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Commercial health insurance online document-free active claim settlement technology

A health insurance and active technology, applied in data processing applications, instruments, finance, etc., can solve problems such as time-consuming, repeated claims, moral hazards, and difficulty in control, and achieve the effect of simplifying the reporting process, improving the timeliness of claim settlement, and ensuring authenticity

Pending Publication Date: 2020-07-28
诺映(上海)信息科技有限公司
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  • Abstract
  • Description
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  • Application Information

AI Technical Summary

Problems solved by technology

[0019] The purpose of the present invention is to provide commercial health insurance online active claim settlement technology without documents to solve the problems in the above-mentioned background technology of the existing commercial health insurance claim settlement technology, such as uncontrollable timeliness of accident reporting, cumbersome procedures for reporting and submitting claim documents, and cumbersome claims. Problems such as cumbersome, time-consuming, false documents, repeated claims and other moral hazards that are difficult to control

Method used

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  • Commercial health insurance online document-free active claim settlement technology
  • Commercial health insurance online document-free active claim settlement technology
  • Commercial health insurance online document-free active claim settlement technology

Examples

Experimental program
Comparison scheme
Effect test

Embodiment

[0060] Example background: The commercial insurance card platform cooperates with a branch of China Life Insurance Company (hereinafter referred to as "China Life") to provide active claim settlement services for a group of high-quality customers. Ms. Zhang is one of these customers.

[0061] Step 1: Ms. Zhang registers and authorizes the active claim settlement service. First, she fills in her mobile phone and verification code on the registration page to register; secondly, enters the authorization page, fills in her name and ID number, and authorizes the platform to verify her identity as a valid customer of China Life Insurance. At the same time, Agree to the platform to push claim reminders for future medical visits;

[0062] Step 2: Soon after, Ms. Zhang went to a hospital for treatment due to physical discomfort. The hospital is one of the medical institutions covered by the commercial insurance card's active claim settlement service. On the second day after Ms. Zhang ...

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Abstract

The invention discloses a commercial health insurance online document-free active claim settlement technology. The technology comprises the steps that 1) an insured person registers and authorizes toopen an active claim settlement service; 2) the insured person obtains a to-be-claimed reminder after seeing a doctor; 3) the insured person authorizes the commercial insurance one-card online to callthe medical data and initiate an insurance claim settlement application; and 4) the insurance company terminal accepts the compensation case officially, and the insured person checks the latest progress of the compensation case in time. Passive claim settlement is changed into active claim settlement, the insurance case reporting timeliness is greatly improved, the case reporting process is thoroughly simplified, document-free claim settlement and insurance company manual information input are realized, the authenticity and high quality of claim settlement data are ensured at the source end,the claim settlement timeliness is greatly improved, the insurance company is helped to avoid repeated claim settlement, and online closed loop of health insurance is completed.

Description

technical field [0001] The invention relates to the technical field of insurance claims, in particular to the technology of active claim settlement without documents on the commercial health insurance line. Background technique [0002] Since 2011, commercial health insurance has maintained rapid growth in mainland China. From 2011 to 2019, the compound annual growth rate of health insurance business income was as high as 34%. It is estimated that by 2021, the overall original premium income of health insurance will reach 1.7 trillion yuan, and will continue to maintain a relatively high growth trend. [0003] Behind the rapid growth of business, health insurance insureds (hereinafter referred to as "insureds") and health insurance underwriting companies (hereinafter referred to as "insurers") are facing more and more challenges and difficulties in handling insurance accident claims. Under the current claim settlement system and process prevailing in the insurance industry,...

Claims

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Application Information

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Patent Type & Authority Applications(China)
IPC IPC(8): G06Q40/08G16H10/60
CPCG06Q40/08G16H10/60
Inventor 王作梁
Owner 诺映(上海)信息科技有限公司
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