Case processing method, device and equipment, and readable storage medium

A processing method and case technology, applied in the field of data processing, can solve problems such as low efficiency of claims settlement, high level of structure, uneven data quality, etc., and achieve the effect of improving the efficiency of claims settlement

Pending Publication Date: 2020-11-13
TAIKANG LIFE INSURANCE CO LTD
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  • Summary
  • Abstract
  • Description
  • Claims
  • Application Information

AI Technical Summary

Problems solved by technology

[0005] However, since the case data provided by hospitals, social security, and third-party platforms cannot guarantee a high level of structure (that is, data quality), the data quality is uneven
Therefore, the judgment of the data quality ...

Method used

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  • Case processing method, device and equipment, and readable storage medium
  • Case processing method, device and equipment, and readable storage medium
  • Case processing method, device and equipment, and readable storage medium

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Embodiment Construction

[0064] The following will clearly and completely describe the technical solutions in the embodiments of the present application with reference to the drawings in the embodiments of the present application. Obviously, the described embodiments are part of the embodiments of the present application, not all of them. Based on the embodiments in this application, all other embodiments obtained by persons of ordinary skill in the art without creative efforts shall fall within the protection scope of this application.

[0065] In related technologies, insurance companies will connect as many hospital institutions as possible to obtain more comprehensive medical information of customers. Under normal circumstances, an insurance company's system will connect with thousands of medical institutions in different regions, and then provide millions of structured case data for the company's multiple application scenarios such as claim verification and underwriting.

[0066] However, the cas...

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Abstract

The embodiment of the invention provides a case processing method, device and equipment and a readable storage medium, and aims to improve the claim settlement efficiency and reduce the cost. The method comprises the steps of obtaining case data of a to-be-claimed case; performing data structured verification on the case data according to a preset verification rule; determining a claim amount value of the to-be-claimed case based on the case data under the condition that the case data passes the data structured verification; and when the difference between the claim amount value of the to-be-claimed case and a claim amount value provided by a third-party platform does not exceed a preset difference, determining that the claim amount value of the to-be-claimed case does not exceed the preset difference; sending the to-be-claimed case to an automatic claim settlement platform corresponding to the to-be-claim settlement case, so that the automatic claim settlement platform outputs claim settlement information for the to-be-claim settlement case according to the claim settlement limit value.

Description

technical field [0001] The embodiments of the present application relate to the technical field of data processing, and in particular, to a case processing method, device, equipment, and readable storage medium. Background technique [0002] With the improvement of people's awareness of insurance, more and more people will invest part of their funds in insurance companies, etc., so that insurance companies need to deal with more and more claims cases. After claims cases occur, users need to ask insurance companies for compensation. The insurance company needs to settle the claim for the claim to determine the compensation amount (ie, the compensation amount) to the user. [0003] Take medical insurance (the type of insurance that pays immediately after the customer is hospitalized due to illness) as an example. The traditional claim settlement method is that after the customer is discharged from the hospital, he gets the settlement documents and medical treatment details fro...

Claims

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Application Information

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IPC IPC(8): G06Q10/10G06Q40/08G06K9/00
CPCG06Q10/103G06Q40/08G06V30/412
Inventor 刘坤邹彬白宇
Owner TAIKANG LIFE INSURANCE CO LTD
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