Vehicle insurance claim cancellation and reinsurance event risk scheduling and protection method and system

Abstract

The application provides a car insurance claim cancellation supplementary certificate event risk scheduling and protection method and system, and belongs to the technical field of electric data processing. The application converts missing evidence, conflict fields, material effectiveness to-be-reviewed items, process event abnormalities and historical similar re-opening reasons in to-be-cancelled, to-be-withdrawn or to-be-automatically-closed cases into candidate supplementary certificate items, avoids treating supplementary certificate processing as a normal notification node, objectifies modeling of the supplementary certificate items, enables the supplementary certificate scheduling to adapt to multi-material replacement, preposition dependence, must nodes, channel receipts and branch office processing constraints in real business, improves the processing efficiency of cancellation cases, reduces the risk of mis-closing caused by direct release due to probability estimation, and reduces mis-closing when key supplementary certificate items are still executable or the closing conditions are not fully met. Through the cancellation process state machine and the protection track retention, the supplementary certificate scheduling basis before closing and the closing protection basis can be restored when re-opening, sampling inspection or responsibility tracing occurs subsequently.

Description

Technical Field

[0001] This invention relates to the field of electrical data processing technology, including insurance claim process control, auto insurance claim cancellation processing, document replacement task scheduling, case status machine verification, asynchronous process event consistency verification, and protection. Specifically, it relates to a method and system for risk scheduling and protection of auto insurance claim cancellation and document replacement events. Background Technology

[0002] In auto insurance claims, some cases may enter a pending cancellation, pending withdrawal, or pending automatic closure status due to reasons such as customer abandonment of claim, incomplete documentation, inability to further confirm accident liability or loss facts, duplicate reporting, invalid claims, insufficient customer feedback to support continued processing, or other business reasons. For such cases, business personnel typically need to determine whether the case meets the conditions for cancellation, whether there is still room for supplementary documentation, whether the supplementary documentation process has been completed, whether the customer is still reachable and capable of providing feedback, and whether there are risks of reopening, failing random inspections, or requiring manual correction after closure.

[0003] In the practice of reviewing and processing special cases and cancellations of auto insurance, general automation tools can assist in understanding call content, interpreting unstructured materials, matching rules, and submitting reviews. This alleviates business bottlenecks such as the time spent on manual review of individual cases (taking several minutes), high daily processing volumes, and the occupation of specialized personnel for repetitive tasks. For example, in the scenario of processing batch cancellation cases, external review tools can pre-organize customer feedback, material status, and system fields into readable processing results and improve submission efficiency through process automation. The above capabilities mainly address the issues of how material or customer feedback is understood and how review conclusions are automatically submitted.

[0004] However, in scenarios awaiting cancellation or automatic closure, simply obtaining the results of external evidence processing or audit rules is insufficient to safely complete the closure process. Key issues in actual business operations include: given the current process status, channel feedback, verification resources, and business rule constraints, which materials or confirmations still need to be supplemented; which supplementary documents are most effective in reducing the risk of reopening after closure; whether there are substitutions or dependencies between multiple supplementary documents; whether the customer remains accessible and able to provide feedback; and whether automatic closure should still be blocked before the closure action is submitted.

[0005] Existing solutions typically treat supplementary documentation processing as a routine notification, task assignment, or manual review node, lacking object-oriented modeling and feasibility scheduling for the supplementary documentation items themselves. For the same case to be cancelled, the system may require all materials to be submitted at once, leading to indiscriminate supplementary documentation and duplicate outreach; it may also close the case based solely on fixed rules, resulting in premature cancellation when key supplementary documentation items are still feasible; and it may also trigger automatic closure before supplementary documentation feedback, verification upgrades, or customer disputes are resolved, due to reversed process events, delayed status synchronization, inconsistent interface receipts, or premature arrival of the closure submission event. Summary of the Invention

[0006] The purpose of this invention is to provide a method and system for risk scheduling and protection in auto insurance claim cancellation and document replacement events, in order to solve at least one of the technical problems existing in the background art. This invention does not rely on general speech recognition, image recognition, privacy-preserving heterogeneous data fusion, general model training, general review action planning, or general review conclusion generation as its core, nor does it require a unified time caliber or unified node fields as necessary input. Instead, it uses the obtained case status, evidence status results, document replacement history, channel receipts, customer feedback records, and business rule constraints as input. For cancellation and closure scenarios, it performs object-oriented modeling, scheduling scoring, minimum set solving, event-driven rolling updates, and pre-closure protection control on document replacement items, thereby reducing the risks of erroneous closure, reopening, and random inspection.

[0007] To achieve the above objectives, the present invention adopts the following technical solution: Firstly, the present invention provides a method for risk scheduling and protection against vehicle insurance claim cancellation and certificate replacement events, including: Obtain case status data, evidence status results, and process event data for auto insurance claims that are pending cancellation, withdrawal, or automatic closure; Based on the case status data, the evidence status results, and the process event data, a set of candidate supplementary evidence items is constructed. Create a supplementary evidence object for each candidate supplementary evidence item; For each candidate supplementary evidence item, calculate the material acquisition cost, customer feedback probability, evidence validity coefficient, conclusion reversal impact value, relative reopening risk reduction ratio, channel reach feasibility, comprehensive execution feasibility, and verification resource requirements. Also, calculate the reopening risk after current closure based on at least one of the following: the proportion of missing key supplementary evidence items, the reopening rate of similar historical cases, process deviation, residual evidence conflict, prior customer objection, event version anomaly, and interface receipt anomaly. Based on the supplementary evidence processing rules, current case status, customer feedback probability, channel reach feasibility, evidence validity, verification upgrade resources, process event version, state machine status, and interface receipt, supplementary evidence feasibility constraints are generated, and action constraints are generated based on the supplementary evidence feasibility constraints. The supplementary evidence scheduling priority is generated based on the material acquisition cost of the candidate supplementary evidence items, the probability of customer feedback, the evidence validity coefficient, the impact value of conclusion reversal, the proportion of relative reopening risk reduction, and the overall execution feasibility. Under the action constraints, filter the current key executable supplementary certification set family, and solve the minimum supplementary certification set that satisfies the risk threshold of reopening after closure, verification resources, nodes that must be supplemented, process status, dependency relationship, substitution relationship, event version consistency and interface receipt consistency in the current key executable supplementary certification set family; If the risk of reopening after closure is higher than the risk threshold for automatic closure and the minimum supplementary evidence set is obtained, then a supplementary evidence request is sent according to the minimum supplementary evidence set and the supplementary evidence scheduling priority; if the risk of reopening after closure is higher than the risk threshold for automatic closure and no minimum supplementary evidence set satisfying the constraints is obtained, then the supplementary evidence sending step based on the minimum supplementary evidence set is not executed, and verification upgrade, manual review, or blocking closure is output; if the risk of reopening after closure is higher than the risk threshold for automatic closure and the current key executable supplementary evidence set family is empty, then the supplementary evidence sending step based on the minimum supplementary evidence set is not executed, and verification upgrade, manual review, or blocking closure is output; if the risk of reopening after closure is not higher than the risk threshold for automatic closure, then no supplementary evidence request is sent, and the closure protection determination is entered. Generate a forced blocking flag, and verify the sequential relationship between the supplementary certificate request, supplementary certificate feedback, protection shutdown, shutdown submission and result receipt, the consistency of event version, the consistency of interface receipt, and the consistency between the shutdown action type and the current status of the case through the cancellation process state machine; Upon receiving events such as a request to close verification, a status change event for supplementary evidence feedback, a case status change event, or a close submission event, the closure protection judgment is performed based on the current risk of reopening after closure, the completion or replacement status of the necessary supplementary evidence nodes, the current key executable supplementary evidence set family, the solution result of the minimum supplementary evidence set, the integrity of the process state machine, and whether the mandatory blocking flag has been triggered. Based on the aforementioned protection closure decision, the system outputs results for automatic cancellation, automatic withdrawal, automatic closure, maintaining supplementary evidence waiting, continuing to supplementary evidence, verification upgrade, blocking closure, or manual review, and saves the protection trajectory before and after closure; among which, the closure action includes automated or controlled submission actions that cause the case to enter the cancellation, withdrawal, or closure business results.

[0008] As a further limitation of the first aspect of the present invention, the conclusion reversal impact value is calculated based on the historical number of times the proposed cancellation conclusion is revoked, postponed, or upgraded after the successful acquisition of the supplementary evidence item, the number of times the supplementary evidence item is successfully acquired, the smoothing item, and the rule importance score.

[0009] As a further limitation of the first aspect of the present invention, the risk of reopening after current closure is calculated from at least one of the following: the proportion of missing key supplementary evidence items, the reopening rate of similar historical cases, the degree of process deviation, the degree of residual evidence conflict, the prior objection of customers, the abnormality of event version, and the abnormality of interface receipt.

[0010] As a further limitation of the first aspect of the present invention, the feasibility constraint for supplementary evidence includes a comprehensive execution feasibility coefficient and an evidence support insufficiency coefficient; the comprehensive execution feasibility coefficient is determined based on the customer feedback probability, channel reach feasibility, dependency satisfaction status, verification resource status, current process status, event version consistency, and interface receipt consistency of the candidate supplementary evidence item, and each input indicator is normalized to the range of 0 to 1; the evidence support insufficiency coefficient is determined based on the validity coefficient of the evidence corresponding to the supplementary evidence item, material completeness, field consistency, and case matching results.

[0011] As a further limitation of the first aspect of the present invention, the supplementary evidence scheduling priority is calculated based on the conclusion reversal impact value, customer feedback probability, relative reopening risk reduction ratio, evidence validity coefficient, comprehensive execution feasibility coefficient, evidence support insufficiency coefficient, and material acquisition cost.

[0012] As a further limitation of the first aspect of the present invention, solving the minimum set of supplementary certifications includes: selecting the set of supplementary certification items with the minimum sum of material acquisition costs from the current critical executable set of supplementary certifications, and ensuring that the expected risk of reopening after the planned execution of the set of supplementary certification items is not higher than the risk threshold for allowing automatic closure, and satisfying the constraints of verification resources, process state constraints, mandatory supplementary certification node coverage constraints, supplementary certification item dependencies, substitution relationships, event version consistency, interface receipt consistency, and action constraints.

[0013] As a further limitation of the first aspect of the present invention, the rolling update after the supplementary evidence feedback includes: when the supplementary evidence materials are valid and the event version is consistent with the case status version, the status of the corresponding candidate supplementary evidence item is updated to completed; when the supplementary evidence materials do not match, the fields conflict, the content is unclear, the validity of the materials does not meet the business rules, the cancellation conclusion cannot be supported, the channel receipt is abnormal, or the event version is inconsistent, the corresponding candidate supplementary evidence item is marked as invalid or pending review, and a new secondary confirmation, material retransmission, channel contact review, manual review, or verification upgrade supplementary evidence item is generated.

[0014] As a further limitation of the first aspect of the present invention, the forced blocking flag is obtained by a logical OR operation from at least one of the following: process abnormality flag, evidence abnormality flag, repeated closure and activation flag, resource abnormality flag, conclusion support missing flag, and version receipt abnormality flag.

[0015] As a further limitation of the first aspect of the present invention, the process anomaly flag is triggered when the following occurs: closing the certificate before re-certification, re-certification feedback precedes the re-certification request, a preset required node is skipped, the closing protection verification is missing, duplicate submission occurs, submission fails but the status has changed, or the result receipt is inconsistent.

[0016] As a further limitation of the first aspect of the present invention, the evidence anomaly flag is triggered when the residual degree of evidence conflict exceeds a threshold, key materials are suspected to be inconsistent with the actual situation, materials do not match the case, or the validity of the evidence is insufficient but no verification upgrade flag is generated.

[0017] As a further limitation of the first aspect of the present invention, the version receipt anomaly flag is triggered when there is inconsistency between the case status version, evidence version, process event version, closed submission event, or core system receipt.

[0018] As a further limitation of the first aspect of the present invention, the closure protection determination includes: when a mandatory blocking flag is triggered, automatic closure, automatic case withdrawal, and other automatic closure actions are prohibited, and verification upgrade, manual review, or closure blocking is output; when a mandatory blocking flag is not triggered, the risk of reopening after the current closure is not higher than the risk threshold for allowing automatic closure, the required supplementary evidence node has been completed or replaced by the verification upgrade result, the process state machine is complete, and the closure submission verification passes, controlled closure submission is allowed; when a mandatory blocking flag is not triggered and the risk of reopening after the current closure is not higher than the risk threshold for allowing automatic closure, but the required supplementary evidence node is not completed and has not been replaced, the process state machine is incomplete, the closure submission verification fails, or the closure action type is inconsistent with the current status of the case, automatic closure is blocked. The system outputs options for completing required nodes, verification upgrade, manual review, or blocking closure. When the mandatory blocking flag is not triggered, the risk of reopening after current closure exceeds the risk threshold for automatic closure, the current key executable supplementary verification set is not empty, and there exists a minimum supplementary verification set that satisfies the constraints, the system blocks automatic closure and continues supplementary verification or maintains a supplementary verification waiting state. When the mandatory blocking flag is not triggered, the risk of reopening after current closure exceeds the risk threshold for automatic closure, and the current key executable supplementary verification set is empty, the system outputs options for verification upgrade, manual review, or blocking closure. When the mandatory blocking flag is not triggered, the risk of reopening after current closure exceeds the risk threshold for automatic closure, the current key executable supplementary verification set is not empty, but there does not exist a minimum supplementary verification set that satisfies the constraints, the system outputs options for verification upgrade, manual review, or blocking closure.

[0019] As a further limitation of the first aspect of the present invention, the expected closure and reopening risk assessment plan supplementary certification set is used in the supplementary certification scheduling stage. In the closure protection stage, the current closure and reopening risk is recalculated based on the actual supplementary certification status of completed, replaced, invalid, pending review, and verified upgrade completed. The recalculated current closure and reopening risk is used as the closure protection judgment input.

[0020] As a further limitation of the first aspect of the present invention, the protection trajectory includes at least one of the following: case status data, evidence status result reference, process event sequence, event version, candidate supplementary evidence item set, supplementary evidence item level index, supplementary evidence scheduling priority, key executable supplementary evidence set family, minimum supplementary evidence set, supplementary evidence request, supplementary evidence feedback, channel receipt, risk of reopening after current closure, closure protection judgment result, forced blocking flag, process state machine event sequence, automatic submission receipt, manual intervention record, and parameter version.

[0021] As a further limitation of the first aspect of the present invention, when a case is subsequently reopened, fails random inspection, fails quality inspection, or is manually corrected, the system will feed the actual results back into the supplementary evidence scheduling parameter library to update the historical reopening rate of similar cases, customer feedback probability, evidence validity coefficient, conclusion reversal impact value, supplementary evidence item cost, evidence support parameters, risk reduction upper limit, marginal reduction coefficient, event version consistency rule, channel receipt rule, and mandatory blocking rule.

[0022] Secondly, this invention provides a risk scheduling and protection system for vehicle insurance claim cancellation and certificate replacement events, including: The case status, evidence status results, and process event access module is used to obtain case status data, evidence status results, and process event data for auto insurance claims that are pending cancellation, withdrawal, or automatic closure, and to construct a set of candidate supplementary evidence items. The supplementary evidence item indicator calculation module is used to calculate the material acquisition cost, customer feedback probability, evidence validity coefficient, conclusion reversal impact value, relative reopening risk reduction ratio, channel reach feasibility, comprehensive execution feasibility and verification resource requirements for each candidate supplementary evidence item, and calculate the reopening risk after current closure. The supplementary evidence feasibility constraint generation module is used to generate supplementary evidence feasibility constraints based on the supplementary evidence item processing rules, current case status, customer feedback probability, channel reach feasibility, evidence validity, verification upgrade resources, process event version, state machine status, and interface receipt, and to generate action constraints based on the supplementary evidence feasibility constraints. The supplementary evidence scheduling priority module is used to generate supplementary evidence scheduling priorities based on the material acquisition cost of the candidate supplementary evidence items, the probability of customer feedback, the evidence validity coefficient, the impact value of conclusion reversal, the proportion of relative reopening risk reduction, and the overall execution feasibility. The minimum supplementary evidence set solving module is used to filter the current key executable supplementary evidence set family under the action constraints, and solve the minimum supplementary evidence set in the current key executable supplementary evidence set family; The shutdown protection judgment module is used to: if the risk of reopening after current shutdown is higher than the risk threshold for automatic shutdown and the minimum supplementary evidence set has been obtained, then send a supplementary evidence request according to the minimum supplementary evidence set and the supplementary evidence scheduling priority; if the risk of reopening after current shutdown is higher than the risk threshold for automatic shutdown and no minimum supplementary evidence set satisfying the constraints has been obtained, then do not execute the supplementary evidence sending step based on the minimum supplementary evidence set, and output verification upgrade, manual review, or blocking shutdown; if the risk of reopening after current shutdown is higher than the risk threshold for automatic shutdown and the current key executable supplementary evidence set family is empty, then do not execute the supplementary evidence sending step based on the minimum supplementary evidence set, and output verification upgrade, manual review, or blocking shutdown; if the risk of reopening after current shutdown is not higher than the risk threshold for automatic shutdown, then do not send a supplementary evidence request, and enter the shutdown protection judgment.

[0023] Thirdly, the present invention provides a non-transitory computer-readable storage medium for storing computer instructions. When the computer instructions are executed by a processor, the method for risk scheduling and protection of vehicle insurance claim cancellation and certificate replacement events as described in the first aspect is implemented.

[0024] Fourthly, the present invention provides a computer device including a memory and a processor, wherein the processor and the memory communicate with each other, the memory stores program instructions that can be executed by the processor, and the processor calls the program instructions to execute the risk scheduling and protection method for vehicle insurance claim cancellation and certificate replacement events as described in the first aspect.

[0025] Fifthly, the present invention provides an electronic device, comprising: a processor, a memory, and a computer program; wherein the processor is connected to the memory, the computer program is stored in the memory, and when the electronic device is running, the processor executes the computer program stored in the memory to cause the electronic device to execute instructions for implementing the risk scheduling and protection method for vehicle insurance claim cancellation and replacement events as described in the first aspect.

[0026] Beneficial effects of this invention: (1) This invention transforms missing evidence, conflict fields, material validity to be reviewed, uncertain reasons for cancellation, abnormal process events and historical reasons for reopening in cases to be cancelled, withdrawn or automatically closed into calculable, sortable and executable candidate supplementary evidence items, thus avoiding treating the supplementary evidence processing as a normal notification node.

[0027] (2) This invention performs object-oriented modeling of supplementary evidence items, records the supplementary evidence type, triggering reason, reaching channel, processing rules, dependency relationship, substitution relationship, mandatory supplementary evidence identifier, key supplementary evidence identifier, evidence group identifier and event reference, so that the supplementary evidence scheduling can adapt to the multiple material substitution, pre-dependent, mandatory node, channel receipt and branch processing constraints in real business.

[0028] (3) This invention does not rely on a unified time standard or a unified node field, but generates supplementary evidence feasibility constraints through process events, channel receipts, resource status, evidence status and case status versions, thereby enhancing the feasibility of the solution in a real claims system.

[0029] (4) This invention solves the minimum set of supplementary evidence by determining the minimum combination of supplementary evidence required for a case to reach the risk threshold for allowing closure under the conditions of verification resources, process status, nodes that must be supplemented with supplementary evidence, dependencies, substitution relationships, event version consistency and action constraints, thereby improving the processing efficiency of cancellation cases.

[0030] (5) The present invention distinguishes between the expected risk in the planning stage and the current risk before closure. Before closure, Gcurrent(c) is recalculated based on the actual completion status of supplementary certification, thereby reducing the risk of false closure caused by direct release due to probability estimation.

[0031] (6) This invention uses the current risk of reopening after closure, the status of nodes that must be supplemented or replaced, the current set of key executable supplementary certificates, the solution result of the minimum supplementary certificate set, the integrity of the process state machine, the consistency of event version, and the forced blocking flag as automatic closure gates to reduce false closure when key supplementary certificates are still executable or the closure conditions are not fully met.

[0032] (7) By canceling the process state machine and retaining the protection trajectory, this invention enables the restoration of the supplementary certification scheduling basis and the closing protection basis before the closure when subsequent reopening, spot checks or responsibility tracing occur.

[0033] (8) This invention continuously optimizes the supplementary evidence scheduling and shutdown protection with business results by updating the supplementary evidence scheduling parameters, evidence group risk reduction upper limit, marginal reduction coefficient, event version consistency rules, channel receipt rules and forced blocking rules through subsequent quality results feedback.

[0034] (9) The protection boundaries of this invention are different from those of the general special case review intelligent agent. Its protection focuses on the supplementary evidence scheduling before cancellation and closure, event status verification and closure protection, and does not cover the recognition and fusion of original recordings, images or texts, privacy protection training and general review action planning.

[0035] The advantages of additional aspects of the invention will be set forth more clearly in the following description or will be learned by practice of the invention. Attached Figure Description

[0036] To more clearly illustrate the technical solutions of the embodiments of the present invention, the drawings used in the following description of the embodiments will be briefly introduced. Obviously, the drawings described below are only some embodiments of the present invention. For those skilled in the art, other drawings can be obtained based on these drawings without creative effort.

[0037] Figure 1 This is a schematic diagram of the risk scheduling and protection system for vehicle insurance claim cancellation and certificate replacement events provided in an embodiment of the present invention.

[0038] Figure 2 The flowchart for supplementary evidence scheduling and minimum supplementary evidence set solution provided in the embodiments of the present invention is shown.

[0039] Figure 3 This is a schematic diagram of the event-driven shutdown protection determination logic provided in an embodiment of the present invention.

[0040] Figure 4 This is a schematic diagram of the state machine and version receipt verification of the cancellation process provided in an embodiment of the present invention. Detailed Implementation

[0041] Embodiments of the present invention are described in detail below, examples of which are shown in the accompanying drawings, wherein the same or similar reference numerals denote the same or similar elements or elements having the same or similar functions throughout. The embodiments described below with reference to the accompanying drawings are exemplary and are only used to explain the present invention, and should not be construed as limiting the present invention.

[0042] To facilitate understanding of the present invention, the present invention will be further explained and described below with reference to the accompanying drawings and specific embodiments. However, the specific embodiments do not constitute a limitation on the embodiments of the present invention.

[0043] Those skilled in the art should understand that the accompanying drawings are merely schematic diagrams of embodiments, and the components in the drawings are not necessarily essential for implementing the present invention.

[0044] This invention provides a risk scheduling and protection method for auto insurance claim cancellation and supplementary certificate events. In cases awaiting cancellation, withdrawal, or automatic closure, a candidate supplementary certificate item set is constructed based on case status data, evidence status results, process events, channel receipts, and status versions. The scheduling value and execution feasibility coefficient of each supplementary certificate item are calculated. First, the current key executable supplementary certificate set family is screened. Then, the minimum supplementary certificate set that satisfies the closure risk threshold, verification resources, necessary supplementary certificate nodes, process status, and dependencies is solved. Before the closure verification request, supplementary certificate feedback status change, or closure submission, a closure protection judgment is performed based on the current risk of reopening after closure, the key executable supplementary certificate set family, the minimum supplementary certificate set solution result, and a mandatory blocking flag. The core of this invention does not lie in general speech recognition, image and text recognition, layout parsing, privacy-protecting heterogeneous data fusion, federated training, general intelligent agent review, or general review action planning, but rather in the supplementary certificate item scheduling mechanism before cancellation and closure, the business event-driven state machine verification mechanism, and the closure protection mechanism. External evidence processing systems, business systems, rule engines, or manual processing results can serve as input sources, and decisions can be made based on these inputs regarding which additional data should be added, which data should be added first, which data should be added at the minimum, which events require rolling updates to the supplementary evidence status, when to block closure, and when to allow controlled closure.

[0045] Example 1 In this embodiment 1, a risk scheduling and protection system for auto insurance claim cancellation and supplementary evidence events is first provided, including: a case status, evidence status result, and process event access module, used to acquire case status data, evidence status results, and process event data of auto insurance claim cases to be cancelled, withdrawn, or automatically closed, and construct a candidate supplementary evidence item set; a supplementary evidence item index calculation module, used to calculate material acquisition cost, customer feedback probability, evidence validity coefficient, conclusion reversal impact value, relative reopening risk reduction ratio, channel reach feasibility, comprehensive execution feasibility, and verification resource requirements for each candidate supplementary evidence item, and calculate the reopening risk after current closure; a supplementary evidence feasibility constraint generation module, used to generate supplementary evidence feasibility constraints based on supplementary evidence item processing rules, current case status, customer feedback probability, channel reach feasibility, evidence validity, verification upgrade resources, process event version, state machine status, and interface receipt, and generate action constraints based on the supplementary evidence feasibility constraints; and a supplementary evidence scheduling priority module, used to calculate the material acquisition cost, customer feedback probability, evidence validity coefficient, conclusion reversal impact value, relative reopening risk reduction ratio, channel reach feasibility, comprehensive execution feasibility, and verification resource requirements for each candidate supplementary evidence item, and calculate the reopening risk after current closure; a supplementary evidence feasibility constraint generation module, used to generate supplementary evidence feasibility constraints based on the material acquisition cost, customer feedback probability, evidence validity coefficient, conclusion reversal impact value, and verification resource requirements for each candidate supplementary evidence item. The system generates a supplementary certification scheduling priority based on the response value, the relative reopening risk reduction ratio, and the overall execution feasibility. A minimum supplementary certification set solving module is used to filter the current key executable supplementary certification set family under the action constraints and solve for the minimum supplementary certification set within the current key executable supplementary certification set family. A shutdown protection judgment module is used to send a supplementary certification request according to the minimum supplementary certification set and the supplementary certification scheduling priority if the current reopening risk after shutdown is higher than the risk threshold for automatic shutdown and the minimum supplementary certification set has been solved. If the current reopening risk after shutdown is higher than the risk threshold for automatic shutdown and no minimum supplementary certification set satisfying the constraints has been solved, the supplementary certification sending step based on the minimum supplementary certification set is not executed, and verification upgrade, manual review, or shutdown blocking is output. If the current reopening risk after shutdown is higher than the risk threshold for automatic shutdown and the current key executable supplementary certification set family is empty, the supplementary certification sending step based on the minimum supplementary certification set is not executed, and verification upgrade, manual review, or shutdown blocking is output. If the current reopening risk after shutdown is not higher than the risk threshold for automatic shutdown, no supplementary certification request is sent, and the shutdown protection judgment is entered.

[0046] In this embodiment, the above-described system is used to implement a risk scheduling and protection method for vehicle insurance claim cancellation and certificate replacement events, including: The system acquires case status data, evidence status results, and process event data for auto insurance claims pending cancellation, withdrawal, or automatic closure. The process event data includes at least one of the following: case status change event, supplementary evidence request event, channel receipt event, customer feedback event, manual task event, verification upgrade event, closure verification request event, closure submission event, and closure submission receipt event. When a closure protection judgment is triggered, at least a closure verification request event or a closure submission event, along with the corresponding case status version, evidence version, or interface receipt, is acquired. If the necessary event, version, or receipt is missing, a process abnormality flag or a version receipt abnormality flag is triggered. Based on the case status data, the evidence status results, and the process event data, a set of candidate supplementary evidence items is constructed based on at least one of the following: missing evidence, key field conflicts, items requiring verification of material validity, uncertain reasons for cancellation, unclear customer intent, historical reasons for similar reopenings, unmet key rules, abnormal process nodes, failed channel outreach, and unfinished key items found in the closure verification request. The candidate supplementary evidence items include at least one of the following: supplementary accident scene photos, supplementary repair invoices, customer confirmation of waiver of claim, customer secondary confirmation, vehicle repair status confirmation, supplementary liability proof, identity or signature confirmation, online confirmation, supplementary inspection records, external system information verification, re-upload of materials, verification of material validity, confirmation of disputed facts, verification of channel outreach, manual task verification, and verification upgrade.

[0047] For each candidate supplementary evidence item, a supplementary evidence item object is established. The supplementary evidence item object includes supplementary evidence type, triggering reason, source, target audience, reach channel, processing rules or completion requirements, dependency relationship, substitution relationship, mandatory supplementary evidence identifier, evidence group identifier, key supplementary evidence identifier, processing status, evidence reference, and process event reference. For each candidate supplementary evidence item, calculate the material acquisition cost, customer feedback probability, evidence validity coefficient, conclusion reversal impact value, relative reopening risk reduction ratio, channel reach feasibility, comprehensive execution feasibility, and verification resource requirements. Also, calculate the reopening risk after current closure based on at least one of the following: the proportion of missing key supplementary evidence items, the reopening rate of similar historical cases, process deviation, residual evidence conflict, prior customer objection, event version anomaly, and interface receipt anomaly. Based on the supplementary evidence processing rules, current case status, customer feedback probability, channel reach feasibility, evidence validity, verification upgrade resources, process event version, state machine status, and interface receipt, supplementary evidence feasibility constraints are generated, and action constraints are generated based on the supplementary evidence feasibility constraints. The supplementary evidence scheduling priority is generated based on the material acquisition cost, customer feedback probability, evidence validity coefficient, conclusion reversal impact value, relative reopening risk reduction ratio, and comprehensive execution feasibility of the candidate supplementary evidence items. The conclusion reversal impact value is calculated based on the historical number of times the proposed cancellation conclusion has been revoked, postponed, or upgraded after successful acquisition of the supplementary evidence item, the number of successful acquisitions of the supplementary evidence item, the smoothing term, and the rule importance score. The relative reopening risk reduction ratio is the ratio between the difference in reopening risk after closure before and after successful acquisition of the supplementary evidence item and the reopening risk after closure before acquisition, and is limited to the range of 0 to 1.

[0048] Under the action constraints, the current key executable supplementary certification set family is first screened. Then, within the current key executable supplementary certification set family, the minimum supplementary certification set that satisfies the risk threshold of reopening after closure, verification resources, required supplementary certification nodes, process status, dependencies, substitution relationships, event version consistency, and interface receipt consistency is solved. The current key executable supplementary certification set family is a non-empty key candidate set family. Dependencies are represented by directed acyclic graphs, and substitution relationships are represented by groups of substitution supplementary certification items. Before solving, circular dependencies, substitution group conflicts, and constraint conflicts between dependencies and substitution relationships are detected. The dependency relationship indicates that a candidate supplementary certification item can only be executed after another candidate supplementary certification item is completed or satisfied. The substitution relationship indicates that the completion of any one of multiple candidate supplementary certification items can satisfy the same business element.

[0049] If the risk of reopening after closure is higher than the risk threshold for automatic closure and the minimum supplementary evidence set is obtained, then a supplementary evidence request is sent according to the minimum supplementary evidence set and the supplementary evidence scheduling priority. If the risk of reopening after closure is higher than the risk threshold for automatic closure and a minimum supplementary evidence set satisfying the constraints is not obtained, then the supplementary evidence sending step based on the minimum supplementary evidence set is not executed, and verification upgrade, manual review, or blocking closure is output. If the risk of reopening after closure is higher than the risk threshold for automatic closure and the current key executable supplementary evidence set family is empty, then the supplementary evidence request based on the minimum supplementary evidence set is not executed. The system executes the steps for sending supplementary evidence and outputs options for verification upgrade, manual review, or blocking closure. If the risk of reopening after closure is not higher than the risk threshold for automatic closure, no supplementary evidence request is sent, and the system enters the closure protection judgment stage. After receiving customer feedback, experiencing channel receipt failure, receiving explicit customer rejection or continuing to claim, receiving manual task return, changing case status, changing evidence status, completing verification upgrade, receiving closure verification request, or receiving closure submission event, the system continuously updates the status of candidate supplementary evidence items, the risk of reopening after closure, the current key executable supplementary evidence set family, the minimum supplementary evidence set, and action constraints. A mandatory blocking flag is generated, and the sequential relationship between the supplementary evidence request, supplementary evidence feedback, protection closure, closure submission and result receipt are verified through the cancellation process state machine. The consistency of event versions, interface receipts, and the consistency between the closure action type and the current case status are also verified. When the mandatory blocking flag is triggered, automatic closure, automatic case withdrawal and other automatic closure actions are prohibited unless the blocking is lifted by manual review and a new closure protection judgment version is generated. Upon receiving events such as a request to close verification, a status change event for supplementary evidence feedback, a case status change event, or a close submission event, the closure protection judgment is performed based on the current risk of reopening after closure, the completion or replacement status of the necessary supplementary evidence nodes, the current key executable supplementary evidence set family, the solution result of the minimum supplementary evidence set, the integrity of the process state machine, and whether the mandatory blocking flag has been triggered. The system outputs the following results based on the closed protection judgment: automatic cancellation, automatic withdrawal, automatic closure, maintaining supplementary evidence waiting, continuing supplementary evidence, verification upgrade, blocking closure, or manual review, and saves the protection trajectory before and after closure. The closure action includes automated or controlled submission actions that cause the case to enter the cancellation, withdrawal, or closure business result process. The protection trajectory includes at least one of the following: case status data, evidence status result reference, process event sequence, event version, candidate supplementary evidence item set, supplementary evidence item-level indicators, supplementary evidence scheduling priority, key executable supplementary evidence set family, minimum supplementary evidence set, supplementary evidence request, supplementary evidence feedback, channel receipt, risk of reopening after current closure, closed protection judgment result, forced blocking flag, process state machine event sequence, automatic submission receipt, manual intervention record, and parameter version.

[0050] In this embodiment, the evidence status result is a structured summary related to cancellation that has been output by the claims core system, external evidence processing system, channel outreach platform, rule engine, or manual node. The structured summary includes at least one of the following: material existence status, material validity status, customer feedback status, field consistency status, cancellation reason support status, dispute status, and external query status. This method does not limit the generation method of the structured summary.

[0051] The system establishes a state machine for the cancellation process and divides the case status into at least the following states: pending cancellation, waiting for supplementary certificates, waiting for supplementary certificates, verification upgrade, prohibition of automatic closure, controlled closure submission, automatic closure completed, manual closure, and reactivation.

[0052] In this embodiment, the risk of reopening after current closure is calculated from at least one of the following: the proportion of missing key supplementary evidence items, the reopening rate of similar historical cases, the degree of process deviation, the degree of residual evidence conflict, the prior knowledge of customer objections, the abnormality of event version, and the abnormality of interface receipt.

[0053] The constraints on the feasibility of supplementary evidence include a comprehensive execution feasibility coefficient and an evidence insufficiency coefficient. The comprehensive execution feasibility coefficient is determined based on the customer feedback probability, channel reach feasibility, dependency satisfaction status, verification resource status, current process status, event version consistency, and interface receipt consistency of the candidate supplementary evidence item, and each input indicator is normalized to the range of 0 to 1. The evidence insufficiency coefficient is determined based on the validity coefficient of the evidence corresponding to the supplementary evidence item, material completeness, field consistency, and case matching results.

[0054] In this embodiment, the priority of supplementary evidence scheduling is calculated based on the impact value of conclusion reversal, customer feedback probability, relative risk reduction ratio of reopening, evidence validity coefficient, comprehensive execution feasibility coefficient, evidence support insufficiency coefficient, and material acquisition cost.

[0055] In this embodiment, solving for the minimum set of supplementary certifications includes: selecting the set of supplementary certification items with the minimum sum of material acquisition costs from the current critical executable set of supplementary certifications, and ensuring that the expected risk of reopening after the planned execution of the set of supplementary certification items is not higher than the risk threshold for automatic closure, and satisfying the constraints of verification resources, process status, mandatory supplementary certification node coverage, supplementary certification item dependencies, substitution relationships, event version consistency, interface receipt consistency, and action constraints.

[0056] The expected risk of reopening after closure is calculated based on evidence groups or risk factor groups, and a maximum of one supplementary evidence item, an upper limit for cumulative risk reduction, or a marginal reduction constraint is set for supplementary evidence items in the same group to avoid double-counting the risk reduction of similar supplementary evidence items.

[0057] When the risk of reopening after closure is higher than the risk threshold for automatic closure and the current set of critical executable supplementary evidence is empty, output verification upgrade, manual review, or blocking closure; when the risk of reopening after closure is higher than the risk threshold for automatic closure, the current set of critical executable supplementary evidence is not empty but there is no minimum supplementary evidence set that satisfies the risk threshold and the mandatory node coverage constraint, it is determined that ordinary supplementary evidence is insufficient to make the case meet the controlled closure conditions, and output verification upgrade, manual review, or blocking closure; when the risk of reopening after closure is not higher than the risk threshold for automatic closure, it is not required to solve for the minimum non-empty supplementary evidence set, no supplementary evidence request is sent, and the case is transferred to the closure protection determination.

[0058] The rolling update after the feedback of supplementary evidence includes: when the supplementary evidence is valid and the event version is consistent with the case status version, the status of the corresponding candidate supplementary evidence item will be updated to completed; when the supplementary evidence does not match, the fields conflict, the content is unclear, the validity of the materials does not meet the business rules, it cannot support the cancellation conclusion, the channel receipt is abnormal, or the event version is inconsistent, the corresponding candidate supplementary evidence item will be marked as invalid or pending review, and a new supplementary evidence item will be generated for secondary confirmation, material retransmission, channel contact review, manual review, or verification upgrade.

[0059] The forced blocking flag is obtained by a logical OR operation from at least one of the following: process abnormality flag, evidence abnormality flag, repeated closure and activation flag, resource abnormality flag, conclusion support missing flag, and version receipt abnormality flag.

[0060] The process anomaly flag is triggered when the system detects events such as closing the application before submitting supplementary evidence, supplementary evidence feedback preceding the supplementary evidence request, skipping preset required nodes, missing closure protection verification, duplicate submission, submission failure with a changed status, or inconsistent result receipts. The evidence anomaly flag is triggered when the residual evidence conflict exceeds a threshold, key materials are suspected of being inconsistent with the actual situation, materials do not match the case, or the evidence's validity is insufficient but no verification upgrade flag is generated. The version receipt anomaly flag is triggered when there is inconsistency between the case status version, evidence version, process event version, closure submission event, or core system receipt.

[0061] In this embodiment, the closure protection judgment includes: when a mandatory blocking flag is triggered, automatic closure, automatic case withdrawal, and other automatic closure actions are prohibited, and verification upgrade, manual review, or closure blocking is output; when no mandatory blocking flag is triggered, the risk of reopening after the current closure is not higher than the risk threshold for allowing automatic closure, the required supplementary evidence node has been completed or replaced by the verification upgrade result, the process state machine is complete, and the closure submission verification passes, controlled closure submission is allowed; when no mandatory blocking flag is triggered and the risk of reopening after the current closure is not higher than the risk threshold for allowing automatic closure, but the required supplementary evidence node is not completed and has not been replaced, the process state machine is incomplete, the closure submission verification fails, or the closure action type is inconsistent with the current status of the case, automatic closure is blocked, and supplementation is output. The system must execute the following commands: Required node, verification upgrade, manual review, or blocking closure; When the mandatory blocking flag is not triggered, the risk of reopening after current closure is higher than the risk threshold for automatic closure, the current key executable supplementary verification set is not empty, and there exists a minimum supplementary verification set that satisfies the constraints, the system blocks automatic closure and continues supplementary verification or maintains supplementary verification waiting; When the mandatory blocking flag is not triggered, the risk of reopening after current closure is higher than the risk threshold for automatic closure, and the current key executable supplementary verification set is empty, the system outputs verification upgrade, manual review, or blocking closure; When the mandatory blocking flag is not triggered, the risk of reopening after current closure is higher than the risk threshold for automatic closure, the current key executable supplementary verification set is not empty, but there does not exist a minimum supplementary verification set that satisfies the constraints, the system outputs verification upgrade, manual review, or blocking closure.

[0062] In this embodiment, the system uses the expected reopening risk assessment plan supplementary evidence set during the supplementary evidence scheduling phase. During the closure protection phase, it recalculates the current reopening risk based on the actual supplementary evidence status of completed, replaced, invalid, pending review, and verified upgrade completed, and uses the recalculated current reopening risk as the closure protection judgment input.

[0063] In this embodiment, when a case is subsequently reopened, fails random inspection, fails quality inspection, or is manually corrected, the system feeds the actual results back into the supplementary evidence scheduling parameter library to update the historical reopening rate of similar cases, customer feedback probability, evidence validity coefficient, conclusion reversal impact value, supplementary evidence item cost, evidence support parameters, risk reduction upper limit, marginal reduction coefficient, event version consistency rules, channel receipt rules, and mandatory blocking rules.

[0064] Example 2 In this embodiment 2, a method for risk scheduling and protection of vehicle insurance claim cancellation and certificate replacement events is provided, including the following steps S1-S10.

[0065] S1. Access to pending case status, evidence status results, and process events. The system acquires case status data, evidence status results, and process event data for auto insurance claims (c) awaiting cancellation, withdrawal, or automatic closure. The case status data includes at least one of the following: case number, reporting time, accident time, current case status, candidate cancellation reasons, historical transfer nodes, submitted materials, supplementary evidence records, customer contact records, customer historical feedback characteristics, business processing rules, case amount, insurance type information, liability determination information, manual lockout flag, and verification upgrade resource status. The evidence status result is a pre-output structured or semi-structured summary from at least one of the following: external evidence processing system, claims core system, channel contact platform, rule engine, manual notes, or external query system. This method does not limit the generation method of this summary. The evidence status result may include at least one of the following: customer waiver of claim status, continued claim status, supplementary evidence commitment status, dispute expression status, confirmation information status, material signature status, date or amount field status, vehicle information matching status, accident photo status, repair invoice field status, inspection record status, external system matching status, and material validity status.

[0066] The process event data includes at least one of the following: case status change event, supplementary evidence request creation event, supplementary evidence request sending event, channel delivery receipt event, channel outreach failure event, customer feedback reception event, manual task assignment or return event, verification upgrade initiation event, verification upgrade completion event, verification request closure event, submission closure event, submission closure receipt event, and reactivation event. Each process event record includes the event type, event occurrence time, source system, event version number, associated case status version, associated evidence version, and idempotency identifier.

[0067] The system generates a cancellation processing instance identifier for case c. It also records the data collection time, source system, data version, evidence summary, evidence status result version, and event version.

[0068] The evidence summary is used to associate the evidence status result with subsequent supplementary evidence items, supplementary evidence requests, closure protection judgments, and closure trajectories, but it does not require the establishment of a general audit fact table, nor does it require the performance of general credibility fusion on data from different sources.

[0069] S2. Definition of Cancellation Processing Status and Construction of Candidate Supplementary Evidence Set To avoid confusion between the concepts of cancellation, withdrawal, and closure, the system establishes a state machine for the cancellation process. The case status will be divided into at least the following states: pending cancellation, waiting for supplementary documents, waiting for supplementary documents, verification upgrade, prohibited from automatic closure, controlled closure in progress, automatic closure completed, manual closure, and reactivation.

[0070] In this embodiment, the closing action refers to the automated or controlled submission action that causes a case to enter the cancellation, withdrawal, or closure business outcome. Unless otherwise specified, automatic closure includes automatic cancellation, automatic withdrawal, and other automatic closure actions. The pending cancellation status can enter the states of waiting for supplementary evidence, verification upgrade, prohibition of automatic closure, or submission of controlled closure. The waiting for supplementary evidence status will recalculate the risk and return to the closure protection verification after customer feedback, channel receipt failure, manual task return, change of evidence status, completion of verification upgrade, or arrival of closure verification request. The automatic closure completion status is the final state, and it will only enter the reopening activation state when a reopening application is submitted or manual correction is triggered.

[0071] The system constructs a set of candidate supplementary evidence items based on case status data, evidence status results, and process event data. , where i represents a candidate for supplementary evidence. Candidates for supplementary evidence are generated by at least the following triggering factors: missing evidence, key field conflicts, material validity pending review, uncertain reasons for cancellation, unclear customer intent, risk warnings for continued claims, reasons for similar reopening in the past, unmet key rules, abnormal process nodes, incomplete verification upgrades, failed channel outreach, manually noted pending items, and unfinished key matters found in the closure verification request.

[0072] In this embodiment, the candidate supplementary certificates may include at least one of the following: supplementary accident scene photos, supplementary repair invoices, customer waiver of claim confirmation, customer secondary confirmation, vehicle repair status confirmation, supplementary liability certificate, identity or signature confirmation, online confirmation, supplementary inspection record, external system information review, material re-upload, material validity review, disputed facts confirmation, channel contact review, manual task review, and verification upgrade.

[0073] The system creates a supplementary evidence object for each candidate supplementary evidence item i. : ; in, Indicates the type of supplementary certificate; Indicate the reason for triggering this supplementary certification item; This indicates the rule, model output, process event, or human source that generated the supplementary certification item; This indicates the recipient of the supplementary certificate or the customer contact. Indicates the channel of contact; This indicates the processing rules or completion requirements corresponding to the supplementary certificate item; This indicates the dependency relationship between the supplementary evidence item and other supplementary evidence items; This indicates the substitution relationship between the supplementary evidence item and other supplementary evidence items; Indicate whether the supplementary certificate item is a node that requires supplementary certificate; Indicate the evidence group or risk factor group to which the supplementary evidence item belongs; This indicates whether the supplementary certificate item is a key supplementary certificate item that still needs to be monitored before the closure; Indicates the current processing status; This indicates a related summary or citation of evidence; Indicates a reference to an associated process event.

[0074] System records dependency substitution graph for supplementary certification items If multiple supplementary documents are interchangeable, the system allows any one of them to satisfy the corresponding business element. If a dependency exists, the system will only include the subsequent supplementary document in the executable set after the preceding supplementary document is completed or substituted. For example, customer waiver of claim confirmation can be satisfied by any one of valid telephone confirmation, valid online confirmation, or valid paper signature confirmation; supplementary repair invoices may depend on customer confirmation of vehicle repair; and the automatic cancellation action is set to unexecutable if the verification upgrade is not yet completed.

[0075] S3, Calculation of Supplementary Certification Item-Level Indicators For each candidate supplementary certification item i, the system calculates the material acquisition cost. Customer feedback probability Evidence validity coefficient Conclusion: Impact value of flipping The proportion of relative reopening risk reduction Feasibility of channel reach Overall feasibility of implementation Evidence group identification and verify resource requirements .

[0076] Among them, material acquisition costs The difficulty or resource consumption of obtaining supplementary certifications can be determined by factors such as the contact channel, the type of materials, whether customer cooperation is required, whether branch office processing is required, whether manual intervention is required, whether verification upgrades are needed, and the historical average resource consumption for similar items. Customer feedback probability is also a factor. The probability of successfully obtaining the supplementary certificate through currently available channels can be determined by customer historical feedback characteristics, customer historical reach success rate, current channel accessibility, supplementary certificate type, channel receipt results, and historical similar feedback statistics.

[0077] Among them, the coefficient of evidence validity This is used to characterize the reliability of the proof of the cancellation conclusion once the supplementary proof is obtained. It is a supplementary evidence item-level indicator, which can be determined by the source of materials, signature or confirmation status, field completeness, material validity, case matching results, material clarity, and number of conflicting fields. It is not used as a general source weight.

[0078] Conclusion: Influence value of flipping It is used to characterize the impact of successfully obtaining supplementary certification on the proposed cancellation conclusion, the judgment of extension, the judgment of verification upgrade, or the risk of reopening after closure. It can be obtained by fusing historical frequency and rule weights: ; in, The number of times that the proposed cancellation conclusion was revoked, postponed, or upgraded after the successful acquisition of supplementary certificate item i; The number of times the supplementary proof item i was successfully obtained; For smoothing terms; The importance score of the supplementary evidence items output by the rule engine; The fusion weight is between 0 and 1.

[0079] Risk of reopening a case after baseline closure This is used to indicate the risk of reopening, failing random inspections, or requiring manual correction after cancellation or closure under the current evidentiary status. It can be calculated by rule scoring, statistical models, or a combination of both, and is limited to the range of 0 to 1: ; in, The proportion of missing key supplementary evidence items. The reopening rate of similar cases in the past, For process deviation, For the residual of conflict of evidence, Prioritize customer objections. to As weight.

[0080] The relative risk reduction ratio of reopening This indicates the relative reduction in the risk of reopening after the successful acquisition of supplementary certification item i (before and after closure): ; in, This indicates the risk of reopening a closed case after the supplementary evidence item i is successfully obtained and recalculated. To prevent extremely small positive numbers with a denominator of zero.

[0081] S4. Generation of Feasibility Constraints and Action Constraints for Supplementary Evidence Based on Event and State Versions The system generates feasibility constraints for supplementary evidence based on the supplementary evidence processing rules, current case status, probability of customer feedback, feasibility of channel outreach, evidence validity, verification upgrade resources, process event version, and state machine status. The supplementary evidence feasibility constraint is used to constrain whether the supplementary evidence item is executable and whether the closing action can be triggered.

[0082] In one specific embodiment, channel reach feasibility, verification or human resource availability, dependency fulfillment status, process status permission flag, event version consistency flag, and interface receipt consistency flag can all be represented by 0 or 1, or by a tiered value between 0 and 1. The customer feedback probability is obtained by statistically analyzing the number of historical valid feedbacks, the number of historical contacts, the current channel reachability flag, the channel receipt result, and the type of supplementary evidence. Each indicator is uniformly normalized to the range of 0 to 1 before entering the scheduling calculation. Therefore, the supplementary evidence feasibility constraint does not rely on a single time value, a unified time caliber, a unified node field, or an overdue status as necessary inputs, but depends on the current process event, resource status, channel status, evidence status, and case status version.

[0083] Overall feasibility coefficient Used to characterize whether supplementary proof item i is suitable to continue execution in the current process state: ; in, Indicates the feasibility of reaching through the channel. Indicates the availability of verification or human resources. This indicates the state where the dependency relationship is satisfied. This indicates that the current process status allows the execution of this supplementary certification item. This indicates that the case status version, evidence version, and event version are consistent. This indicates that no inconsistencies were found in the feedback from the channel or core system. to These are the weighting coefficients.

[0084] Insufficient Evidence Coefficient Used to characterize the degree to which the evidence corresponding to the supplementary evidence item is insufficient to support the conclusion of cancellation: ; In another specific embodiment, corrections can also be made by combining evidence type, material completeness, field consistency, and case matching results. The system is based on , , Available verification resources State machine status and forced blocking flag Generate action constraints Motion constraints It should include at least one of the following: allowing continued submission of supplementary documents, allowing continued waiting for supplementary documents, allowing verification upgrades, allowing manual review, allowing controlled closure of submissions, allowing automatic cancellation, and prohibiting automatic closure.

[0085] S5. Priority generation for supplementary certification scheduling The system calculates the priority of supplementary certification scheduling based on supplementary certification item-level indicators. : ; in, , , , , and The weights are non-negative. This is used to generate the order of execution for supplementary evidence, the pruning order of candidate sets, or the optimal selection rule for executable sets with the same cost. In this formula, higher values ​​for conclusion reversal impact, feedback probability, risk reduction ratio, evidence validity, and execution feasibility result in higher priority, while higher values ​​for insufficient evidence support coefficient and material acquisition cost result in lower priority.

[0086] The system prioritizes supplementary evidence items with high impact of conclusion reversal, high feedback probability, large risk reduction ratio, strong evidence validity, consistent event version, and low acquisition cost. For supplementary evidence items with abnormal process status, unmet dependencies, unavailable channels, insufficient verification resources, inconsistent event versions, or inconsistent interface receipts, the system lowers their scheduling priority or marks them as currently unexecutable.

[0087] S6. Key executable supplementary evidence set family selection and minimum supplementary evidence set solution In action constraints Under the constraints of dependencies and substitution relationships with supplementary evidence items, the system first filters the current key executable supplementary evidence set family. And then Find the minimum complement set in the middle The dependencies are represented using a directed acyclic graph. This indicates that the substitution relationship adopts the substitution supplementary evidence item group. This indicates that the system performs certain checks before forming an executable set. Perform circular dependency detection. If a circular dependency, alternative group conflict, or dependency and alternative constraints cannot be satisfied simultaneously are detected, trigger a process exception flag or output manual review. This represents a non-empty set of key candidates that satisfy the following criteria: access channels, verification resources, process status, dependencies, substitution relationships, event version consistency, and action constraints. Indicates in The system further selects the set of supplementary evidence items that meet the risk threshold and the requirement to cover necessary supplementary evidence nodes while minimizing the cost of obtaining materials. If any necessary event or version information in the required closing verification request event, closing submission event, closing submission receipt, case status version, or evidence version is missing, the system will not automatically close the submission but will instead trigger a process exception flag or a version receipt exception flag.

[0088] Current key executable supplementary evidence set family It can be represented as: ; in, This indicates that set X is a non-empty set; This indicates that there exists at least one in the set X that is an incomplete key supplementary evidence item, a required supplementary evidence item, or a supplementary evidence item that can substantially change the risk of reopening after closure. This indicates that the corresponding reach channel for set X is available. This indicates that verification or human resources are available. This indicates that the current process status allows for the issuance of supplementary certificates. This indicates that the case status version, evidence version, and process event version are consistent. This indicates that no inconsistencies were found between the channel feedback and the interface closure feedback. This indicates that the dependency relationship is satisfied and there is no circular dependency. This indicates that the substitution relationship is satisfied and the same substitution business element is not counted repeatedly. This indicates that the action constraint allows set X to execute.

[0089] In this embodiment, let Indicates whether candidate supplementary proof item i is selected. The value is either 0 or 1, where 0 indicates that candidate item i was not selected into the supplementary evidence set, and 1 indicates that candidate item i was selected into the supplementary evidence set. The minimum supplementary evidence set can be represented as the following constrained optimization problem: ; ; in, This indicates the expected risk of closing and reopening after the execution of plan X. This indicates the reopening risk threshold that allows automatic shutdown; This indicates the currently available resources for verification and upgrades; This represents the minimum verification resources required for set X; This indicates that the node requiring verification has been covered by X or replaced by a verification upgrade result. If the risk of reopening after the current shutdown exceeds the reopening risk threshold allowed for automatic shutdown, then... Empty, or Not empty but there is no such constraint. Then the system will not send based on The normal supplementary certificate request is processed, and the output is verified upgrade, manual review or blocking closure based on the action constraints; when the risk of reopening after the current closure is not higher than the reopening risk threshold that allows automatic closure, it is not required to solve the non-empty minimum supplementary certificate set, and no normal supplementary certificate request is sent and the closure protection judgment is entered.

[0090] To avoid the risk of repeatedly calculating similar supplementary evidence items, the system calculates by evidence group or risk factor group. Furthermore, for each supplementary certification item in the same group, a maximum of one item can be selected, and a cumulative risk reduction cap or diminishing marginal constraints can be set. Specifically, this can take the following form: ; ; ; Where g represents the evidence group or risk factor group; This represents the percentage reduction in effective risk of set X on group g; This indicates the upper limit of risk reduction for group g; This represents the marginal reduction factor of the supplementary proof term i in the same group; This represents the m-th alternative supplementary item group.

[0091] When multiple executable sets with similar costs exist, the system selects the best option based on factors such as supplementary documentation scheduling priority, execution feasibility, number of customer contacts, human resource consumption, branch office processing capacity, event version stability, and historical success rate of similar cases. If the risk of reopening after current closure exceeds the reopening risk threshold allowed for automatic closure, then... If empty, the system outputs that there is currently no set of critical executable supplementary certificates, and proceeds to verification upgrade, manual review, or blocking closure based on action constraints. Not empty but does not exist that satisfy the risk threshold and the mandatory node coverage constraint. If the system determines that ordinary supplementary evidence is insufficient to meet the conditions for controlled closure of the case, it cannot directly execute the automatic closure action and will output options for verification upgrade, manual review, or blocked closure. This will only be considered if the solution is obtained. Only then will the system follow The supplementary certificate request is sent according to the priority of the supplementary certificate scheduling; otherwise, the supplementary certificate sending step based on the minimum supplementary certificate set is not executed. When the risk of reopening after the current closure is not higher than the reopening risk threshold that allows automatic closure, it is not required to solve for the non-empty minimum supplementary certificate set, and no ordinary supplementary certificate request is sent before entering the closure protection judgment.

[0092] S7, Supplementary Certificate Execution and Event-Driven Rolling Updates When the risk of reopening after current closure is higher than the reopening risk threshold that allows automatic closure, and the minimum supplementary proof set is obtained by solving the problem. The system follows The supplementary certificate request is sent with priority based on the supplementary certificate scheduling; if the risk of reopening after the current closure is higher than the reopening risk threshold that allows automatic closure, then... Empty or no constraint-satisfied The system does not execute the normal supplementary evidence sending steps based on the minimum supplementary evidence set. Instead, it outputs verification upgrade, manual review, or blocking closure based on action constraints. When the risk of reopening after closure is not higher than the reopening risk threshold allowed for automatic closure, it does not require solving for the non-empty minimum supplementary evidence set, does not send a normal supplementary evidence request, and enters the closure protection judgment. Supplementary evidence requests can be sent via SMS, telephone, online claims platform, WeChat, email, manual tasks, voice outbound calls, branch office tasks, or RPA tasks. Each supplementary evidence request records the supplementary evidence item number, case process instance identifier, contact channel, sending time, supplementary evidence processing rules, request content summary, related evidence citations, related event version, and idempotency identifier.

[0093] When a customer, branch office, business system, or manual processing personnel submits supplementary evidence, the system receives the new evidence status result or manual confirmation result and updates the status of the corresponding supplementary evidence item. If the supplementary evidence is valid, the system updates the status of the corresponding supplementary evidence item to "completed"; if the evidence is mismatched, fields conflict, content is unclear, the validity of the evidence does not meet business rules, or it cannot support the cancellation conclusion, the system marks the corresponding supplementary evidence item as invalid or pending review, and may generate new supplementary evidence items requiring secondary confirmation, retransmission of materials, channel outreach for review, or verification upgrade.

[0094] The system continuously updates the candidate set of supplementary evidence items after receiving customer feedback, receiving failure receipts from channels, receiving explicit customer rejection or continued claims, receiving manual task returns, changes in case status, changes in evidence status, completion of verification upgrades, arrival of verification closure requests, or arrival of closure submission events. Status of supplementary evidence items Customer feedback probability Evidence validity coefficient Risk of reopening after current closure Key executable supplementary evidence set family Minimal Supplementary Proof Set and action constraints If the current risk has dropped below the threshold, the system will proceed to disable protection. If there are still critical executable supplementary verification sets, the system will continue to supplement verification or maintain a waiting period for supplementary verification. If ordinary supplementary verification cannot bring the risk to the standard, the system will output verification upgrade, manual review, or blocking shutdown based on action constraints.

[0095] During the supplementary certification scheduling phase, the system uses the expected reopening risk after closure, G_expect(c), to evaluate the expected effect of the planned supplementary certification set. During the closure protection phase, the system does not directly allow closure based on the planned expected value, but instead recalculates the current reopening risk after closure based on the actual supplementary certification status, such as completed, replaced, invalid, pending review, and verification upgrade completed, using the following formula: Gcurrent(c)=G_base(c)×∏_{i∈I_c}[1-E_i×R_i^actual]; Where I_c represents the set of supplementary evidence items included in the risk recalculation before closure; E_i represents the actual completion status indicator of the i-th supplementary evidence item, where E_i=1 when the supplementary evidence item has been completed, and the materials are valid, the case matches, the version is consistent, and the receipt verification is passed; otherwise, E_i=0; R_i^actual represents the relative reopening risk reduction ratio confirmed by the actual status verification. For supplementary evidence items that have been replaced by verification upgrade results, only the supplementary evidence item or verification result that has the replacement effect is counted once; supplementary evidence items that are incomplete, invalid, or pending review are not counted in the risk reduction. Therefore, Gcurrent(c) no longer multiplies the customer feedback probability during the scheduling phase.

[0096] S8, Forced Interception Flag and Cancellation Process State Machine The system generates a mandatory blocking flag based on case status, supplementary evidence status, evidence conflicts, customer objections, regulatory risks, manual notes, process events, status versions, and external system receipts. . The value can be 0 or 1, when At this time, the system prohibits any automatic shutdown actions, including automatic deregistration, automatic withdrawal of cases, and other automatic shutdowns; unless the block is lifted by manual review, the reason for lifting is recorded, and a new shutdown protection judgment version is formed, the controlled shutdown submission shall not be allowed.

[0097] Forced blocking sign Process anomaly flag Abnormal Evidence Markers Repeatedly turn off the activation flag Resource anomaly markers The conclusion lacks supporting markers. Version receipt exception flag At least one of them is obtained through a logical OR operation: ; Process abnormality flag The evidence anomaly flag is triggered when the following occurs: closing the verification before supplementing the verification request, supplementing the verification feedback preceding the supplementing the verification request, skipping preset required nodes, missing closing protection verification, missing closing verification request event, missing closing submission event, missing closing submission receipt, duplicate submission, or submission failure with a changed status or inconsistent result receipt. Triggered when residual evidence conflict exceeds the threshold, key materials are suspected of being inconsistent with the actual situation, materials do not match the case, or the validity of evidence is insufficient but no verification upgrade indicator is generated; repeatedly deactivating the activation indicator. Triggered when the number of repeated shutdowns and reactivations exceeds a threshold within a preset historical sample range; resource anomaly flag. Triggered when verification upgrade resources are unavailable and the risk of reopening a currently closed case exceeds a high-risk threshold; conclusion supports missing flag. Triggered when key supporting evidence for conclusions is missing and not replaced by verified upgrade results; Version receipt anomaly flag. Triggered when there is inconsistency between the case status version, evidence version, process event version, closed submission event, closed verification request event, closed submission receipt, or core system receipt.

[0098] Cancellation Processing State Machine This is used to determine the sequence of events: constraint status access, candidate supplementary evidence construction, indicator calculation, supplementary evidence feasibility constraint generation, supplementary evidence request sending, supplementary evidence feedback reception, rolling updates, protection closure determination, controlled closure submission, result receipt, and trajectory archiving. If necessary events are missing, reversed, duplicated, fail to generate effective feedback, have inconsistent versions, inconsistent receipts, circular dependencies, conflicting alternative groups, or the closure action type does not match the current case status, the system will set the case to a blocked closure or verification upgrade status and record the corresponding forced blocking reason.

[0099] S9, Disable Protection Decision Upon receiving a request to close verification, a change in the status of supplementary evidence feedback, a change in the case status, or a closure submission event, the system executes a closure protection determination. The closure protection determination employs branching logic, rather than relying solely on a single risk threshold or a uniform timeframe as the automatic closure condition.

[0100] The decision to disable protection includes at least the following branches: If If the value is 1, then regardless of whether the risk assessment meets the standard, any automatic shutdown action will be prohibited, and manual review, verification upgrade, or blocking shutdown will be prompted; if... 0, Not higher than , For true, For true and If true, then controlled automatic closure submission is allowed, wherein the controlled automatic closure submission submits automatic cancellation, automatic withdrawal, or other automatic closure results based on the case closure action type; if =0 and Not exceeding the risk threshold that allows automatic shutdown, but , or If any of the above is false, the system will automatically close and output the following options: complete the required nodes, upgrade verification, manual review, or close the system. 0, Higher than and It is not empty, and there exists a condition that satisfies the risk threshold and the mandatory node coverage constraint. If the system automatically shuts down and outputs either "continue to provide supplementary documentation" or "maintain waiting for supplementary documentation," then the process will continue. 0, Higher than , Not empty but there is no constraint satisfying If the output is "verification upgrade, manual review, or blocking closure", then the output will be displayed. 0, Higher than and If empty, the output will be: verification upgrade, manual review, or blocking shutdown.

[0101] Wherein, Gcurrent(c) represents the risk of reopening after the current closure, which is recalculated based on the actual supplementary certification status; This indicates the reopening risk threshold that allows automatic shutdown; MustDoneOrReplaced indicates that the node that must be recertified has either completed the verification or has been replaced by the verification upgrade result. This indicates that the state machine for the cancellation process is complete and no critical event anomalies have been detected. This indicates that the submission event is closed, the verification request is closed, the submission receipt is closed, the case status version, the evidence version, and the core system receipt are consistent. A non-empty value indicates that the current set of critical executable supplementary verification documents is not empty under the constraints of verification resources, process status, dependencies, substitution relationships, event versions, and action constraints. If the closure action type is automatic withdrawal or other automatic closure, It also includes consistency verification between the type of action to close the case and the current status of the case, the reason for cancellation, or the reason for withdrawal.

[0102] The output of the protection closure decision includes automatic cancellation, automatic withdrawal, automatic closure, maintaining pending supplementary documentation, continuing supplementary documentation, verification upgrade, blocking closure, or manual review. The output results are linked to the risk of reopening after closure, the minimum set of supplementary documentation, incomplete key supplementary documentation items, supplementary documentation feasibility constraints, mandatory blocking flag, process state machine event sequence, supplementary documentation request and feedback summary, model or rule version, closure submission receipt, closure action type, and reason for closure protection.

[0103] S10, Controlled Closure Submission, Track Retention and Parameter Reinjection For cases where the closure protection determination allows for automatic cancellation or automatic closure, the system submits the closure result through the claims core system interface, workflow interface, or controlled RPA process. Before submission, the system re-verifies the case status, cancellation reason, customer confirmation materials, mandatory blocking flag, closure protection determination result, process state machine integrity, event version consistency, and interface receipt consistency. After submission, the system reads the receipt to confirm that the case status has been correctly changed to cancelled, withdrawn, or closed.

[0104] The system saves the protection trajectory before and after closure. This trajectory includes at least case status data, evidence status result references, process event sequences, event versions, candidate supplementary evidence item sets, supplementary evidence item-level indicators, supplementary evidence scheduling priority, minimum supplementary evidence set, supplementary evidence requests, supplementary evidence feedback, channel receipts, risk of reopening after current closure, closure protection judgment results, forced blocking flags, state machine verification results, automatic submission receipts, manual intervention records, and parameter versions. This trajectory is used to reconstruct the supplementary evidence scheduling basis, closure protection basis, and blocking basis before automatic closure.

[0105] When a case subsequently undergoes reopening, fails random inspection, fails quality inspection, or requires manual correction, the system feeds the actual results back into the supplementary evidence scheduling parameter database. This updates historical data such as the reopening rate of similar cases, customer feedback probability, evidence validity coefficient, impact value of conclusion reversal, cost of supplementary evidence items, evidence support parameters, risk reduction ceiling, marginal reduction coefficient, event version consistency rules, channel receipt rules, and mandatory blocking rules. This forms a closed loop between supplementary evidence scheduling, closure protection, and subsequent quality feedback.

[0106] Example 3 In this embodiment 3, a risk scheduling and protection system for vehicle insurance claim cancellation and supplementary certificate events is first provided. This system includes: a case status, evidence status result, and process event access module, used to acquire case status data, evidence status results, and process event data for cases to be cancelled, withdrawn, or automatically closed; a cancellation status management module, used to define and manage the states of pending cancellation, supplementary certificate waiting, maintaining supplementary certificate waiting, verification upgrade, prohibited automatic closure, controlled closure submission, automatic closure completed, manual closure, and reopening activation; a candidate supplementary certificate item construction module, used to construct a set of candidate supplementary certificate items; and a supplementary certificate item object modeling module, used to create a supplementary certificate item object for each candidate supplementary certificate item; and a supplementary certificate item object modeling module. The module calculates the following indicators: Material acquisition cost, customer feedback probability, evidence validity coefficient, impact of conclusion reversal, relative risk reduction ratio of reopening, channel reach feasibility, overall execution feasibility, and verification resource requirements. The module generates feasibility constraints for supplementary evidence, including execution feasibility coefficient, evidence insufficiency coefficient, and action constraints. The supplementary evidence scheduling priority module generates scheduling priorities for candidate supplementary evidence items. The key executable set filtering module filters the current key executable supplementary evidence set family. The minimum supplementary evidence set solving module solves for satisfying risk thresholds, verification resources, mandatory supplementary evidence nodes, process status, dependencies, substitution relationships, and event version one. The system includes: a minimum set of supplementary evidence with consistency and action constraints; an evidence group risk reduction module for calculating the expected reopening risk after closure by evidence group or risk factor group, and setting a maximum selection, cumulative risk reduction cap, or marginal reduction constraint for supplementary evidence items in the same group; a supplementary evidence execution and event-driven rolling update module for sending supplementary evidence requests and rolling updates upon customer feedback, channel receipts, manual task returns, verification upgrade completion, case status change, evidence status change, or closure verification request arrival; a mandatory blocking flag generation module for generating mandatory blocking flags to control automatic cancellation or automatic closure; and a cancellation process state machine module for verifying the sequential relationship between cancellation and closure process events. The system includes: document version and interface receipt; a shutdown protection judgment module, used to determine whether automatic cancellation or automatic shutdown is allowed based on the current risk of reopening after shutdown, the completion or replacement status of nodes that must be recertified, the current set of key executable recertification sets, the solution result of the minimum recertification set, the integrity of the process state machine, and the mandatory blocking flag; a controlled shutdown submission module, used to submit the cancellation, withdrawal, or shutdown result when the shutdown protection judgment allows it; a protection trajectory retention module, used to save the recertification scheduling basis, shutdown protection basis, and blocking basis before and after shutdown; and a parameter feedback update module, used to update the recertification scheduling parameters and mandatory blocking rules based on subsequent reopening, sampling failure, quality inspection failure, or manual correction results.

[0107] In this embodiment, the system is first integrated with evidence status results and process events. For example... Figure 1As shown, the system is deployed between the core claims system, external evidence processing service, channel outreach platform, and process processing platform. For cases entering the pending cancellation queue, the system receives the case status, historical progress nodes, submitted materials, and business processing rules output by the core claims system. It also receives the evidence status results output by the external evidence processing service or manual processing node, and receives process events such as requests for supplementary evidence, channel receipts, manual tasks, closure verification requests, and closure submission receipts.

[0108] For example, in a case, the customer feedback summary shows that the customer only indicated that they would supplement the materials later, without explicitly giving up the claim; the system fields show that the repair invoice is missing; historical similar cases show that the reopening rate of such cases with missing invoices is relatively high after closure; at the same time, the channel platform receipt shows that the previous request for supplementary documents was not delivered. Based on this, the system generates three candidate supplementary document items: repair invoice supplementation, customer secondary confirmation, and channel contact review, instead of directly closing the case based on the pending cancellation status.

[0109] For example, if a customer's waiver of claim confirmation can be achieved through any of three methods—online confirmation, telephone confirmation, or paper signature confirmation—the system will record these three as substitutes. Once online confirmation has been effectively obtained, the event version matches the case status version, and the core system's response is normal, the system will not repeatedly contact the customer to request paper signature confirmation, thereby reducing the need for duplicate documentation.

[0110] For solving the problem of supplementary evidence scheduling and finding the minimum supplementary evidence set, such as Figure 2 As shown, the system obtains a baseline closure risk G_base(c) of 0.455 for case c, an automatic closure risk threshold of 0.30, and the current process status allows the request for supplementary evidence to continue. As shown in Table 1, candidate supplementary evidence items include supplementary accident scene photos, supplementary repair invoices, customer waiver of claim confirmation, and channel contact verification.

[0111] Table 1 Additional photos of the accident scene 0.20 0.80 0.90 0.18 yes yes Repair Invoice Supplement 0.30 0.60 0.75 0.12 yes yes Customer waiver of claim confirmation 0.40 0.50 0.70 0.25 yes yes Channel outreach and verification 0.10 0.90 0.95 0.05 no yes If the selection of parallel execution for supplementing accident scene photos and confirming customer waiver of claim is made, and both satisfy constraints regarding reach channels, process status, event version, and dependencies, then the expected risk reduction estimate is as follows: G_expect=0.455*(1-0.80*0.18)*(1-0.50*0.25)=0.341; Since 0.341 is still higher than the threshold of 0.30, the system cannot be automatically deregistered. It should continue to solve other sets or enter the maintenance and supplementary proof waiting phase.

[0112] If all three required supplementary proofs meet the feasibility constraints and are initiated in parallel, then based on the expected risk reduction estimate: G_expect=0.455*(1-0.80*0.18)*(1-0.60*0.12)*(1-0.50*0.25)=0.316; Since 0.316 is still higher than the threshold of 0.30, the system determines that the ordinary supplementary evidence set is insufficient to meet the closure risk threshold and should not directly execute the automatic closure action. Instead, it should output verification upgrade, manual review or blocking closure.

[0113] If the expected reduction ratio of the reopening risk for the customer waiver of claim confirmation is updated from 0.25 to 0.45, then during the scheduling phase, the expected reopening risk after closure for the three sets of supplementary evidence is: G_expect=0.455×(1-0.80×0.18)×(1-0.60×0.12)×(1-0.50×0.45)=0.280; Since 0.280 is lower than the threshold of 0.30, it indicates that the supplementary certification set of the plan meets the expected risk constraints of the scheduling phase, but this expected value is not directly used as the basis for allowing automatic shutdown.

[0114] After the three supplementary evidence requests are received, the system verifies the validity of the materials, the case matching relationship, the event version, and the interface receipt. If all three supplementary evidence requests have been genuinely completed and passed the validity verification, the corresponding actual completion status indicator will be 1. If the relative reopening risk reduction ratio confirmed by the actual status verification is 0.18, 0.12, and 0.45 respectively, the current risk before closure will be recalculated as follows: Gcurrent(c)=0.455×(1-0.18)×(1-0.12)×(1-0.45)=0.181; Since 0.181 is lower than the threshold of 0.30, the system will only allow controlled automatic shutdown when all nodes that must be supplemented with additional certificates have been completed or effectively replaced, the process state machine is normal, the event versions are consistent, the interface receipts are consistent, and the forced blocking flag has not been triggered.

[0115] For event-driven rolling updates following supplementary evidence feedback, after the system sends a secondary confirmation request to the customer, the customer provides confirmation information through the channel platform. External evidence processing services or manual nodes output the content status, vehicle information, and material validity of this confirmation information. The system determines that the confirmation information is consistent with the case vehicle information, clear in content, valid in materials, and that the event version matches the case status version. Therefore, it updates the status of the corresponding supplementary evidence item to "completed" and recalculates Gcurrent(c), Y_c^key, and... And A_c.

[0116] If the feedback content does not match the case, is unclear, the channel receipt is abnormal, or the event version is outdated compared to the current case status version, the system will mark the supplementary evidence item as invalid or pending review, and generate a new material retransmission, secondary confirmation, channel contact review, or manual review supplementary evidence item.

[0117] For the determination of disabling protection, such as Figure 3 As shown, before submitting a closure request or when a closure verification request arrives, the system first checks whether the mandatory blocking flag M_c is 1. If M_c is 1, for example, if the customer expresses an intention to continue the claim, there is a risk of dispute in the case, there is a conflict of key materials, the verification upgrade is not completed, the process state machine detects an anomaly of closing before supplementing evidence, necessary closure events are missing, or interface receipts are inconsistent, then the system will block automatic cancellation, automatic withdrawal of the case, and other automatic closure actions regardless of whether the current risk meets the standard, and will proceed to manual review or verification upgrade.

[0118] If M_c is 0, the system recalculates Gcurrent(c) based on the actual supplementary evidence status and determines whether the required supplementary evidence node has been completed or replaced, whether the process state machine is normal, whether the close submission event is consistent with the case status version, and whether the close action type matches the current case status. Only when the current risk is not higher than the threshold and all the above conditions are met will the system allow controlled close submission. If the current risk is not higher than the threshold but the required node is not completed, the process state machine is abnormal, the submission verification fails, or the close action type does not match, automatic close will still be blocked, and the system will output options for completing the required node, verification upgrade, manual review, or closed blocking. If the current risk does not meet the standard and Y_c^key is not empty, the system further determines whether there is a case that meets the risk threshold. If the evidence exists, continue to obtain supplementary evidence; if it does not exist, upgrade the verification process, conduct manual review, or block and shut down the system.

[0119] For the retention of protection trajectory and parameter reinjection, the system saves the protection trajectory before and after the case is closed, including candidate supplementary evidence items, supplementary evidence item level indicators, supplementary evidence scheduling priority, key executable supplementary evidence set family, minimum supplementary evidence set, supplementary evidence request and feedback, channel receipt, protection closure judgment, forced blocking flag, process state machine event sequence, event version, submission receipt and manual intervention record.

[0120] After a case is closed, if it is subsequently reopened, the system will feed the actual results back into the supplementary evidence scheduling parameter database. For example, if multiple similar cases are reopened due to insufficient online confirmation in a single instance, the system will lower the evidence validity coefficient of that type of supplementary confirmation item or increase the weight of the mandatory blocking rule for that scenario. This will make the system more inclined to request supplementary paper signature confirmation, telephone confirmation, or manual review in subsequent similar cases.

[0121] In summary, the method for risk scheduling and protection of auto insurance claim cancellation and supplementary evidence events provided in this embodiment of the invention obtains case status data, evidence status results, and process event data of cases to be cancelled, withdrawn, or automatically closed; constructs a set of candidate supplementary evidence items based on missing evidence, key field conflicts, material validity pending review, uncertain reasons for cancellation, historical reasons for similar reopening, abnormal process nodes, failed channel access, and incomplete key matters found in the closure verification request; establishes a supplementary evidence item object for each candidate supplementary evidence item, including triggering reason, channel, processing rules, dependency relationship, substitution relationship, mandatory supplementary evidence identifier, key supplementary evidence identifier, evidence group identifier, and event reference; calculates material acquisition cost, customer feedback probability, evidence validity coefficient, conclusion reversal impact value, relative reopening risk reduction ratio, channel access feasibility, and comprehensive execution feasibility; and generates supplementary evidence feasibility constraints. The system prioritizes and filters the current key executable supplementary evidence sets, finding the minimum supplementary evidence set that satisfies the risk threshold for reopening after closure, verification resources, mandatory supplementary evidence nodes, process status, dependencies, substitution relationships, event version consistency, and interface receipt consistency. It continuously updates the status of supplementary evidence items, the current risk of reopening after closure, the key executable supplementary evidence set family, the minimum supplementary evidence set, and action constraints after customer feedback, channel receipts, manual task returns, case status changes, evidence status changes, verification upgrade completion, closure verification requests, or closure submission events. Before closure, it recalculates the current risk of reopening after closure based on the actual supplementary evidence status, and combines the completion or substitution status of mandatory supplementary evidence nodes, the key executable supplementary evidence set family, the minimum supplementary evidence set solution results, process state machine integrity, event version consistency, interface receipt consistency, and mandatory blocking flags to execute closure protection judgments. This invention does not rely on a general special case review intelligent agent, privacy protection heterogeneous data fusion, or general review action planning as its core protection, nor does it depend on a unified time caliber or unified node field. Instead, it forms a business closed loop for the supplementary certificate scheduling and protection before cancellation and closure, thereby reducing the risk of accidental closure when key supplementary certificate items are still executable or when process events are abnormal, and reducing the risk of reopening, objection, and spot checks.

[0122] While the specific embodiments of the present invention have been described above in conjunction with the accompanying drawings, this is not intended to limit the scope of protection of the present invention. Those skilled in the art should understand that, based on the technical solutions disclosed in the present invention, various modifications or variations that can be made by those skilled in the art without creative effort should be included within the scope of protection of the present invention.

Claims

1. A method for risk scheduling and protection in vehicle insurance claim cancellation and certificate replacement events, characterized in that, include: Obtain case status data, evidence status results, and process event data for auto insurance claims that are pending cancellation, withdrawal, or automatic closure, and construct a set of candidate supplementary evidence items; For each candidate supplementary evidence item, calculate the material acquisition cost, customer feedback probability, evidence validity coefficient, conclusion reversal impact value, relative reopening risk reduction ratio, channel reach feasibility, comprehensive execution feasibility, and verification resource requirements, and calculate the reopening risk after current closure. Based on the supplementary evidence processing rules, current case status, customer feedback probability, channel reach feasibility, evidence validity, verification upgrade resources, process event version, state machine status, and interface receipt, supplementary evidence feasibility constraints are generated, and action constraints are generated based on the supplementary evidence feasibility constraints. The supplementary evidence scheduling priority is generated based on the material acquisition cost of the candidate supplementary evidence items, the probability of customer feedback, the evidence validity coefficient, the impact value of conclusion reversal, the proportion of relative reopening risk reduction, and the overall execution feasibility. Under the action constraints, filter the current set of key executable supplementary evidence, and solve for the minimum supplementary evidence set in the current set of key executable supplementary evidence; If the risk of reopening after closure is higher than the risk threshold for automatic closure and the minimum supplementary evidence set is obtained, then a supplementary evidence request is sent according to the minimum supplementary evidence set and the supplementary evidence scheduling priority. If the risk of reopening after closure is higher than the risk threshold for automatic closure and no minimum supplementary evidence set that satisfies the constraints is obtained, then the supplementary evidence sending step based on the minimum supplementary evidence set is not executed, and verification upgrade, manual review, or blocking closure is output. If the risk of reopening after closure is higher than the risk threshold for automatic closure and the current key executable supplementary evidence set family is empty, then the supplementary evidence sending step based on the minimum supplementary evidence set is not executed, and verification upgrade, manual review, or blocking closure is output. If the risk of reopening after closure is not higher than the risk threshold for automatic closure, then no supplementary evidence request is sent, and the closure protection determination is entered.

2. The method for risk scheduling and protection of vehicle insurance claim cancellation and certificate replacement events according to claim 1, characterized in that, The constraints on the feasibility of supplementary evidence include a comprehensive execution feasibility coefficient and an evidence insufficiency coefficient. The comprehensive execution feasibility coefficient is determined based on the customer feedback probability, channel reach feasibility, dependency satisfaction status, verification resource status, current process status, event version consistency, and interface receipt consistency of the candidate supplementary evidence item, and each input indicator is normalized to the range of 0 to 1. The evidence insufficiency coefficient is determined based on the validity coefficient of the evidence corresponding to the supplementary evidence item, material completeness, field consistency, and case matching results.

3. The method for risk scheduling and protection of vehicle insurance claim cancellation and certificate replacement events according to claim 1, characterized in that, The rolling update after the feedback of supplementary evidence includes: when the supplementary evidence is valid and the event version is consistent with the case status version, the status of the corresponding candidate supplementary evidence item will be updated to completed; when the supplementary evidence does not match, the fields conflict, the content is unclear, the validity of the materials does not meet the business rules, it cannot support the cancellation conclusion, the channel receipt is abnormal, or the event version is inconsistent, the corresponding candidate supplementary evidence item will be marked as invalid or pending review, and a new supplementary evidence item will be generated for secondary confirmation, material retransmission, channel contact review, manual review, or verification upgrade.

4. The method for risk scheduling and protection of vehicle insurance claim cancellation and certificate replacement events according to claim 1, characterized in that, The forced blocking flag is obtained by a logical OR operation from at least one of the following: process abnormality flag, evidence abnormality flag, repeated closure and activation flag, resource abnormality flag, conclusion support missing flag, and version receipt abnormality flag.

5. The method for risk scheduling and protection of vehicle insurance claim cancellation and certificate replacement events according to claim 4, characterized in that, The process anomaly flag is triggered when the following occurs: closing the case before obtaining a replacement certificate; the replacement certificate feedback precedes the replacement certificate request; a preset required node is skipped; the closure verification request is missing; the closure protection verification is missing; the closure submission event is missing; the closure result receipt is missing; duplicate submission; submission fails but the case status has changed; the closure action type is inconsistent with the current case status; or the event version or result receipt is inconsistent.

6. The method for risk scheduling and protection of vehicle insurance claim cancellation and certificate replacement events according to claim 1, characterized in that, The closure protection judgment includes: when a mandatory blocking flag is triggered, automatic closure, automatic case withdrawal, and other automatic closure actions are prohibited, and verification upgrade, manual review, or closure blocking is output; when no mandatory blocking flag is triggered, the risk of reopening after the current closure is not higher than the risk threshold for allowing automatic closure, the required supplementary evidence node has been completed or replaced by the verification upgrade result, the process state machine is complete, and the closure submission verification passes, controlled closure submission is allowed; when no mandatory blocking flag is triggered and the risk of reopening after the current closure is not higher than the risk threshold for allowing automatic closure, but the required supplementary evidence node is not completed and has not been replaced, the process state machine is incomplete, the closure submission verification fails, or the closure action type is inconsistent with the current status of the case, automatic closure is blocked, and the required supplementary evidence node is output. The system outputs options for verification upgrade, manual review, or blocking closure. When no mandatory blocking flag is triggered, the risk of reopening after current closure exceeds the risk threshold for automatic closure, the current key executable supplementary evidence set is not empty, and there exists a minimum supplementary evidence set that satisfies the constraints, the system blocks automatic closure and continues supplementary evidence processing or maintains a supplementary evidence waiting state. When no mandatory blocking flag is triggered, the risk of reopening after current closure exceeds the risk threshold for automatic closure, and the current key executable supplementary evidence set is empty, the system outputs options for verification upgrade, manual review, or blocking closure. When no mandatory blocking flag is triggered, the risk of reopening after current closure exceeds the risk threshold for automatic closure, the current key executable supplementary evidence set is not empty, but there does not exist a minimum supplementary evidence set that satisfies the constraints, the system outputs options for verification upgrade, manual review, or blocking closure.

7. The method for risk scheduling and protection of vehicle insurance claim cancellation and certificate replacement events according to claim 1, characterized in that, During the supplementary certification scheduling phase, the expected closure and reopening risk assessment plan supplementary certification set is used. During the closure protection phase, the current closure and reopening risk is recalculated based on the actual supplementary certification status of completed, replaced, invalid, pending review, and verified upgrade completed. The recalculated current closure and reopening risk is used as the input for closure protection judgment.

8. The method for risk scheduling and protection of vehicle insurance claim cancellation and certificate replacement events according to claim 1, characterized in that, The protection trajectory includes at least one of the following: case status data, evidence status result reference, process event sequence, event version, candidate supplementary evidence item set, supplementary evidence item level indicator, supplementary evidence scheduling priority, key executable supplementary evidence set family, minimum supplementary evidence set, supplementary evidence request, supplementary evidence feedback, channel receipt, risk of reopening after current closure, closure protection judgment result, forced blocking flag, process state machine event sequence, automatic submission receipt, manual intervention record, and parameter version.

9. The method for risk scheduling and protection of vehicle insurance claim cancellation and certificate replacement events according to claim 1, characterized in that, When a case is subsequently reopened, fails random inspection, fails quality inspection, or requires manual correction, the system will feed the actual results back into the supplementary evidence scheduling parameter library to update the historical reopening rate of similar cases, customer feedback probability, evidence validity coefficient, conclusion reversal impact value, supplementary evidence item cost, evidence support parameters, risk reduction upper limit, marginal reduction coefficient, event version consistency rules, channel receipt rules, and mandatory blocking rules.

10. A risk scheduling and protection system for vehicle insurance claim cancellation and certificate replacement events, characterized in that, include: The case status, evidence status results, and process event access module is used to obtain case status data, evidence status results, and process event data for auto insurance claims that are pending cancellation, withdrawal, or automatic closure, and to construct a set of candidate supplementary evidence items. The supplementary evidence item indicator calculation module is used to calculate the material acquisition cost, customer feedback probability, evidence validity coefficient, conclusion reversal impact value, relative reopening risk reduction ratio, channel reach feasibility, comprehensive execution feasibility and verification resource requirements for each candidate supplementary evidence item, and calculate the reopening risk after current closure. The supplementary evidence feasibility constraint generation module is used to generate supplementary evidence feasibility constraints based on the supplementary evidence item processing rules, current case status, customer feedback probability, channel reach feasibility, evidence validity, verification upgrade resources, process event version, state machine status, and interface receipt, and to generate action constraints based on the supplementary evidence feasibility constraints. The supplementary evidence scheduling priority module is used to generate supplementary evidence scheduling priorities based on the material acquisition cost of the candidate supplementary evidence items, the probability of customer feedback, the evidence validity coefficient, the impact value of conclusion reversal, the proportion of relative reopening risk reduction, and the overall execution feasibility. The minimum supplementary evidence set solving module is used to filter the current key executable supplementary evidence set family under the action constraints, and solve the minimum supplementary evidence set in the current key executable supplementary evidence set family; The shutdown protection judgment module is used to: if the risk of reopening after current shutdown is higher than the risk threshold for automatic shutdown and the minimum supplementary evidence set has been obtained, then send a supplementary evidence request according to the minimum supplementary evidence set and the supplementary evidence scheduling priority; if the risk of reopening after current shutdown is higher than the risk threshold for automatic shutdown and no minimum supplementary evidence set satisfying the constraints has been obtained, then do not execute the supplementary evidence sending step based on the minimum supplementary evidence set, and output verification upgrade, manual review, or blocking shutdown; if the risk of reopening after current shutdown is higher than the risk threshold for automatic shutdown and the current key executable supplementary evidence set family is empty, then do not execute the supplementary evidence sending step based on the minimum supplementary evidence set, and output verification upgrade, manual review, or blocking shutdown; if the risk of reopening after current shutdown is not higher than the risk threshold for automatic shutdown, then do not send a supplementary evidence request, and enter the shutdown protection judgment.

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