Method and system for providing customized content based on analysis of indemnity insurance claim data and medical information

Abstract

The present invention relates to a method for providing customized content based on the analysis of indemnity insurance claim data and medical information, comprising the steps of: a user terminal executing a dedicated application and inputting personal identification information and requesting an insurance claim from a cloud server; the cloud server requesting a hospital server to verify a medical history; the hospital server verifying medical data corresponding to the medical history and transmitting the medical data to the cloud server; and the cloud server analyzing disease codes based on the medical data.

Description

Technology Field

[0001] The present invention relates to a method and system for providing customized content based on the analysis of medical indemnity insurance claim data and medical information, which can analyze disease codes using a patient's hospital treatment data and medical indemnity insurance claim history, and can provide patient-customized guides and content by combining disease codes and health examination data. Background Technology

[0003] As the aging society continues, people's interest in quality of life and healthy eating habits is growing. This increased interest is not only driving the growth of the health functional food market but also leading to an increase in the number of people striving for self-care through regular exercise. Consequently, apps have emerged that provide daily calorie intake based on inputted height, weight, and muscle mass, as well as apps that display exercise videos tailored to a user's physical condition upon inputting it.

[0004] However, since calorie and exercise videos are recommended based solely on physical information or condition, it cannot be considered truly personalized. If a user is physically healthy but genetically unsuitable for certain foods, or if they are recommended exercises that strain their joints despite having joint problems, their condition may actually worsen. Therefore, by merging and analyzing a user's insurance claim history, medical records, health checkup data, and genetic data, and providing personalized health content based on the analysis results, it would be possible to assist in their treatment recovery and improve their healthy lifestyle.

[0005] Prior art includes Korean Patent Publication No. 10-2016-0063850 (Insurance service system and method providing health services), but it merely includes a database unit that stores information on sports centers, customer information and subscribed insurance information, customer exercise result information, customer hospital usage information and insurance product information, and a server that searches for and provides available sports centers near the customer when customer information subscribed to insurance is input from an operator terminal, and reflects the exercise result in the insurance rate at the time of insurance renewal when the customer's exercise result information is received from the sports center terminal. The problem to be solved

[0007] The problem that the present invention aims to solve is to provide a method and system for providing customized content based on the analysis of indemnity insurance claim data and medical information, which can provide personalized health content tailored to a patient's constitution by merging medical biometric information and genomic analysis information obtained through a patient's insurance claim history, and which can help improve the patient's treatment recovery and healthy lifestyle through the health content. means of solving the problem

[0009] The present invention relates to a method for providing customized content based on the analysis of indemnity insurance claim data and medical information, comprising the steps of: a user terminal executing a dedicated application and inputting personal identification information and requesting an insurance claim from a cloud server; the cloud server requesting a hospital server to verify a medical history; the hospital server verifying medical data corresponding to the medical history and transmitting the medical data to the cloud server; and the cloud server analyzing disease codes based on the medical data.

[0010] A system for providing customized content based on the analysis of medical information and actual loss insurance claim data according to an embodiment of the present invention includes a user terminal that requests an insurance claim from a cloud server, transmits consent for the use of personal information to the cloud server, and receives insurance payment results and customized health content from the cloud server, and a hospital server that requests verification of medical history to receive medical data, analyzes disease codes based on the medical data, generates an automatic actual loss insurance claim form, transmits the automatic actual loss insurance claim form to an insurance company server, requests completion of the insurance claim and consent for the use of personal information from the user terminal, maps customized health content based on the analysis of insurance claim history and disease codes, and transmits insurance payment results and customized health content to the user terminal. Effects of the invention

[0011] According to the present invention, disease codes can be analyzed using a patient's hospital medical data.

[0012] In addition, various customized health content can be provided by analyzing disease codes based on patients' insurance claim history.

[0013] In addition, health content can help improve patients' treatment recovery and healthy lifestyles. Brief explanation of the drawing

[0015] FIG. 1 is a flowchart illustrating a method for providing customized content based on the analysis of actual loss insurance claim data and medical information according to an embodiment of the present invention. FIG. 2 is a flowchart illustrating a method for providing customized content based on the analysis of actual loss insurance claim data and medical information according to another embodiment of the present invention. FIG. 3 is a configuration diagram illustrating a customized content provision system based on the analysis of actual loss insurance claim data and medical information according to an embodiment of the present invention. Specific details for implementing the invention

[0016] Specific structural or functional descriptions of embodiments according to the concept of the present invention disclosed herein are provided merely for the purpose of explaining embodiments according to the concept of the present invention, and embodiments according to the concept of the present invention may be implemented in various forms and are not limited to the embodiments described herein.

[0017] Embodiments according to the concept of the present invention may be subject to various modifications and may take various forms; therefore, embodiments are illustrated in the drawings and described in detail in this specification. However, this is not intended to limit the embodiments according to the concept of the present invention to specific disclosed forms, and includes all modifications, equivalents, or substitutions that fall within the spirit and scope of the present invention.

[0018] The terms used herein are used merely to describe specific embodiments and are not intended to limit the invention. Singular expressions include plural expressions unless the context clearly indicates otherwise. In this specification, terms such as "comprising" or "having" are intended to indicate the existence of the features, numbers, steps, actions, components, parts, or combinations thereof described herein, and should be understood as not precluding the existence or addition of one or more other features, numbers, steps, actions, components, parts, or combinations thereof.

[0019] Hereinafter, embodiments of the present invention will be described in detail with reference to the drawings attached to this specification.

[0021] FIG. 1 is a flowchart illustrating a method for providing customized content based on the analysis of actual loss insurance claim data and medical information according to an embodiment of the present invention.

[0022] FIG. 1 is a flowchart illustrating a method for providing customized content based on the analysis of actual loss insurance claim data and medical information according to another embodiment of the present invention.

[0023] Referring to FIG. 1, the user terminal (100) executes a dedicated application and inputs personal identification information (S101), and requests an insurance claim from the cloud server (200) (S103). The dedicated application is software implemented to enable claims for medical indemnity insurance, and in addition to conventional medical indemnity insurance claims, if an automatic medical indemnity claim service is applied for, medical indemnity insurance can be claimed automatically after treatment, and if user consent is given, customized health content can be mapped using the user's medical information and provided to the user terminal (100).

[0024] The cloud server (200) requests the hospital server (300) to verify the medical history (S105), the hospital server (300) verifies the medical data corresponding to the medical history (S107), and transmits the medical data to the cloud server (200) (S109). The cloud server (200) analyzes the disease code based on the medical data (S111). The disease code is a disease classification code, which refers to a code in which a symbol is attached using an alphabet and a number after classifying diseases by type.

[0025] The cloud server (200) generates an automatic claim form for indemnity insurance (S113) and selects an insurance company to submit it (S115). The cloud server (200) can generate an automatic claim form for indemnity insurance for all medical history eligible for automatic indemnity insurance claims by analyzing medical data. The cloud server (200) transmits the automatic claim form for indemnity insurance to the insurance company server (300) (S117), the insurance company server (400) transmits the completion of the insurance claim to the cloud server (200) (S119), and the cloud server (200) transmits the completion of the insurance claim to the user terminal (100) and requests consent for the use of personal information (S121). The above consent for the use of personal information may be consent to receive a customized health content program for each user (patient) using the user (patient)'s disease, medical, health, and insurance claim data.

[0026] The user terminal (100) transmits consent for the use of personal information to the cloud server (200) (S123), and the cloud server (200) analyzes the insurance claim history (S125). The cloud server (200) analyzes at least one insurance claim and insurance claim history of the user that is stored in advance to identify and store at least one of the following: the medical department and disease name for which the user is continuously receiving treatment, the medical department and disease name for which treatment has been completed and is no longer being received, the medical department and disease name for which new treatment has started, the frequency of hospital visits, and the correlation between medical departments or diseases where the timing of treatment overlaps by comparing at least two insurance claims. Additionally, the cloud server (200) can extract a disease code by analyzing at least one insurance claim and insurance claim history of the user that is stored in advance. The cloud server (200) maps customized health content based on the analysis of the insurance claim history and the disease code (S127). The insurance company server (400) reviews the payment of insurance benefits (S129) and transmits the completion of the payment of insurance benefits to the cloud server (200) (S131). The cloud server (200) transmits the payment of insurance benefits result and customized health content to the user terminal (100) (S133).

[0028] FIG. 2 is a flowchart illustrating a method for providing customized content based on the analysis of actual loss insurance claim data and medical information according to another embodiment of the present invention.

[0029] Referring to FIG. 2, the user terminal (100) executes a dedicated application and inputs personal identification information (S201), and requests health information from the cloud server (200) (S203). The health information may include medical data and examination data.

[0030] The cloud server (200) receives a request for health information, analyzes medical data (S205), and requests the examination results from the hospital server (300) (S207). The medical data may include at least one of medical data regarding treatment previously received by the user (patient) and examination data regarding examinations previously received, but is not necessarily limited thereto. The hospital server (300) verifies the examination data corresponding to the examination results (S209) and transmits the examination data to the cloud server (200) (S211). The examination data may be data corresponding to the examination results and may include at least one of blood test results, genetic information, genomic information, skin condition, and bone density degree, but is not necessarily limited thereto. The cloud server (200) transmits health information including medical data and examination data to the user terminal (100) (S213).

[0031] The user terminal (100) checks health information and generates health data by combining the PGHD received from the user with the health information (S215). At this time, PGHD stands for Patient-Generated Health Data and refers to medical data measured outside of a hospital. PGHD is all health-related data generated, recorded, and collected by the patient or the patient's guardian. It involves the patient or the patient's guardian directly recording information that could not be measured at the hospital, and the user terminal (100) may receive at least one of the patient's medication records, lifestyle patterns, medical history, blood pressure status, and pulse status as PGHD from the user. The user can check the above health data through the user terminal (100) and, if necessary, receive medical treatment at a hospital or receive remote medical treatment. After the treatment is finished, the user terminal (100) requests an insurance claim from the cloud server (200) (S217).

[0032] The cloud server (200) requests the hospital server (300) to verify the medical history (S219), the hospital server (300) verifies the medical data corresponding to the medical history (S221), and transmits the medical data to the cloud server (200) (S223). The cloud server (200) analyzes the disease code based on the medical data (S225). The disease code is a disease classification code, which refers to a code in which a symbol is attached using an alphabet and a number after classifying diseases by type.

[0033] The cloud server (200) generates an automatic claim form for indemnity insurance (S227) and selects an insurance company to submit it (S229). The cloud server (200) can generate an automatic claim form for indemnity insurance for all medical history eligible for automatic indemnity insurance claims by analyzing medical data. The cloud server (200) transmits the automatic claim form for indemnity insurance to the insurance company server (300) (S231), and the cloud server (200) analyzes the insurance claim history (S233). The cloud server (200) can analyze at least one insurance claim form and insurance claim history of a user that is stored in advance to identify and store at least one of the following: the medical department and disease name for which the user is continuously receiving treatment, the medical department and disease name for which treatment has been completed and is no longer being received, the medical department and disease name for which new treatment has started, the frequency of hospital visits, and the correlation between at least two insurance claims and the medical department or disease with overlapping treatment times. In addition, the cloud server (200) can extract a disease code by analyzing at least one insurance claim and insurance claim history of a user that is stored in advance.

[0034] The cloud server (200) requests health data from the user terminal (100) (S235), and the user terminal (100) transmits the health data to the cloud server (200) (S237). The cloud server (200) analyzes the health data and disease codes to generate merged data (S239). Additionally, the cloud server (200) can generate merged data by analyzing not only the health data and disease codes but also at least one medical biological age among obesity body age, healthy lifestyle age, skin age, and bone age identified through medical data, along with the disease risk level. The insurance company server (400) transmits the completion of the insurance claim to the cloud server (200) (S241), and the cloud server (200) transmits the completion of the insurance claim to the user terminal (100) and requests consent for the use of personal information (S243). The above use of personal information may be consent to receive customized health content programs for each user (patient) using the user's (patient's) disease, medical, health, and insurance claim data.

[0035] The user terminal (100) transmits consent for the use of personal information to the cloud server (200) (S245), and the cloud server (200) maps customized health content based on the insurance claim history analysis and merged data (S247). The merged data includes at least one of the user (patient)'s previous medical data, previous examination data, added examination data, PGHD received from the user, added treatment data, and disease codes analyzed based on treatment data. When the cloud server (200) maps customized health content, the merged data includes past medical information such as the user (patient)'s previous medical data and previous examination data, and since past medical information can be double-checked through the insurance claim history, the user (patient)'s medical information is accumulated, making it suitable for recommending health content customized to the user. The insurance company server (400) reviews the payment of insurance benefits (S249) and transmits the completion of the payment of insurance benefits to the cloud server (200) (S251). The cloud server (200) delivers the insurance payout result and customized health content to the user terminal (100) (S253).

[0037] FIG. 3 is a configuration diagram illustrating a customized content provision system based on the analysis of actual loss insurance claim data and medical information according to an embodiment of the present invention.

[0038] Referring to FIG. 3, the customized content provision system (10) based on the analysis of actual loss insurance claim data and medical information consists of a user terminal (100), a cloud server (200), a hospital server (300), and an insurance company server (400).

[0039] The user terminal (100) can execute a dedicated application, input personal identification information, and request health information from the cloud server (200). The health information may include medical data and examination data. The dedicated application is software implemented to enable claims for indemnity medical insurance. In addition to conventional indemnity medical insurance claims, if an automatic indemnity claim service is applied for, indemnity medical insurance can be claimed automatically after treatment. Furthermore, if user consent is obtained, the software is implemented to map customized health content using the user's medical information and provide it to the user terminal (100). The personal identification information is data for application user authentication, verifying patient information from the hospital server, and checking treatment history to make follow-up appointments. Although the present invention is described as an embodiment equipped with a patient-only application, it can also be implemented in the form of a messenger-based notification message rather than a patient-only application. The personal identification information may include at least one of the insurance company, insurance type, and insurance name, which are information regarding the insurance subscribed to by the user.

[0040] The user terminal (100) can receive health information, including medical data and examination data, from the cloud server (100). The user terminal (100) can check the received health information and receive PGHD input from the user. The user terminal (100) can combine the health information and PGHD to generate health data. At this time, PGHD stands for Patient-Generated Health Data and refers to medical data measured outside of a hospital. PGHD is all health-related data generated, recorded, and collected by the patient or the patient's guardian. It is information that could not be measured at the hospital, which is directly recorded by the patient or the patient's guardian. The user terminal (100) can receive at least one of the patient's medication intake records, lifestyle patterns, medical history, blood pressure status, and pulse status as PGHD input from the user. The user can check the above health data through the user terminal (100) and, if necessary, receive medical treatment at a hospital or receive remote medical treatment. After medical treatment is completed, the user terminal (100) may request an insurance claim from the cloud server (200). When the user terminal (100) receives a request for health data from the cloud server (200), it may transmit the health data. When the user terminal (100) receives a request for the completion of the insurance claim and consent to the use of personal information from the cloud server (200), it may transmit the consent to the use of personal information to the cloud server (200). The above consent to the use of personal information may be consent to receive a customized health content program for each user (patient) using the user (patient)'s disease, medical, health, and insurance claim data. The user terminal (100) may receive the insurance payment results and customized health content from the cloud server (200).

[0041] The user terminal (100) is a device that is connected to a cloud server (200) through a network, and may be, for example, a smartphone, smart pad, tablet PC, etc., and may be any type of wireless communication device such as a PCS (Personal Communication System), GSM (Global System for Mobile communication), PDC (Personal Digital Cellular), PHS (Personal Handyphone System), PDA (Personal Digital Assistant), IMT (International Mobile Telecommunication)-2000, CDMA (Code Division Multiple Access)-2000, W-CDMA (W-Code Division Multiple Access), Wibro (Wireless Broadband Internet) terminal, and a fixed terminal such as a desktop computer, smart TV.

[0042] Examples of networks for sharing information between a user terminal (100) and a cloud server (200) may include, but are not limited to, a 3GPP (3rd Generation Partnership Project) network, an LTE (Long Term Evolution) network, a 5G network, a WIMAX (World Interoperability for Microwave Access) network, a wired / wireless Internet (Internet), a LAN (Local Area Network), a Wireless LAN (Wireless Local Area Network), a WAN (Wide Area Network), a PAN (Personal Area Network), a Bluetooth network, a Wi-Fi network, a NFC (Near Field Communication) network, a satellite broadcasting network, an analog broadcasting network, a DMB (Digital Multimedia Broadcasting) network, etc.

[0043] The cloud server (200) is composed of a health information management unit (210), a medical data management unit (220), an insurance claim management unit (230), a data analysis unit (240), a health content mapping unit (250), a storage unit (260), and a communication unit (270).

[0044] The above health information management unit (210) is composed of a medical data management module (211) and a medical examination data management module (212). When the medical data management module (211) receives personal identification information and a corresponding health information request from a user terminal (100), it can search for and find medical data corresponding to the personal identification information that is already stored in the storage unit (260). The medical data may include at least one of medical data regarding treatment previously received by the user (patient) and medical examination data regarding medical examinations previously received, but is not necessarily limited thereto. The medical examination may refer not only to regular health checkups but also to all tests received by the user (patient) at a hospital.

[0045] When the examination data management module (212) receives a request for personal identification information and corresponding health information from the user terminal (100), it may request the examination results corresponding to the personal identification information from the hospital server (300). The examination data management module (212) may receive examination data from the hospital server (300) and store it in the storage unit (260). The examination data may be data corresponding to the examination results and may include at least one of blood test results, genetic information, genomic information, skin condition, and bone density, but is not necessarily limited thereto. The examination data management module (212) may combine the medical data corresponding to the personal identification information found by the medical data management module (211) in the storage unit (260) with the examination data to generate health information and transmit the health information to the user terminal (100).

[0046] When the above medical data management unit (220) receives an insurance claim request along with personal identification information from the user terminal (100), it may request the hospital server (300) to verify the medical history. The medical data management unit (220) may receive and store medical data corresponding to the medical history from the hospital server (300).

[0047] The above insurance claim management unit (230) can generate an automatic indemnity insurance claim form based on the above medical data. The insurance claim management unit (230) can analyze the medical data to generate an automatic indemnity insurance claim form for all medical history eligible for automatic indemnity insurance claims. Once the generation of the automatic indemnity insurance claim form is complete, the insurance claim management unit (230) can select an insurance company to receive the claim and transmit the automatic indemnity insurance claim form to the insurance company server (400). When the insurance claim management unit (230) receives the completion of the insurance claim from the insurance company server (400), it can transmit the completion of the insurance claim to the user terminal (100) and request consent for the use of personal information. The above use of personal information may be consent to receive a customized health content program for each user (patient) using the user (patient)'s disease, medical, health, and insurance claim data. When the insurance claim management department (230) receives the completion of insurance payment from the insurance company server (400), it can transmit the result of the insurance payment to the user terminal (100).

[0048] The above data analysis unit (240) can analyze received and stored data and is composed of a medical data analysis module (241), an insurance claim history analysis module (242), and a health data analysis module (243).

[0049] The medical data analysis module (241) can analyze disease codes based on medical data. The disease code is a disease classification code, which refers to a code in which a symbol is assigned using an alphabet and a number after classifying diseases by type. In one embodiment, if 'E23.0' is included in the medical data, the medical data analysis module (241) can analyze it as a disease of 'pituitary hypofunction'. In another embodiment, if 'Q33.6' is included in the medical data, the medical data analysis module (241) can analyze it as a disease of 'lung hypoplasia and dysplasia'. In yet another embodiment, if the medical data contains content regarding a disease of 'lung hypoplasia and dysplasia', the medical data analysis module (241) can analyze it as the disease code 'Q33.6'. Additionally, the medical data analysis module (241) can analyze at least one medical biological age among obesity body type age, healthy lifestyle age, skin age, and bone age based on medical data. Additionally, the medical data analysis module (241) can analyze disease risk based on medical data.

[0050] The insurance claim history analysis module (242) can analyze the insurance claim history of a user (patient) stored in the storage unit (260). The insurance claim history analysis module (242) can analyze at least one insurance claim and insurance claim history of the user that is stored in advance to identify and store at least one of the following: the medical department and disease name for which the user is continuously receiving treatment, the medical department and disease name for which treatment has been completed and is no longer being received, the medical department and disease name for which new treatment has started, the frequency of hospital visits, and the correlation between medical departments or diseases where the timing of treatment overlaps by comparing at least two insurance claims. Additionally, the insurance claim history analysis module (242) can extract a disease code by analyzing at least one insurance claim and insurance claim history of the user that is stored in advance.

[0051] The health data analysis module (243) can request health data from the user terminal (100) and receive health data. The health data may include health information and PGHD. In this case, PGHD is medical data measured outside of a hospital and is all health-related data generated, recorded, or collected by the patient or the patient's guardian. Therefore, the health data may include PGHD containing at least one of the patient's medication intake record, lifestyle pattern, medical history, blood pressure status, and pulse status received from the patient or the patient's guardian, medical data including medical data regarding treatment previously received by the user (patient) and examination data regarding examinations previously received, and examination data. The health data analysis module (243) can generate merged data by analyzing the health data and disease codes. In addition, the health data analysis module (243) can generate merged data by analyzing at least one medical biological age among obesity body age, healthy lifestyle age, skin age, and bone age identified through the above health data and disease codes as well as medical data, and the disease risk.

[0052] When the above health content mapping unit (250) receives consent for the use of personal information from the user terminal (100), it can map customized health content based on the insurance claim history analysis content analyzed by the insurance claim history analysis module (242) and the disease code analyzed by the medical data analysis module (241). At this time, the insurance claim history analysis content may include content regarding disease codes analyzed based on insurance claim history, and the health content mapping unit (250) can map customized health content based on at least one disease code among the disease code analyzed by the insurance claim history analysis module (242) and the disease code analyzed by the medical data analysis module (241). In one embodiment, if the disease code analyzed by the medical data analysis module (241) is 'K05', the health content mapping unit (250) can map health content such as food and exercise that is good for gingivitis and periodontal disease. In another embodiment, if the disease code analyzed by the insurance claim history analysis module (242) is 'D55', the health content mapping unit (250) can map health content such as food and exercise to resolve anemia caused by enzyme deficiency.

[0053] Additionally, the health content mapping unit (250) can map customized health content based on the disease code and insurance claim history analysis content analyzed by the insurance claim history analysis module (242) and the merged data analyzed by the health data analysis module (243). The merged data includes at least one of the user's (patient's) previous medical data, previous examination data, added examination data, PGHD received from the user, added treatment data, and disease code analyzed based on the treatment data. The health content mapping unit (250) can map at least one customized health content among recommended exercise, recommended food, obesity management method and program, and blood pressure management method and program by merging the disease code and insurance claim history analysis content among the merged data. The health content mapping unit (250) can map customized health content corresponding to detailed disease codes, and if multiple customized health contents exist within the same disease code category, it can provide them to the user terminal (100) by mapping priorities differently for each user through the analysis of insurance claim history. Additionally, the health content mapping unit (250) can map customized health content by merging the above merged data and the analysis of insurance claim history to count at least one state among the counting of diseases that occurred to the user (patient), counting of measurement values, correlation analysis, counting of the number of medical treatments, and counting of the number of hospital visits. Furthermore, when the health content mapping unit (250) maps customized health content, the merged data includes past medical information such as the user's (patient's) previous medical data and previous check-up data, and since past medical information can be double-checked through the insurance claim history, the user's (patient's) medical information is accumulated, making it suitable for recommending customized health content to the user.In addition, the health content mapping unit (250) can not only map customized health content but also recommend medical treatment based on merged data and insurance claim history analysis, and can additionally recommend at least one of the hospital, medical department, and specialist corresponding to the treatment. The above customized health content, customized health program, customized health content, health content program, customized content, and health content all refer to health content suitable for the user (patient)'s health and have the same meaning. Furthermore, the above health content may include not only exercise information but also at least one of dietary habits, diet, nutritional components of food, food products, exercise videos, exercise methods, exercise time, sleeping habits, sleep time, clothing, number of hospital visits, recommended hospitals, and medical treatment, but is not necessarily limited thereto. The health content mapping unit (250) can deliver the mapped customized health content to the user terminal (100).

[0054] The storage unit (260) can store all information generated within the cloud server (200). The communication unit (270) enables each component of the user terminal (100), hospital server (300), and insurance company server (400) to communicate with the cloud server (200) through a network. The network means may include at least one CDMA-based (or HSDPA-based) mobile communication network, and / or an IEEE 802.16x-based high-speed wireless internet, and / or an IEEE 802.11x-based wireless LAN communication network, but is not necessarily limited thereto.

[0055] When the hospital server (300) receives a request for a medical examination result from the cloud server (200), it can verify the medical examination data corresponding to the medical examination result and transmit the medical examination data to the cloud server (200). When the hospital server (300) receives a request to verify a medical history from the cloud server (200), it can verify the medical data corresponding to the medical history and transmit the medical data to the cloud server (200).

[0057] The invention has been described with reference to embodiments illustrated in the drawings, but this is merely illustrative, and those skilled in the art will understand that various modifications and equivalent alternative embodiments are possible therefrom. Accordingly, the true technical scope of protection of the invention should be determined by the technical spirit of the appended claims. Explanation of the symbols

[0059] 10; System for providing customized content based on analysis of indemnity insurance claim data and medical information 100; User terminal 200; Cloud server 210; Health Information Management Department 211; Medical Data Management Module 212; Examination Data Management Module 220; Medical Data Management Department 230; Insurance Claims Management Department 240; Data Analysis Department 241; Medical Data Analysis Module 242; Insurance Claim History Analysis Module 243; Health Data Analysis Module 250; Health Content Mapping Department 260; Storage unit 270; Communication unit 300; Hospital server 400; Insurance company server

Claims

Claim 1 A method for providing customized content based on the analysis of medical indemnity insurance claim data and medical information comprises: a step in which a user terminal executes a dedicated application and inputs personal identification information, and requests an insurance claim from a cloud server; a step in which the cloud server requests a hospital server to verify medical history; a step in which the hospital server verifies medical data corresponding to the medical history and transmits the medical data to the cloud server; a step in which the cloud server analyzes disease codes based on the medical data; a step in which the cloud server generates an automatic medical indemnity insurance claim form, selects an insurance company to submit it, and transmits the automatic medical indemnity insurance claim form to the insurance company server; a step in which the insurance company server transmits the completion of the insurance claim to the cloud server; a step in which the cloud server transmits the completion of the insurance claim to the user terminal and requests consent for the use of personal information; a step in which the user terminal transmits consent for the use of personal information to the cloud server; and a step in which the cloud server analyzes the insurance claim history. A method for providing customized content based on analysis of actual loss insurance claim data and medical information, comprising the step of a cloud server mapping customized health content based on insurance claim history analysis and disease codes, wherein the cloud server analyzes the insurance claim history to identify and store at least one of the following: a medical department and disease name for which the user is continuously receiving treatment, a medical department and disease name for which treatment has been completed and is no longer being received, a medical department and disease name for which treatment has newly started, a frequency of hospital visits, and a correlation regarding medical departments or diseases with overlapping treatment periods by comparing at least two insurance claims; wherein the cloud server maps customized health content corresponding to detailed disease codes, and if multiple customized health contents exist within the same disease code category, maps the priority differently for each user through the insurance claim history analysis. Claim 2 delete Claim 3 A method for providing customized content based on the analysis of actual loss insurance claim data and medical information, comprising, in claim 1, a step in which an insurance company server reviews the payment of insurance benefits and transmits the completion of the payment of insurance benefits to a cloud server; and a step in which a cloud server transmits the payment result of insurance benefits and customized health content to a user terminal. Claim 4 A user terminal that requests an insurance claim from a cloud server, transmits consent for the use of personal information to the cloud server, and receives insurance payment results and customized health content from the cloud server; The system includes a cloud server that requests verification of medical history from a hospital server to receive medical data, analyzes disease codes based on the medical data, generates an automatic claim form for indemnity insurance, transmits the automatic claim form to an insurance company server, requests the completion of the insurance claim and consent to the use of personal information from a user terminal, maps personalized health content based on the analysis of the insurance claim history and disease codes, and delivers the results of the insurance payment and personalized health content to the user terminal. The cloud server analyzes the insurance claim history to identify and store at least one of the following: the medical department and disease name for which the user is continuously receiving treatment, the medical department and disease name for which treatment has been completed and is no longer being received, the medical department and disease name for which new treatment has started, the frequency of hospital visits, and the correlation between medical departments or diseases with overlapping treatment periods by comparing at least two insurance claims. The cloud server maps personalized health content corresponding to detailed disease codes, and if multiple personalized health contents exist within the same disease code category, maps the priority differently for each user based on the analysis of the insurance claim history. System for providing customized content based on analysis of indemnity insurance claim data and medical information. Claim 5 In paragraph 4, the above disease code is a disease classification code, characterized by classifying diseases by type and assigning symbols using alphabets and numbers, and is a customized content provision system based on the analysis of actual loss insurance claim data and medical information.

Images