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Anti-fraud identification method and apparatus for insurance claim settlement

An identification method and a technology for processing devices, which are applied in the field of anti-fraud identification methods and devices for insurance claims, can solve the problems of insufficient identification of hidden risks and low efficiency of anti-fraud identification, and achieve the goals of strengthening strength, rapid processing, and improving efficiency Effect

Inactive Publication Date: 2017-10-10
CHINA PING AN LIFE INSURANCE CO LTD
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Problems solved by technology

In order to avoid such risks, financial and insurance-related companies usually set up special claims review posts, and use manual review to conduct anti-fraud identification on customers’ claim applications based on professional experience. The efficiency of anti-fraud identification is low. The level varies, so some cases may have insufficient identification of hidden risks

Method used

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  • Anti-fraud identification method and apparatus for insurance claim settlement
  • Anti-fraud identification method and apparatus for insurance claim settlement
  • Anti-fraud identification method and apparatus for insurance claim settlement

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Embodiment Construction

[0044] The principles and features of the present invention are described below in conjunction with the accompanying drawings, and the examples given are only used to explain the present invention, and are not intended to limit the scope of the present invention.

[0045] like figure 1 as shown, figure 1 It is a schematic flow chart of an embodiment of the anti-fraud identification method for insurance claims of the present invention. The anti-fraud identification method for insurance claims includes the following steps:

[0046] Step S1: After receiving the claim application carrying the claim information, the claim settlement anti-fraud system determines the claim settlement case type corresponding to the claim settlement application, and obtains the claim settlement case type corresponding to the claim settlement application according to the association relationship between the predetermined claim settlement case type and the anti-fraud identification model. Anti-fraud rec...

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Abstract

The invention relates to an anti-fraud identification method and an apparatus for insurance claim settlement, wherein the method comprises: after a claim settlement anti-fraud system receives a claim settlement application with the claim settlement information, determining the type of the claim settlement case corresponding to the claim settlement application; obtaining a pre-trained and generated anti-fraud identification model corresponding to the claim settlement application; obtaining the risk factors for the anti-fraud identification model corresponding to the claim settlement application; obtaining from a booked financial system the risk factor information of the anti-fraud identification model corresponding to the claim settlement application; inputting the risk factor information to the anti-fraud identification model; outputting the risk index value corresponding to the claim settlement application; based on the risk index value and the preset risk processing rules, determining the risk processing manner corresponding to the claim settlement application; and based on the risk processing manner, performing risk processing to the claim settlement application. With the method and the apparatus of the invention, it is possible to quickly process the claim settlement applications in batch, to increase the efficiency of anti-fraud identification, and to identify the hidden fraud risks to the largest extent.

Description

technical field [0001] The invention relates to the technical field of finance and insurance, in particular to an anti-fraud identification method and device for insurance claims. Background technique [0002] At present, in the field of financial insurance (for example, in the field of life insurance), some customers will purchase insurance for the purpose of defrauding insurance when handling related insurance claims, or provide false claim information (for example, fabricating insurance accidents, exaggerating the severity of insurance accidents) wait). In order to avoid such risks, financial and insurance-related companies usually set up special claims review posts, and use manual review to conduct anti-fraud identification on customers’ claim applications based on professional experience. The efficiency of anti-fraud identification is low. The level varies, so some cases may have insufficient identification of hidden risks. Contents of the invention [0003] The pur...

Claims

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Application Information

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IPC IPC(8): G06Q40/08G06Q30/00
CPCG06Q30/0185G06Q40/08
Inventor 郝晓丽褚卫庆陈吕郭放蒋益辉田香勇
Owner CHINA PING AN LIFE INSURANCE CO LTD
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