a claim settler terminal, wherein the claim decision request carries an identity mark of a patient to be settled; Searching corresponding current diagnostic text and diagnostic results according to the identity identifier, extracting multiple keywords of the current diagnostic text; Searching the target standard words corresponding to the keywords from the preset standard vocabulary database to obtain the target standard words set; Obtaining the trained decision tree model corresponding to the diagnosis results as the target decision tree model, and obtaining the corresponding treatment types of the patients to be settled according to the target standard word set and the target decision tree model; According to the treatment type, querying the corresponding preset claim data, obtaining the target decision data according to the preset claim data, and sending the target decision data to the claim settlerterminal. The method can save the claim cost and reduce the occurrence of wrong claim and omission.

Description

technical field [0001] The present application relates to the technical field of commercial insurance claims, in particular to a claim decision-making method, device, computer equipment and storage medium. Background technique [0002] With the continuous improvement of the informatization level of commercial insurance business, the need to improve the professionalism of insurance claims business and the accuracy of compensation is becoming more and more urgent. [0003] In traditional technology, commercial insurance claims, such as personal injury claims in car accidents, often require a large number of medical professionals or non-medical professionals who have received a certain degree of professional training to arrive at the scene of the car accident for on-site investigation, underwriting and claim verification. However, due to this method, due to the high medical literacy requirements for claimants, commercial insurance companies need to spend a lot of manpower and m...

AI Technical Summary

Problems solved by technology

However, due to this method, due to the high medical literacy requirements for claimants, commercial insurance companies need to spend a lot of manpower and material resources on relevant training in the early stage, resulting in high costs for commercial claims; on the other hand, manual judgment of claims is limited to Experience and professional knowledge, it is easy to misjudge the customer's injury, resulting in the phenomenon of wrong compensation and missed compensation

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