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1. (WO2017157030) MEDICAL INSURANCE PREMIUM DISCOUNT ACTUARIAL SYSTEM AND METHOD

Pub. No.:    WO/2017/157030    International Application No.:    PCT/CN2016/105114
Publication Date: Fri Sep 22 01:59:59 CEST 2017 International Filing Date: Wed Nov 09 00:59:59 CET 2016
IPC: G06Q 40/00
Applicants: ANYCHECK INFORMATION TECHNOLOGIES CO. LTD.
深圳市前海安测信息技术有限公司
Inventors: ZHANG, Guanjing
张贯京
Title: MEDICAL INSURANCE PREMIUM DISCOUNT ACTUARIAL SYSTEM AND METHOD
Abstract:
A medical insurance premium discount actuarial system and method. The method comprises the steps of: obtaining, from a medical insurance database, an insurance premium amount of a policyholder in a predetermined period, and adding the insurance premium amount to an insurance amount list (S31); establishing a claim settlement risk assessment model of the policyholder according to health data of the policyholder (S32); obtaining the insurance claim amount, which is already paid to the policyholder, from the medical insurance database, and storing the insurance claim amount in the insurance amount list (S33); predicting and precisely calculating, according to the claim settlement risk assessment model, the insurance claim amount that needs to be paid to the policyholder, and performing error verification (S34, S35); adding, to the insurance amount list, the insurance claim amount that needs to be paid, when the insurance claim amount that needs to be paid has no error (S36); and calculating the discount amount of the medical insurance premium of the policyholder in the predetermined period according to the insurance premium data and the insurance claim amount in the insurance amount list (S37). The medical insurance premium discount of a policyholder is precisely calculated by performing error verification on the insurance claim amount paid to the policyholder.