TWI866380B - Device and method for generating insurance advice based on policy information and medical information - Google Patents
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Abstract
Description
一種投保建議裝置及其方法,特別係指一種依據保單資料及醫療資料產生投保建議之裝置及方法。 An insurance recommendation device and method, in particular, a device and method for generating insurance recommendations based on policy information and medical information.
目前,國內保險產品種類繁多,大多數保險產品是由保險公司的業務員介紹保險產品給消費者後,再由消費者填寫投保申請單等資料,之後,再由業務員將消費者所填寫的資料帶回保險公司,並由保險公司進行資格審查,當審核通過後,保險公司會寄出保單,以確保保險公司及消費者雙方權益。 At present, there are many types of insurance products in China. Most insurance products are introduced to consumers by insurance company salesmen, and then consumers fill out insurance application forms and other information. After that, the salesmen take the information filled out by consumers back to the insurance company, and the insurance company conducts qualification review. Once the review is passed, the insurance company will send out the insurance policy to ensure the rights and interests of both the insurance company and the consumer.
傳統購買保險的方式大部分是透過保險公司的業務員面對面的銷售,消費者想要投保時難以即時找到合適可靠的業務員,而且業務員的水準差異各不相同,再加上保險產品種類繁多,因此,多數情況下,業務員很難根據消費者實際的投保情況與投保需求提供合適的投保方案給使用者。 The traditional way to buy insurance is mostly through face-to-face sales by insurance company salesmen. It is difficult for consumers to find suitable and reliable salesmen immediately when they want to buy insurance. In addition, the level of salesmen varies. In addition, there are many types of insurance products. Therefore, in most cases, it is difficult for salesmen to provide users with suitable insurance plans based on the actual insurance situation and insurance needs of consumers.
為了解決上述的問題,目前有部分的保險公司提供了保單健檢服務,但礙於法規與其他限制,單一保險公司的保單健檢服務僅能基於自身公司的保險產品、單一客戶以投保的保險產品、及該客戶所提供之保單資料進行分 析比較,同時,現有保單健檢服務也只依據客戶所提供之保險產品進行分析比對,但並未考慮客戶的身體狀況。因此,現有的保單健檢服務除了需要耗費大量時間外,所產生的分析結果難以延續至市場上所有保單產品,並不一定可以比對出真正適合客戶的保單,甚至,合理的保單配置也不一定適合客戶的身體狀況。 In order to solve the above problems, some insurance companies currently provide policy health check services. However, due to regulations and other restrictions, the policy health check service of a single insurance company can only be based on the company's own insurance products, the insurance products insured by a single customer, and the policy information provided by the customer for analysis and comparison. At the same time, the existing policy health check service only analyzes and compares the insurance products provided by the customer, but does not consider the customer's physical condition. Therefore, in addition to taking a lot of time, the existing policy health check service also produces analysis results that are difficult to extend to all policy products on the market, and it is not necessarily possible to match the policy that is truly suitable for the customer. Even a reasonable policy configuration may not be suitable for the customer's physical condition.
綜上所述,可知先前技術中長期以來一直存在現有保單健檢服務並無法提供真正適合客戶的保險產品的問題,因此有必要提出改進的技術手段,來解決此一問題。 In summary, it can be seen that the existing policy health checkup services have long been a problem in the prior art that they cannot provide insurance products that are truly suitable for customers. Therefore, it is necessary to propose improved technical means to solve this problem.
有鑒於先前技術存在保單健檢服務並無法提供真正適合客戶的保險產品的問題,本發明遂揭露一種依據保單資料及醫療資料產生投保建議之裝置及方法,其中:本發明所揭露之依據保單資料及醫療資料產生投保建議之裝置,至少包含:通訊介面,用以接收民眾客戶端所產生之授權訊息,及用以接收民眾客戶端所輸入之民眾個人資料;處理模組,用以執行計算機指令以產生:資料取得模組,用以依據授權訊息透過通訊介面取得民眾保單資料及民眾醫療資料;保單健檢模組,用以依據民眾保單資料產生保單健檢資料,其中,保單健檢資料包含與多個健檢項目對應之投保額度;健康統計模組,用以依據民眾醫療資料中所包含之各種疾病計算健康分類之等級值以產生健康等級資料;產品推薦模組,用以透過通訊介面取得保險產品資訊,並依據健檢項目對應之各標準額度及各投保額度由保險產品資訊中選出保險產品以產生推薦產品清單; 投保建議模組,用以取得與健康分類之分類風險值,並依據與健康分類之等級值對應之分類風險值及保險產品之基本保費產生投保建議資料,及用以取得與民眾個人資料對應之投保人風險值,並依據投保人風險值及投保建議資料選擇保險產品並計算對應之預估保費以產生專屬投保訊息。 In view of the problem that the policy health check service in the prior art cannot provide insurance products that are truly suitable for customers, the present invention discloses a device and method for generating insurance recommendations based on policy information and medical information, wherein: the device for generating insurance recommendations based on policy information and medical information disclosed in the present invention at least includes: a communication interface for receiving the authorization message generated by the public client information, and is used to receive the personal data of the public input by the public client; the processing module is used to execute computer instructions to generate: the data acquisition module is used to obtain the public's insurance policy information and the public's medical information through the communication interface according to the authorization information; the insurance policy health examination module is used to generate the insurance policy health examination data according to the public's insurance policy data, wherein the insurance policy health examination data includes the corresponding items of multiple health examinations The insured amount; the health statistics module is used to calculate the health classification level value based on the various diseases included in the medical data of the people to generate health level data; the product recommendation module is used to obtain insurance product information through the communication interface, and select insurance products from the insurance product information based on the standard amounts and insured amounts corresponding to the health examination items to generate a list of recommended products; Insurance The recommendation module is used to obtain the classified risk value corresponding to the health classification, and generate insurance recommendation data based on the classified risk value corresponding to the level value of the health classification and the basic premium of the insurance product, and to obtain the insured person's risk value corresponding to the personal information of the people, and select insurance products based on the insured person's risk value and insurance recommendation data and calculate the corresponding estimated premium to generate exclusive insurance information.
本發明所揭露之依據保單資料及醫療資料產生投保建議之方法,其步驟至少包括:民眾客戶端產生授權訊息並傳送授權訊息至保單健檢主機;保單健檢主機依據授權訊息取得民眾保單資料,並依據民眾保單資料產生保單健檢資料,其中,保單健檢資料包含與多個健檢項目對應之投保額度;保單健檢主機依據授權訊息取得民眾醫療資料,並依據民眾醫療資料中所包含之各種疾病計算健康分類之等級值以產生健康等級資料;保單健檢主機取得保險產品資訊,並依據健檢項目對應之各標準額度及各投保額度由保險產品資訊中選出保險產品以產生推薦產品清單;保單健檢主機取得與健康分類之分類風險值,並依據與健康分類之等級值對應之分類風險值及保險產品之基本保費產生投保建議資料;民眾客戶端輸入民眾個人資料並傳送民眾個人資料至保單健檢主機;保單健檢主機取得與民眾個人資料對應之投保人風險值,並依據投保人風險值及投保建議資料選擇保險產品並計算對應之預估保費以產生專屬投保訊息。 The method disclosed in the present invention for generating insurance recommendations based on policy data and medical data includes at least the following steps: a citizen client generates an authorization message and transmits the authorization message to a policy health check host; the policy health check host obtains the citizen policy data based on the authorization message, and generates policy health check data based on the citizen policy data, wherein the policy health check data includes an insurance amount corresponding to a plurality of health check items; the policy health check host obtains the citizen medical data based on the authorization message, and calculates the health classification level value based on the various diseases included in the citizen medical data to generate health level data; the policy health check host obtains insurance product information, According to the standard limits and insured limits corresponding to the health check items, insurance products are selected from the insurance product information to generate a list of recommended products; the policy health check host obtains the classified risk value corresponding to the health classification, and generates insurance recommendation information according to the classified risk value corresponding to the level value of the health classification and the basic premium of the insurance product; the public client enters the public's personal data and transmits the public's personal data to the policy health check host; the policy health check host obtains the insured's risk value corresponding to the public's personal data, and selects insurance products according to the insured's risk value and insurance recommendation information and calculates the corresponding estimated premium to generate exclusive insurance information.
本發明所揭露之裝置及方法如上,與先前技術之間的差異在於本發明透過保單健檢主機依據民眾保單資料產生保單健檢資料並依據民眾醫療資料產生健康分類之等級值後,依據保單健檢資料所包含之健檢項目的投保額度與標準額度選出保險產品,及依據民眾個人資料選擇保險產品並依據民眾個人資料對應之投保人風險值計算預估保費以產生專屬投保訊息,藉以解決先前技 術所存在的問題,並可以達成依據民眾醫療狀況與民眾生活需求推薦個人化保險產品的技術功效。 The device and method disclosed in the present invention are as described above. The difference between the present invention and the prior art is that the present invention generates the policy health check data based on the policy data of the citizens and generates the health classification level value based on the medical data of the citizens through the policy health check host, selects the insurance product based on the insured amount and the standard amount of the health check items included in the policy health check data, selects the insurance product based on the personal data of the citizens and calculates the estimated premium based on the risk value of the insured person corresponding to the personal data of the citizens to generate exclusive insurance information, so as to solve the problems existing in the prior art and achieve the technical effect of recommending personalized insurance products based on the medical conditions and life needs of the citizens.
110:民眾客戶端 110: Public client
120:平台伺服器 120: Platform server
130:保單健檢主機 130: Policy health check host
131:通訊介面 131: Communication interface
132:記憶體模組 132: Memory module
133:處理模組 133: Processing module
140:醫療資料伺服器 140: Medical data server
150:保險伺服器 150: Insurance server
170:業務客戶端 170:Business client
210:資料取得模組 210: Data acquisition module
220:保單健檢模組 220: Policy health check module
230:健康統計模組 230: Health Statistics Module
250:產品推薦模組 250: Product recommendation module
260:投保建議模組 260: Insurance suggestion module
280:諮詢服務模組 280: Consultation service module
290:線上投保模組 290: Online insurance module
步驟301:民眾客戶端產生授權訊息並傳送授權訊息至保單健檢主機 Step 301: The citizen client generates an authorization message and sends the authorization message to the policy health check host
步驟310:保單健檢主機依據授權訊息取得民眾保單資料,並依據民眾保單資料產生保單健檢資料 Step 310: The policy health check host obtains the public's policy information based on the authorization message, and generates policy health check data based on the public's policy information.
步驟320:保單健檢主機依據授權訊息取得民眾醫療資料,並依據民眾醫療資料中所包含之各種疾病計算健康分類之等級值以產生健康等級資料 Step 320: The policy health check host obtains the public's medical data based on the authorization message, and calculates the health classification level value based on the various diseases contained in the public's medical data to generate health level data
步驟330:保單健檢主機取得保險產品資訊,並依據健檢項目之標準額度及投保額度由保險產品資訊中選出保險產品以產生推薦產品清單 Step 330: The policy health check host obtains insurance product information and selects insurance products from the insurance product information based on the standard amount and insured amount of the health check items to generate a recommended product list
步驟340:保單健檢主機取得與健康分類之等級值對應之分類風險值,並依據分類風險值及保險產品之基本保費產生投保建議資料 Step 340: The policy health check host obtains the classified risk value corresponding to the health classification level value, and generates insurance recommendation data based on the classified risk value and the basic premium of the insurance product.
步驟350:民眾客戶端輸入民眾個人資料並傳送民眾個人資料至保單健檢主機 Step 350: The public client enters the public's personal information and sends the public's personal information to the policy health check host
步驟360:保單健檢主機由投保建議資料中篩選出與民眾個人資料相符之保險產品,並取得與民眾個人資料對應之投保人風險值,及依據投保人風險值計算篩選後之保險產品之預估保費以產生專屬投保訊息 Step 360: The policy health check host selects insurance products that match the personal information of the citizens from the insurance recommendation data, obtains the risk value of the insured person corresponding to the personal information of the citizens, and calculates the estimated premium of the selected insurance products based on the risk value of the insured person to generate exclusive insurance information
步驟370:民眾客戶端輸入諮詢內容並傳送諮詢內容至保單健檢主機 Step 370: The client inputs the consultation content and sends it to the policy health check host
步驟373:民眾客戶端取得個人保險資料並加密以產生加密檔案 Step 373: The public client obtains personal insurance information and encrypts it to generate an encrypted file
步驟375:民眾客戶端產生與加密檔案對應之檔案取得資訊並將檔案取得資訊加入諮詢內容 Step 375: The public client generates file acquisition information corresponding to the encrypted file and adds the file acquisition information to the consultation content
步驟381:保單健檢主機傳送諮詢內容至保險伺服器,保險伺服器傳送諮詢內容至業務客戶端顯示 Step 381: The policy health check host sends the consultation content to the insurance server, and the insurance server sends the consultation content to the business client for display
步驟383:業務客戶端依據檔案取得資訊傳送請求訊息至保單健檢主機,保單健檢主機傳送請求訊息至民眾客戶端 Step 383: The business client obtains information based on the file and sends a request message to the policy health check host, and the policy health check host sends a request message to the public client
步驟385:民眾客戶端產生與請求訊息對應之確認訊息並傳送確認訊息至保單健檢主機 Step 385: The public client generates a confirmation message corresponding to the request message and sends the confirmation message to the policy health check host
步驟387:保單健檢主機傳送確認訊息至保險伺服器,保險伺服器依據確認訊息傳送加密檔案至業務客戶端 Step 387: The policy health check host sends a confirmation message to the insurance server, and the insurance server sends an encrypted file to the business client based on the confirmation message
步驟389:業務客戶端解密加密檔案以取得並顯示個人保險資料 Step 389: The business client decrypts the encrypted file to obtain and display personal insurance information
步驟391:業務客戶端輸入與諮詢內容對應之回應內容及傳送回應內容至保險伺服器 Step 391: The business client enters the response content corresponding to the consultation content and sends the response content to the insurance server
步驟393:保險伺服器傳送回應內容至保單健檢主機 Step 393: The insurance server sends the response content to the policy health check host
步驟395:保單健檢主機判斷回應內容中是否包含不符規則之內容 Step 395: The policy health check host determines whether the response contains content that does not comply with the rules.
步驟397:保單健檢主機傳送回應內容至民眾客戶端顯示 Step 397: The policy health check host sends the response content to the public client for display
第1圖為本發明所提之依據保單資料及醫療資料產生投保建議之系統架構圖。 Figure 1 is a diagram of the system architecture for generating insurance recommendations based on policy information and medical information as mentioned in the present invention.
第2圖為本發明所提之依據保單資料及醫療資料產生投保建議之平台伺服器之元件示意圖。 Figure 2 is a schematic diagram of the components of the platform server for generating insurance recommendations based on policy information and medical information as mentioned in the present invention.
第3A圖為本發明所提之依據保單資料及醫療資料產生投保建議之方法流程圖。 Figure 3A is a flow chart of the method for generating insurance recommendations based on policy information and medical information proposed in the present invention.
第3B圖為本發明所提之產生並傳送與資訊內容對應之回應內容之方法流程圖。 Figure 3B is a flow chart of the method for generating and transmitting response content corresponding to information content proposed by the present invention.
第3C圖為本發明所提之產生加密檔案與存取加密檔案之方法流程圖。 Figure 3C is a flow chart of the method for generating encrypted files and accessing encrypted files proposed by the present invention.
以下將配合圖式及實施例來詳細說明本發明之特徵與實施方式,內容足以使任何熟習相關技藝者能夠輕易地充分理解本發明解決技術問題所應用的技術手段並據以實施,藉此實現本發明可達成的功效。 The following will be used in conjunction with diagrams and embodiments to explain in detail the features and implementation methods of the present invention. The content is sufficient to enable anyone familiar with the relevant technology to easily and fully understand the technical means used by the present invention to solve technical problems and implement them accordingly, thereby achieving the effects that can be achieved by the present invention.
本發明可以依據民眾的醫療資料與保單資料將個人化的保險產品推薦給民眾。本發明所提之醫療資料包含但不限於就診記錄、病歷資料、醫療影像、檢驗報告、用藥內容等。 This invention can recommend personalized insurance products to the public based on their medical information and policy information. The medical information mentioned in this invention includes but is not limited to medical records, medical history data, medical images, test reports, medication content, etc.
在本發明中也有提到計算設備,本發明所提之計算設備包含但不限於一個或多個處理模組、一條或多條記憶體模組、以及連接不同硬體元件(包括記憶體模組和處理模組)的匯流排等硬體元件。透過所包含之多個硬體元件,計算設備可以載入並執行作業系統,使作業系統在計算設備上運行,也可以執行軟體或程式。計算設備也包含一個外殼,上述之各個硬體元件設置於外殼內。 The present invention also mentions a computing device, which includes but is not limited to one or more processing modules, one or more memory modules, and hardware components such as a bus connecting different hardware components (including memory modules and processing modules). Through the multiple hardware components included, the computing device can load and execute an operating system so that the operating system runs on the computing device, and can also execute software or programs. The computing device also includes a housing, and the above-mentioned hardware components are arranged in the housing.
本發明所提之計算設備的匯流排可以包含一種或多個類型,例如包含資料匯流排(data bus)、位址匯流排(address bus)、控制匯流排(control bus)、擴充功能匯流排(expansion bus)、及/或局域匯流排(local bus)等類型的匯流排。計算設備的匯流排包括但不限於的工業標準架構(Industry Standard Architecture,ISA)匯流排、周邊元件互連(Peripheral Component Interconnect,PCI)匯流排、視頻電子標準協會(Video Electronics Standards Association,VESA)局域匯流排、以及串列的通用序列匯流排(Universal Serial Bus,USB)、快速周邊元件互連(PCI Express,PCI-E/PCIe)匯流排等。 The bus of the computing device mentioned in the present invention may include one or more types, such as data bus, address bus, control bus, expansion bus, and/or local bus. The bus of the computing device includes but is not limited to Industry Standard Architecture (ISA) bus, Peripheral Component Interconnect (PCI) bus, Video Electronics Standards Association (VESA) local bus, and serial Universal Serial Bus (USB), Peripheral Component Interconnect Express (PCI Express, PCI-E/PCIe) bus, etc.
本發明所提之計算設備的處理模組與匯流排耦接。處理模組包含暫存器(Register)組或暫存器空間,暫存器組或暫存器空間可以完全的被設置在處理模組之處理晶片上,或全部或部分被設置在處理晶片外並經由專用電氣連接及/或經由匯流排耦接至處理晶片。處理模組可為中央處理器、微處理器或任何合適的處理元件。若計算設備為多處理器設備,也就是計算設備包含多個處理模組,則計算設備所包含的處理模組都相同或類似,且透過匯流排耦接與通訊。在部分的實施例中,處理模組可以解釋一個計算機指令或一連串的多個計算機指令以進行特定的運算或操作,例如,數學運算、邏輯運算、資料比對、複製/移動資料等,藉以驅動計算設備中的其他硬體元件或運行作業系統或執行 各種程式及/或模組。計算機指令可以是組合語言指令、指令集架構指令、機器指令、機器相關指令、微指令、韌體指令、或者以一種或多種程式語言的任意組合編寫的原始碼或目的碼(Object Code),且計算機指令可以完全地在單一個計算設備上被執行、部分地在單一個計算設備上被執行、部分在一個計算設備上被執行且部分在相連接之另一計算設備上被執行。其中,上述之程式語言包括物件導向(Object-oriented)的程式語言,如Common Lisp、Python、C++、Objective-C、Smalltalk、Delphi、Java、Swift、C#、Perl、Ruby等,及常規的程序式(Procedural)程式語言,如C語言或其他類似的程式語言。 The processing module of the computing device of the present invention is coupled to a bus. The processing module includes a register group or a register space, which can be completely set on the processing chip of the processing module, or completely or partially set outside the processing chip and coupled to the processing chip via a dedicated electrical connection and/or via a bus. The processing module can be a central processing unit, a microprocessor or any suitable processing element. If the computing device is a multi-processor device, that is, the computing device includes multiple processing modules, the processing modules included in the computing device are the same or similar, and are coupled and communicated through a bus. In some embodiments, the processing module can interpret a computer instruction or a series of multiple computer instructions to perform specific calculations or operations, such as mathematical operations, logical operations, data comparison, copying/moving data, etc., so as to drive other hardware components in the computing device or run the operating system or execute various programs and/or modules. The computer instruction can be an assembly language instruction, an instruction set architecture instruction, a machine instruction, a machine-related instruction, a microinstruction, a firmware instruction, or a source code or object code (Object Code) written in any combination of one or more programming languages, and the computer instruction can be completely executed on a single computing device, partially executed on a single computing device, partially executed on one computing device and partially executed on another connected computing device. The above-mentioned programming languages include object-oriented programming languages, such as Common Lisp, Python, C++, Objective-C, Smalltalk, Delphi, Java, Swift, C#, Perl, Ruby, etc., and conventional procedural programming languages, such as C language or other similar programming languages.
計算設備中通常也包含一個或多個晶片組(Chipset)。計算設備的處理模組可以與晶片組耦接或透過匯流排與晶片組電性連接。晶片組是由一個或多個積體電路(Integrated Circuit,IC)組成,包含記憶體控制器以及周邊輸出入(I/O)控制器等,也就是說,記憶體控制器以及周邊輸出入控制器可以包含在一個積體電路內,也可以使用兩個或更多的積體電路實現。晶片組通常提供了輸出入和記憶體管理功能、以及提供多個通用及/或專用暫存器、計時器等,其中,上述之通用及/或專用暫存器與計時器可以讓耦接或電性連接至晶片組的一個或多個處理模組存取或使用。在部分的實施例中,晶片組也可能屬於處理模組的一部份。 The computing device usually also includes one or more chipsets. The processing module of the computing device can be coupled to the chipset or electrically connected to the chipset through a bus. The chipset is composed of one or more integrated circuits (ICs), including a memory controller and a peripheral input/output (I/O) controller, etc. That is, the memory controller and the peripheral input/output (I/O) controller can be included in one IC, or can be implemented using two or more ICs. The chipset usually provides input/output and memory management functions, as well as multiple general and/or dedicated registers, timers, etc., wherein the above-mentioned general and/or dedicated registers and timers can be accessed or used by one or more processing modules coupled or electrically connected to the chipset. In some embodiments, the chipset may also be part of the processing module.
計算設備的處理模組也可以透過記憶體控制器存取安裝於計算設備上的記憶體模組和大容量儲存區中的資料。上述之記憶體模組包含任何類型的揮發性記憶體(volatile memory)及/或非揮發性(non-volatile memory,NVRAM)記憶體,例如靜態隨機存取記憶體(Static Random Access Memory,SRAM)、動態隨機存取記憶體(Dynamic Random Access Memory,DRAM)、 唯讀記憶體(Read-Only Memory,ROM)、快閃記憶體(Flash memory)等。上述之大容量儲存區可以包含任何類型的儲存裝置或儲存媒體,例如,硬碟機、光碟(optical disc)、隨身碟(flash drive)、記憶卡(memory card)、固態硬碟(Solid State Disk,SSD)、或任何其他儲存裝置等。也就是說,記憶體控制器可以存取靜態隨機存取記憶體、動態隨機存取記憶體、快閃記憶體、硬碟機、固態硬碟中的資料。 The processing module of the computing device can also access the data in the memory module and the mass storage area installed on the computing device through the memory controller. The above-mentioned memory module includes any type of volatile memory and/or non-volatile memory (NVRAM) memory, such as static random access memory (SRAM), dynamic random access memory (DRAM), read-only memory (ROM), flash memory, etc. The above-mentioned mass storage area can include any type of storage device or storage media, such as a hard drive, optical disc, flash drive, memory card, solid state disk (SSD), or any other storage device. In other words, the memory controller can access data in static random access memory, dynamic random access memory, flash memory, hard drive, and solid state disk.
計算設備的處理模組也可以透過周邊輸出入控制器經由周邊輸出入匯流排與周邊輸出裝置、周邊輸入裝置、通訊介面、各種資料或訊號接收裝置等周邊裝置或介面連接並通訊。周邊輸入裝置可以是任何類型的輸入裝置,例如鍵盤、滑鼠、軌跡球、觸控板、搖桿等,周邊輸出裝置可以是任何類型的輸出裝置,例如顯示器、印表機等,周邊輸入裝置與周邊輸出裝置也可以是同一裝置,例如觸控螢幕等。通訊介面可以包含無線通訊介面及/或有線通訊介面,無線通訊介面可以包含支援無線區域網路(如Wi-Fi、Zigbee等)、藍牙、紅外線、近場通訊(Near-field communication,NFC)、3G/4G/5G等行動通訊網路(蜂巢式網路)或其他無線資料傳輸協定的介面,有線通訊介面可為乙太網路裝置、DSL數據機、纜線(Cable)數據機、非同步傳輸模式(Asynchronous Transfer Mode,ATM)裝置、或光纖通訊介面及/或元件等。資料或訊號接收裝置可以包含GPS接收器或生理訊號接收器,生理訊號接收器所接收的生理訊號包含但不限於心跳、血氧等。處理模組可以週期性地輪詢(polling)各種周邊裝置與介面,使得計算設備能夠透過各種周邊裝置與介面進行資料的輸入與輸出,也能夠與具有上面描述之硬體元件的另一個計算設備進行通訊。 The processing module of the computing device can also be connected and communicated with peripheral devices or interfaces such as peripheral output devices, peripheral input devices, communication interfaces, various data or signal receiving devices, etc. through the peripheral input/output controller via the peripheral input/output bus. The peripheral input device can be any type of input device, such as a keyboard, a mouse, a trackball, a touchpad, a joystick, etc. The peripheral output device can be any type of output device, such as a display, a printer, etc. The peripheral input device and the peripheral output device can also be the same device, such as a touch screen, etc. The communication interface may include a wireless communication interface and/or a wired communication interface. The wireless communication interface may include an interface supporting wireless local area networks (such as Wi-Fi, Zigbee, etc.), Bluetooth, infrared, near-field communication (NFC), 3G/4G/5G and other mobile communication networks (cellular networks) or other wireless data transmission protocols. The wired communication interface may be an Ethernet device, a DSL modem, a cable modem, an asynchronous transfer mode (ATM) device, or an optical fiber communication interface and/or component. The data or signal receiving device may include a GPS receiver or a physiological signal receiver. The physiological signals received by the physiological signal receiver include but are not limited to heartbeat, blood oxygen, etc. The processing module can periodically poll various peripheral devices and interfaces, so that the computing device can input and output data through various peripheral devices and interfaces, and can also communicate with another computing device with the hardware components described above.
以下先以「第1圖」本發明所提之依據保單資料及醫療資料產生投保建議之系統架構圖來說明本發明的運作。如「第1圖」所示,本發明含有民眾客戶端110、保單健檢主機130,本發明也包含可附加的平台伺服器120、醫療資料伺服器140、一個或多個保險伺服器150、一個或多個業務客戶端170。其中,民眾客戶端110、平台伺服器120、保單健檢主機130、醫療資料伺服器140、保險伺服器150、業務客戶端170都可以是計算設備,且相互之間可以透過有線或無線方式傳遞資料或訊號。
The following first uses "Figure 1" as a system architecture diagram of the present invention for generating insurance recommendations based on policy information and medical information to explain the operation of the present invention. As shown in "Figure 1", the present invention includes a
民眾客戶端110可以是手機或電腦,但本發明並不以此為限。
The
民眾客戶端110負責產生授權訊息並傳送授權訊息至保單健檢主機130。一般而言,民眾客戶端110所產生的授權訊息包含允許保單健檢主機130存取民眾保單資料的第一授權訊息及允許保單健檢主機130由醫療資料伺服器140下載民眾醫療資料的第二授權訊息。其中,授權訊息通常可以包含民眾客戶端110之使用者的民眾識別資料。
The
民眾客戶端110也負責輸入民眾個人資料並傳送民眾個人資料至保單健檢主機130。一般而言,民眾客戶端110可以提供輸入介面給使用者輸入民眾個人資料,本發明所提的民眾個人資料包含但不限於職業、年收入、日常交通工具、家庭總人口數、抽菸狀態、喝酒狀態、身體質量指數(BMI)等資料。
The
民眾客戶端110也可以接收保單健檢主機130所傳送之個人保險資料,本發明所提之個人保險資料包含但不限於保單健檢主機130所產生之保單健檢資料、健康等級資料、推薦產品清單、投保建議資料、專屬投保訊息等資料。民眾客戶端110也可以顯示所接收到的個人保險資料,並可以選擇專屬投保
訊息中所包含的保險產品,及可以將所選擇之保險產品的產品識別資料傳送到保單健檢主機130。
The
民眾客戶端110也可以提供輸入諮詢內容,並可以將所輸入的諮詢內容傳送到保險伺服器150。民眾客戶端110也可以接收保險伺服器150所傳送之與諮詢內容對應的回應內容,並可以顯示所接收到的回應內容。要說明的是,民眾客戶端110可以依據保單健檢主機130所提供的連接訊息直接將諮詢內容傳送給保險伺服器150,或可以透過保單健檢主機130間接將諮詢內容傳送給保險伺服器150。其中,上述之諮詢內容可以包含民眾客戶端110之使用者(通常即為要保人)所提出的疑問,也可以包含民眾客戶端110所產生的檔案取得資訊(稍後說明);上述之連接訊息可以包含保險伺服器150的網域名稱(Domain Name)或網路位址(IP address),也可以包含保險伺服器150所提供的應用程式介面(Application Programming Interface,API),在部分的實施例中,也可以包含保險伺服器150所提供的埠號(port number)。
The
民眾客戶端110也可以接收保單健檢主機130所傳送的個人保險資料,並可以加密所接收到的個人保險資料以產生加密檔案。民眾客戶端110也可以產生與所產生之加密檔案對應的檔案取得資訊並可以將所產生的檔案取得資訊加入所輸入的諮詢內容中。民眾客戶端110也可將所產生的加密檔案與所產生的諮詢內容一同傳送至保險伺服器150。其中,檔案取得資訊可以包含民眾客戶端110的客戶端識別資料、民眾客戶端110所產生之加密檔案的檔案名稱或檔案識別碼、保單健檢主機130的網域名稱或網路位址,也可以包含保單健檢主機130所提供的應用程式介面(API)等。上述之客戶端識別資料可以是民眾客戶端110上之電路板或處理器或其他晶片等特定硬體的序號,也可以是民眾客戶端
110之網路介面所使用的媒體存取控制層之實體位址(MAC address),或可以是保險伺服器150給予民眾客戶端110的專屬資料。
The
民眾客戶端110也可以接收保險伺服器150所產生之請求訊息,並可以產生與所接收到之請求訊息對應的確認訊息。其中,請求訊息表示有業務客戶端170請求取得民眾客戶端110所產生的加密檔案,確認訊息表示是否允許業務客戶端取得所產生的加密檔案。
The
平台伺服器120可以維護保險產品資料庫。保險產品資料庫可以記錄多個保險產品的保險產品資訊,且保險產品資料庫所記錄之保險產品的保險產品資訊來自於各家保險公司,在部分的實施例中,平台伺服器120可以接收各家保險公司的保險伺服器150以預定資料格式所傳送之保險產品資訊。
The
醫療資料伺服器140可以儲存多個民眾的醫療資料,在本發明中,醫療資料伺服器140所儲存的醫療資料也被稱為民眾醫療資料。一般而言,醫療資料伺服器140所儲存的醫療資料都通過所屬病患的授權,也就是說,通常在民眾允許自身的醫療資料被上傳到醫療資料伺服器140後,醫療資料伺服器140才可以儲存該民眾的醫療資料。
The
醫療資料伺服器140也可以提供保單健檢主機130連接,並可以將保單健檢主機130所請求之民眾醫療資料傳送給保單健檢主機130。
The
保單健檢主機130可以提供民眾客戶端110連接,也可以與醫療資料伺服器140、保險伺服器150連接。
The policy
保單健檢主機130可以分析民眾保單資料與民眾醫療資料,並可以依據分析結果選出包含民眾現有保單中保障較為缺乏之項目的保險產品,及可以將所選出的保險產品推薦給民眾。在一部分的實施例中,保單健檢主機130
可以如「第2圖」所示,包含通訊介面131、處理模組133,也可以包含記憶體模組132,其中,通訊介面131、記憶體模組132、處理模組133透過匯流排(圖中未示)連接。
The policy
通訊介面131可以提供保單健檢主機130與民眾客戶端110、醫療資料伺服器140、保險伺服器150連接,藉以提供處理模組133與民眾客戶端110、醫療資料伺服器140、保險伺服器150交換資料或訊號。
The
記憶體模組132可以儲存一個、多個、一組、或多組計算機指令。
The
處理模組133可以執行記憶體模組132所儲存的計算機指令,並可以在執行計算機指令後產生資料取得模組210、保單健檢模組220、健康統計模組230、產品推薦模組250、投保建議模組260等軟體模組,在部分的實施例中,處理模組133也可以產生可附加的諮詢服務模組280、線上投保模組290等軟體模組。實務上,資料取得模組210、保單健檢模組220、健康統計模組230、產品推薦模組250、投保建議模組260(及諮詢服務模組280與線上投保模組290)也可以是硬體元件組成,例如由一組或多組電路及/或一個、多個、或部分的積體電路組成,即處理模組133也可以是包含組成上述各模組之硬體元件的硬體模組。以下將對處理模組133所包含或所產生之各模組分別說明。
The
資料取得模組210負責透過通訊介面131取得民眾客戶端110所產生的授權訊息,並負責透過通訊介面131取得向保單健檢主機130本身或平台伺服器120請求之與所接收到之授權訊息相符的民眾保單資料,及負責透過通訊介面131取得向醫療資料伺服器140請求之與所接收到之授權訊息相符的民眾醫療資料。一般而言,民眾保單資料/民眾醫療資料與授權訊息相符表示民眾保單資料/民眾醫療資料中所記載之身分識別資料(即民眾保單資料/民眾醫療資料之擁
有者的身分識別資料)與授權訊息中所包含之民眾識別資料相同,但本發明並不以此為限。
The data acquisition module 210 is responsible for obtaining the authorization message generated by the
保單健檢模組220負責依據資料取得模組210所取得的民眾保單資料產生保單健檢資料,其中,保單健檢資料包含但不限於與身故給付、意外醫療住院日額、疾病醫療住院日額、門診/住院手術給付、單次事件實支實付上限額度、癌症醫療給付、重大傷病給付、長照給付、傷殘給付等多個健檢項目對應之投保額度。一般而言,保單健檢模組220可以搜尋民眾保單資料中與各健檢項目對應的關鍵字詞以取得與各健檢項目對應投保額度,或可以對民眾保單資料進行文字及/或文意分析以取得與各健檢項目對應投保額度,其中,當民眾保單資料包含多份保單,或是單一份保單中包含兩個或兩個以上之與特定健檢項目對應的投保額度時,保單健檢模組220可以加總所取得的投保額度以產生與該特定之健檢項目對應的投保額度。 The policy health check module 220 is responsible for generating policy health check data based on the public policy data obtained by the data acquisition module 210, wherein the policy health check data includes but is not limited to the insurance amounts corresponding to multiple health check items such as death benefits, accidental medical hospitalization days, disease medical hospitalization days, outpatient/inpatient surgery benefits, single event actual payment limit, cancer medical benefits, major injury and disease benefits, long-term care benefits, and disability benefits. Generally speaking, the insurance policy health check module 220 can search for keywords corresponding to each health check item in the public insurance policy data to obtain the insurance amount corresponding to each health check item, or can perform text and/or context analysis on the public insurance policy data to obtain the insurance amount corresponding to each health check item. When the public insurance policy data includes multiple insurance policies, or a single insurance policy includes two or more insurance amounts corresponding to specific health check items, the insurance policy health check module 220 can add up the obtained insurance amounts to generate the insurance amount corresponding to the specific health check item.
健康統計模組230負責依據資料取得模組210所取得的民眾醫療資料中所包含之各種疾病計算一個或多個健康分類的等級值以產生健康等級資料。舉例來說,健康統計模組230可以取得預先儲存之男女性風險指數、國際疾病分類(the International statistical Classification of Diseases and Related Health Problems,ICD)碼(目前通常使用第10或11版)、與國際疾病分類碼中之各分類碼對應的權重值、及與各分類碼對應的健康分類,也可以取出民眾醫療資料中所包含的國際疾病分類碼,並依據所取出之國際疾病分類碼計算各健康分類的權重值總和後再計算各健康分類之權重值總和的平均值,及以男女性風險指數為基本數值,將男女性風險指數對應到所計算出之各健康分類的平均值,以產生各健康分類的等級值。其中,健康分類包含但不限於生命等級、罹癌等級、
重疾等級、住院等級等;上述之男女性風險指數、國際疾病分類碼、與各分類碼對應的權重值、及與各分類碼對應的健康分類可以被儲存到檔案或資料庫中,上述之檔案或資料庫被設置在保單健檢主機130上的儲存媒體或與保單健檢主機130透過無線或實體連接的儲存裝置或資料伺服器(圖中未示)。但健康統計模組230產生健康分類之等級值的方式並不以上述為限。
The health statistics module 230 is responsible for calculating the level values of one or more health categories based on various diseases included in the public medical data obtained by the data acquisition module 210 to generate health level data. For example, the health statistics module 230 can obtain pre-stored male and female risk indexes, the International Statistical Classification of Diseases and Related Health Problems (ICD) code (currently the 10th or 11th edition is usually used), the weight values corresponding to each classification code in the International Classification of Disease code, and the health categories corresponding to each classification code. It can also retrieve the International Classification of Disease code contained in the public medical data, and calculate the sum of the weight values of each health category based on the retrieved International Classification of Disease code, and then calculate the average of the sum of the weight values of each health category, and use the male and female risk index as the basic value, and correspond the male and female risk index to the calculated average value of each health category to generate a level value for each health category. Among them, health classification includes but is not limited to life level, cancer level, serious illness level, hospitalization level, etc.; the above-mentioned male and female risk index, international disease classification code, weight value corresponding to each classification code, and health classification corresponding to each classification code can be stored in a file or database, and the above-mentioned file or database is set on the storage medium of the insurance policy
產品推薦模組250可以由平台伺服器120所維護的保險產品資料庫或透過通訊介面131由保險伺服器150取得保險產品資訊,並負責依據保單健檢模組220所產生之各健檢項目的投保額度及各健檢項目的標準額度由所取得的保險產品資訊中選出一個或多個保險產品以產生推薦產品清單。舉例來說,產品推薦模組250可以取得預先建立或設定之各健檢項目的標準額度,並可以分別比對各健檢項目的投保額度與標準額度,產品推薦模組250可以記錄投保額度低於標準額度的健檢項目,並可以依據所取得之保險產品資訊中所記錄之與各健檢項目對應的保險額度尋找產品推薦模組250所記錄之各健檢項目的保險額度與投保額度加總後大於或等於標準額度的單一保險產品,若產品推薦模組250成功尋找到適合的保險產品,則可以產生包含所尋找到之保險產品的推薦產品清單,若產品推薦模組250沒有成功尋找到適合的單一保險產品,產品推薦模組250可以嘗試組合多個保險產品以產生推薦產品清單。但產品推薦模組250選擇保險產品的方式並不以上述為限。
The product recommendation module 250 can obtain insurance product information from the insurance product database maintained by the
投保建議模組260負責取得健康統計模組230所產生之健康分類之等級值對應的分類風險值,並負責依據與各健康分類之等級值對應的分類風險值與產品推薦模組250所產生之推薦產品清單中所包含之保險產品的基本保費產生投保建議資料。舉例來說,投保建議模組260可以取得預先建立之包含各 健康分類之等級值與對應之分類風險值的分類風險表,並可以由分類風險表中查找出與各健康分類之等級值對應的分類風險值,及可以由推薦產品清單中之保險產品的保險產品資訊中取得保險產品的基本保費及相對應的健康分類,再依據與保險產品對應之健康分類的分類風險值調整該保險產品的基本保費以產生估計保費(如將分類風險值與基本保費的乘積做為估計保費),並將所產生之估計保費加入該保險產品的保險產品資訊中以產生包含保險產品之保險產品資訊與估計保費的投保建議資料。 The insurance recommendation module 260 is responsible for obtaining the classified risk values corresponding to the health classification level values generated by the health statistics module 230, and is responsible for generating insurance recommendation data based on the classified risk values corresponding to the level values of each health classification and the basic premiums of the insurance products included in the recommended product list generated by the product recommendation module 250. For example, the insurance recommendation module 260 can obtain a pre-established classification risk table including the level values of each health category and the corresponding classification risk values, and can find the classification risk value corresponding to the level value of each health category from the classification risk table, and can obtain the basic premium of the insurance product and the corresponding insurance product from the insurance product information of the recommended product list. Health classification, and then adjust the basic premium of the insurance product according to the classified risk value of the health classification corresponding to the insurance product to generate an estimated premium (such as taking the product of the classified risk value and the basic premium as the estimated premium), and add the generated estimated premium to the insurance product information of the insurance product to generate insurance recommendation data including the insurance product information and estimated premium of the insurance product.
投保建議模組260也負責透過通訊介面131接收民眾客戶端110所傳送之民眾個人資料,並負責依據所接收到之民眾個人資料由所產生之投保建議資料中選擇一個或多個保險產品以產生民眾客戶端110之使用者的專屬投保訊息。舉例來說,投保建議模組260可以比對民眾個人資料中的各資料與投保建議資料中所包含之保險產品的保險產品資訊以判斷民眾個人資料是否與保險產品相符,例如比對保險產品資訊中所記錄的理賠內容是否包含民眾個人資料中的日常交通工具、又如比對年收入高於保險產品資訊中所記錄之估計保費一定比例等,藉以由投保建議資料中篩選出與民眾個人資料相符的保險產品以產生專屬投保訊息。
The insurance suggestion module 260 is also responsible for receiving the public personal information transmitted by the
在部分的實施例中,投保建議模組260也可以取得與所接收到之民眾個人資料對應的一個或多個投保人風險值,並可以依據所取得之投保人風險值計算由所產生之投保建議資料中選出的保險產品之預估保費,及可以將所計算出之預估保費取代所產生之專屬投保訊息中同一保險產品的估計保費。舉例來說,投保建議模組260可以取得預先建立之與民眾個人資料中所包含之各資料對應的資料類別風險表,及可以依據民眾個人資料中之各資料由各個對應之 資料類別風險表中取得相對應的投保人風險值,並依據估計保費與各投保人風險值計算出預估保費,例如,計算估計保費與各投保人風險值的乘積。 In some embodiments, the insurance recommendation module 260 can also obtain one or more policyholder risk values corresponding to the received personal information of the citizens, and can calculate the estimated premium of the insurance product selected from the generated insurance recommendation data based on the obtained policyholder risk values, and can replace the estimated premium of the same insurance product in the generated exclusive insurance information with the calculated estimated premium. For example, the insurance recommendation module 260 can obtain a pre-established data category risk table corresponding to each data included in the personal data of the public, and can obtain the corresponding insured person risk value from each corresponding data category risk table according to each data in the personal data of the public, and calculate the estimated premium according to the estimated premium and each insured person risk value, for example, calculate the product of the estimated premium and each insured person risk value.
諮詢服務模組280可以透過通訊介面131接收民眾客戶端110所輸入並傳送的諮詢內容,並可以透過通訊介面131將所接收到的諮詢內容傳送到一個或多個保險伺服器150。諮詢服務模組280也可以透過通訊介面131接收一個或多個業務客戶端所輸入並傳送之與諮詢內容對應的回應內容,並可以透過通訊介面131將所接收到的回應內容傳回至民眾客戶端110。
The consultation service module 280 can receive the consultation content input and sent by the
值得一提的是,諮詢服務模組280也可以判斷透過通訊介面131所接收到之回應內容(在部分的實施例中也可以判斷諮詢內容)中是否包含不符規則之內容,並可以在判斷所接收到的回應內容中包含不符規則之內容時不將回應內容傳送至民眾客戶端110,也可以在判斷所接收到的諮詢內容中包含不符規則之內容時產生表示內容不符規則之提示內容並將所產生的提示內容傳送至民眾客戶端110。其中,諮詢服務模組280可以對回應內容/諮詢內容進行判斷的規則包含回應內容是否包含業務員的聯絡方式或諮詢內容是否包含要保人(民眾客戶端110之使用者)的聯絡方式,回應內容/諮詢內容是否包含不當的文字等,但本發明並不以此為限。
It is worth mentioning that the consultation service module 280 can also determine whether the response content (in some embodiments, the consultation content) received through the
諮詢服務模組280也可以透過通訊介面131將包含保單健檢資料、健康等級資料、推薦產品清單、投保建議資料、及/或專屬投保訊息之個人保險資料傳送到民眾客戶端110。
The consultation service module 280 can also transmit personal insurance information including policy health checkup information, health level information, recommended product list, insurance suggestion information, and/or exclusive insurance information to the
諮詢服務模組280也可以透過通訊介面131接收一個或多個業務客戶端依據檔案取得資訊所傳送之請求訊息,並可以依據請求訊息中所包含的客戶端識別資料透過通訊介面131將所接收到的請求訊息傳送至民眾客戶端
110。諮詢服務模組280也可以透過通訊介面131接收民眾客戶端110所產生並傳送的確認訊息,並可以依據確認訊息中所包含之保險伺服器150的連線資訊透過通訊介面131將所接收到的確認訊息傳送到保險伺服器150。
The consultation service module 280 can also receive a request message sent by one or more business clients based on file acquisition information through the
線上投保模組290可以取得通訊介面131所接收到之民眾客戶端所選擇並傳送的一個或多個投保產品,並可以透過通訊介面131連線提供被民眾客戶端110選擇之投保產品的保險伺服器150,及可以與所連接之保險伺服器150進行與被民眾客戶端110選擇之投保產品對應的線上投保作業,例如,接收民眾客戶端110所傳送的投保資料,並可以將投保資料傳送給保險伺服器150,以使保險伺服器150進行線上投保作業。
The online insurance module 290 can obtain one or more insurance products selected and sent by the public client received by the
要說明的是,在某些實施例中,上述之保單健檢主機130可以合併至平台伺服器120中。
It should be noted that in some embodiments, the above-mentioned insurance policy
保險伺服器150可以接收民眾客戶端110所輸入的諮詢內容、民眾客戶端110產生的加密檔案及與加密檔案對應的檔案取得資訊,其中,諮詢內容、加密檔案與檔案取得資訊可以直接由民眾客戶端110傳送或是由民眾客戶端110交由保單健檢主機130轉送,本發明沒有特別的限制。
The
保險伺服器150也可以選擇一個或多個業務客戶端170,並可以將所接收到的諮詢內容傳送給所選擇的業務客戶端170。保險伺服器150也可以接收業務客戶端170所傳送的請求訊息,並可以將所接收到的請求訊息直接傳送給民眾客戶端110或透過保單健檢主機130轉送給民眾客戶端110。保險伺服器150也可以接收保單健檢主機130所傳送之確認訊息並判斷確認訊息表示允許傳送加密檔案時,將加密檔案傳送給發出與確認訊息對應之請求訊息的業務客戶端170。舉例來說,保險伺服器150可以記錄收發請求訊息之民眾客戶端110與業務
客戶端170的客戶端識別資料,藉以在接收到與確認訊息時,取得發出與確認訊息對應之請求訊息的業務客戶端170的客戶端識別資料,並依據所取得的客戶端識別資料將加密檔案傳送給業務客戶端170,但本發明並不以此為限。
The
業務客戶端170可以接收保險伺服器150所傳送的諮詢內容,並可以提供輸入與諮詢內容對應的回應內容,及可以將所輸入的回應內容傳送給保險伺服器150。
The
業務客戶端170也可以在諮詢內容中包含檔案取得資訊時,產生並傳送請求訊息,並可以將所產生的請求訊息傳送給保險伺服器150。業務客戶端170也可以接收保險伺服器150所傳送之加密檔案,並可以解密所接收到的加密檔案以取得保單健檢主機130所產生之保單健檢資料、健康等級資料、推薦產品清單、投保建議資料、及/或專屬投保訊息等個人投保資料,及可以顯示所接收到的個人投保資料。
The
接著以一個實施例來解說本發明的運作系統與方法,並請參照「第3A圖」本發明所提之依據保單資料及醫療資料產生投保建議之方法流程圖。在本實施例中,假設保單健檢主機130與平台伺服器120為不同的計算設備。
Next, an embodiment is used to explain the operating system and method of the present invention, and please refer to "Figure 3A" for the flow chart of the method for generating insurance recommendations based on policy information and medical information. In this embodiment, it is assumed that the policy
首先,當有民眾使用執行有本發明之保單健檢主機130產生建議的保險產品時,民眾可以操作民眾客戶端110產生授權訊息,並將所產生授權訊息傳送到保單健檢主機130(步驟301)。在本實施例中,假設民眾可以在民眾客戶端110上安裝與保單健檢主機130相容的應用程式,並可以執行該應用程式以使得民眾客戶端110顯示使用者介面,及可以在使用者介面中選擇產生授權訊息的選項以使得應用程式產生授權訊息並將所產生的授權訊息傳送到保單健檢主機130。
First, when a citizen uses the insurance policy
在保單健檢主機130的資料取得模組210透過保單健檢主機130的通訊介面131接收到民眾客戶端110所產生的授權訊息後,保單健檢主機130的保單健檢模組220可以依據資料取得模組210所取得的授權訊息取得民眾保單資料,並可以依據所取得的民眾保單資料產生保單健檢資料(步驟310)。在本實施例中,假設保單健檢模組220可以透過通訊介面131向保單健檢主機130請求符合授權訊息所包含之身分識別資料的民眾保單資料,並可以由所取得的民眾保單資料中取得與身故給付、意外醫療住院日額、疾病醫療住院日額、門診/住院手術給付、單次事件實支實付上限額度、癌症醫療給付、重大傷病給付、長照給付、傷殘給付等九個健檢項目對應的投保額度,並可以產生包含與上述九個健檢項目對應之投保額度的保單健檢資料。
After the data acquisition module 210 of the insurance policy
在保單健檢主機130的保單健檢模組220依據民眾保單資料產生保單健檢資料(步驟310)後,保單健檢主機130的產品推薦模組250可以取得一家或多家保險公司之保險產品的保險產品資訊,並可以依據保單健檢模組220所產生之健檢項目的標準額度與投保額度由所取得的保險產品資訊中選出保險產品以產生推薦產品清單(步驟330)。在本實施例中,假設產品推薦模組250可以透過保單健檢主機130的通訊介面131連線到保單健檢主機130,藉以由保單健檢主機130所維護的保險產品資料庫下載多家保險公司的保險產品資訊,接著,產品推薦模組250可以逐一比對保單健檢模組220所產生之九個健檢項目的投保額度與預先設定的標準額度,並可以在投保額度低於標準額度時記錄投保額度低於標準額度的健檢項目,之後,產品推薦模組250可以依據保險產品資訊中所記錄之各健檢項目的保險額度,在保險產品資訊中尋找產品推薦模組250所記錄之健檢項目的保險額度與同一健檢項目之投保額度加總後大於或等於同一健檢
項目之標準額度的保險產品,並可以產生包含所尋找到之保險產品的推薦產品清單。
After the insurance policy health check module 220 of the insurance policy
同樣在保單健檢主機130的資料取得模組210透過保單健檢主機130的通訊介面131接收到民眾客戶端110所產生的授權訊息後,保單健檢主機130的健康統計模組230可以依據資料取得模組210所取得的授權訊息取得民眾醫療資料,並可以依據所取得的民眾醫療資料中所包含的各種疾病計算產生健康分類的等級值以產生健康等級資料(步驟320)。在本實施例中,假設醫療資料伺服器140為健保署所提供之健康存摺伺服器,健康統計模組230可以透過通訊介面131向醫療資料伺服器140請求符合授權訊息所包含之身分識別資料的民眾醫療資料,並可以由所取得之民眾醫療資料中取出所包含的各種疾病之國際疾病分類碼,及可以讀取與所取得之國際疾病分類碼對應的健康分類與權重值,並可以計算與各國際疾病分類碼對應之權重值的平均值以產生生命等級、罹癌等級、重疾等級、住院等級等四個健康分類的等級值,藉以產生包含上述四個健康分類之等級值的健康等級資料。
Similarly, after the data acquisition module 210 of the insurance policy
在保單健檢主機130的健康統計模組230計算出各個健康分類的等級值以產生健康等級資料(步驟320)且保單健檢主機130的產品推薦模組250選出保險產品以產生推薦產品清單(步驟330)後,保單健檢主機130的投保建議模組260可以取得與各個健康分類之等級值對應的分類風險值,並可以依據所取得之分類風險值與推薦產品清單中之各保險產品的基本保費產生投保建議資料(步驟340)。在本實施例中,假設健康統計模組230所計算出之生命等級、罹癌等級、重疾等級、住院等級等四個健康分類的等級值分別為7、8、6、6,且預先建立之分類風險對應表如下:
則投保建議模組260可以取得與生命等級、罹癌等級、重疾等級、住院等級等四個健康分類之等級值對應的分類風險值分別為1.1、1、1.3、1.05。接著,投保建議模組260可以計算與保險產品對應之健康分類的分類風險值與保險產品之基本保費的乘積以產生估計保費,並可以將所產生之估計保費加入同一保險產品的保險產品資訊中,藉以產生包含產品推薦模組250所產生之推薦產品清單中所有保險產品的保險產品資訊與估計保費之投保建議資料。 The insurance recommendation module 260 can obtain the classification risk values corresponding to the level values of the four health categories, namely, life level, cancer level, serious illness level, and hospitalization level, which are 1.1, 1, 1.3, and 1.05 respectively. Then, the insurance recommendation module 260 can calculate the product of the classification risk value of the health category corresponding to the insurance product and the basic premium of the insurance product to generate an estimated premium, and can add the generated estimated premium to the insurance product information of the same insurance product, so as to generate insurance recommendation data including the insurance product information and estimated premium of all insurance products in the recommended product list generated by the product recommendation module 250.
在保單健檢主機130的投保建議模組260產生投保建議資料(步驟340)後,保單健檢主機130的通訊介面131可以將保單健檢主機130的保單健檢模組220、健康統計模組230、產品推薦模組250、及/或投保建議模組260所產生的保單健檢資料、健康等級資料、推薦產品清單、及/或投保建議資料傳送給民眾客戶端110。在民眾客戶端110接收到保單健檢主機130所傳送的保單健檢資料、健康等級資料、推薦產品清單、及/或投保建議資料後,民眾客戶端110上所執行的應用程式可以隨著使用者的操作顯示保單健檢資料、健康等級資料、推薦產品清單、或投保建議資料,且民眾客戶端110所執行的應用程式也可以提供
資料輸入介面給使用者輸入民眾個人資料,及可以在使用者完成民眾個人資料的輸入後,將被輸入的民眾個人資料傳送到保單健檢主機130(步驟350)。
After the insurance recommendation module 260 of the policy
在保單健檢主機130的投保建議模組260透過保單健檢主機130的通訊介面131接收到民眾客戶端110所傳送的民眾個人資料後,投保建議模組260可以由所產生之投保建議資料中篩選出與所接收到之民眾個人資料相符的保險產品,並可以取得與民眾個人資料對應的投保人風險值,及可以依據所取得之投保人風險值計算篩選後之保險產品的預估保費以產生專屬投保訊息(步驟360)。在本實施例中,假設預先建立的職業風險表、交通風險表、BMI值風險表如下:
若民眾個人資料中記錄職業為工程師,日常交通工具為騎車,BMI值為20,則投保建議模組260可以得到三個投保人風險值,分別為1.1、1.2、1,投保建議模組260可以計算篩選後之保險產品的保險產品資訊中之估計保費與上述三個投保人風險值的乘積以產生預估保費,進而產生民眾客戶端110之使用者的專屬投保訊息。
If the citizen's personal data records that his occupation is engineer, his daily means of transportation is cycling, and his BMI is 20, then the insurance recommendation module 260 can obtain three insured person risk values, which are 1.1, 1.2, and 1 respectively. The insurance recommendation module 260 can calculate the product of the estimated premium in the insurance product information of the screened insurance product and the above three insured person risk values to generate an estimated premium, and then generate exclusive insurance information for the user of the
在保單健檢主機130的投保建議模組260產生專屬投保訊息(步驟360)後,投保建議模組260可以透過保單健檢主機130的通訊介面131將所產生的專屬投保訊息傳送到民眾客戶端110,使得民眾客戶端110所執行的應用程式顯示專屬於民眾之推薦的保險產品。
After the insurance recommendation module 260 of the policy
如此,透過本發明,可以依據民眾的醫療資料與保單資料取得包含民眾現有保險產品所缺乏之項目的保險產品,並可以將所取得之保險產品推薦給民眾,使得民眾可以獲得個人化推薦的保險產品。 Thus, through the present invention, people can obtain insurance products that include items that are lacking in their existing insurance products based on their medical information and policy information, and the obtained insurance products can be recommended to the public, so that the public can obtain personalized recommended insurance products.
上述實施例中,在保單健檢主機130的投保建議模組260產生專屬投保訊息(步驟360)且民眾客戶端110顯示專屬投保訊息後,還可以如「第3B圖」之流程所示,當民眾客戶端110的使用者有所疑問,民眾客戶端110可以提供使用者輸入諮詢內容,並可以將被輸入的諮詢內容傳送到保單健檢主機130(步驟370)。
In the above embodiment, after the insurance recommendation module 260 of the policy
在保單健檢主機130的諮詢服務模組280透過保單健檢主機130的通訊介面131接收到民眾客戶端110所傳送的諮詢內容後,可以透過通訊介面131將所接收到的諮詢內容傳送給保險伺服器150,保險伺服器150可以在接收到保單健檢主機130所傳送的諮詢內容後,選擇一個或多個業務客戶端170,並可以將所接收到的諮詢內容傳送給所選擇的業務客戶端170,業務客戶端170可以在
業務員開啟與保險伺服器150相容的應用程式後,顯示接收自保險伺服器150的諮詢內容(步驟381)。
After the consultation service module 280 of the policy
業務客戶端170可以在顯示諮詢內容後提供業務員輸入與被顯示之諮詢內容對應的回應內容,並可以將被輸入的回應內容傳送回保險伺服器150(步驟391),保險伺服器可以將所接收到的回應內容傳回保單健檢主機130(步驟393),保單健檢主機130可以將回應內容傳送回民眾客戶端110,民眾客戶端110可以顯示所接收到的回應內容(步驟397)。其中,保單健檢主機130在接收到回應內容後,可以先判斷回應內容是否包含不符規則的內容(步驟395),若否,則可以將回應內容傳送回民眾客戶端110,若是,則將不傳送回應內容,而可以產生提示訊息並將所產生的提示訊息傳回保險伺服器150,使得保險伺服器將提示訊息傳送到業務客戶端170顯示。
After displaying the consultation content, the
另外,上述實施例更可以如「第3C圖」之流程所示,在保單健檢主機130的投保建議模組260產生專屬投保訊息(步驟360)後,民眾客戶端110可以提供使用者輸入諮詢內容(步驟370)時,若使用者所輸入的諮詢內容中需要提供保單健檢資料、健康等級資料、推薦產品清單、投保建議資料、及/或專屬投保訊息等個人保險資料時,使用者也可以在民眾客戶端110所執行之應用程式所提供的輸入介面中選擇需要提供的個人保險資料,民眾客戶端110所執行的應用程式可以在使用者選擇個人保險資料後,加密被選擇的保單健檢資料、健康等級資料、推薦產品清單、投保建議資料、及/或專屬投保訊息等個人保險資料以產生加密檔案(步驟373),並可以產生與所產生之加密檔案對應的檔案取得資訊,及可將所產生之檔案取得資訊加入諮詢內容中(步驟375),如此,當
民眾客戶端110所執行之應用程式將諮詢內容傳送到保單健檢主機130時,可以將加密檔案一起傳送到保單健檢主機130。
In addition, the above embodiment can be further shown in the process of "Figure 3C". After the insurance recommendation module 260 of the policy
當保單健檢主機130將諮詢內容傳送給保險伺服器150時,同樣會一併將加密檔案傳送給保險伺服器150,保險伺服器150在接收到諮詢內容與加密檔案後,可以儲存加密檔案,並可以將所接收到的諮詢內容傳送到業務客戶端170(步驟381)。
When the policy
業務客戶端170在接收到諮詢內容後,可以顯示所接收到的諮詢內容,當業務員希望瀏覽諮詢內容之撰寫者的個人保險資料時,業務員可以在業務客戶端170所提供的使用者介面上進行操作以使得業務客戶端170依據諮詢內容所包含的檔案取得訊息產生並傳送請求訊息至保單健檢主機130,保單健檢主機130在接收到請求訊息後可以將所接收到的請求訊息傳送給民眾客戶端110(步驟383)。
After receiving the consultation content, the
民眾客戶端110在接收到保單健檢主機130所傳送的請求訊息後,民眾客戶端110所執行的應用程式可以提示使用者是否要允許業務員存取加密檔案,若使用者在應用程式所提供的操作介面中選擇允許,則應用程式可以產生確認訊息,若使用者選擇不允許,則應用程式可以產生拒絕訊息,之後,應用程式可以將所產生之確認訊息或拒絕訊息傳送到保單健檢主機130(步驟385)。
After receiving the request message sent by the policy
在保單健檢主機130接收到民眾客戶端110所傳送之確認訊息或拒絕訊息後,保單健檢主機130可以將所接收到的確認訊息/拒絕訊息傳送到保險伺服器150,保險伺服器150可以在接收到確認訊息時將加密檔案傳送給業務客
戶端170(步驟387),並可以在接收到拒絕訊息時傳送提示訊息到業務客戶端170。
After the policy
當業務客戶端170接收到加密檔案後,可以解密所接收到的加密檔案,藉以取得加密檔案中所包含的保單健檢資料、健康等級資料、推薦產品清單、投保建議資料、及/或專屬投保訊息等個人保險資料,並可以顯示所取得的個人保險資料給業務員參考(步驟389),使得業務員可以輸入與諮詢內容對應的回應內容(步驟391)。
After receiving the encrypted file, the
綜上所述,可知本發明與先前技術之間的差異在於具有保單健檢主機依據民眾保單資料產生保單健檢資料並依據民眾醫療資料產生健康分類之等級值後,依據保單健檢資料所包含之健檢項目的投保額度與標準額度選出保險產品,及依據民眾個人資料選擇保險產品並依據民眾個人資料對應之投保人風險值計算預估保費以產生專屬投保訊息之技術手段,藉由此一技術手段可以來解決先前技術所存在保單健檢服務並無法提供真正適合客戶的保險產品的問題,進而達成依據民眾醫療狀況與民眾生活需求推薦個人化保險產品之技術功效。 In summary, the difference between the present invention and the prior art is that the policy health check host generates policy health check data based on the public's policy data and generates health classification level values based on the public's medical data, selects insurance products based on the insured amount and standard amount of the health check items included in the policy health check data, and selects insurance products based on the public's personal data and generates health classification level values based on the public's medical data. The technology calculates the estimated premium based on the risk value of the insured person corresponding to the personal data of the people to generate exclusive insurance information. This technology can solve the problem that the policy health check service in the previous technology cannot provide insurance products that are truly suitable for customers, and thus achieve the technical effect of recommending personalized insurance products based on the medical conditions and life needs of the people.
再者,本發明之依據保單資料及醫療資料產生投保建議之方法,可實現於硬體、軟體或硬體與軟體之組合中,亦可在電腦系統中以集中方式實現或以不同元件散佈於若干互連之電腦系統的分散方式實現。 Furthermore, the method of generating insurance recommendations based on policy information and medical information of the present invention can be implemented in hardware, software, or a combination of hardware and software, and can also be implemented in a centralized manner in a computer system or in a distributed manner with different components distributed in a number of interconnected computer systems.
雖然本發明所揭露之實施方式如上,惟所述之內容並非用以直接限定本發明之專利保護範圍。任何本發明所屬技術領域中具有通常知識者,在不脫離本發明所揭露之精神和範圍的前提下,對本發明之實施的形式上及細節 上作些許之更動潤飾,均屬於本發明之專利保護範圍。本發明之專利保護範圍,仍須以所附之申請專利範圍所界定者為準。 Although the implementation methods disclosed in the present invention are as above, the contents described are not used to directly limit the scope of patent protection of the present invention. Any person with common knowledge in the technical field to which the present invention belongs, without departing from the spirit and scope disclosed by the present invention, makes slight changes and modifications to the implementation of the present invention in form and details, which are all within the scope of patent protection of the present invention. The scope of patent protection of the present invention shall still be based on the scope defined in the attached patent application.
步驟301:民眾客戶端產生授權訊息並傳送授權訊息至保單健檢主機 Step 301: The citizen client generates an authorization message and sends the authorization message to the policy health check host
步驟310:保單健檢主機依據授權訊息取得民眾保單資料,並依據民眾保單資料產生保單健檢資料 Step 310: The policy health check host obtains the public's policy information based on the authorization message, and generates policy health check data based on the public's policy information.
步驟320:保單健檢主機依據授權訊息取得民眾醫療資料,並依據民眾醫療資料中所包含之各種疾病計算健康分類之等級值以產生健康等級資料 Step 320: The policy health check host obtains the public's medical data based on the authorization message, and calculates the health classification level value based on the various diseases contained in the public's medical data to generate health level data
步驟330:保單健檢主機取得保險產品資訊,並依據健檢項目之標準額度及投保額度由保險產品資訊中選出保險產品以產生推薦產品清單 Step 330: The policy health check host obtains insurance product information and selects insurance products from the insurance product information based on the standard amount and insured amount of the health check items to generate a recommended product list
步驟340:保單健檢主機取得與健康分類之等級值對應之分類風險值,並依據分類風險值及保險產品之基本保費產生投保建議資料 Step 340: The policy health check host obtains the classified risk value corresponding to the health classification level value, and generates insurance recommendation data based on the classified risk value and the basic premium of the insurance product.
步驟350:民眾客戶端輸入民眾個人資料並傳送民眾個人資料至保單健檢主機 Step 350: The public client enters the public's personal information and sends the public's personal information to the policy health check host
步驟360:保單健檢主機由投保建議資料中篩選出與民眾個人資料相符之保險產品,並取得與民眾個人資料對應之投保人風險值,及依據投保人風險值計算篩選後之保險產品之預估保費以產生專屬投保訊息 Step 360: The policy health check host selects insurance products that match the personal information of the citizens from the insurance recommendation data, obtains the risk value of the insured person corresponding to the personal information of the citizens, and calculates the estimated premium of the selected insurance products based on the risk value of the insured person to generate exclusive insurance information
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TW112129842A TWI866380B (en) | 2023-08-08 | 2023-08-08 | Device and method for generating insurance advice based on policy information and medical information |
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CN111179102A (en) * | 2019-12-25 | 2020-05-19 | 北京亚信数据有限公司 | Medical insurance underwriting and protecting wind control method and device and storage medium |
US10803528B2 (en) * | 2013-07-01 | 2020-10-13 | Nader Mdeway | Consumer-centered risk analysis and insurance purchasing systems and methods |
TWI744542B (en) * | 2018-06-05 | 2021-11-01 | 沈燁 | Insurance service optimization system |
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US10803528B2 (en) * | 2013-07-01 | 2020-10-13 | Nader Mdeway | Consumer-centered risk analysis and insurance purchasing systems and methods |
TWI744542B (en) * | 2018-06-05 | 2021-11-01 | 沈燁 | Insurance service optimization system |
CN111179102A (en) * | 2019-12-25 | 2020-05-19 | 北京亚信数据有限公司 | Medical insurance underwriting and protecting wind control method and device and storage medium |
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