Intelligent claim settlement processing method and device

Abstract

The embodiment of the invention discloses an intelligent claim settlement processing method, and is used for further improving claim settlement processing efficiency on the basis of an automatic claimsettlement system. The method of the embodiment of the invention comprises the following steps that: determining a claim settlement case, which is from the automatic claim settlement system and is not approved, as a target case; adopting a preset intelligent checking condition to check the target case, wherein the intelligent checking condition is wider than the checking condition of the automatic claim settlement system in a restricted range that the case is approved; carrying out automatic adjustment processing on the target case which is approved to obtain the claim settlement result of the target case; according to a preset intelligent pushing mechanism, pushing the target case and the corresponding claim settlement result to a sampling inspection post to be subjected to sampling inspection processing; and if the target case passes the sampling inspection processing, outputting the target case and the corresponding claim settlement result. The embodiment of the invention also provides an intelligent claim settlement processing device.

Description

technical field [0001] The invention relates to the field of financial services, in particular to an intelligent claim settlement processing method and device. Background technique [0002] At present, with the increase of insurance business volume, most insurance companies have introduced automatic claim settlement system. The automatic claim settlement system can provide customers with a self-service claim settlement channel. After the customer fills in the claim settlement information, the automatic claim settlement system will automatically review and process the claim settlement case, reducing the labor cost of the insurance company and greatly improving the claim settlement processing efficiency of the insurance company. . [0003] However, since the claim information of most claim cases is filled in or provided by customers themselves, and customers do not have professional knowledge in the insurance industry, the claim data of many claim cases cannot pass the review...

AI Technical Summary

Problems solved by technology

[0003] However, since the claim information of most claim cases is filled in or provided by customers themselves, and customers do not have professional knowledge in the insurance industry, the claim data of many claim cases cannot pass the review of the automatic claim settlement system, and the claim cases that fail to pass the review It will be transferred to the manual review post for manual adjustment and confirmation

In this case, as the number of cases continues to increase, the labor cost of the insurance company will also increase.

Images