A claim settlement task dispatching method and device, a computer device and a storage medium
By generating task assignment curves and formulating assignment strategies, the system intelligently matches the workload of claims processing personnel, solving the problem of uneven task matching and improving customer satisfaction and human resource utilization.
Patent Information
- Authority / Receiving Office
- CN · China
- Patent Type
- Patents(China)
- Current Assignee / Owner
- CHINA PING AN PROPERTY INSURANCE CO LTD
- Filing Date
- 2023-05-05
- Publication Date
- 2026-06-26
AI Technical Summary
The existing claims task assignment method cannot guarantee the full utilization of manpower and the quality of customer service, resulting in poor service from claims staff or increased labor costs.
By acquiring the historical task volume and task completion status of each claims handler, a task assignment curve is generated. Based on the curve, an assignment strategy is formulated to match the optimal task volume and acceptable task volume range for each person, thereby achieving intelligent matching of task volume.
This solved the problem of uneven workload matching, improved the work efficiency of claims processing personnel, and enhanced customer satisfaction and human resource utilization.
Smart Images
Figure CN116562564B_ABST
Abstract
Description
Technical Field
[0001] This application relates to the field of data analysis technology, and in particular to a method, apparatus, computer equipment, and storage medium for dispatching claims tasks. Background Technology
[0002] In the insurance industry, claims task assignment refers to the process where, after an insured event occurs, the insured notifies the insurer, and the insurer dispatches claims personnel to the scene to investigate and process the claim. Each claims personnel completes a large number of system-assigned tasks daily. These tasks are categorized into different types, such as newly generated tasks like initial investigation and loss assessment, previously followed tasks requiring continued follow-up, and temporary emergency tasks triggered by customer complaints, task delays, or supervisory oversights. Currently, claims task assignment typically uses a sequential, evenly distributed method, with each claims personnel receiving the same number of tasks, and the difficulty of the tasks is randomly assigned. However, in practice, within limited working hours, each claims personnel has varying levels of experience and workload capacity. Too many tasks can lead to inadequate service and negatively impact customer satisfaction and loyalty, while too few tasks increase labor costs. Therefore, it is necessary to develop a more scientific task assignment method for claims personnel that ensures both efficient use of manpower and high-quality customer service. Summary of the Invention
[0003] This application provides a claims task assignment method, apparatus, computer equipment, and storage medium, aiming to solve the technical problems that existing claims task assignment methods cannot guarantee the full utilization of human resources and the quality of customer service.
[0004] To solve the above-mentioned technical problems, the technical solution adopted in this application is as follows:
[0005] A method for assigning claims tasks includes:
[0006] Obtain the historical task volume received by each claims processing staff member within a set time period, as well as the task completion status of each historical task;
[0007] The task volume and number of claims processing personnel corresponding to each task completion status are calculated separately, and the cumulative percentage of the number of claims processing personnel in the total number of claims processing personnel is calculated for each task completion status.
[0008] Based on the cumulative percentage calculation results, a task assignment curve is generated, which consists of the task volume and the cumulative percentage.
[0009] A dispatching strategy is formulated based on the task dispatching curve, and claims tasks are dispatched according to the dispatching strategy.
[0010] The technical solution adopted in this application embodiment also includes: the task completion status includes: completed on the same day and all tasks did not exceed the time limit, completed on the same day but some tasks exceeded the time limit, not completed on the same day but the tasks did not exceed the time limit, and not completed on the same day and the tasks exceeded the time limit.
[0011] The technical solution adopted in this application embodiment further includes: the step of separately calculating the task volume and the number of claims processing personnel corresponding to each task completion status, and separately calculating the cumulative percentage of the number of claims processing personnel in the total number of claims processing personnel under each task completion status, specifically as follows:
[0012] The task completion status is divided into different task completion types, and the task volume and number of claims processing personnel corresponding to each task completion type are calculated separately. Based on the task volume, the cumulative percentage of claims processing personnel under each task completion type in the total number of claims processing personnel is calculated. The task completion types include "relatively easy", "too easy", "relatively difficult", and "too difficult". For the two task completion types of "relatively easy" and "too easy", the cumulative percentage is calculated by accumulating the task volume from high to low. For the two task completion types of "relatively difficult" and "too difficult", the cumulative percentage is calculated by accumulating the task volume from low to high.
[0013] The technical solution adopted in this application embodiment further includes: the specific method of generating a task assignment curve composed of the task volume and the cumulative percentage based on the cumulative percentage calculation result is as follows:
[0014] The task volume range is used as the X-axis in the task assignment curve, and the cumulative percentage of claims processing personnel under different task completion types in the total number of claims processing personnel is used as the Y-axis in the task assignment curve.
[0015] The technical solution adopted in this application embodiment further includes: the specific method of formulating a dispatch strategy based on the task dispatch curve is as follows:
[0016] Obtain the intersection points between each pair of curves in the task assignment curve diagram and the corresponding task quantity for each intersection point, and formulate an assignment strategy based on the task quantity corresponding to each intersection point; wherein, the intersection points between each pair of curves in the task assignment curve diagram include: intersection point A between the two task completion types of "too easy" and "relatively difficult", intersection point B between the two task completion types of "relatively easy" and "too difficult", intersection point C between the two task completion types of "relatively easy" and "relatively difficult", and intersection point D between the two task completion types of "too easy" and "too difficult".
[0017] The technical solution adopted in this application embodiment further includes: the step of formulating a dispatch strategy based on the task dispatch curve further includes:
[0018] The task quantity corresponding to the intersection point A in the task assignment curve is taken as the minimum acceptable task quantity for claims settlement personnel, the task quantity corresponding to the intersection point B is taken as the maximum acceptable task quantity for claims settlement personnel, and the task quantity range between the "acceptable minimum task quantity" and the "acceptable maximum task quantity" is divided into the acceptable task quantity range for claims settlement personnel; the task quantity corresponding to the intersection point C is taken as a task quantity that is neither easy nor difficult, and the task quantity corresponding to the intersection point D is taken as the optimal task quantity.
[0019] Another technical solution adopted in this application embodiment is: a claims task dispatching device, comprising:
[0020] Data acquisition module: used to acquire the historical task volume received by each claims processing staff member within a set time period, as well as the task completion status of each historical task;
[0021] Percentage Calculation Module: Used to calculate the task volume and number of claims processing personnel corresponding to each task completion status, and to calculate the cumulative percentage of the number of claims processing personnel in the total number of claims processing personnel for each task completion status.
[0022] The curve generation module is used to generate a task assignment curve composed of the task quantity and the cumulative percentage based on the cumulative percentage calculation result.
[0023] Strategy formulation module: used to formulate a dispatch strategy based on the task dispatch curve, and to dispatch claims tasks according to the dispatch strategy.
[0024] The technical solution adopted in this application embodiment further includes: the strategy formulation module formulates a dispatch strategy based on the task dispatch curve, specifically as follows:
[0025] Obtain the intersection points between each pair of curves in the task assignment curve diagram and the corresponding task quantity for each intersection point, and formulate an assignment strategy based on the task quantity corresponding to each intersection point; wherein, the intersection points between each pair of curves in the task assignment curve diagram include: intersection point A between the two task completion types of "too easy" and "relatively difficult", intersection point B between the two task completion types of "relatively easy" and "too difficult", intersection point C between the two task completion types of "relatively easy" and "relatively difficult", and intersection point D between the two task completion types of "too easy" and "too difficult";
[0026] The workload corresponding to intersection point A is taken as the minimum acceptable workload for claims processing personnel, the workload corresponding to intersection point B is taken as the maximum acceptable workload for claims processing personnel, and the workload range between the "minimum acceptable workload" and the "maximum acceptable workload" is divided into the acceptable workload range for claims processing personnel; the workload corresponding to intersection point C is taken as a workload that is neither easy nor difficult, and the workload corresponding to intersection point D is taken as the optimal workload.
[0027] Another technical solution adopted in this application embodiment is: a computer device, the computer device comprising:
[0028] A memory that stores executable program instructions;
[0029] The processor connected to the memory;
[0030] The processor calls the executable program instructions stored in the memory to execute the claims task dispatching method described above.
[0031] Another technical solution adopted in this application embodiment is: a storage medium storing processor-executable program instructions, the program instructions being used to execute the above-mentioned claims task dispatching method.
[0032] The claims task dispatching method, apparatus, computer equipment, and storage medium of this application embodiment obtain the historical task volume, task type, and task completion status of each claims worker within a set time period through a background process. It statistically analyzes the task volume and number of workers corresponding to each task completion type, and calculates the cumulative percentage of workers under each task completion type out of the total number of workers based on the task volume. Based on the cumulative percentage calculation results, it generates a task dispatching curve composed of a task volume range and the cumulative percentage of workers under different task completion types out of the total number of workers. Based on the task dispatching curve, it formulates a dispatching strategy and performs task dispatching. This application embodiment can focus on the optimal task volume and the most reasonable acceptable task volume range for each claims worker, thereby intelligently matching the task volume of each person, solving the problem of uneven task volume matching caused by difficulty factors, and measuring the optimal service status of claims workers through optimal workload and bearable workload, thereby ensuring customer experience and improving customer satisfaction. Attached Figure Description
[0033] Figure 1 This is a flowchart illustrating the claims task assignment method according to the first embodiment of this application;
[0034] Figure 2 This is a flowchart illustrating the claims task assignment method according to the second embodiment of this application;
[0035] Figure 3 This is a task dispatch curve diagram of an embodiment of this application;
[0036] Figure 4 This is a schematic diagram of the structure of the claims task dispatching device according to an embodiment of this application;
[0037] Figure 5 This is a schematic diagram of the computer device structure according to an embodiment of this application;
[0038] Figure 6 This is a schematic diagram of the storage medium structure according to an embodiment of this application. Detailed Implementation
[0039] The technical solutions of the embodiments of this application will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only a part of the embodiments of this application, and not all of the embodiments. Based on the embodiments of this application, all other embodiments obtained by those of ordinary skill in the art without creative effort are within the scope of protection of this application.
[0040] The terms "first," "second," and "third" in this application are for descriptive purposes only and should not be construed as indicating or implying relative importance or implicitly specifying the number of indicated technical features. Therefore, a feature defined as "first," "second," or "third" may explicitly or implicitly include at least one of that feature. In the description of this application, "multiple" means at least two, such as two, three, etc., unless otherwise explicitly specified. All directional indications (such as up, down, left, right, front, back, etc.) in the embodiments of this application are only used to explain the relative positional relationships and movements between components in a specific orientation (as shown in the figures). If the specific orientation changes, the directional indications also change accordingly. Furthermore, the terms "comprising" and "having," and any variations thereof, are intended to cover non-exclusive inclusion. For example, a process, method, system, product, or device that includes a series of steps or units is not limited to the listed steps or units, but may optionally include steps or units not listed, or may optionally include other steps or units inherent to these processes, methods, products, or devices.
[0041] In this document, the term "embodiment" means that a particular feature, structure, or characteristic described in connection with an embodiment may be included in at least one embodiment of this application. The appearance of this phrase in various places throughout the specification does not necessarily refer to the same embodiment, nor is it a separate or alternative embodiment mutually exclusive with other embodiments. It will be explicitly and implicitly understood by those skilled in the art that the embodiments described herein can be combined with other embodiments.
[0042] This application's embodiments can acquire and process relevant data based on artificial intelligence (AI) technology. AI is the theory, methods, technology, and application system that uses digital computers or computers-controlled machines to simulate, extend, and expand human intelligence, perceive the environment, acquire knowledge, and use that knowledge to obtain optimal results. Basic AI technologies generally include sensors, dedicated AI chips, cloud computing, distributed storage, big data processing technology, operating / interactive systems, and mechatronics. AI software technologies mainly include computer vision, robotics, biometrics, speech processing, natural language processing, and machine learning / deep learning.
[0043] Please see Figure 1 This is a flowchart illustrating the claims task assignment method according to the first embodiment of this application. The claims task assignment method according to the first embodiment of this application includes the following steps:
[0044] S100: Obtain the historical task volume received by each claims processing staff member within a set time period and the task completion status of each historical task;
[0045] S110: Calculate the task volume and number of claims processing personnel corresponding to each task completion status, and calculate the cumulative percentage of the number of claims processing personnel in the total number of claims processing personnel for each task completion status.
[0046] S120: Generate a task assignment curve graph composed of the task quantity and the cumulative percentage based on the cumulative percentage calculation result;
[0047] S130: Formulate a dispatch strategy based on the task dispatch curve, and dispatch claims tasks according to the dispatch strategy.
[0048] Based on the above, the claims task assignment method of the first embodiment of this application obtains the historical task volume received by each claims worker within a set time period and the task completion status of each historical task in the background. It calculates the cumulative percentage of claims workers with different task completion statuses in the total number of claims workers. Based on the cumulative percentage calculation result, it generates a task assignment curve composed of the task volume range and the cumulative percentage of workers under different task completion types in the total number of workers. Based on the task assignment curve, it formulates an assignment strategy and performs task assignment. This embodiment of the application can focus on the optimal task volume and the most reasonable acceptable task volume range for each claims worker, thereby intelligently matching the task volume of each person, solving the problem of uneven task volume matching caused by difficulty factors, thus ensuring customer experience and improving customer satisfaction.
[0049] Please see Figure 2This is a flowchart illustrating the claims task assignment method according to the second embodiment of this application. The claims task assignment method according to the second embodiment of this application includes the following steps:
[0050] S200: Obtain the historical task volume, task type, and task completion status of each historical task received by each claims processing staff member within a set time period;
[0051] In this step, historical task volume refers to the number of dispatched tasks received by each claims adjuster within a set time period, which includes, but is not limited to, daily, weekly, or monthly periods. Task completion status refers to whether the claims adjuster completes the dispatched tasks within the specified time (day). Task completion status typically includes four scenarios: completed on the day and all tasks are within the time limit; completed on the day but some tasks are overdue; not completed on the day but tasks are not overdue; and not completed on the day and tasks are overdue. Based on the task completion status, the claims adjuster's work experience and workload capacity can be assessed, and the corresponding task completion type can be categorized.
[0052] S210: Divide the task completion status into different task completion types, and separately calculate the task volume and the number of claims processing personnel under each task completion type. Calculate the cumulative percentage of the number of claims processing personnel under each task completion type in the total number of claims processing personnel based on the task volume.
[0053] In this step, task completion types can be categorized into four types based on different task completion outcomes: "relatively easy," "too easy," "relatively difficult," and "too difficult." It's important to understand that the classification methods and number of task completion types are not limited to the above and can be set according to the actual application scenario. The cumulative percentage represents the total number of people in each task completion type within a set time period. Generally, as the workload decreases, the number of people in the "relatively easy" and "too easy" task completion types increases, and conversely, as the workload increases, the number of people in the "relatively difficult" and "too difficult" task completion types increases. Therefore, to improve the accuracy of the cumulative percentage calculation, for the "relatively easy" and "too easy" task completion types, the cumulative percentage is calculated by adding the tasks from highest to lowest workload; for the "relatively difficult" and "too difficult" task completion types, the cumulative percentage is calculated by adding the tasks from lowest to highest workload. The calculated data will be shown in Table 1 below.
[0054] Table 1: Cumulative Percentage of People with Different Task Completion Types in the Total Number of People
[0055]
[0056]
[0057] S220: Generate a task assignment curve based on the cumulative percentage calculation results. The X-axis in the task assignment curve represents the task volume range, and the Y-axis in the task assignment curve represents the cumulative percentage of the number of claims processing personnel under different task completion types in the total number of claims processing personnel.
[0058] In this step, the generated task assignment curve is as follows: Figure 3 As shown, a certain task range and task quantity assignment interval can be defined based on the intersection points between the two curves in the task assignment curve graph. The task quantity interval on the X-axis is a task quantity interval with an interval of 8, and the cumulative percentage on the Y-axis is a percentage interval with an interval of 25%. The specific interval values can be set according to the actual application scenario.
[0059] S230: Obtain the intersection points between each pair of curves in the task assignment curve graph and the task quantity corresponding to each intersection point, and formulate an assignment strategy based on the task quantity corresponding to each intersection point.
[0060] In this step, such as Figure 3 As shown in the task assignment curve diagram, the intersections between each pair of curves include: Intersection A between "too easy" and "relatively difficult" task completion types; Intersection B between "relatively easy" and "too difficult" task completion types; Intersection C between "relatively easy" and "relatively difficult" task completion types; and Intersection D between "too easy" and "too difficult" task completion types. Intersection A represents the minimum acceptable workload for claims processing personnel; that is, for the workload corresponding to intersection A, the percentage of users who consider it "too easy" and "relatively difficult" are equal. If the workload is lower than that corresponding to intersection A, the claims processing personnel's workload is considered too low, resulting in wasted manpower. Intersection B represents the maximum acceptable workload for claims processing personnel; that is, for the workload corresponding to intersection B, the percentage of users who consider it "relatively easy" and "too difficult" are equal. If the workload is higher than that corresponding to intersection B, the claims processing personnel's workload is considered too high, leading to poor task completion quality and affecting customer satisfaction. The workload corresponding to intersection point C is neither easy nor difficult; that is, the percentage of users who consider the workload at intersection point C to be "relatively easy" and "too difficult" are equal. This workload is unbearable for claims processing personnel. The workload corresponding to intersection point D is the optimal workload; that is, the percentage of users who consider the workload at intersection point D to be "too easy" and "too difficult" are equal. This workload makes full use of human resources while ensuring the quality of task completion by claims processing personnel.
[0061] The specific method for formulating the work assignment strategy is as follows: the task quantity corresponding to the intersection point A in the task assignment curve is taken as the minimum acceptable task quantity for claims settlement personnel, the task quantity corresponding to the intersection point B is taken as the maximum acceptable task quantity for claims settlement personnel, and the task quantity range between the "acceptable minimum task quantity" and the "acceptable maximum task quantity" is divided into the acceptable task quantity range for claims settlement personnel; the task quantity corresponding to the intersection point C is taken as the task quantity that is neither easy nor difficult, and the task quantity corresponding to the intersection point D is taken as the optimal task quantity.
[0062] S240: Assign tasks according to the established assignment strategy;
[0063] In this step, to ensure the rationality of work assignment for each claims adjuster, the workload capacity and optimal workload of each claims adjuster can be recorded separately in actual work assignment scenarios. When the workload is sufficient, priority is given to ensuring that each claims adjuster's workload reaches the "acceptable minimum workload," and then gradually matching each person's workload to the optimal workload. When the total workload continues to surge, automatic matching is performed based on each person's current workload, prioritizing ensuring that all personnel's workload capacity is within the "acceptable maximum workload" range.
[0064] Based on the above, the claims task dispatching method of the second embodiment of this application obtains the historical task volume, task type, and task completion status of each historical task received by each claims worker within a set time period through the background. It then calculates the corresponding task volume and number of workers for each task completion type, and calculates the cumulative percentage of workers for each task completion type out of the total number of workers based on the task volume. Based on the cumulative percentage calculation results, it generates a task dispatching curve composed of the task volume range and the cumulative percentage of workers for different task completion types out of the total number of workers. Based on the task dispatching curve, it formulates a dispatching strategy and performs task dispatching. This embodiment of the application can focus on the optimal task volume and the most reasonable acceptable task volume range for each claims worker, thereby intelligently matching the dispatching task volume for each person, solving the problem of uneven task volume matching caused by difficulty factors, and measuring the optimal service status of claims workers through optimal workload and bearable workload, thereby ensuring customer experience and improving customer satisfaction.
[0065] In an alternative implementation, the results of the claims task dispatching method can also be uploaded to the blockchain.
[0066] Specifically, based on the results of the claims task assignment method, corresponding summary information is obtained. Specifically, the summary information is obtained by hashing the results of the claims task assignment method, for example, using the SHA256 algorithm. Uploading the summary information to the blockchain ensures its security and fairness and transparency to users. Users can download the summary information from the blockchain to verify whether the results of the claims task assignment method have been tampered with. The blockchain referred to in this example is a new application model of computer technologies such as distributed data storage, peer-to-peer transmission, consensus mechanisms, and encryption algorithms. A blockchain is essentially a decentralized database, a chain of data blocks linked using cryptographic methods. Each data block contains information about a batch of network transactions, used to verify the validity of the information (anti-counterfeiting) and generate the next block. A blockchain can include a blockchain underlying platform, a platform product service layer, and an application service layer.
[0067] Please see Figure 4 This is a schematic diagram of the claims task dispatching device according to an embodiment of this application. The claims task dispatching device 40 according to an embodiment of this application includes:
[0068] Data acquisition module 41: Used to acquire the historical task volume received by each claims processing worker within a set time period and the task completion status of each historical task; wherein, the historical task volume refers to the number of dispatched tasks received by each claims processing worker within the set time period, and the set time period includes, but is not limited to, daily, weekly, or monthly. Task completion status refers to whether the claims processing worker completes the dispatched tasks within the specified time (day), and task completion status typically includes four situations: completed on the day and all tasks are within the time limit, completed on the day but some tasks are within the time limit, not completed on the day but no tasks are within the time limit, and not completed on the day and tasks are within the time limit.
[0069] Percentage Calculation Module 42: This module is used to separately calculate the task volume and number of claims processing personnel corresponding to each task completion status, and to calculate the cumulative percentage of claims processing personnel in the total number of claims processing personnel for each task completion status. Specifically, the percentage calculation module 42 categorizes tasks into different completion types based on their completion status, and separately calculates the task volume and number of claims processing personnel for each completion type. Based on the task volume, it calculates the cumulative percentage of claims processing personnel in each task completion type in the total number of claims processing personnel. Specifically, task completion types can be divided into four categories: "relatively easy," "too easy," "relatively difficult," and "too difficult." It is understood that the classification methods and number of task completion statuses and types are not limited to the above and can be set according to the actual application scenario. The cumulative percentage represents the cumulative proportion of the number of people in each task completion type within the total number of people over a set period. Generally, as the workload decreases, the number of people completing tasks in the "relatively easy" and "too easy" categories increases; conversely, as the workload increases, the number of people completing tasks in the "relatively difficult" and "too difficult" categories increases. Therefore, to improve the accuracy of the cumulative percentage calculation, for the "relatively easy" and "too easy" task completion categories, the cumulative percentage is calculated by adding the percentages upwards from the workload level; for the "relatively difficult" and "too difficult" task completion categories, the cumulative percentage is calculated by adding the percentages upwards from the workload level.
[0070] The curve generation module 43 is used to generate a task assignment curve composed of the task volume and the cumulative percentage based on the cumulative percentage calculation result; wherein, the X-axis of the task assignment curve represents the task volume range, and the Y-axis of the task assignment curve represents the cumulative percentage of the number of claims processing personnel under different task completion types in the total number of claims processing personnel.
[0071] Strategy formulation module 44: This module formulates a task assignment strategy based on the task assignment curve and assigns claims tasks according to the strategy. Specifically, the intersections of the curves in the task assignment curve include: intersection point A between "too easy" and "relatively difficult" task completion types; intersection point B between "relatively easy" and "too difficult" task completion types; intersection point C between "relatively easy" and "relatively difficult" task completion types; and intersection point D between "too easy" and "too difficult" task completion types. Intersection point A represents the minimum acceptable workload for claims processing personnel; that is, for the workload corresponding to intersection point A, the percentage of users who consider "too easy" and "relatively difficult" to be the same. If the workload is lower than that corresponding to intersection point A, the workload of claims processing personnel is considered too low, resulting in wasted manpower. Intersection point B represents the maximum acceptable workload for claims processing personnel; that is, for the workload corresponding to intersection point B, the percentage of users who consider "relatively easy" and "too difficult" to be the same. If the workload exceeds that corresponding to intersection point B, the claims processing staff will be considered overburdened, leading to poor task quality and impacting customer satisfaction. Intersection point C represents a workload that is neither too easy nor too difficult; the percentage of users who consider it "relatively easy" and "too difficult" is equal. This workload is beyond the capacity of claims processing staff. Intersection point D represents the optimal workload; the percentage of users who consider it "too easy" and "too difficult" is equal. This workload effectively utilizes human resources while ensuring the quality of task completion by claims processing staff.
[0072] Furthermore, the dispatching strategy of the strategy formulation module 44 is specifically formulated as follows: the task quantity corresponding to the intersection point A in the task dispatching curve is taken as the minimum acceptable task quantity for claims processing personnel, the task quantity corresponding to the intersection point B is taken as the maximum acceptable task quantity for claims processing personnel, and the task quantity range between the "acceptable minimum task quantity" and the "acceptable maximum task quantity" is divided into the acceptable task quantity range for claims processing personnel; the task quantity corresponding to the intersection point C is taken as the task quantity that is neither easy nor difficult, and the task quantity corresponding to the intersection point D is taken as the optimal task quantity.
[0073] The claims task dispatching device in this embodiment obtains the historical task volume received by each claims handler within a set time period and the task completion status of each historical task in the background. It calculates the cumulative percentage of claims handlers with different task completion statuses out of the total number of claims handlers. Based on the cumulative percentage calculation result, it generates a task dispatching curve consisting of a task volume range and the cumulative percentage of personnel with different task completion types out of the total number of personnel. Based on the task dispatching curve, it formulates a dispatching strategy and performs task dispatching. This embodiment can focus on the optimal task volume and the most reasonable acceptable task volume range for each claims handler, thereby intelligently matching the task volume for each person, solving the problem of uneven task volume matching caused by difficulty factors, thus ensuring customer experience and improving customer satisfaction.
[0074] Please see Figure 5 This is a schematic diagram of a computer device structure according to an embodiment of this application. The computer device 50 includes:
[0075] Memory 51 storing executable program instructions;
[0076] Processor 52 connected to memory 51;
[0077] The processor 52 is used to call the executable program instructions stored in the memory 51 and perform the following steps: obtain the historical task volume received by each claims processing worker within a set time and the task completion status of each historical task; respectively calculate the task volume and the number of claims processing workers corresponding to each task completion status, and respectively calculate the cumulative percentage of the number of claims processing workers in each task completion status to the total number of claims processing workers; generate a task dispatch curve composed of the task volume and the cumulative percentage based on the cumulative percentage calculation result; formulate a dispatch strategy based on the task dispatch curve, and dispatch claims tasks according to the dispatch strategy.
[0078] The processor 52 can also be referred to as a CPU (Central Processing Unit). The processor 52 may be an integrated circuit chip with signal processing capabilities. The processor 52 can also be a general-purpose processor, a digital signal processor (DSP), an application-specific integrated circuit (ASIC), an off-the-shelf programmable gate array (FPGA), or other programmable logic devices, discrete gate or transistor logic devices, or discrete hardware components. A general-purpose processor can be a microprocessor or any conventional processor.
[0079] The computer device in this embodiment obtains the historical task volume received by each claims adjuster within a set time period and the task completion status of each historical task in the background. It calculates the cumulative percentage of claims adjusters with different task completion statuses out of the total number of claims adjusters. Based on the cumulative percentage calculation, it generates a task assignment curve consisting of a task volume range and the cumulative percentage of personnel with different task completion types out of the total number of personnel. Based on the task assignment curve, it formulates an assignment strategy and performs task assignment. This embodiment can focus on the optimal task volume and the most reasonable acceptable task volume range for each claims adjuster, thereby intelligently matching the task volume for each person, solving the problem of uneven task volume matching caused by difficulty factors, thus ensuring customer experience and improving customer satisfaction.
[0080] Please see Figure 6 , Figure 6 This is a schematic diagram of the storage medium in an embodiment of this application. The storage medium in this embodiment stores program instructions 61 capable of implementing the following steps: obtaining the historical task volume received by each claims processing worker within a set time period and the task completion status of each historical task; statistically analyzing the task volume and the number of claims processing workers corresponding to each task completion status, and calculating the cumulative percentage of the number of claims processing workers in each task completion status to the total number of claims processing workers; generating a task assignment curve composed of the task volume and the cumulative percentage based on the cumulative percentage calculation result; formulating an assignment strategy based on the task assignment curve, and assigning claims tasks according to the assignment strategy. The program instructions 61 can be stored in the aforementioned storage medium in the form of a software product, including several instructions to cause a computer device (which may be a personal computer, server, or network device, etc.) or processor to execute all or part of the steps of the methods in various embodiments of this application. The aforementioned storage media include: USB flash drives, portable hard drives, read-only memory (ROM), random access memory (RAM), magnetic disks, optical disks, and other media capable of storing program instructions, or terminal devices such as computers, servers, mobile phones, and tablets. Servers can be independent servers or cloud servers providing basic cloud computing services such as cloud services, cloud databases, cloud computing, cloud functions, cloud storage, network services, cloud communication, middleware services, domain name services, security services, content delivery networks (CDNs), and big data and artificial intelligence platforms.
[0081] The storage medium in this embodiment obtains the historical task volume received by each claims adjuster within a set time period and the task completion status of each historical task in the background. It calculates the cumulative percentage of claims adjusters with different task completion statuses out of the total number of claims adjusters. Based on the cumulative percentage calculation, it generates a task assignment curve consisting of a task volume range and the cumulative percentage of personnel with different task completion types out of the total number of personnel. Based on the task assignment curve, it formulates an assignment strategy and performs task assignment. This embodiment can focus on the optimal task volume and the most reasonable acceptable task volume range for each claims adjuster, thereby intelligently matching the task volume for each person, solving the problem of uneven task volume matching caused by difficulty factors, thus ensuring customer experience and improving customer satisfaction.
[0082] In the several embodiments provided in this application, it should be understood that the disclosed systems, apparatuses, and methods can be implemented in other ways. For example, the system embodiments described above are merely illustrative; for instance, the division of units is only a logical functional division, and in actual implementation, there may be other division methods. For example, multiple units or components may be combined or integrated into another system, or some features may be ignored or not executed. Furthermore, the coupling or direct coupling or communication connection shown or discussed may be an indirect coupling or communication connection through some interfaces, apparatuses, or units, and may be electrical, mechanical, or other forms.
[0083] Furthermore, the functional units in the various embodiments of this application can be integrated into one processing unit, or each unit can exist physically separately, or two or more units can be integrated into one unit. The integrated units described above can be implemented in hardware or as software functional units. The above are merely embodiments of this application and do not limit the patent scope of this application. Any equivalent structural or procedural transformations made based on the description and drawings of this application, or direct or indirect applications in other related technical fields, are similarly included within the patent protection scope of this application.
Claims
1. A method for assigning claims processing tasks, characterized in that, include: Obtain the historical task volume received by each claims processing staff member within a set time period, as well as the task completion status of each historical task; The task completion status is divided into different task completion types, and the task volume and number of claims processing personnel corresponding to each task completion type are calculated separately. Based on the task volume, the cumulative percentage of claims processing personnel under each task completion type in the total number of claims processing personnel is calculated. The task completion types include "relatively easy", "too easy", "relatively difficult", and "too difficult". For the two task completion types of "relatively easy" and "too easy", the cumulative percentage is calculated by accumulating the task volume from high to low. For the two task completion types of "relatively difficult" and "too difficult", the cumulative percentage is calculated by accumulating the task volume from low to high. Based on the cumulative percentage calculation results, a task assignment curve is generated, which consists of the task volume and the cumulative percentage. A dispatching strategy is formulated based on the task dispatching curve, and claims tasks are dispatched according to the dispatching strategy. Specifically, the step of formulating a dispatch strategy based on the task dispatch curve is as follows: Obtain the intersection points between each pair of curves in the task assignment curve graph and the corresponding task quantity for each intersection point, and formulate an assignment strategy based on the task quantity corresponding to each intersection point; wherein, the intersection points between each pair of curves in the task assignment curve graph include: intersection point A between the two task completion types of "too easy" and "relatively difficult", intersection point B between the two task completion types of "relatively easy" and "too difficult", intersection point C between the two task completion types of "relatively easy" and "relatively difficult", and intersection point D between the two task completion types of "too easy" and "too difficult"; The task quantity corresponding to the intersection point A in the task assignment curve is taken as the minimum acceptable task quantity for claims settlement personnel, the task quantity corresponding to the intersection point B is taken as the maximum acceptable task quantity for claims settlement personnel, and the task quantity range between the "acceptable minimum task quantity" and the "acceptable maximum task quantity" is divided into the acceptable task quantity range for claims settlement personnel; the task quantity corresponding to the intersection point C is taken as the task quantity that is neither easy nor difficult, and the task quantity corresponding to the intersection point D is taken as the optimal task quantity.
2. The claims task assignment method according to claim 1, characterized in that, The task completion status includes: completed on the same day and all tasks did not exceed the time limit, completed on the same day but some tasks exceeded the time limit, not completed on the same day but tasks did not exceed the time limit, and not completed on the same day and tasks exceeded the time limit.
3. The claims task assignment method according to claim 1, characterized in that, The specific steps for generating the task assignment curve chart composed of the task volume and the cumulative percentage based on the cumulative percentage calculation result are as follows: The task volume range is used as the X-axis in the task assignment curve, and the cumulative percentage of the number of claims processing personnel under different task completion types in the total number of claims processing personnel is used as the Y-axis in the task assignment curve.
4. A claims task dispatching device for implementing the claims task dispatching method as described in any one of claims 1-3, characterized in that, include: Data acquisition module: used to acquire the historical task volume received by each claims processing staff member within a set time period, as well as the task completion status of each historical task; Percentage Calculation Module: Used to calculate the task volume and number of claims processing personnel corresponding to each task completion status, and to calculate the cumulative percentage of the number of claims processing personnel in the total number of claims processing personnel for each task completion status. The curve generation module is used to generate a task assignment curve composed of the task quantity and the cumulative percentage based on the cumulative percentage calculation result. Strategy formulation module: used to formulate a dispatch strategy based on the task dispatch curve, and to dispatch claims tasks according to the dispatch strategy.
5. A computer device, characterized in that, The computer device includes: A memory that stores executable program instructions; The processor connected to the memory; The processor calls the executable program instructions stored in the memory to execute the claims task dispatching method as described in any one of claims 1-3.
6. A storage medium storing processor-executable program instructions, characterized in that, The program instructions are used to execute the claims task dispatching method according to any one of claims 1 to 3.