JP2015032111A - Business processing system, business processing method, and business-processing program - Google Patents

Abstract

[PROBLEMS] To enable outsourcing of insurance business.
SOLUTION: Systematization is based on the expertise of insurance company personnel to judge the processing of claims, and part of insurance-related work is automatically processed based on the systematized information. . Specifically, the billing information from the customer side is referred to, and a processing pattern identifier is assigned to the billing information according to the contents of the billing information. In addition, with reference to a processing pattern table in which each of a plurality of processing pattern identifiers and at least one of a plurality of processing items related to a billing procedure are associated with each other, an assignment is made among the plurality of processing items related to a billing procedure. The processing item associated with the processing pattern identifier is specified. Further, processing related to the billing procedure is automatically executed based on the specified processing item.
[Selection] Figure 1

Description

  The present invention relates to a business processing system, and more particularly to a business processing system that supports a business of a life insurance company.

  Life insurance companies make human judgments and processes through “persons” for various tasks in response to requests from customers (contractors or payees). For example, on the basis of “manual, knowledge, experience”, etc., necessary forms are selected manually according to customer attributes and insurance contract conclusions. In addition, processing to determine a “business process flow” according to the request received from the customer side and confirmation of the submitted documents received from the customer side are performed.

  Since life insurance companies have a wide range of operations and the number of daily claims is enormous, it is preferable if they can be processed automatically by a computer, etc., regardless of human resources. Cannot be implemented.

  As an example of a technology that automates a part of work related to claim guidance for insurance money and benefits, Japanese Patent Application Laid-Open No. 2011-123646 discloses a claim guidance system for insurance money / benefits. This insurance / benefits billing guidance system uses the customer number as a key for the customer's offer, extracts other subscription contracts other than the offer contract, creates a receipt information by bundling multiple pieces of contract information, Based on the application reception information, documents such as related invoices, procedure guides, application confirmations, request guidance guidance and in-house inspection slips are generated, and these documents are bundled and printed.

JP 2011-123646 A

  When performing human judgment and processing via “person”, since it depends on the judgment of the person in charge, “wrong guidance to customer side, wrong processing” may be performed due to a judgment error or the like. There is a concern that “complaints, complaints” may occur due to such erroneous processing, delay due to re-guidance, and the like, which may lead to deterioration of customer satisfaction (CS).

  In addition, since the person in charge who makes the above judgments and processes generally needs to have specialized knowledge on insurance, personnel costs are determined from the arrangement system of “persons who have specialized knowledge (experts and experienced persons)”. However, there is also a problem that puts pressure on profitability. In addition, because of the complexity of insurance products and the response to changes in the external environment such as laws and guidelines, it takes training time and expenses to make the person in charge acquire specialized knowledge. In Japan, the age ratio of life insurance companies is often proportional to the “total population”, and the number of insurance claims is on an “increase trend” due to “increase in the elderly” and “decrease in the number of young people”. However, those in charge of administrative procedures are in a “declining trend”. For this reason, there is a problem that it is difficult to secure a person who has specialized knowledge.

For example, in the insurance business, the following expertise is required.
・ Knowledge of various procedures related to the determination of required documents in the billing procedure ・ Explanation based on the related rules at the time of creating `` Guide to billing procedures and notice of deficiencies '' ・ Civil Code, Commercial Code, Income Tax Law, Company Law, Consumer Contract Law , Peripheral laws and regulations such as the Personal Information Protection Law, Identity Verification Law, etc.

  In addition, in life insurance companies, management efficiency has become an issue, and it is expected that office work will be outsourced more widely than ever. In such a case, a problem arises in securing a person who has the above-mentioned specialized knowledge in the consignment company.

  The object of the present invention is to systematize based on the expertise of the insurance company personnel to judge the processing of claims in order to enable outsourcing of insurance business, and based on the systematized information It is to provide a paper processing system that automatically processes some of the processes that can be outsourced out of all processes in the insurance business.

  The business processing system according to the present invention is a business processing system that executes processing related to a billing procedure in accordance with a billing request from a customer based on a concluded contract. The business processing system includes a pattern storage unit, a pattern determination unit, a process item specifying unit, and a process execution unit. The pattern storage unit has a plurality of processing items related to the billing procedure, and stores a processing pattern table in which each of the plurality of processing pattern identifiers is associated with at least one of the plurality of processing items related to the billing procedure. To do. The pattern determination unit refers to the billing information from the customer side and assigns a processing pattern identifier to the billing information according to the contents of the billing information. The processing item identification unit refers to the processing pattern table and identifies a processing item associated with the allocated processing pattern identifier among the plurality of processing items related to the billing procedure. The process execution unit automatically executes a process related to the billing procedure based on the specified process item.

  Note that the business processing system described above can also be realized by causing a computer to execute the business processing program according to the present invention. This business processing program can be stored in a storage device or a storage medium.

  When assessing documents in response to a claim application from a customer (contractor or payee) at a life insurance company, it is automatically performed without human intervention based on a business process flow that changes according to the customer's request. It becomes possible to confirm the deficiencies. As a result, a consignment company that is not a life insurance company can perform part of the insurance-related business without securing a person (expert or experienced person) who has specialized knowledge.

It is a figure which shows the structural example of the paperwork system which concerns on this invention. It is a figure which shows an example of the data structure of claim information. It is a figure which shows an example of the data structure of process pattern information. It is a figure which shows the structural example of the pattern determination part in a paperwork system. It is a figure which shows an example of the data structure of a header. It is a figure for demonstrating the procedure of paperwork. It is a figure which shows an example of the data structure of a form document list table. It is a figure which shows an example of the data structure of a public document list table. It is a figure which shows an example of the submission document list which is a document determination result. It is a figure which shows an example of a document excess / deficiency determination result. It is a figure which shows an example of the data structure of a document excess / deficiency determination table. It is a figure which shows an example of the data structure of a form document inspection table. It is a figure which shows an example of the data structure of a public document check table. It is a figure which shows an example of a form check result. It is a figure which shows an example of a public document check result. It is a figure which shows an example of the data structure of an information collation table. It is a figure which shows an example of an information collation result.

<Embodiment>
Embodiments of the present invention will be described below with reference to the accompanying drawings.

[System configuration]
With reference to FIG. 1, the structural example of the paperwork processing system which concerns on this invention is demonstrated.

  The business processing system according to the present invention includes a life insurance company server 1 and a consignment company server 2.

[Life insurance company server]
The life insurance company server 1 is a server managed by the life insurance company. Life insurance companies are just an example. Actually, it is not limited to a life insurance company, but may be an organization operating other contract business.

  The life insurance company server 1 includes a contract information storage unit 11 and a billing information storage unit 12.

  The contract information storage unit 11 stores contract information of an insurance contract concluded with a life insurance company. As an example of the breakdown of the contract information, a security number, an insurance contractor name, an insured person name, a payee name, an address, a contract date, a security content, and the like can be considered. Here, it is assumed that the contract information storage unit 11 is managed by a life insurance company, and contract information is registered in advance (in advance). The contract information storage unit 11 is prepared by the life insurance company so that the contract company can use the contract information, and is a storage device accessible from the contract company side.

  The billing information storage unit 12 stores billing information from the customer side (contractor or recipient) as billing information. As an example of the breakdown of the billing information, there may be a reception number, business content, billing content, contract form, target person, contractor status, information on the customer side, identification information (processing pattern ID) indicating a processing pattern, etc. . Here, it is assumed that the billing information storage unit 12 is managed by a life insurance company, and billing information is set (registered, updated, etc.) when the life insurance company accepts a billing from the customer side. Regarding the information regarding the receipt number, business content, billing content, contract type, target person, contractor status, customer side, etc., the billing information newly created by processing on the life insurance company server 1 side at the time of claim acceptance It is newly set as an item. About processing pattern ID, after setting each said information, it associates (associates) with each said information by the process by the consignment company server 2 side mentioned later. The billing information storage unit 12 is prepared by the life insurance company so that the commissioning company can use the billing information, and is a storage device accessible from the commissioning company side.

[Consignment company server]
The consignment company server 2 is a server managed by a consignment company outsourced by a life insurance company.

  The consignment company server 2 includes a pattern storage unit 21, a pattern determination unit 22, a process item identification unit 23, and a process execution unit 24.

  The pattern storage unit 21 has a plurality of processing items related to the billing procedure, and each of the plurality of processing pattern IDs is associated with at least one of the plurality of processing items related to the billing procedure ( Process pattern table). Here, it is assumed that the pattern storage unit 21 stores processing pattern information in advance (in advance). For example, the pattern storage unit 21 organizes a processing flow that changes according to “business content, billing content, and customer-side attribute information” as processing pattern information, and arranges it in a matrix (lattice, matrix) Stored in the processing pattern database format. More specifically, information related to processing patterns systematized based on expertise for determining processing for billing is stored in a table format. The pattern storage unit 21 temporarily stores data (intermediate data, result data) generated by the processing in the pattern determination unit 22.

  The pattern determination unit 22 refers to the contract information storage unit 11, the billing information storage unit 12, and the pattern storage unit 21, and performs processing pattern assignment processing on the billing information stored in the billing information storage unit 12. Here, when the billing information is stored in the billing information storage unit 12 by the life insurance company, the pattern determination unit 22 accesses the billing information storage unit 12 and refers to the billing information. Further, the contract information storage unit 11 is accessed to refer to the contract information. In addition, the pattern storage unit 21 is accessed, and the contract information and each attribute information included in the billing information are used as keys to collate with the processing pattern information, and the billing information stored in the billing information storage unit 12 is processed. Assign an ID. At this time, the assigned processing pattern ID is stored in association with (associated with) the billing information stored in the billing information storage unit 12. That is, the billing information stored in the billing information storage unit 12 is updated. Or you may memorize | store in the pattern memory | storage part 21. FIG. The pattern determination unit 22 raises an alert (warning) when a request for a processing pattern not registered in the pattern storage unit 21 occurs, notifies the system administrator or the like, and stores the processing pattern in the pattern storage unit 21. Additional registration may be performed.

  The process item identification unit 23 accesses the pattern storage unit 21 based on the process pattern ID assigned to the billing information, refers to the process pattern information, and assigns the process assigned among the plurality of process items related to the billing procedure. The processing item associated with the pattern ID is specified.

  The process execution unit 24 automatically executes a process related to the billing procedure based on the specified process item. Details will be described later.

  It is assumed that the pattern storage unit 21, the pattern determination unit 22, the process item specifying unit 23, and the process execution unit 24 are linked to each other. Actually, they may be physically the same device.

[Billing information data structure]
An example of the data structure of billing information will be described with reference to FIG.

  The billing information consists of “reception number”, “business content”, “billing content”, “contract form”, “target person”, “contractor status”, “billinger”, “processing” It has an area (field) for storing “pattern ID”.

  The “reception number” is a number assigned for each received request, and is identification information for specifying the request information.

  “Business content” is information indicating the type of business. Examples of business content include new contract business (underwriting of insurance contracts), storage business (storage of insurance premiums), maintenance business (address change / name change / content change), insurance payment business (hospitalization / death / maturity / pension) Etc.)).

  “Billing content” is information indicating the content of the bill received from the customer side. As an example of the contents of the charge, there may be a change of surname request, a special contract cancellation request, a cancellation request, and the like.

  “Contract type” is information indicating the type of insurance contract that is concluded. As an example of the contract form, an individual contract, a corporate contract, etc. can be considered.

  “Target person” is information indicating a person who is a target of the business according to the content of the claim. As an example of the target person, a contractor, an insured person, a payee, and the like can be considered.

  “Contractor status” is information indicating the current status of the contractor. Examples of contractor status include adults, minors, adult guardians and foreigners.

  “Biller” is information indicating a person who has actually made a claim among customers on the customer side. As an example of a claimant, a contractor, a parent, a guardian of an adult, a legal representative, a delegation agent, a representative director in a corporate contract, or the like can be considered.

  “Processing pattern ID” is identification information indicating a processing pattern. The processing pattern ID is specified by the pattern determination unit 22 based on each piece of information when each piece of information is set, and is associated (associated) with each piece of information.

[Data structure of processing pattern information]
With reference to FIG. 3, an example of the data structure of the processing pattern information will be described.

  The processing pattern information includes areas (fields) for storing “processing pattern ID”, “subject”, “contractor status”, “requester”, “processing flow”, and the like.

  The “processing pattern ID”, “subject”, “contractor status”, and “requester” are as described above. That is, these are the same as those described in the configuration of billing information.

  “Processing flow” is information indicating a processing flow that changes according to business content, billing content, customer-side attribute information (target person, contractor status, billing person, etc.), and the like. The business content, billing content, and customer-side attribute information are indicated by the above processing pattern ID that is common to the billing information. Here, as an example of the processing flow, there are shown the submitted documents and the like required on the customer side according to the business content, the billing content, the customer side attribute information, and the like.

[Configuration of processing execution unit]
A configuration example of the process execution unit 24 will be described with reference to FIG. Since the configuration other than the processing execution unit 24 is the same as that in FIG. 1, the description and illustration are omitted.

  The processing execution unit 24 includes a billing document automatic creation unit 241, a document image control unit 242, a submitted document determination unit 243, a document excess / deficiency determination unit 244, a document inspection unit 245, an information matching unit 246, and a defect notification. An automatic document creation unit 247 is provided.

  The billing document automatic creation unit 241 automatically creates billing documents such as billing guidance and forms for various billing procedures. Also, processing related to these printings is performed. At this time, on the form that needs to be returned from the customer side, the coded information (hereinafter, coded information) such as a barcode for specifying the form (or two-dimensional code or the like) is printed and printed. Shall. The printed billing information and billing documents are sent (sent) to the customer. In addition, documents received from the customer side are finally accepted by the consignment company. For example, when the process item specified by the process item specifying unit 23 is a document requesting the customer to submit, the billing document automatic creating unit 241 includes a form creating unit 2411 and a guide creating unit 2412. The form creation unit 2411 automatically creates layout data of a form provided with an entry field corresponding to the contents of the billing information as a document requested to be submitted to the customer, and prints the form. The guide creation unit 2412 automatically creates guide layout data related to documents requested to be submitted to the customer and prints the guide. At this time, the billing document automatic creation unit 241 stores the form and guide layout data to be a template, and based on the form and guide layout data to be a template, the form and guide layout data is necessary. May be edited. Examples of matters included in the layout data of forms and guides include matters relating to documents (guidance, forms, etc.) to be sent to the claimant, matters relating to documents (submitted documents) generated in the billing unit, messages printed on documents, customers It may be possible to deal with individual matters such as information on the side of the site and alerting at the time of submission. The billing document automatic creation unit 241 omits entry fields and document names that are no longer necessary according to the billing contents from the layout data of the form and guidance, and appropriately changes the contents of the form, guidance title, and message. This is expected to reduce printing costs and improve usability (ease of use) for filling out forms for contractors. In addition, for a form that needs to be returned from the customer side, coded information (such as a bar code) for specifying the form is inserted and added to the layout data of the form. Then, as output, print data based on the layout data of the form and guidance is transmitted to a printing apparatus such as an on-demand printer, and variable printing of the form and guidance is performed.

  The document image control unit 242 scans and submits the submitted documents (filled billing documents, official documents, etc.) received from the customer side using a scanner (Scanner) or an equivalent device / function. Create document image data. Each request (in units of billing information) creates a unique “header” (header) for managing the submitted document, and adds a header to the image data of the submitted document at the time of scanning. For example, the OCR function (character / image recognition function) is used to analyze the coded information (barcode, etc.) given to the submitted documents and automatically create a header based on that information. May be. It is assumed that the document created by the consignment company is printed with coded information (such as a barcode). In addition, documents (official documents, etc.) submitted by customers shall be prepared in advance (in advance) with stickers (labels, etc.) printed with coded information (barcodes, etc.) for each document that is expected to be submitted. , The sticker shall be attached to the submitted documents (public documents, etc.) before scanning. Thereby, at the time of scanning, encoding information (barcode etc.) can be converted into image data together with the submitted documents.

  The submitted document determination unit 243 refers to the image data and specifies the type of document using the OCR function (character / image recognition function). For example, the encoded information (barcode or the like) given to the submitted document or the information included in the header is analyzed, and the type of the submitted document (form, public document) is specified based on the information.

  The document excess / deficiency determination unit 244 determines the excess / deficiency of documents between the “necessary documents according to the request contents” and the “submission documents”. In addition, information on “temporary”, “acceptance”, and “confirmation” is collated with respect to all submitted documents received from the customer side, and as a result, it is determined whether there are excess or deficiency of documents at each stage in the billing procedure. “Temporary placement” is a document at the time of acceptance from the customer side. “Reception” is a document at the time of scanning. “Confirm” is a document at the time when the type is specified. As a result of judging the excess and deficiency, if there is any excess or deficiency, check whether the document corresponds to "additional document", "unsubmitted", "returned document", or "no submission required" along with the document code of the document .

  The document inspection unit 245 refers to the image data and performs an automatic assessment to check the submitted documents. The document contents, seal (presence / absence, status, position), presence / absence of the original (original, copy), validity (validity) , Expiry date). For completed forms, the document status is checked by registering the description status. For official documents, the validity etc. are checked by registering necessary items.

  The information verification unit 246 refers to the image data, performs information verification on the submitted document by automatic assessment, and confirms the correctness of the information. Examples of items to be verified include name, date of birth, sex, date of death, and the like. Examples of objects to be collated include official documents, forms, and insurance contract contents. For example, a public key, a form, the contents of an insurance contract, etc. are collated with a “key” common to each document such as a name. Further, the contract information storage unit 11 may be accessed to collate the contract information with the contents of the submitted document.

  The deficiency notice automatic creation unit 247 performs a comprehensive evaluation on the processing results of the document excess / deficiency determination unit 244, the document inspection unit 245, and the information collation unit 246, and a deficiency (error) occurs in any of the processes. If there is, the deficiency notice is automatically created. Also, processing related to these printings is performed. In practice, the billing document automatic creation unit 241 may also serve as the deficiency notice automatic creation unit 247. That is, the billing document automatic creation unit 241 and the deficiency notice automatic creation unit 247 may be shared or integrated. For example, when reissuing (printing) a billing document or the like whose description has been partially changed together with or as a deficiency notice, it is preferable that the billing document automatic creation unit 241 perform the processing.

[Data structure of header]
An example of the header data structure according to the present invention will be described with reference to FIG.

  The header contains “underwriting company category”, “business category”, “partner category”, “consignment category”, “billing details”, “work order”, and “collaboration with other departments”. And an area (field) for storing “progress status” and the like.

  The “underwriting company category” is information indicating the name or identification code of the life insurance company.

  “Business classification” is information indicating the name or identification code of the corresponding business. Examples of operations include new contract operations (underwriting of insurance contracts), storage operations (storage of insurance premiums), maintenance operations (address change / name change / content change), insurance payment operations (hospitalization / death / maturity / pension, etc.) Payment).

  The “partnership category” is information indicating the name or identification code of the branch. In the case of directly exchanging with a customer without going through the sales office, this is indicated (display or identification code such as direct customer delivery).

  The “consignment work category” is information indicating whether or not the business is consigned from the life insurance company (within the business scope, outside the business scope).

  “Billing content” is information indicating a billing name or billing code corresponding to the billing content.

  The “work order” is information indicating the work order determined according to the business category and the billing content. The document image control unit 242 may automatically rearrange the image data based on the work order.

  “Cooperation with other departments” is information for instantly coordinating the submitted documents when a cooperative work with other departments occurs. For example, information indicating the name or identification code of another department can be considered.

  “Progress status” is information indicating the processing status of the submitted document with the header. Examples of the progress status are “unprocessed”, “processing in progress”, “occurrence of deficiency”, “completed”, and the like. “Unprocessed” indicates a status of not yet started. “Processing” indicates a status where processing is started. “Deficiency occurrence” indicates a situation where there is some deficiency and a solution is being made. “Completed” indicates a state where the processing is completed.

[Procedure for paperwork]
With reference to FIG. 6, the procedure of paperwork will be described by taking a business in a life insurance company as an example.

(1) Claim application (step S101)
The customer (contractor or beneficiary) makes a claim for “maintenance / insurance payment” to the life insurance company.

(2) Claim acceptance (step S201)
The life insurance company accepts claims in response to claims from customers. At this time, when the life insurance company server 1 makes a request to the life insurance company verbally (telephone, counter service) or in writing (mailing of documents, etc.), the person in charge of the reception (call center) An input operation of billing information from an operator, a person in charge at a window, etc. is accepted. In addition, when a claim is made by data transmission from the customer side to the life insurance company, the claim is accepted by data reception, and the billing information is extracted from the received data. Then, the billing information storage unit 12 stores the billing information. That is, the life insurance company server 1 stores the billing information in the billing information storage unit 12 at the time of billing reception.

(3) Billing information cooperation (step S301)
The pattern determination unit 22 accesses the billing information storage unit 12 with reference to the billing information registration process in the billing information storage unit 12 and refers to the billing information. Further, the contract information storage unit 11 is accessed, and the contract information corresponding to the securities number or the like is referred to. In addition, the pattern storage unit 21 is accessed, pattern determination processing is performed by comparing the contract information with each piece of attribute information included in the billing information and processing pattern information, and the pattern determination result information ( Process pattern ID). The pattern determination unit 22 may constantly monitor the billing information registration process in the billing information storage unit 12. In addition, when the billing information registration process for the billing information storage unit 12 is performed, a notification to that effect or the billing information may be received. The process item identification unit 23 accesses the pattern storage unit 21 based on the process pattern ID assigned to the billing information, refers to the process pattern information, and assigns the process assigned among the plurality of process items related to the billing procedure. The processing item associated with the pattern ID is specified. The process execution unit 24 automatically executes a process related to the billing procedure based on the specified process item. Here, since the process item specified by the process item specifying unit 23 is a document requesting the customer to submit, the billing document automatic creating unit 241 is activated.

(4) Form output (step S302)
The billing document automatic creation unit 241 changes the type, layout, print contents / message, and the like of the output form according to the contents of the billing information. Then, the form to be sent to the contractor is output to a printing apparatus such as an on-demand printer together with the “billing procedure guide” to perform variable printing. For example, the form creation unit 2411 prints contract information or the like on an image form, converts the form into a PDF, and prints it with an on-demand printer or the like. An image form refers to an invoice that is patterned in units of invoice names. By converting the form to PDF, it is possible to respond to re-creation requests from customers (re-creation function). In the existing system, since there is no re-creation function, it is necessary to create a new form every time, and the amount of work and work time for that has occurred, but in this system, there is no need to create a new form every time Therefore, the work amount and work time for that purpose do not occur. Furthermore, since the form is converted to PDF, the contents of the sent out form can be confirmed in response to an inquiry from a customer (inquiry corresponding function). At this time, for each form to be printed, a key associated with the billing information is printed in the form of coded information (barcode or the like) for each form. The consignment company encloses the printed form together with the “billing procedure guide” in an envelope and sends it to the customer side.

(5) Document entry / submission (step S102)
The customer side fills in the necessary information on the mailed forms based on the “Request Procedure Information” mailed by the consignment company, obtains the necessary documents (public documents, etc.), Submit necessary documents to the contractor.

(6) Scan (step S303)
The document image control unit 242 scans a form or attached document submitted from the customer side and converts it into image data. Further, at the time of scanning, by analyzing the coded information (bar code or the like) printed on the form, a header is created for each billing unit, and the header is added to the image data. At this time, “image data rearrangement” or the like may be automatically performed based on the work order included in the header. In addition, for attached documents such as copies of identity verification documents that do not have coding information (barcode etc.) printed, it is a secondary coding linked to this based on the form coding information (unique key). Information (subkey) is created, and a sticker (label or the like) on which the sub-coded information is printed is pasted on the attached document.

(7) Data input (step S304)
The document image control unit 242 displays image data acquired by scanning on a display such as a PC (personal computer), and data such as information entered by a contractor or information on attached documents in accordance with an input operation by the input operator. Make input. At this time, the order of data input by the input operator (the order of input operations) and the like are automatically determined based on the scan results (header, coded information, etc.). Note that data input may be automatically performed using an OCR function (character / image recognition function) instead of the input operation of the input operator. The input data is managed in association with the billing information in the billing information storage unit 12.

(8) Document identification (step S305)
The submitted document determination unit 243 refers to the image data, uses the OCR function (character / image recognition function), analyzes the encoded information (such as a barcode) and the information included in the header, and determines the type of the document. Identify. Here, based on the “form document list table” (see FIG. 7) and the “public document list table” (see FIG. 8), the document name corresponding to the coded information (barcode or the like) is specified. As a result, a list of submitted documents (see FIG. 9) is obtained. At this time, the list of submitted documents (see FIG. 9) may be displayed on a display such as a PC (personal computer). In practice, the “form document list table” and the “public document list table” may be integrated.

(9) Document excess / deficiency determination (step S306)
The document excess / deficiency determination unit 244 refers to the processing pattern information, confirms the presence / absence of “document excess / deficiency” at each stage, and confirms the document excess / deficiency determination result (see FIG. 10). ) Is obtained. Based on the document excess / deficiency determination result (see FIG. 10), the “document excess / deficiency determination table” (see FIG. 11) is referred to and the deficiency content and the solution method are specified. At this time, the document excess / deficiency determination result (see FIG. 10) may be displayed on a display such as a PC (personal computer) together with the incomplete contents and the solution.

(10) Document inspection (step S307)
The document checking unit 245 checks the document and checks whether there are “insufficient items such as invoices”, “form document check table” (see FIG. 12) and “official document check table” (see FIG. 13). ) To identify deficiencies and solutions. As a result, for individual documents, a form check result (see FIG. 14) and a public document check result (see FIG. 15) are obtained. At this time, the form inspection result (see FIG. 14) and the official document inspection result (see FIG. 15) may be displayed on a display such as a PC (personal computer).

(11) Information collation (step S308)
The information collating unit 246 performs information collation, confirms the presence / absence of “information mismatch”, and identifies the deficiency content and the solution method based on the “information collation table” (see FIG. 16). As a result, an information collation result (see FIG. 17) is obtained. At this time, the information collation result (see FIG. 17) may be displayed on a display such as a PC (personal computer).

(12) Confirmation of deficiencies (step S309)
The deficiency notice automatic creation unit 247 performs a comprehensive evaluation through each of the above-described processes (steps S306 to S308), and any one of “overs and shorts of documents”, “insufficiency of items such as invoices”, and “inconsistency of information” Check whether any such deficiencies have occurred.

(13) Creation of deficiency notice (step S310)
When the deficiency notice automatic creation unit 247 has at least one deficiency among “overs and shorts of documents”, “deficiencies in invoices, etc.” and “inconsistency of information” (if there is deficiency) Then, the “deficiency notice” is automatically created, and the deficiency notice is variable-printed using a printing device such as an on-demand printer. The consignment company encloses the printed deficiency notice in an envelope and sends it to the customer.

(14) Incomplete solution / submission (step S103)
Based on the information on the “Notification of Deficiency” for the billing procedure, the customer will submit the completed / corrected documents to the consignment company after solving the deficiencies (supplement / correction of documents). The document image control unit 242 newly scans the replenished / corrected document and converts it to image data (the process proceeds to step S33).

(15) Approval request (step S311)
When the deficiency notice automatic creation unit 247 does not have any deficiencies of “document deficiency”, “insufficiency of invoices, etc.” or “inconsistency of information” (when there is no deficiency), life insurance Send the image data of the submitted documents to the company and request the approval process. For example, if the requested content is a change of name, etc., the request for name change based on the submitted documents is requested.

(16) Confirmation of processing contents (step S202)
The life insurance company displays the image data of the submitted documents on a display such as a PC (personal computer), checks the registered information, and confirms the contents of the change.

(17) Approval process (step S203)
If there is no problem as a result of the confirmation of the processing details, the life insurance company performs approval processing. For example, the contract information stored in the contract information storage unit 11 is updated.

(18) Send notification of completion (step S312)
When the life insurance company completes the approval process, the consignment company prints a “completion notice” and sends the completion notice to the customer side. The “completion notice” is preferably a “crimp postcard” from the viewpoint of costs such as “mailing / working”. The consignment company presses the completion notice (postcard) with a mail sealer and then sends it to the customer.

(19) Temporary document storage (step S313)
The consignment company temporarily stores the original submitted documents.

[Supplement]
“Form document list table” (see FIG. 7), “Public document list table” (see FIG. 8), “Document excess / deficiency determination table” (see FIG. 11), “Form document check table” (see FIG. 12) ), “Official document check table” (see FIG. 13), and “information collation table” (see FIG. 16) may be stored in the pattern storage unit 21. In this case, the submitted document determination unit 243, the document excess / deficiency determination unit 244, the document inspection unit 245, and the information collation unit 246 are:
The pattern determination unit 22 may be linked or may be realized by the pattern determination unit 22.

[Progress confirmation]
The life insurance company can access the business processing system according to the present invention, and inquire / confirm the progress of billing processing (processing status of billing documents). For example, in the paperwork system, a process indicating “processed” or “unprocessed” can be performed by assigning (linking) a flag indicating process completion for each process to the billing information at the timing of process completion of each process. It is possible to check and confirm the progress status.

[Change processing pattern information]
In response to changes in laws, guidelines, terms and conditions, products, rules, etc., life insurance companies will change to a consignment company if the “new / revised forms (including layout), processing flow / priority criteria” changes. On the other hand, a request for changing the processing pattern information is made. At this time, the information related to the change of the processing pattern information is provided in the form of data after adjusting the appearance according to the recording state of the processing pattern. The consignment company receives the processing pattern information change request and the change content data from the life insurance company, refers to the pattern storage unit 21, and overwrites the change portion of the target processing pattern based on the change content data. -Perform additional processing. When the pattern storage unit 21 is a DB (database) that stores a large number of processing pattern number information, if a keyword is input when changing the processing pattern information in order to facilitate maintenance, the related processing pattern If the change contents are extracted and the change contents are input, the related patterns may be changed at once. Actually, the pattern storage unit 21 can be mounted on the life insurance company server 1 side. For example, by managing the pattern storage unit 21 by the life insurance company, it is possible to quickly and easily change the processing pattern information when changes in laws, guidelines, terms, articles, products, rules, and the like occur.

[Synchronization processing]
The contract information storage unit 11, the billing information storage unit 12, and the pattern storage unit 21 may be individually installed in both the life insurance company server 1 and the commission company server 2. By performing synchronization processing of the contract information storage unit 11, the billing information storage unit 12, and the pattern storage unit 21 at any time between the life insurance company server 1 and the consignment company server 2, a strong cooperation can be achieved. In addition, when a change in information occurs on either side, it can be reflected on the other side.

<Example of hardware>
Hereinafter, specific examples of hardware for realizing the business processing system according to the present invention will be described.

  As examples of the life insurance company server 1 and the consignment company server 2, a computer such as a PC (personal computer), an appliance (Appliance), a server for a thin client, a workstation, a mainframe, and a supercomputer is assumed. Note that the business processing system may be realized by a plurality of computers or cloud computing. In addition to a terminal or a server, a relay device, a peripheral device, or a virtual machine (VM: Virtual Machine) constructed on a physical machine may be used.

  Although not shown, the above-described computer or the like is realized by a processor that is driven based on a program and executes predetermined processing, a memory that stores the program and various data, and an interface used for communication with a network. The

  Examples of the processor include a CPU (Central Processing Unit), a network processor (NP), a microprocessor, a microcontroller (microcontroller), or a semiconductor integrated circuit (LSI: Large Scale) having a dedicated function. Integration) or the like.

  Examples of the memory include semiconductor storage devices such as a RAM (Random Access Memory), a ROM (Read Only Memory), an EEPROM (Electrically Erasable and Programmable Read Only Memory), a flash memory, and an HDD (Hold SMD). An auxiliary storage device such as State Drive), a removable disk such as a DVD (Digital Versatile Disk), a storage medium such as an SD memory card (Secure Digital memory card), or the like is conceivable. Further, a buffer, a register, or the like may be used. Alternatively, DAS (Direct Attached Storage), FC-SAN (Fibre Channel-Storage Area Network), NAS (Network Attached Storage), IP-SAN (IP-Storage Area), etc. may be used.

  Note that the processor and the memory may be integrated. For example, in recent years, a single chip such as a microcomputer has been developed. Therefore, a case where a one-chip microcomputer mounted on an electronic device or the like includes the above processor and the above memory can be considered.

  Examples of the interfaces include semiconductor integrated circuits such as substrates (motherboards and I / O boards) and chips that support network communication, network adapters such as NIC (Network Interface Card), and similar expansion cards and communication devices such as antennas. A communication port such as a connection port (connector) is conceivable.

  Examples of the network include the Internet, a LAN (Local Area Network), a wireless LAN (Wireless LAN), a WAN (Wide Area Network), a backbone (Backbone), a cable television (CATV) line, a fixed telephone network, a mobile phone network, WiMAX (IEEE 80216a), 3G (3rd Generation), dedicated line (lease line), IrDA (Infrared Data Association), Bluetooth (registered trademark), serial communication line, data bus, and the like can be considered.

  The internal components of the life insurance company server 1 and the commission company server 2 may be modules, components, dedicated devices, or their activation (calling) programs.

  However, actually, it is not limited to these examples.

<Summary>
In the present invention, for example, in an insurance contract concluded with a life insurance company, the customer side (contractor or beneficiary) receives an “insurance, maintenance”, etc. , “Determination of necessary documents” and “determination of billing document layout” that change according to event contents, insurance contract conclusion contents and claim contents. As a result, “automation of business process flow”, “simplification of subsequent processing”, and the like can be realized based on the form.

  In the business processing system according to the present invention, processing is systematized on the basis of expert knowledge for determining processing for claims possessed by insurance company personnel. Here, the “pattern storage unit” holds the processing pattern in a database format. The “contract information storage unit” stores contract details. The “billing information storage unit” stores billing contents. The “processing pattern determination unit” refers to the above “pattern storage unit”, “contract information storage unit”, and “billing information storage unit”, depending on the content of the bill and the customer side attribute associated with the billing. The processing pattern is determined, and the processing pattern information is associated with the billing information storage unit. This makes it possible to automate the determination of the processing pattern for billing, link various databases with scanners, printers, PCs, etc. used in business processing, and automate a series of processing from billing reception to form printing. be able to.

  The business processing system according to the present invention also includes a mechanism for classifying “other” and performing exception processing when a case occurs in which the billing information does not correspond to an existing processing pattern, It is also possible to adopt a mechanism (a mechanism capable of input / reference operation) for making a judgment manually through “ When making a personal decision, a request classified as “others” is notified to the system administrator or the like, and an input / reference operation is permitted, and the process proceeds to a process of making a decision on a document. In this way, even when an unexpected request that cannot be processed automatically is received, it is possible to respond without processing omission or error.

  In addition, the paperwork processing system according to the present invention, when creating a document to be shipped to the customer side according to the billing content in the “form layout creation unit”, “rearrange the form layout, The purpose is to “minimize the number of customer entries” by printing, so it is possible to minimize the number of sheets and improve usability (convenience).

  In addition, the business processing system according to the present invention provides a “work order” item in the header in the “document image control unit”, so that a request that requires immediate work processing is provided for other requests. The processing order can be rearranged so that processing is performed preferentially, and the response can be accelerated.

  In addition, the business processing system according to the present invention can collectively convert processing patterns according to revisions of laws and guidelines, and can be expected to improve usability of pattern management.

  As described above, according to the present invention, in the document appraisal business generated by the customer (contractor or beneficiary) of the life insurance company by the claim application such as “insurance, maintenance”, etc., It is possible to automatically determine “necessary documents, business process flow, processing priority” etc. that change according to “contents, insurance contract conclusion content” without human intervention, and automatically check for deficiencies. Become.

<Remarks>
As mentioned above, although embodiment of this invention was explained in full detail, actually, it is not restricted to said embodiment, Even if there is a change of the range which does not deviate from the summary of this invention, it is included in this invention.

DESCRIPTION OF SYMBOLS 1 ... Life insurance company server 11 ... Contract information storage part 12 ... Billing information storage part 2 ... Consignment company server 21 ... Pattern storage part 22 ... Pattern determination part 23 ... Process item specific | specification part 24 ... Process execution part 241 ... Automatic billing document creation Section 2411 ... Form creation section 2412 ... Guidance creation section 242 ... Document image control section 243 ... Submitted document determination section 244 ... Document excess / deficiency determination section 245 ... Document inspection section 246 ... Information collation section 247 ... Incomplete notification form automatic creation section

Claims (6)

A business processing system that executes processing related to a billing procedure in response to a billing request from a customer based on a signed contract,
A pattern storage unit having a plurality of processing items related to a billing procedure, and storing a processing pattern table in which each of a plurality of processing pattern identifiers is associated with at least one of the plurality of processing items related to the billing procedure When,
Referring to billing information from the customer side, and according to the content of the billing information, a pattern determination unit that assigns a processing pattern identifier to the billing information;
Referring to the process pattern table, a process item specifying unit for specifying a process item associated with the assigned process pattern identifier among a plurality of process items related to the billing procedure;
A business processing system comprising: a process execution unit that automatically executes a process related to the billing procedure based on the specified process item. The specified processing item is a document requesting the customer to submit,
The process execution unit
As a document requesting submission to the customer side, automatically creating layout data of a form provided with an entry field according to the content of the billing information, a form creation unit for printing the form,
The business processing system according to claim 1, further comprising: a guide creation unit that automatically creates layout data of a guide related to a document requested to be submitted to the customer side and prints the guide. The process execution unit
Scan the document received from the customer side to create image data, create a unique header for managing the image data in units of the billing information, assign it to the image data, work included in the header A document image control unit that automatically rearranges the image data in units of the billing information based on the order;
A submitted document determination unit that refers to the image data and identifies the type of document received from the customer side,
A document excess / deficiency determination unit for determining excess / deficiency of documents in the billing procedure;
Document inspection by referring to the image data, carrying out document inspection by automatic assessment, and confirming the description content, seal, original existence, validity, and
An information verification unit that refers to the image data, performs information verification by automatic assessment, and confirms the correctness of the information;
Comprehensive evaluation for each processing result of the document excess / deficiency determination unit, the document inspection unit, and the information verification unit, and if any deficiencies have occurred regarding the document received from the customer side, to the customer side The business processing system according to claim 2, further comprising: a deficiency notice automatic creation unit that automatically creates a deficiency notice. Of the documents received from the customer side, coded information is printed on the form, and a seal printed with the coded information is pasted on a document other than the form,
The document image control unit converts the encoded information together with the document received from the customer side into image data,
The business processing system according to claim 3, wherein the submission document determination unit reads the coded information included in the image data and identifies the type of document received from the customer side. A paper processing method in which a computer executes processing related to a billing procedure in response to a billing request from a customer based on a contract concluded,
Referring to billing information from the customer side, and assigning a processing pattern identifier to the billing information according to the content of the billing information;
Each of the plurality of processing pattern identifiers is referred to a processing pattern table associated with at least one of the plurality of processing items related to the billing procedure, and the assigned among the plurality of processing items related to the billing procedure is assigned. Identifying a process item associated with the process pattern identifier,
And a step of automatically executing a process related to the billing procedure based on the specified process item. A program for causing a computer to execute processing related to a billing procedure in response to a billing request from a customer based on a signed contract,
Referring to billing information from the customer side, and assigning a processing pattern identifier to the billing information according to the content of the billing information;
Each of the plurality of processing pattern identifiers is referred to a processing pattern table associated with at least one of the plurality of processing items related to the billing procedure, and the assigned among the plurality of processing items related to the billing procedure is assigned. Identifying a process item associated with the process pattern identifier,
A business processing program for causing a computer to execute a step of automatically executing processing relating to the billing procedure based on the specified processing item.

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