A commercial insurance intelligent service system and method

Abstract

The present application belongs to the technical field of commercial insurance intelligent service, and discloses a commercial insurance intelligent service system and method; comprising: a claim configuration unit is constructed; the satisfaction state of each liability element is time sequence updated, a liability state track is constructed, and an unclosed liability link is identified; according to the supplement initiation, the supplement arrival, the return and the re-notification relationship in the historical supplement interaction record, a supplement round trip pressure sequence is generated, and a supplement pressure section is identified; by analyzing the association between the advancing change attribute of the unclosed liability link in the liability state track and the supplement pressure section in the supplement round trip pressure sequence, a pressure enhancement section is obtained; according to the section to which the supplement round belongs, a receiving and shunting sequencing result is generated, a target receiving queue and a processing node shunting instruction are output. The present application takes into account the liability closure progress and the supplement round trip pressure, and realizes more accurate claim receiving sequencing and shunting.

Description

Technical Field

[0001] This invention relates to the field of intelligent service technology for commercial insurance, and more specifically, to an intelligent service system and method for commercial insurance. Background Technology

[0002] Intelligent service methods for commercial insurance refer to approaches that organize and process the application, claims processing, document exchange, and service scheduling stages through digital platforms, particularly for commercial health insurance, accident insurance, and other insurance business scenarios. The claims processing stage requires continuous tracking of application details, liability requirements, and document submission status, along with monitoring the service interaction status during the user's document supplementation process to ensure a smooth transition in subsequent processing steps. Therefore, improving the continuity of claims services and the targeted nature of processing scheduling has become a key technical challenge in the field of intelligent commercial insurance services.

[0003] Existing commercial insurance claims processing technologies can typically manage claims application records, document submission status, and supplementary document interaction processes, and accordingly conduct queuing and supplementary document notification. However, in practical applications, there are still some areas that require further improvement: On the one hand, existing methods, when determining the order of acceptance, often focus more on the current submission status of materials, the order of acceptance time, or the result of a single round of supplementary documents. They lack a unified and interconnected representation of whether the liability elements are in a continuous closed-loop process, whether the unclosed liability links have been stalled for a long time, and whether the burden of supplementary document repetitions is continuously accumulating. Therefore, when facing claims that are close to closure but repeatedly blocked, or have been stalled for a long time but have frequent supplementary document interactions, the targeting of the acceptance order still has room for improvement. On the other hand, although existing methods can record the number of supplementary documents, the results of supplementary documents, and some interaction statuses, they are still insufficient in continuously utilizing cross-round evolutionary characteristics such as waiting time, repeated notifications, repeated submission of similar materials, and resubmission after rejection. It is difficult to further distinguish the actual pressure and processing needs of different claims at the acceptance stage. Therefore, further research is needed on refined scheduling and process connection when sorting queues and diverting processing nodes. Summary of the Invention

[0004] To overcome the aforementioned deficiencies of the prior art and to achieve the above objectives, the present invention provides the following technical solution: a commercial insurance intelligent service method, comprising: Obtain claims application records, material submission record sequences, liability requirement sets, and historical supplementary document interaction records to construct a claims configuration unit; Based on the mapping relationship between the material submission record sequence and the material categories in the set of responsibility requirements, the satisfaction status of each responsibility requirement is updated in time sequence to construct a responsibility status trajectory and identify unclosed responsibility links; Based on the relationships between replacement initiation, replacement arrival, return and resubmission, and re-notification in the historical replacement interaction records, a replacement round-trip pressure sequence is generated to identify replacement pressure segments. By analyzing the correlation between the advancement change attributes of unclosed responsibility links in the responsibility state trajectory and the pressure segment of the replenishment in the replenishment round-trip pressure sequence, the pressure enhancement segment is obtained; Based on the segment to which the supplementary document belongs in the round, generate the acceptance and diversion sorting results, and output the target acceptance queue and processing node diversion instructions.

[0005] Preferably, the method for constructing the claims configuration unit includes: Based on the insurance product configuration record, the list of coverage responsibilities and the table of claims types, extract the liability elements information corresponding to the target claims to form an initial set of liability elements; Obtain the material proof purpose for each responsibility element in the initial set of responsibility elements, thus obtaining the material proof purpose set. Extract the corresponding material category based on the material proof purpose set to form the material group corresponding to the responsibility element. Based on the substitution, parallel, and sequential supplementary relationships between different material categories under the same liability element, a mapping structure between liability elements and material categories is constructed to generate a claims configuration unit.

[0006] Preferably, the method for constructing a responsibility state trajectory and identifying unclosed responsibility links includes: Read the material submission record sequence of the target claim, organize the responsibility according to the material arrival time, material category identifier and corresponding liability element identifier, and form a responsibility arrival event table; Based on the mapping relationship between liability requirements and material categories in the claims configuration unit, each event in the liability arrival event table is matched with liability requirements one by one to determine whether the corresponding material category has been submitted. If the material category is submitted, the corresponding responsibility element will be recorded as closed. If the material category is not fully submitted, check if the material category exists. If the material category exists, record the corresponding responsibility requirements as partially met. If no material category exists, the corresponding responsibility requirement will be recorded as unmet. The status of different responsibility elements is combined according to the order of material arrival time to obtain the responsibility status trajectory; Obtain the last state in each responsibility state trajectory, mark the responsibility elements whose last state is not a closed state as candidate unclosed items, and generate unclosed responsibility links based on the candidate unclosed items and the last state.

[0007] Preferably, the method for generating the reciprocating pressure sequence of the supplementary component includes: Read the historical supplementary document interaction records of the target claim, and organize them into a supplementary document round event chain according to the supplementary document notification initiation time, user supplementary document submission time, platform return time, and re-notification time. For each round of supplementary submissions in the supplementary submission event chain, the waiting time, the number of repeated notifications, the number of repeated submissions of the same type of material, and the number of returned submissions are extracted and combined to obtain supplementary submission pressure information. By combining the pressure information of the replacement parts according to the replacement round sequence, a replacement part pressure sequence is obtained; By analyzing the adjacency variation characteristics of adjacent replenishment rounds in the replenishment pressure information in the replenishment pressure sequence, replenishment pressure segments are identified.

[0008] Preferably, the method for extracting the waiting time and the number of repeated notifications includes: Calculate the difference between the notification time for the missing document and the time the user submits the missing document in each round of missing document submission, and record the result as the waiting time; Determine if there are multiple supplementary document notifications in each round of supplementary document replenishment. If there are multiple supplementary document notifications, identify the reason for the supplementary document replenishment, extract the reason for the supplementary document replenishment, and count the number of the same reason for the supplementary document replenishment in the corresponding round of supplementary document replenishment, which is recorded as the number of duplicate notifications. If there are no multiple requests for supplementary documents, the number of duplicate requests is counted as zero.

[0009] Preferably, the method for extracting the number of repeated submissions and the number of returns for resubmission of the same type of material includes: Record and integrate the types of materials submitted by users in each round of supplementary parts submissions to obtain a list of material types; For the materials submitted by users in each round of supplementary materials, it is determined whether there are materials of the same type in the material type list. If there are materials of the same type, it is determined that the materials in the corresponding supplementary materials round are submitted repeatedly, and the number of repeated submissions of materials of the same type is counted. If no materials of the same type exist, the number of times the same type of materials are submitted repeatedly is recorded as zero; Based on the round order in the replacement round event chain, construct the replacement round sequence, traverse the replacement round sequence, and mark the traversed replacement rounds as the target rounds; Based on the order of the replacement rounds in the replacement round sequence, the next replacement round of the target round is combined with the target round to obtain adjacent round pairs; In each pair of adjacent rounds, determine whether the system rejection in the previous round and the user's submission in the next round occur simultaneously. If they occur simultaneously, record a rejection-submission event; if they do not occur simultaneously, do not record it. Count the number of times a return and resubmission event occurs in each adjacent round pair, and record it as the return and resubmission count in the corresponding adjacent round pair.

[0010] Preferably, the method for identifying pressure sections of the replacement component includes: Determine whether there is a replacement round interval with continuously increasing waiting time in different replacement pressure information. If there is a replacement round interval with continuously increasing waiting time, then construct a replacement pressure segment. If there is no replenishment round interval with continuously increasing waiting time, then determine whether there is a replenishment round interval with a consistent number of repeated notifications in different replenishment pressure information. If there is a replenishment round interval with a fixed number of repeated notifications, then a replenishment pressure segment is constructed. If there is no interval between the number of repeated notifications and the number of resubmission rounds, then the number of repeated submissions of different types of materials is combined according to the order of the resubmission rounds to obtain the resubmission sequence of the corresponding type of materials; For each category of materials, determine whether there is a supplementary document round interval where the number of repeated submissions continues to increase; If there is a gap in the number of duplicate submissions that continues to increase, then construct a gap pressure zone. If there is no interval between resubmission rounds where the number of duplicate submissions continues to increase, then determine whether there is an interval between resubmission rounds where the number of returned resubmissions remains unchanged in different resubmission pressure information. If there exists a range of replacement rounds where the number of replacement submissions remains constant, then a replacement pressure range is constructed.

[0011] Preferably, the method for analyzing the correlation between the advancement change attributes of unclosed responsibility links in the responsibility state trajectory and the component pressure segment in the component round-trip pressure sequence includes: Read the liability status trajectory corresponding to the target claim, calculate the reduction in the number of unclosed liability links according to the order of supplementary document rounds, and obtain the sequence of changes in the number of unclosed links; Identify the round intervals in the unclosed quantity change sequence where the quantity has not decreased, and generate the responsibility closure pressure segment; Calculate the intersection of the supplementary pressure section and the responsibility closing pressure section, and determine whether the intersection is empty; If the intersection is not empty, the interval obtained from the intersection is marked as the pressure enhancement segment; if the intersection is empty, no operation is performed.

[0012] Preferably, the method for generating the acceptance and triage ranking results includes: Track the segment type of each supplementary document round in real time. If the supplementary document round does not belong to any segment, the target claim will be placed in the fast processing mode. If the supplementary document round falls within the liability closure pressure zone, the target claim will be placed in the regular supplementary document processing mode; If the replacement document round falls within the increased pressure zone, the target claim will be prioritized for intervention. The processing and triage results are generated according to the order of priority processing intervention mode, fast processing mode and regular supplementary document processing mode.

[0013] This invention also provides a commercial insurance intelligent service system, applied to the aforementioned commercial insurance intelligent service method, comprising: The claims configuration module retrieves claims application records, material submission record sequences, liability requirement sets, and historical supplementary document interaction records to construct claims configuration units. The responsibility trajectory construction module updates the satisfaction status of each responsibility element in a time sequence based on the mapping relationship between the material submission record sequence and the material category in the responsibility element set, constructs the responsibility status trajectory, and identifies unclosed responsibility links. The replacement part pressure generation module generates a replacement part round-trip pressure sequence and identifies replacement part pressure segments based on the relationship between replacement part initiation, replacement delivery arrival, return and resubmission, and re-notification in the historical replacement part interaction records. The pressure correlation analysis module identifies pressure-enhancing sections by analyzing the correlation between the advancement and change attributes of unclosed responsibility links in the responsibility status trajectory and the pressure segments of the replenishment in the replenishment round-trip pressure sequence. The acceptance and diversion output module generates acceptance and diversion sorting results based on the segment to which the replacement document belongs in the round, and outputs the target acceptance queue and processing node diversion instructions.

[0014] The technical effects and advantages of the intelligent service method for commercial insurance of this invention are as follows: By establishing a claims configuration unit, a liability status trajectory is formed and unclosed liability links are identified. At the same time, a claims back-and-forth pressure sequence is generated based on the relationship between the initiation of supplementary documents, arrival of supplementary documents, return for resubmission, and re-notification. This invention can overcome the limitations of existing methods that judge the acceptance order based solely on the completeness of the material surface or the status of a single round of supplementary documents. It also reflects the repeated back-and-forth pressure in the supplementary document process, thus making it more conducive to identifying claims that are difficult to advance and have a continuously accumulating interactive burden.

[0015] This invention extracts supplementary document pressure information, constructs a supplementary document round-trip pressure sequence, and identifies supplementary document pressure segments. Further, by combining the reduction of unclosed responsibility links in the responsibility status trajectory, it identifies responsibility closure pressure segments and determines pressure enhancement segments through the intersection of the two types of segments. Finally, it generates acceptance diversion and sorting results based on the segment to which the supplementary document belongs. Through these steps, this invention overcomes the shortcomings of existing acceptance processes that struggle to precisely distinguish the processing needs of different matters during the supplementary document round-trip process. This allows the system to allocate matters to more suitable processing paths according to their actual progress status, thereby improving the targeting of claims acceptance scheduling and the efficiency of process integration. Attached Figure Description

[0016] Figure 1This is a schematic diagram of the overall process of a commercial insurance intelligent service method according to the present invention.

[0017] Figure 2 This is a schematic diagram of the method for generating a replacement round-trip pressure sequence in a commercial insurance intelligent service method of the present invention.

[0018] Figure 3 This is a schematic diagram of the module structure of a commercial insurance intelligent service system according to the present invention. Detailed Implementation

[0019] The technical solutions of the embodiments of the present invention will be clearly and completely described below with reference to the accompanying drawings. Obviously, the described embodiments are only some embodiments of the present invention, and not all embodiments. Based on the embodiments of the present invention, all other embodiments obtained by those skilled in the art without creative effort are within the scope of protection of the present invention.

[0020] This application provides a method for intelligent commercial insurance services. By constructing a claims configuration unit, a liability status trajectory, and a supplementary document round-trip pressure sequence, and by identifying unclosed liability links, supplementary document pressure segments, and pressure enhancement segments, it jointly generates a claims acceptance sorting and ranking result, and outputs the target acceptance queue and processing node sorting instructions. This invention takes into account both the progress of liability closure and the supplementary document round-trip pressure, achieving more accurate claims acceptance sorting and distribution.

[0021] Example 1, please refer to Figure 1 and Figure 2 In Embodiment 1 of the present invention, a commercial insurance intelligent service method is implemented in detail through the following steps: In this embodiment, the scenario focuses on an online claims processing platform for a commercial health insurance company. The insurance company provides commercial insurance coverage for inpatient medical care, outpatient special disease care, and accidental medical care. After receiving medical treatment or experiencing an accident, insured users initiate claims applications via a mobile app, WeChat mini-program, or in-store verification terminal. During the processing phase, the platform does not directly perform fraud detection, medical diagnosis, or compensation calculation. Instead, it organizes the processing order and steps based on whether the claim materials can support a closed-loop liability assessment and whether the process of requesting supplementary documents has created high pressure.

[0022] Obtain claims application records, material submission record sequences, liability requirement sets, and historical supplementary document interaction records to construct a claims configuration unit; Methods for constructing claims configuration units include: Based on the insurance product configuration record, the list of coverage responsibilities and the table of claims types, extract the liability elements information corresponding to the target claims to form an initial set of liability elements; In this embodiment, for the target claim application, the basic fields directly related to liability extraction are read from the claim application record, including at least the policy product code, protection plan code, insured identifier, claim item type code, accident or medical treatment time, claim liability type, selected claim sub-item, and policy status identifier, and these fields are organized into a target item identification record; Among them, the target item identification record is used to uniformly carry "which product, which scope of liability, and which claim scenario this case belongs to" in the subsequent liability extraction process, avoiding direct analysis of each item in the original application text; the claim item type code prioritizes the standard item types preset by the platform, such as outpatient and emergency medical care, inpatient medical care, accident medical care, and allowance payment.

[0023] Secondly, based on the policy product code and protection plan code in the target item identification record, filter out the product liability configuration fragments in the insurance product configuration record that are consistent with the current policy version and are within the valid range corresponding to the time of the accident or medical treatment. The insurance product configuration record includes at least the product code, plan code, liability code, liability name, liability effective period, set of applicable event types, liability requirement template identifier, pre-acceptance condition identifier, and whether it is enabled identifier. The filtering method prioritizes the extraction of multi-field joint filtering based on "equal product code, equal plan code, time falling within the valid period, and configuration status being enabled".

[0024] Then, the list of coverage responsibilities is read, the scope of responsibility is limited to the responsibility codes in the product responsibility configuration segment, and the responsibility information of the current policy that is actually insured and the current application that is allowed to enter the acceptance stage is retained to form a set of candidate responsibility information; The list of covered liabilities can come from policy underwriting results, amendment records, and liability activation lists, and should at least include liability code, liability name, whether it is insured, liability status, liability start and end time, and liability level label; the scope of liability limitation means that even if a certain liability exists in the overall configuration of an insurance product, it will not be included in the candidate liability information set as long as the liability has not been selected by the current policy, has expired, has been amended and terminated, or does not fall within the scope of liability of this application.

[0025] Next, each liability code in the candidate liability information set is matched with the claim type table to determine whether the liability is applicable to the current claim type. Liability information that is incompatible with the claim type is filtered out to obtain the claim-fit liability set. For each liability information in the claim-fit liability set, the pre-acceptance condition verification is performed again, and only liability information that has met the basic acceptance conditions is retained. This liability information is then used as the target liability information. The pre-acceptance condition verification does not involve the calculation of compensation amount or the substantive determination of accident liability. Instead, it only checks whether the basic acceptance thresholds necessary for the extraction of liability requirements are met, such as the policy status being valid, the liability being in effect, the relationship between the applicant and the insured being identifiable, the type of matter not exceeding the scope of the liability allowed for declaration, and the application time not exceeding the reporting or acceptance time limit for the liability.

[0026] Finally, all liability information is summarized according to the claim item identifier, and each item is attached with a liability code, item type code, liability level label and source template identifier to form an initial set of liability items.

[0027] Obtain the material proof purpose for each responsibility element in the initial set of responsibility elements, thus obtaining the material proof purpose set. Extract the corresponding material category based on the material proof purpose set to form the material group corresponding to the responsibility element. Among them, the purpose of the supporting materials refers to the description of the purpose of the materials in the acceptance stage to prove the occurrence of the accident, the attribution of responsibility, the identity relationship, the occurrence of expenses, or the triggering of liability. The material categories are selected from the material name, applicable responsibility, substitutable relationship, and submission channel records in the material catalog table. The above steps are illustrated with an example below: Taking inpatient medical claims in commercial health insurance as an example, when a user submits an inpatient medical claim application, with the claim type being "inpatient medical care" and the corresponding coverage being "inpatient medical care liability," the system first reads the initial set of liability requirements corresponding to this claim from the claim configuration rules, which may include, for example: Verify the correspondence between the applicant and the insured; It is necessary to confirm that this hospitalization actually occurred; It is necessary to confirm the actual occurrence of these medical expenses; It needs to be confirmed that the relevant fees fall within the scope of liability and are acceptable. The initial set of responsibility elements read by the system can be exemplified as follows: Verification of identity relationship, verification of hospitalization fact, verification of expense occurrence, and expense verification; corresponding to proof of identity relationship, proof of medical treatment, proof of expense occurrence, and proof of expense details, respectively; The system retrieves the supporting documentation for each liability requirement, resulting in the following: Prove the correspondence between the applicant and the insured / patient; prove the actual occurrence and process of the hospitalization; prove the actual expenses incurred for the hospitalization; prove that the expenses fall within the scope of acceptable expenses. The system retrieves the corresponding material category based on the purpose of the material proof, and obtains the material group corresponding to the liability requirements, as shown in the example below: Proof of identity: insured's identity document, patient's identity document; Medical evidence includes: hospitalization certificate, medical record cover sheet, and discharge summary; Proof of expenses: Medical bills, total list of medical expenses; Proof of expenses: Detailed list of medical expenses, medical insurance settlement statement; Based on the substitution, parallel, and sequential supplementary relationships between different material categories under the same liability element, a mapping structure between liability elements and material categories is constructed to generate a claims configuration unit; Among them, the substitution relationship is used to indicate that the arrival of any one of multiple material categories is sufficient to support the same proof purpose; the parallel relationship is used to indicate that multiple material categories must arrive together to satisfy the liability requirements; the sequential supplementary relationship is used to indicate that after the arrival of the preceding material, subsequent materials are still required to reinforce it. For example, to prove that "the insured and the applicant are of the same identity", the following can be submitted: the insured's identity certificate, the household registration book's relationship page, and the identity relationship certificate issued by the public security authority. These types of materials can all support the sub-purpose of "identity relationship certificate", so they can be set as substitutes for each other. For example, in order to prove that "the hospitalization expenses were actually incurred and the details can be verified", it is not enough to only have the receipts; a detailed list of expenses is also required. Therefore, medical receipts and detailed lists of medical expenses should be considered as parallel materials under this liability requirement. For example, in accidental medical claims, submitting outpatient and emergency room medical records first can prove that the visit has occurred; however, if further proof of the accident and the conditions for triggering liability is required, then supplementary documents such as an explanation of the accident and materials issued by the public security or traffic police should be submitted. Thus, there is a sequential supplementary relationship between outpatient and emergency room medical records and explanations of the accident.

[0028] Based on the mapping relationship between the material submission record sequence and the material categories in the set of liability requirements, the fulfillment status of each liability requirement is updated in time sequence to construct a liability status trajectory and identify unclosed liability links; among which, the liability status trajectory is oriented towards a single claim matter; Methods for constructing state trajectories and identifying unclosed responsibility links include: Read the material submission record sequence of the target claim, organize the responsibility according to the material arrival time, material category identifier and corresponding liability element identifier, and form a responsibility arrival event table; The material submission record sequence includes at least the following material events: initial submission, supplementary submission, resubmission after rejection, and resubmission after withdrawal; the responsibility arrival event table is used to convert the original submission action into a set of time-series events that can directly participate in the responsibility closure determination. Based on the mapping relationship between liability requirements and material categories in the claims configuration unit, each event in the liability arrival event table is matched with liability requirements one by one to determine whether the corresponding material category has been submitted. If the material category is submitted, the corresponding responsibility element will be recorded as closed. If the material category is not fully submitted, check if the material category exists. If the material category exists, record the corresponding responsibility requirements as partially met. If no material category exists, the corresponding responsibility requirement will be recorded as unmet. The status of different responsibility elements is combined according to the order of material arrival time to obtain the responsibility status trajectory; Obtain the last state in each responsibility state trajectory, mark the responsibility elements whose last state is not a closed state as candidate unclosed items, and generate unclosed responsibility links based on candidate unclosed items and the last state; An example illustrating an unclosed responsibility loop is provided below: For example, taking a "hospitalization medical claim" as an example, after the user has submitted the first claim application, the processing platform finds that the "hospitalization invoice details page" and "discharge summary signature page" corresponding to the claim do not meet the material requirements of the liability requirements, so multiple rounds of supplementary document interaction occur in the subsequent processing process; The initial set of liability requirements includes verification of identity, verification of hospitalization facts, and verification of expense occurrence. Among them, verification of hospitalization facts requires the following documents: admission record, diagnosis certificate, and signed discharge summary page; verification of expense occurrence requires the following documents: hospital invoice, hospital invoice details page, and expense classification page. When filing their first claim on June 1, 2022, the user submitted all relevant documents for identity verification, hospital admission records, diagnostic certificates, and hospital invoices. However, they failed to submit the signed discharge summary page, the detailed page of the hospital invoice, and the expense classification page. Therefore, the system initiated a request for supplementary documents as follows: The request for supplementary documents was initiated at 9:15 AM on June 2, 2022. The reason for requesting supplementary documents was: missing the detailed page of the hospital invoice and the signed page of the discharge summary. 2022-06-03-18:42 User's supplementary submissions arrived, related content: uploaded inpatient invoice details page, discharge summary; The application was returned by the platform at 10:08 AM on June 4, 2022. Reason for return: No hospital discharge summary with hospital stamp. 2022-06-04 10:15 Notification again, reason for requesting additional documents: submit a signed and stamped discharge summary again; 2022-06-05-16:21 User submitted supplementary information; related content: uploaded signed version of discharge summary. The platform returned the invoice at 9:32 AM on June 6, 2022, citing the reason that the invoice details page lacked a fee category page. Notice was issued again at 9:40 AM on June 6, 2022, regarding the reason for requesting additional documents: to submit a complete invoice with a detailed fee category page. 2022-06-07 14:03 User's supplementary payment arrived; related content: Uploaded complete fee category page; Therefore, when the initial submission was made on June 1, 2022, the material categories were not fully submitted, but the admission record and diagnosis certificate were already submitted. Thus, the responsibility requirement of verifying the hospitalization facts was recorded by the system as partially satisfied, with the last status being partially satisfied. Similarly, the responsibility requirement of verifying the occurrence of expenses was also recorded by the system as partially satisfied, with the last status being partially satisfied. Therefore, there are two unclosed responsibility links. At 18:42 on June 3, 2022, the user's first supplementary payment still lacked the discharge summary signature page. The responsibility requirement of verifying the hospitalization facts was still recorded by the system as partially satisfied. At this time, the last status was partially satisfied. Similarly, the responsibility requirement of verifying the occurrence of expenses was also recorded by the system as partially satisfied. Thus, there were two unclosed responsibility links. At 16:21 on June 5, 2022, the user submitted a signed discharge summary. At this time, the responsibility requirement of verifying the hospitalization facts was still recorded by the system as closed. At this time, the last state was closed. Similarly, the responsibility requirement of verifying the occurrence of expenses was recorded by the system as partially satisfied. At this time, there was only one unclosed responsibility link. Until 14:03 on June 7, 2022, when the user submitted the complete fee category page, the responsibility requirement of fee verification was recorded by the system as closed. At this time, the last status was closed, and the number of unclosed responsibility links was zero.

[0029] Based on the relationships between replacement initiation, replacement arrival, return and resubmission, and re-notification in the historical replacement interaction records, a replacement round-trip pressure sequence is generated to identify replacement pressure segments. Methods for generating the reciprocating pressure sequence of the complement include: Read the historical supplementary document interaction records of the target claim, and organize them into a supplementary document round event chain according to the supplementary document notification initiation time, user supplementary document submission time, platform return time, and re-notification time. The following is an example illustrating the event chain for generating replacement parts: The system takes the first "supplementary document notification initiation time" as the starting point of the first round of supplementary documents. Supplementary documents and return events from the start of that notification until the next "re-notification time" are grouped into the same supplementary document round. According to this rule, the system generates round identification results and constructs the supplementary document round event chain identifier as follows.

[0030] Round 1: 2022-06-02-09:15 Notification for supplementary documents issued; 2022-06-03-18:42 User submits supplementary documents; 2022-06-04-10:08 Platform returns; 2022-06-04-10:15 Notification issued again; Round Two: 2022-06-04-10:15 - Another notification initiated; 2022-06-05-16:21 - User made supplementary payment; 2022-06-06-09:32 - Platform refunded; 2022-06-06-09:40 - Another notification issued; Round 3: A second notification was issued at 9:40 AM on June 6, 2022; the user made up the difference at 2:03 PM on July 7, 2022; no refunds were made after this round.

[0031] For each round of supplementary submissions in the supplementary submission event chain, the waiting time, the number of repeated notifications, the number of repeated submissions of the same type of material, and the number of returned submissions are extracted and combined to obtain supplementary submission pressure information. Methods for extracting waiting time and number of repeated notifications include: Calculate the difference between the notification time for the missing document and the time the user submits the missing document in each round of missing document submission, and record the result as the waiting time; The following is an example illustrating the extraction waiting time: The notification for Round 1 was initiated at 09:15 on 2026-04-02, and the first valid supplementary submission arrived at 18:42 on 2026-04-03. Therefore, the waiting time for Round 1 was 1 day, 9 hours and 27 minutes. The notification for Round Two was initiated at 10:15 on April 4, 2026, and the first valid supplementary submission arrived at 16:21 on April 5, 2026. Therefore, the waiting time for Round Two was 1 day, 6 hours and 6 minutes. The notification for Round 3 was initiated at 09:40 on 2026-04-06, and the first valid supplementary submission arrived at 14:03 on 2026-04-07. Therefore, the waiting time for Round 3 was 1 day, 4 hours and 23 minutes.

[0032] Determine if there are multiple supplementary document notifications in each round of supplementary document replenishment. If there are multiple supplementary document notifications, identify the reason for the supplementary document replenishment, extract the reason for the supplementary document replenishment, and count the number of the same reason for the supplementary document replenishment in the corresponding round of supplementary document replenishment, which is recorded as the number of duplicate notifications. If there are no multiple requests for supplementary documents, the number of duplicate requests is counted as zero. The following is an example illustrating how to extract the number of duplicate notifications: Round 1 is the first notification, therefore the number of repeated notifications is recorded as 0; The "signed discharge summary" required in Round Two is actually a continuation of the "missing signature page of discharge summary" in Round One. Therefore, the system identified it as the same missing item and notified the user again. The number of repeated notifications is counted as 1. Although the "complete invoice expense classification page" required in Round 3 belongs to the same category of invoice materials as the "hospitalization invoice details page" in Round 1, the missing purpose has been refined into new liability support content. Therefore, in this embodiment, it is not directly included in the duplicate notification of Round 1, but is treated as a new missing purpose, and the number of duplicate notifications is recorded as 0.

[0033] Methods for extracting the number of duplicate submissions and the number of returns for resubmission of similar materials include: Record and integrate the types of materials submitted by users in each round of supplementary parts submissions to obtain a list of material types; For the materials submitted by users in each round of supplementary materials, it is determined whether there are materials of the same type in the material type list. If there are materials of the same type, it is determined that the materials in the corresponding supplementary materials round are submitted repeatedly, and the number of repeated submissions of materials of the same type is counted. If no materials of the same type exist, the number of times the same type of materials are submitted repeatedly is recorded as zero; The following is an example illustrating the number of times the same type of material can be submitted repeatedly: In Round 1, users submitted "Hospital Invoice Details Page". This category had not been submitted before, so the number of times the same type of material was submitted repeatedly in Round 1 was 0. In Round Two, if a user submits a "signed version of the discharge summary", and the system finds that the user has already uploaded an unsigned version of the discharge summary in the first claim application materials, then the material category is considered as a resubmission of the same type of material. However, because the version submitted this time has been effectively strengthened, the system still records it as a duplicate submission of the same type of material once. In Round 3, users submit a "complete invoice expense category page". If a user has already uploaded an incomplete invoice page in Round 1, then this round is a resubmission of the same type of invoice material. Therefore, the number of times the same type of material is submitted repeatedly in Round 3 is counted as 1.

[0034] Based on the round order in the replacement round event chain, construct the replacement round sequence, traverse the replacement round sequence, and mark the traversed replacement rounds as the target rounds; Based on the order of the replacement rounds in the replacement round sequence, the next replacement round of the target round is combined with the target round to obtain adjacent round pairs; In each pair of adjacent rounds, determine whether the system rejection in the previous round and the user's submission in the next round occur simultaneously. If they occur simultaneously, record a rejection-submission event; if they do not occur simultaneously, do not record it. Count the number of times the event of return followed by submission occurs in each pair of adjacent rounds, and record it as the number of return and submission events in the corresponding pair of adjacent rounds; The following is an example illustrating the number of times a submission has been returned for resubmission: At the end of Round 1, the system returned the application at 10:08 on 2026-04-04 and notified the user again at 10:15 on 2026-04-04; the user subsequently submitted a signed discharge summary in Round 2, so the number of times the application was returned and resubmitted in Round 1 was counted as 1. At the end of Round Two, the platform refunded the payment again at 09:32 on 2026-04-06 and notified the user again at 09:40 on 2026-04-06; the user subsequently paid the full fee category page in Round Three, so the number of refunds and payments corresponding to Round Two is counted as 1. No further returns occurred after round three, therefore the number of returns and resubmissions in round three is recorded as 0.

[0035] By combining the pressure information of the replacement parts according to the replacement round sequence, a replacement part pressure sequence is obtained; By analyzing the adjacency variation characteristics of adjacent replenishment rounds in the replenishment pressure information in the replenishment pressure sequence, replenishment pressure segments are identified; Methods for identifying pressure zones in replacement parts include: Determine whether there is a replacement round interval with continuously increasing waiting time in different replacement pressure information. If there is a replacement round interval with continuously increasing waiting time, then construct a replacement pressure segment. In this embodiment, the waiting time for round two is 1 day, 6 hours and 6 minutes, which is shorter than the waiting time for round one, which is 1 day, 9 hours and 27 minutes; the waiting time for round three is 1 day, 4 hours and 23 minutes, which is shorter than the waiting time for round two, which is 1 day, 6 hours and 6 minutes. Therefore, there is no interval between replacement rounds where the waiting time continues to increase. If there is no replenishment round interval with continuously increasing waiting time, then determine whether there is a replenishment round interval with a consistent number of repeated notifications in different replenishment pressure information. If there is a replenishment round interval with a fixed number of repeated notifications, then a replenishment pressure segment is constructed. Here, "maintaining" means that the number of repeated notifications does not decrease under different replenishment pressure information. In this embodiment, the number of repeated notifications in round one is 0, the number of repeated notifications in round two is 1, and the number of repeated notifications in round three is 0. There is no replenishment round interval where the number of repeated notifications is maintained. If there is no interval between the number of repeated notifications and the number of resubmission rounds, then the number of repeated submissions of different types of materials is combined according to the order of the resubmission rounds to obtain the resubmission sequence of the corresponding type of materials; For each category of materials, determine whether there is a supplementary document round interval where the number of repeated submissions continues to increase; In this embodiment: In round two, the user submits a "signed discharge summary," which is a supplement to the previously submitted but incomplete discharge summary. Therefore, round two has a duplicate submission of the same type of material, with a duplicate submission count of 1. In round three, the user submits a "complete invoice fee category page," which is a supplement to the previously submitted but incomplete invoice. Therefore, round three also has a duplicate submission of the same type of material, with a duplicate submission count of 2. Between rounds two and three, the number of duplicate submissions for discharge summary materials changes from 1 to 2, indicating a continuous increase in the number of supplementary submissions in rounds two to three.

[0036] If there is a gap in the number of duplicate submissions that continues to increase, then construct a gap pressure zone. If there is no interval between resubmission rounds where the number of duplicate submissions continues to increase, then determine whether there is an interval between resubmission rounds where the number of returned resubmissions remains unchanged in different resubmission pressure information. In this embodiment, the number of times the workpiece is resubmitted after being returned in round one is 1, and the number of times the workpiece is resubmitted after being returned in round two is also 1. Therefore, the system determines that round one to round two is the interval between the number of resubmissions and replacements. Therefore, the pressure zones for the supplementary components in this embodiment are from round one to round three.

[0037] If there exists a range of replacement rounds where the number of replacement submissions remains constant, then a replacement pressure range is constructed.

[0038] The existing technology for claims processing sorting usually focuses more on the current submission status of materials, the order of acceptance time, or the status of a single supplementary document, which makes it difficult to simultaneously reflect whether the elements of liability are being continuously closed and whether the supplementary document interaction has entered a high round-trip burden stage. This invention first constructs a claims configuration unit by acquiring claims application records, material submission record sequences, liability requirement sets, and historical supplementary document interaction records. Then, it updates the liability requirement fulfillment status in a time sequence according to the material category mapping relationship, forming a liability status trajectory and identifying unclosed liability links. At the same time, it generates a supplementary document round-trip pressure sequence based on the relationship between supplementary document initiation, supplementary document arrival, return for resubmission, and re-notification. Through the above steps, the present invention can overcome the limitations of existing methods that judge the order of acceptance based solely on the completeness of the material surface or the status of a single round of replacement parts, and also reflects the repeated back-and-forth pressure in the replacement process, thus making it more conducive to identifying claims that are difficult to advance and have a continuously accumulating interactive burden.

[0039] By analyzing the correlation between the advancement change attributes of unclosed responsibility links in the responsibility state trajectory and the pressure segment of the replenishment in the replenishment round-trip pressure sequence, the pressure enhancement segment is obtained; Methods for analyzing the correlation between the advancement and change attributes of unclosed responsibility links in the responsibility state trajectory and the pressure segments of the replenishment parts in the replenishment part round-trip pressure sequence include: Read the liability status trajectory corresponding to the target claim, calculate the reduction in the number of unclosed liability links according to the order of supplementary document rounds, and obtain the sequence of changes in the number of unclosed links; In this embodiment, the first submission has two unclosed responsibility links, and the first round also has two unclosed responsibility links, resulting in a reduction of zero; the second round has one unclosed responsibility link, resulting in a reduction of 1; and the third round has no unclosed responsibility links, resulting in a reduction of 1. Identify the round intervals in the unclosed quantity change sequence where the quantity has not decreased, and generate the responsibility closure pressure segment; In this embodiment, the responsibility closure pressure range is round one; Calculate the intersection of the supplementary pressure section and the responsibility closing pressure section, and determine whether the intersection is empty; If the intersection is not empty, the interval obtained from the intersection is marked as the pressure enhancement segment; if the intersection is empty, no operation is performed.

[0040] Based on the segment to which the supplementary document belongs in the round, generate the acceptance and diversion sorting results, and output the target acceptance queue and processing node diversion instructions; Methods for generating acceptance and triage ranking results include: Track the segment type of each supplementary document round in real time. If the supplementary document round does not belong to any segment, the target claim will be placed in the fast processing mode. Among them, the fast processing mode is used to allocate target claims to fast processing nodes. Claims that are progressing well in the unclosed responsibility process and have entered a near-closed state are given priority review, fast entry into the queue and direct transfer, so as to shorten the processing time of low friction matters. If the supplementary document round falls within the liability closure pressure zone, the target claim will be placed in the regular supplementary document processing mode; Among them, the regular supplementary document acceptance mode is used to allocate target claims to regular acceptance nodes, output the list of supplementary documents according to the mapping relationship between the set of liability requirements and the material categories, and maintain the current sequential processing status of claims in the claims queue. This mode is suitable for claims that have not yet formed significant pressure to supplement documents and have not yet closed the liability process with low progress. If the replacement document round falls within the increased pressure zone, the target claim will be prioritized for intervention. Among them, the priority acceptance intervention mode is used to allocate target claims to the responsibility supplementary document coordination node, centrally merge unclosed responsibility links, merge missing purposes that repeatedly appear in historical supplementary document interactions, and generate priority supplementary document processing order according to the degree of responsibility closure blockage, so as to reduce the acceptance stagnation caused by continuous back and forth. The processing and triage results are generated according to the order of priority processing intervention mode, fast processing mode and regular supplementary document processing mode. It should be noted that when the progress of the unclosed responsibility link is good, the need for multiple rounds of replacement parts will generally not occur. That is, the situation that only belongs to the replacement pressure section is not considered in the situation listed in this embodiment. In existing technologies, supplementary document management can often record the number of supplementary documents and the results of supplementary documents, but it does not make full use of the continuous evolution relationship between different rounds of waiting time, repeated notifications, repeated submission of similar materials, and resubmission after return. Therefore, it is not easy to distinguish which matters are suitable for rapid processing and which matters require priority coordination or key intervention. This invention generates a supplementary document round event chain by reading historical supplementary document interaction records, extracts supplementary document pressure information such as waiting time, number of repeated notifications, number of repeated submissions of the same type of materials, and number of returned supplementary submissions, constructs a supplementary document round-trip pressure sequence, and identifies supplementary document pressure segments; further, it identifies responsibility closure pressure segments by combining the reduction of unclosed responsibility links in the responsibility status trajectory, and determines the pressure enhancement segment by the intersection of the two types of segments; finally, it generates the acceptance diversion sorting result according to the segment to which the supplementary document round belongs, and outputs the target acceptance queue and processing node diversion instructions; Through the above steps, this invention can make up for the shortcomings of the existing acceptance process in that it is difficult to distinguish the processing needs of different matters in the process of supplementing documents. It enables the system to allocate the matters to a more suitable processing path according to the actual progress status of the matters, thereby improving the targeting of claims acceptance scheduling and the efficiency of process connection.

[0041] Example 2, please refer to Figure 3 In Embodiment 2 of the present invention, a commercial insurance intelligent service system is implemented in detail through the following modules: The claims configuration module retrieves claims application records, material submission record sequences, liability requirement sets, and historical supplementary document interaction records to construct claims configuration units. The responsibility trajectory construction module updates the satisfaction status of each responsibility requirement in a time sequence based on the mapping relationship between the material submission record sequence and the material category in the responsibility requirement set, constructs the responsibility status trajectory, and identifies unclosed responsibility links. The replacement part pressure generation module generates a replacement part round-trip pressure sequence and identifies replacement part pressure segments based on the relationship between replacement part initiation, replacement delivery, return and resubmission, and re-notification in the historical replacement part interaction records. The pressure correlation analysis module identifies pressure-enhancing sections by analyzing the correlation between the advancement and change attributes of unclosed responsibility links in the responsibility status trajectory and the pressure segments of the replenishment in the replenishment round-trip pressure sequence. The acceptance and diversion output module generates acceptance and diversion sorting results based on the segment to which the replacement document belongs in the round, and outputs the target acceptance queue and processing node diversion instructions.

[0042] The above description is merely a preferred embodiment of the present invention and is not intended to limit the present invention. Although the present invention has been described in detail with reference to the foregoing embodiments, those skilled in the art can still modify the technical solutions described in the foregoing embodiments or make equivalent substitutions for some of the technical features. Any modifications, equivalent substitutions, improvements, etc., made within the spirit and principles of the present invention should be included within the protection scope of the present invention.

[0043] It should be noted that, in this document, the terms "comprising," "including," or any other variations thereof are intended to cover non-exclusive inclusion, such that a process, method, article, or apparatus that comprises a list of elements includes not only those elements but also other elements not expressly listed, or elements inherent to such a process, method, article, or apparatus. Unless otherwise specified, an element defined by the phrase "comprising one..." does not exclude the presence of other identical elements in the process, method, article, or apparatus that includes said element.

[0044] All formulas in this manual are dimensionless and calculated numerically. The formulas are derived from software simulations based on a large amount of collected data to obtain the most recent real-world results. The preset parameters and thresholds in the formulas are set by those skilled in the art according to the actual situation.

[0045] Although embodiments of the invention have been shown and described, those skilled in the art will understand that various changes, modifications, substitutions and alterations can be made to these embodiments without departing from the principles and spirit of the invention, the scope of which is defined by the claims and their equivalents.

Claims

1. A method for providing intelligent services in commercial insurance, characterized in that, include: Obtain claims application records, material submission record sequences, liability requirement sets, and historical supplementary document interaction records to construct a claims configuration unit; Based on the mapping relationship between the material submission record sequence and the material categories in the set of responsibility requirements, the satisfaction status of each responsibility requirement is updated in time sequence to construct a responsibility status trajectory and identify unclosed responsibility links; Based on the relationships between replacement initiation, replacement arrival, return and resubmission, and re-notification in the historical replacement interaction records, a replacement round-trip pressure sequence is generated to identify replacement pressure segments. By analyzing the correlation between the advancement change attributes of unclosed responsibility links in the responsibility state trajectory and the pressure segment of the replenishment in the replenishment round-trip pressure sequence, the pressure enhancement segment is obtained; Based on the segment to which the supplementary document belongs in the round, generate the acceptance and diversion sorting results, and output the target acceptance queue and processing node diversion instructions.

2. The commercial insurance intelligent service method according to claim 1, characterized in that, The method for constructing a claims configuration unit includes: Based on the insurance product configuration record, the list of coverage responsibilities and the table of claims types, extract the liability elements information corresponding to the target claims to form an initial set of liability elements; Obtain the material proof purpose for each responsibility element in the initial set of responsibility elements, thus obtaining the material proof purpose set. Extract the corresponding material category based on the material proof purpose set to form the material group corresponding to the responsibility element. Based on the substitution, parallel, and sequential supplementary relationships between different material categories under the same liability element, a mapping structure between liability elements and material categories is constructed to generate a claims configuration unit.

3. The commercial insurance intelligent service method according to claim 2, characterized in that, The method for constructing a responsibility status trajectory and identifying unclosed responsibility links includes: Read the material submission record sequence of the target claim, organize the responsibility according to the material arrival time, material category identifier and corresponding liability element identifier, and form a responsibility arrival event table; Based on the mapping relationship between liability requirements and material categories in the claims configuration unit, each event in the liability arrival event table is matched with liability requirements one by one to determine whether the corresponding material category has been submitted. If the material category is submitted, the corresponding responsibility element will be recorded as closed. If the material category is not fully submitted, check if the material category exists. If the material category exists, record the corresponding responsibility requirements as partially met. If no material category exists, the corresponding responsibility requirement will be recorded as unmet. The status of different responsibility elements is combined according to the order of material arrival time to obtain the responsibility status trajectory; Obtain the last state in each responsibility state trajectory, mark the responsibility elements whose last state is not a closed state as candidate unclosed items, and generate unclosed responsibility links based on the candidate unclosed items and the last state.

4. The commercial insurance intelligent service method according to claim 3, characterized in that, The method for generating the complement reciprocating pressure sequence includes: Read the historical supplementary document interaction records of the target claim, and organize them into a supplementary document round event chain according to the supplementary document notification initiation time, user supplementary document submission time, platform return time, and re-notification time. For each round of supplementary submissions in the supplementary submission event chain, the waiting time, the number of repeated notifications, the number of repeated submissions of the same type of material, and the number of returned submissions are extracted and combined to obtain supplementary submission pressure information. By combining the pressure information of the replacement parts according to the replacement round sequence, a replacement part pressure sequence is obtained; By analyzing the adjacency variation characteristics of adjacent replenishment rounds in the replenishment pressure information in the replenishment pressure sequence, replenishment pressure segments are identified.

5. The commercial insurance intelligent service method according to claim 4, characterized in that, The methods for extracting the waiting time and the number of repeated notifications include: Calculate the difference between the notification time for the missing document and the time the user submits the missing document in each round of missing document submission, and record the result as the waiting time; Determine if there are multiple supplementary document notifications in each round of supplementary document replenishment. If there are multiple supplementary document notifications, identify the reason for the supplementary document replenishment, extract the reason for the supplementary document replenishment, and count the number of the same reason for the supplementary document replenishment in the corresponding round of supplementary document replenishment, which is recorded as the number of duplicate notifications. If there are no multiple requests for supplementary documents, the number of duplicate requests is counted as zero.

6. The commercial insurance intelligent service method according to claim 5, characterized in that, The method for extracting the number of repeated submissions and the number of returns for resubmission of the same type of material includes: Record and integrate the types of materials submitted by users in each round of supplementary parts submissions to obtain a list of material types; For the materials submitted by users in each round of supplementary materials, it is determined whether there are materials of the same type in the material type list. If there are materials of the same type, it is determined that the materials in the corresponding supplementary materials round are submitted repeatedly, and the number of repeated submissions of materials of the same type is counted. If no materials of the same type exist, the number of times the same type of materials are submitted repeatedly is recorded as zero; Based on the round order in the replacement round event chain, construct the replacement round sequence, traverse the replacement round sequence, and mark the traversed replacement rounds as the target rounds; Based on the order of the replacement rounds in the replacement round sequence, the next replacement round of the target round is combined with the target round to obtain adjacent round pairs; In each pair of adjacent rounds, determine whether the system rejection in the previous round and the user's submission in the next round occur simultaneously. If they occur simultaneously, record a rejection-submission event; if they do not occur simultaneously, do not record it. Count the number of times a return and resubmission event occurs in each adjacent round pair, and record it as the return and resubmission count in the corresponding adjacent round pair.

7. The commercial insurance intelligent service method according to claim 6, characterized in that, The method for identifying pressure zones in replacement parts includes: Determine whether there is a replacement round interval with continuously increasing waiting time in different replacement pressure information. If there is a replacement round interval with continuously increasing waiting time, then construct a replacement pressure segment. If there is no replenishment round interval with continuously increasing waiting time, then determine whether there is a replenishment round interval with a consistent number of repeated notifications in different replenishment pressure information. If there is a replenishment round interval with a fixed number of repeated notifications, then a replenishment pressure segment is constructed. If there is no interval between the number of repeated notifications and the number of resubmission rounds, then the number of repeated submissions of different types of materials is combined according to the order of the resubmission rounds to obtain the resubmission sequence of the corresponding type of materials; For each category of materials, determine whether there is a supplementary document round interval where the number of repeated submissions continues to increase; If there is a gap in the number of duplicate submissions that continues to increase, then construct a gap pressure zone. If there is no interval between resubmission rounds where the number of duplicate submissions continues to increase, then determine whether there is an interval between resubmission rounds where the number of returned resubmissions remains unchanged in different resubmission pressure information. If there exists a range of replacement rounds where the number of replacement submissions remains constant, then a replacement pressure range is constructed.

8. The commercial insurance intelligent service method according to claim 7, characterized in that, The method for analyzing the correlation between the advancement change attributes of unclosed responsibility links in the responsibility state trajectory and the component pressure segment in the component round-trip pressure sequence includes: Read the liability status trajectory corresponding to the target claim, calculate the reduction in the number of unclosed liability links according to the order of supplementary document rounds, and obtain the sequence of changes in the number of unclosed links; Identify the round intervals in the unclosed quantity change sequence where the quantity has not decreased, and generate the responsibility closure pressure segment; Calculate the intersection of the supplementary pressure section and the responsibility closing pressure section, and determine whether the intersection is empty; If the intersection is not empty, the interval obtained from the intersection is marked as the pressure enhancement segment; if the intersection is empty, no operation is performed.

9. A commercial insurance intelligent service method according to claim 8, characterized in that, The method for generating the acceptance and triage ranking results includes: Track the segment type of each supplementary document round in real time. If the supplementary document round does not belong to any segment, the target claim will be placed in the fast processing mode. If the supplementary document round falls within the liability closure pressure zone, the target claim will be placed in the regular supplementary document processing mode; If the replacement document round falls within the increased pressure zone, the target claim will be prioritized for intervention. The processing and triage results are generated according to the order of priority processing intervention mode, fast processing mode and regular supplementary document processing mode.

10. A commercial insurance intelligent service system, applied to the commercial insurance intelligent service method described in any one of claims 1 to 9, characterized in that, include: The claims configuration module retrieves claims application records, material submission record sequences, liability requirement sets, and historical supplementary document interaction records to construct claims configuration units. The responsibility trajectory construction module updates the satisfaction status of each responsibility element in a time sequence based on the mapping relationship between the material submission record sequence and the material category in the responsibility element set, constructs the responsibility status trajectory, and identifies unclosed responsibility links. The replacement part pressure generation module generates a replacement part round-trip pressure sequence and identifies replacement part pressure segments based on the relationship between replacement part initiation, replacement delivery arrival, return and resubmission, and re-notification in the historical replacement part interaction records. The pressure correlation analysis module identifies pressure-enhancing sections by analyzing the correlation between the advancement and change attributes of unclosed responsibility links in the responsibility status trajectory and the pressure segments of the replenishment in the replenishment round-trip pressure sequence. The acceptance and diversion output module generates acceptance and diversion sorting results based on the segment to which the replacement document belongs in the round, and outputs the target acceptance queue and processing node diversion instructions.

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