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Intelligent claim settlement method and system based on big data

A big data and intelligent technology, applied in the field of big data, can solve problems such as the inability to guarantee the accuracy and timeliness of risk data

Active Publication Date: 2019-12-24
CHINA PING AN LIFE INSURANCE CO LTD
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

[0004] Traditional machine learning can only calculate the corresponding risk coefficient in advance by using the offline historical data of the same type of business according to different businesses, and then exchange data with the database through the application interface (Application Interface, API). The accuracy and timeliness of risk data cannot be guaranteed

Method used

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  • Intelligent claim settlement method and system based on big data
  • Intelligent claim settlement method and system based on big data
  • Intelligent claim settlement method and system based on big data

Examples

Experimental program
Comparison scheme
Effect test

Embodiment 1

[0083] refer to figure 1 , shows a flow chart of the steps of the big data-based intelligent claim settlement method in Embodiment 1 of the present invention. It can be understood that the flowchart in this method embodiment is not used to limit the sequence of execution steps. It should be noted that this embodiment uses the computer device 2 as an execution subject for exemplary description. details as follows:

[0084] Step S100, receiving claim settlement request information of pending claim settlement cases sent by the claim settlement terminal.

[0085] Exemplarily, when a user initiates a claim settlement request at the claim settlement terminal, the computer device 2 receives claim settlement request information of the claim settlement request.

[0086] Step S102, according to the claim request information, obtain the information of pending claims from the centralized claim settlement operation system.

[0087] Exemplarily, the factors of the claim case information...

Embodiment 2

[0105] refer to figure 2 , shows a flow chart of the steps of the big data-based intelligent claim settlement method in Embodiment 2 of the present invention. Embodiment 2 of the present invention includes steps S200 to S204 in addition to steps S100 to S116 in Embodiment 1.

[0106] Step S200, capturing risk characteristic factors from the information of the historical claim settlement cases, wherein the risk characteristic factors are captured by way of information value (Information Value, IV) or weight of evidence (Weight of Evidence, WOE).

[0107] Specifically, if the information value of certain information in the historical claim settlement case information is greater, then this information is a risk characteristic factor.

[0108] In a preferred embodiment, the step of capturing risk characteristic factors from the historical claim settlement case information includes: counting the number of claims for each of the multiple factors according to the historical claim s...

Embodiment 3

[0116] see image 3 , shows a schematic diagram of the hardware architecture of the computer device according to Embodiment 3 of the present invention. The computer device 2 includes, but is not limited to, a memory 21, a processing 22 and a network interface 23 that can communicate with each other through a system bus, figure 2 Only the computer device 2 is shown with components 21-23, but it should be understood that implementation of all of the illustrated components is not required and that more or fewer components may instead be implemented.

[0117] The memory 21 includes at least one type of readable storage medium, and the readable storage medium includes a flash memory, a hard disk, a multimedia card, a card-type memory (for example, SD or DX memory, etc.), random access memory (RAM), static Random Access Memory (SRAM), Read Only Memory (ROM), Electrically Erasable Programmable Read Only Memory (EEPROM), Programmable Read Only Memory (PROM), Magnetic Memory, Magneti...

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PUM

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Abstract

The embodiment of the invention provides an intelligent claim settlement method based on big data. The method comprises the steps of obtaining to-be-claimed case information according to received claim settlement request information; identifying a claim settlement type of the to-be-claimed case; acquiring information of a historical claim settlement case consistent with the claim settlement type from a historical claim settlement database according to the claim settlement type; determining a historical risk coefficient of the information of the historical claim settlement case consistent withthe claim settlement type and a risk coefficient of the to-be-claimed settlement case by utilizing a risk coefficient model; calculating the risk score of the to-be-claimed case according to the historical risk coefficient, the risk coefficient of the to-be-claimed case and a preset algorithm, and predicting the risk degree of the to-be-claimed case; and according to the risk degree, determining apreset rule preset in a claim settlement operation database and matched with the to-be-claimed case, and sending claim settlement information to a claim settlement terminal, so that the claim settlement terminal performs claim settlement according to the claim settlement information. Through the embodiment of the invention, the accuracy of the risk prediction result and the claim settlement service quality can be improved.

Description

technical field [0001] The embodiments of the present invention relate to the field of big data, and in particular to a big data-based intelligent claim settlement method, intelligent claim settlement system, computer equipment, and a readable storage medium. Background technique [0002] With the increasingly fierce competition in the insurance industry and the increasing awareness of customer service, traditional claims services mainly rely on manual experience for risk management and control. The operating efficiency is too low and the leakage rate of risk cases is high. It has been unable to meet the needs of customers and insurance companies. Therefore, the demand for extreme, fast and accurate quick claims and differentiated services is becoming more and more urgent. [0003] Of course, the improvement of service will inevitably be accompanied by the increase of cost, and the relationship between risk control and extreme, fast and accurate quick compensation is contrad...

Claims

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Application Information

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Patent Type & Authority Applications(China)
IPC IPC(8): G06Q40/08G06F16/903
CPCG06Q40/08G06F16/90335
Inventor 刘行行王进
Owner CHINA PING AN LIFE INSURANCE CO LTD