JP7498229B2 - Support device and support method - Google Patents

Description

The present invention relates to a support device and a support method.

Systems that perform damage assessments for insurance payment processing are known. For example, Patent Document 1 discloses a system that compares damage data with reference data stored in a reference database and determines whether or not to pay insurance based on the comparison results. This allows assessment decisions to be made uniformly and centrally.

JP 2003-030441 A

Depending on the type of compensation involved in insurance claims, etc., at least part of the procedure from acceptance to payment may not be able to be performed by a computer using standardized processing, and human intervention may be required. However, the system described in Patent Document 1 is unable to efficiently process the granting of compensation when human intervention is required.

Therefore, in view of the above problems, the present invention aims to improve the efficiency of providing compensation.

The support device according to one aspect of the present invention includes an event information acquisition unit that acquires event information related to an event that is the subject of an insurance claim from a first terminal device, a storage unit that stores process information including one or more processes required to determine the compensation content for the event and a process progress condition that must be satisfied by predetermined information including the event information in order to progress the process, a progress control unit that progresses or stops the process based on the process progress condition, a notification unit that notifies a second terminal device different from the first terminal device in response to the process being stopped by the progress control unit, and an additional information acquisition unit that acquires additional information for progressing the process from the notified second terminal device, and the progress control unit progresses the process based on the additional information.

A support method according to another aspect of the present invention has a computer execute an acquisition step of acquiring event information relating to an event that is the subject of an insurance claim from a first terminal device, a progress control step of progressing or stopping the process based on a process progress condition that must be satisfied by predetermined information including the event information in order to progress one or more processes necessary to determine the compensation content for the event, a notification step of notifying a second terminal device different from the first terminal device in response to the process being stopped by the progress control step, and an additional information acquisition unit of acquiring additional information for progressing the process from the second terminal device that has received the notification, and the progress control step progresses the process based on the additional information.

The present invention makes it possible to provide compensation more efficiently.

FIG. 2 is a diagram for explaining an example of a functional configuration of the system according to the present embodiment. FIG. 2 is a diagram for explaining an example of the operation of the system according to the present embodiment. FIG. 2 is a diagram for explaining an example of the operation of the system according to the present embodiment. FIG. 2 is a diagram for explaining an example of the operation of the system according to the present embodiment. FIG. 2 is a diagram for explaining an example of the operation of the system according to the present embodiment. FIG. 2 is a diagram illustrating an example of a hardware configuration of a system according to the present embodiment.

A preferred embodiment of the present invention (hereinafter, referred to as "the present embodiment") will be described with reference to the attached drawings. Note that in each drawing, parts with the same reference numerals have the same or similar configurations.

In this invention, "part", "means", "device", and "system" do not simply mean physical means, but also include cases where the functions of the "part", "means", "device", and "system" are realized by software. Furthermore, the functions of one "part", "means", "device", or "system" may be realized by two or more physical means, devices, or software, and the functions of two or more "parts", "means", "device", or "system" may be realized by one physical means, device, or software.

Figure 1 shows a schematic diagram of the support system in this embodiment. The support system accepts a compensation claim from a first terminal device 10, and executes various processes for granting compensation using a support device 1 and a second terminal device 12.

1. System configuration
An example of the system configuration of the support system will be described with reference to FIG.

As shown in FIG. 1, the support system includes a support device 1, a first terminal device 10, a second terminal device 12, an external storage device 14, and a communication network 16. The number of terminal devices is not limited to two, for example, and may be three or more. The support device 1, the first terminal device 10, the second terminal device 12, and the external storage device 14 are connected to each other via the communication network 16. Note that the support system may be part of another system.

The support device 1 is an information processing device that allows a user of the first terminal device 10 (hereinafter referred to as the "first user" or "insured person") to proceed or stop the process for receiving insurance compensation, and is an information processing device capable of communicating with the first terminal device 10, the second terminal device 12, and the external storage device 14. The support device 1 can execute various processes for proceeding or stopping the process by executing a specified program.

The first terminal device 10 is a terminal device of a user who wishes to receive compensation, and is a terminal device capable of communicating with the support device 1 and the second terminal device 12. The first terminal device 10 can also be called a user terminal device or an insured person terminal device. The first terminal device 10 can transmit event information to the support device 1 by executing a specified program.

The second terminal device 12 is a terminal device of a user (hereinafter referred to as the "second user") who grants compensation to the user of the first terminal device 10, and is a terminal device capable of communicating with the support device 1, the first terminal device 10, and the external storage device 14. The second terminal device 12 can also be called a person in charge terminal device or an operator terminal device. The second terminal device 12 can transmit additional information to the support device 1 by executing a specified program.

The external storage device 14 is an information processing device that stores various information and is capable of communicating with the support device 1 and the second terminal device 12. The various information includes information about the contract of the first user, information about messages sent and received between the first user and the second user, information about damages suffered by the first user, and information about compensation granted to the first user.

Here, one or more processes involved in determining the compensation content for an event include determining liability, initial response, damage assessment, and granting compensation.

The liability determination is a process for determining whether or not the person managing the assistance device 1 (hereinafter referred to as the "insurer") is responsible for providing compensation to the first user. Circumstances in which the insurer is not responsible for providing compensation (i.e., is not liable) include, for example, when the first user drives without a license and causes an accident, or when the first user causes an accident outside the contract period of the insurance contract.

The initial response is the process in which the insurer obtains from the first user the information required for the damage assessment. Information obtained in the initial response includes, for example, the type of accident, the location of the accident, the place of delivery, images of the damaged area, whether or not there are any injuries, etc. The place of delivery refers to the contractor or the like to which the damaged area will be repaired.

Damage assessment is the process of determining the content of compensation (e.g., the amount of insurance payout) that the insurer will grant to the first user. In damage assessment, for example, repair costs are estimated based on images of the damaged area, and the amount of the insurance payout is calculated.

The granting of compensation is the process in which the insurer directly or indirectly grants the compensation calculated in the damage assessment to the first user. The granting of compensation includes, for example, transferring the insurance money to the first user, settling the repair costs paid in advance by the first user, paying the repair shop and arranging for repairs.

Determining the compensation content includes not only deciding to provide compensation to the first user, but also deciding not to provide compensation to the first user, for example, by determining that the insurer is not liable in a liability determination.

Event information is information relating to an event for which the first user is to receive compensation. For example, if the first user is involved in a car accident, the event information is information relating to the car accident, since the event for which the first user is to receive compensation is the car accident. Specific examples of event information will be described later with reference to FIG. 3.

An event is any occurrence that may be the subject of an insurance claim and may be covered by compensation. Examples of events include automobile accidents, large-scale disasters (e.g., fires, windstorms, and floods), theft, loss, and damage.

The additional information is information acquired by the support device 1 from the second terminal device 12 in order to progress the process. The additional information includes, for example, information regarding corrections to the event information of the first user and information regarding the first user's response to a message from the second user. Specific examples of the additional information will be described later with reference to FIG. 5.

Furthermore, the support device 1 progressing the process includes the support device 1 executing at least a part of the processing for completing the process. For example, if the process includes three unexecuted steps of "information acquisition," "information processing," and "information output," progressing the process includes executing one of these steps, "information acquisition."

Furthermore, stopping a process by the support device 1 includes temporarily stopping at least a part of the processing by the support device 1 to complete the process. For example, if a process includes an "information acquisition" step that has already been executed, and "information processing" and "information output" steps that have not yet been executed, stopping a process includes notifying the second user without executing the "information processing" and "information output" steps.

The stopped process can be resumed in response to input from the second user (i.e., additional information). Resuming a process means causing the stopped process to proceed again by the assistance device 1. For example, if a process is stopped after the execution of the "information acquisition" step, resuming the process means executing the remaining "information processing" and "information output" steps. Specific examples of proceeding, stopping, and resuming a process will be described later with reference to Figures 2 to 5.

2. Functional configuration of each device
An example of the functions of each device included in the support system will be described with reference to the functional block diagram of FIG.

As shown in FIG. 1, the support system includes a support device 1, a first terminal device 10, a second terminal device 12, an external storage device 14, and a communication network 16.

- Support device 1 -
The support device 1 includes a control unit 100, a storage unit 102, and a network interface unit 104, which are electrically connected to each other via a bus 106.

The memory unit 102 includes a process information DB (Database) 102a, an event information DB 102b, an additional information DB 102c, and an external information DB 102d.

The process information DB 102a stores process information. The process information includes information regarding one or more processes required to determine compensation for an event, and process progress conditions that must be satisfied by predetermined information including event information in order to progress the process. The process progress conditions include a number of items and conditions associated with each of the multiple items. A specific example of a process will be described later using FIG. 2, and a specific example of a process progress condition will be described later using FIG. 4.

The event information DB 102b stores the event information acquired by the support device 1 from the first terminal device 10 by the acquisition unit 100a. The stored event information is used to progress or stop a process in the progress control unit 100c of the support device 1. Specific examples of event information will be described later with reference to FIG. 3.

The additional information DB 102c stores additional information acquired by the support device 1 from the second terminal device 12 by the acquisition unit 100a. The stored additional information is used to resume the process in the progress control unit 100c of the support device 1. Specific examples of additional information will be described later with reference to FIG. 5.

The external information DB 102d stores information (hereinafter referred to as "external information") acquired by the support device 1 from the external storage device 14 by the acquisition unit 100a. The stored external information, together with event information, is used to progress or stop a process in the progress control unit 100c of the support device 1. Specific examples of external information will be described later with reference to FIG. 3.

The control unit 100 includes an acquisition unit 100a, an execution determination unit 100b, a progress control unit 100c, a notification unit 100d, a fraud detection unit 100e, and a communication unit 100f.

The acquisition unit 100a (event information acquisition unit) acquires event information from the first terminal device 10 and stores it in the event information DB 102b. The event information includes, for example, information about the occurrence of the event, information about the status of damage caused by the event, information about the transfer destination of the insurance money that is compensation, information about the intention to claim compensation, information about the storage destination of the vehicle or the like, and location information of the first terminal device 10.

The acquisition unit 100a (additional information acquisition unit) also acquires additional information from the second terminal device 12 and stores it in the additional information DB 102c. The additional information is typically information input by the second user.

The acquisition unit 100a also acquires information from the external storage device 14 and stores it in the external information DB 102d. The external storage device 14 is a device that stores information on external systems (e.g., a contract system, a response system, a settlement system, etc.). The information acquired from the external storage device 14 includes, for example, information on the first user's eligibility to receive compensation (e.g., contract status, license validity, etc.), information on messages sent and received between the first user and the second user, and information on the content of compensation for the first user.

The execution determination unit 100b determines whether or not to start the progress of the process by the progress control unit 100c based on the acquired event information. Typically, if the event is routine and can be processed mainly by a computer, it is determined to be "yes." On the other hand, if the event is atypical and complex, it is determined to be "no."

The progress control unit 100c progresses or stops the process based on the process progress conditions stored in the process information DB 102a. Specific examples of how to progress and stop the process will be described later with reference to Figures 2 to 5.

The notification unit 100d notifies the second terminal device 12 that the progress control unit 100c has stopped the process. The content of the notification typically requests the second user to input additional information to progress the process.

Notifying the second terminal device 12 means enabling the second user to recognize the content of the notification. In other words, notifying includes, for example, proactively sending a notification from the server device side, such as a push notification, as well as requesting and obtaining information about the notification from the second terminal device 12 to the server device side.

The fraud detection unit 100e detects the presence of fraud in the event information based on information including the event information and external information. An example of a case in which fraud exists is when compensation is claimed even though an event for which compensation is to be received has not actually occurred.

The communication unit 100f communicates with the first terminal device 10, the second terminal device 12, and the external storage device 14 via the network interface unit 104. Specific examples of information sent and received will be described later with reference to FIG. 2 etc.

The network interface unit 104 communicates with the first terminal device 10, the second terminal device 12, and the external storage device 14 via the communication network 16.

-First terminal device 10-
The first terminal device 10 is a terminal device used by a user who wishes to receive compensation. The first terminal device 10 is, for example, a personal computer, a smart device, a connected car, or the like.

The first terminal device includes a control unit, a memory unit, an input unit, an output unit, and a communication unit (not shown). The control unit executes various programs stored in the memory unit to perform predetermined processes such as sending event information. The input unit causes a microphone, keyboard, touch panel, camera, etc. to function. The output unit causes a display device such as an LCD screen, and a speaker, etc. to function. The communication unit communicates with the support device 1 and the second terminal device 12.

-Second terminal device 12-
The second terminal device 12 is a terminal device used by a user who provides compensation. The second terminal device 12 is, for example, a personal computer.

The second terminal device includes a control unit, a memory unit, an input unit, an output unit, and a communication unit (not shown). The control unit executes various programs stored in the memory unit to perform predetermined processes such as sending additional information. The input unit causes a microphone, keyboard, touch panel, camera, etc. to function. The output unit causes a display device such as an LCD screen, and a speaker, etc. to function. The communication unit communicates with the support device 1, the first terminal device 10, and the external storage device 14.

-External storage device 14-
As described above, the external storage device 14 is a device that stores information stored in an external system, and includes a contract information DB 14a, a message information DB 14b, a damage information DB 14c, and a compensation information DB 14d.

The contract information DB14a stores information about the contract of the first user. The information about the contract includes information such as the contract status, license validity, contract period, grade, age of the first user, amount of insurance premium, and insurance premium payment history.

Message information DB14b stores information about messages sent and received between a first user and a second user. Information about messages includes messages sent by the first user to the second user and information about the second user's response to the messages. For example, if the second user has not responded to a message sent by the first user to the second user (or the insurance company to which the second user belongs), the information "no response" is stored.

Damage information DB14c stores information about damage caused by events. Information about damage includes the scale of the damage, the specific location of the damage, whether the damaged items can be used, image data about the damage situation, and estimate data about damage assessment.

Compensation information DB14d stores information about compensation for the first user. The information about compensation includes the content of the compensation for the first user (e.g., the amount of insurance payment).

<3. Operation example>
An example of the operation of the support system will be described with reference to Figures 2 to 5. In this example, the processes for providing compensation to the first user are liability determination, initial response, damage assessment, and compensation provision, which are referred to as the first process to the fourth process, respectively.

In this example, the event is a car accident, and the provision of compensation is the payment of insurance money. Furthermore, the support device 1 and the second user belong to an insurance company, and the first user is a person who has a contract for insurance provided by the insurance company.

After an accident occurs (S300), the first user notifies the insurance company of the accident, and the support device 1 acquires the event information by the acquisition unit 100a (S302). The first user may directly contact the insurance company (for example, by submitting a web form or by telephone) to notify the accident, or an insurance agency may act as an intermediary between the first user and the insurance company.

Referring to FIG. 3, an example of event information acquired by the support device 1 is shown. The event information includes the items of "accident type," "location," "entry point," and "image of damaged area," each of which includes the values of "automobile accident, collision (single vehicle/property damage)," "domestic," "unknown," and "not registered."

Note that for "Destination" and "Image of Damaged Area" whose values are "Unknown" and "Not Registered", they are not transmitted in the accident report. In other words, the first user is assumed to have transmitted only information related to "Type of Accident" and "Location of Occurrence" in the accident report.

The support device 1 that has acquired the event information performs an automatic processing execution determination using the execution determination unit 100b (S304). The automatic processing execution determination is a determination as to whether or not the processing of the process is to be executed by the support device 1. Typically, if the accident is a typical accident, it is determined that automatic processing is "possible," and if the accident is a non-typical accident, it is determined that automatic processing is "not possible."

A typical accident is, for example, an accident involving property damage caused by the first user alone and without any injuries. Atypical accidents are, for example, accidents involving many stakeholders, accidents involving injuries, bodily injury accidents, and accidents causing large-scale damage.

In this example, the first user reports a typical accident. In other words, the result of S304 is "OK," and the support device 1 starts the first process's responsibility determination (P1). In the first process, the support device 1 acquires external information from the external storage device 14 by the acquisition unit 100a (S306).

Referring to Figure 3, an example of external information is shown. The external information has items of "contract status", "validity of license", and "payment amount", and the values "valid", "valid", and "undecided" are set, respectively. In the following, information including event information and external information is referred to as "predetermined information".

As for the "Payment amount" item, since damage assessment has not been carried out in the first process, the value obtained at this point is "Undetermined."

The support device 1, which has acquired the information from the external storage device 14, performs a progress condition determination using the progress control unit 100c (S308). In other words, a determination is made as to whether to proceed with or stop the process based on the process progress conditions.

An example of a method for determining progress conditions will be described with reference to Figures 3 and 4. Figure 4 is a diagram showing an example of a process progress condition. The process progress condition includes multiple conditions corresponding to multiple items belonging to the process.

The multiple items belonging to a process are typically items that are the subject of judgment in that process. For example, the multiple items belonging to the first process can be said to be four items: "accident type," "location of occurrence," "contract status," and "validity of license," and the multiple items belonging to all processes from the first process to the fourth process can be said to be seven items: "accident type," "location of occurrence," "contract status," "validity of license," "warehouse location," "image of damaged area," and "amount paid."

Furthermore, the multiple conditions corresponding to the multiple items belonging to a process are typically conditions associated with each item. For example, in the process progress conditions, the following conditions are associated with each of the seven items "accident type," "location of occurrence," "contract status," "license validity," "location of storage," "image of damaged area," and "amount of payment": "It is a property damage accident involving an automobile," "The location of the accident is domestic," "The contract is valid," "The license is valid," "The storage location is known," "There is no message to respond to," and "The insurance payment amount is less than 300,000 yen."

The items to be judged may differ depending on the stage of the process. For example, as shown in FIG. 4, four items, "accident type," "location of occurrence," "contract status," and "validity of license," may be judged in judging the progress conditions of the first process, and two items, "accident type" and "warehouse location," may be judged in judging the progress conditions of the second process.

Note that the specified information may change as the process progresses, so the conditions for a particular item may be subject to judgment in multiple processes. For example, the item "accident type" may be subject to judgment in each of the first to third processes.

According to FIG. 4, in the first process, conditions corresponding to four items, "accident type," "location," "contract status," and "validity of license," are judged. According to FIG. 3, the event information acquired for "accident type" is "automobile accident, collision (single vehicle/object damage)," which satisfies the condition "automobile object damage accident" corresponding to "accident type." Furthermore, the event information acquired for "location" is "domestic," which satisfies the condition "the location of the accident is domestic," which corresponds to "location." Furthermore, the external information acquired for "contract status" is "valid," which satisfies the condition "contract is valid," which corresponds to "contract status." Furthermore, the external information acquired for "license validity" is "valid," which satisfies the condition "license is valid," which corresponds to "license validity." In summary, the specified information satisfies all of the conditions associated with each of the multiple items in the first process.

In this example, the progress control unit 100c progresses a process when the specified information satisfies all of the multiple conditions in a certain process, and stops the process when any one or more of the multiple conditions are not satisfied. As described above, the specified information illustrated in FIG. 3 satisfies all of the conditions associated with the multiple items in the first process, so in the progress condition determination (S308), the support device 1 determines that the process should be progressed.

After the process has progressed and the first process of determining the presence or absence of responsibility has been completed, the second process of initial response is started (P2). In the second process, the assistance device 1 requests the first user to transmit information related to the accident (S310). The request may be made via dedicated application software installed on the first terminal device 10. The request may also be related to information that was not transmitted in the accident notification (S302). In this example, the content of the request is to transmit information related to the vehicle's storage location that was not transmitted in the accident notification (S302).

The support device 1 that sent the request acquires information regarding the response from the first user through the acquisition unit 100a (S312). In this example, the response obtained from the first user in response to the support device 1's request is "XX Factory." In other words, the event information after acquiring the information regarding the response includes "XX Factory" in the "Destination" field (see FIG. 5).

The support device 1 may be in a standby state between the request for accident information (S310) and the acquisition of the first user's response (S312). In this case, even in the standby state, the process is said to be in progress.

After acquiring the information regarding the answer, the support device 1 performs a progress condition determination (S314).

According to FIG. 4, in the second process, the conditions corresponding to the items "accident type" and "destination" are subject to judgment. According to FIG. 5, the event information acquired for "accident type" is "automobile accident, collision (single vehicle/object damage)", which satisfies the condition "automobile object damage accident" corresponding to "accident type". In addition, the event information acquired for "destination" is "XX factory", which satisfies the condition "destination is known" corresponding to "destination". Therefore, since the specified information satisfies all of the conditions associated with the items in the second process, in the progress condition judgment (S314), the support device 1 judges to progress the process.

If the event information (corresponding to the "Event Information" column in FIG. 5) obtained after receiving a response from the first user does not satisfy the process progress conditions, the support device 1 may again execute a request for accident information (corresponding to S310). For example, if the information regarding the receiving destination obtained in the response is "XX Factory" and the receiving destination does not actually exist, the support device 1 may again request information regarding the receiving destination to be sent so that an actually existing receiving destination is provided.

After progressing through the process and completing the second process, the initial response, the third process, damage assessment, begins (P3). In the third process, the support device 1 determines the conditions for proceeding (S315).

According to FIG. 4, in the third process, the conditions corresponding to the items "accident type" and "image of damaged area" are subject to judgment. According to FIG. 5, the event information acquired for "accident type" is "automobile accident, collision (single vehicle/object damage)", which satisfies the condition "automobile object damage accident" corresponding to "accident type". On the other hand, the event information acquired for "image of damaged area" is "not registered", which does not satisfy the condition "image of damaged area registered" corresponding to "image of damaged area". Therefore, since the specified information does not satisfy at least some of the conditions associated with the items in the third process, in the progress condition judgment (S315), the support device 1 judges to stop the process.

The support device 1 that has stopped the process notifies the second user by the notification unit 100d (S316). The notification is sent, for example, via dedicated application software installed on the second terminal device 12, email, a pop-up on the display screen of the second terminal device 12, or the like. The content of the notification typically notifies the user that the process has been stopped and instructs the user to take a specific action to proceed with the process.

In this example, the unsatisfied condition relates to the item "Image of the damaged area," so the notification instructs the first user to obtain an image of the damaged area from the first user and to register the image as additional information in the support device 1.

The second user who has received the notification requests the first user to send a response (S318). In this example, the request is for sending an image of the damaged area. The second user may make a request to the first user by email, telephone, or the like, in addition to using dedicated application software.

The first user who receives the request transmits information including the answer to the second user (S320). In this example, the information including the answer is an image file of the damaged area. In addition to transmitting the information to the second user directly to the second terminal device 12, transmitting the information to the second user also includes uploading the file to a server device and making the second terminal device 12 accessible to the file.

The second user transmits additional information to the support device 1 based on the received information (S322). An example of the additional information is shown with reference to FIG. 5. For the item "Image of damaged area", "Not registered" is displayed in the event information, whereas "Image file of damaged area registered" is displayed in the additional information.

Having received the additional information, the support device 1 again performs a progress condition determination using the progress control unit 100c (S323). The condition corresponding to the "accident type" is met as described above, and furthermore, the additional information for "image of the damaged area" is "image file of the damaged area has been registered", which satisfies the condition corresponding to "image of the damaged area" that "image of the damaged area has been registered". Therefore, the specified information and additional information in FIG. 5 satisfy all of the conditions associated with the multiple items in the third process, and therefore the support device 1 determines to proceed with the process.

After determining the progress conditions, the support device 1 calculates the insurance payment amount (S324). The payment amount is calculated, for example, by AI (Artificial Intelligence) based on the image files of the damaged areas registered as additional information. In this case, the AI typically uses a machine learning model created by learning the relationship between image files of the damaged areas in many accidents and the actual insurance payment amount for each of those accidents. By using such AI, it is possible to calculate the insurance payment amount that is estimated to be appropriate based on past cases by inputting the image files of the damaged areas registered as additional information.

In this example, the insurance payment amount is calculated to be "250,000 yen." The calculated insurance payment amount is stored in the external information DB 102d and the external storage device 14. In other words, the external information after obtaining information regarding the response includes "250,000 yen" in the "Payment amount" field (see Figure 5).

After calculating the insurance payment amount, the fourth process, which is the granting of compensation, begins (P4). In the fourth process, the support device 1 determines the progress conditions (S325).

According to FIG. 4, in the fourth process, the condition corresponding to the "payment amount" item is to be judged. According to FIG. 5, the external information acquired for the "payment amount" is "250,000 yen", which satisfies the condition "the insurance payment amount is less than 300,000 yen" corresponding to the "payment amount". Therefore, since the specified information satisfies all of the conditions associated with the items in the fourth process, in the progress condition judgment (S325), the support device 1 judges that the process should proceed.

After the decision is made to proceed with the process, the support device 1 confirms with the first user whether or not they intend to make a claim (S326).

The first user, whose intention to make a claim has been confirmed, responds to the support device 1 that he or she intends to make a claim (S328).

The support device 1 that has received the response from the first user executes the payment of the insurance money (S334). At this time, the support device 1 may cause a system other than the support system (e.g., an approval system) to execute the payment.

In summary, the support device 1 in this embodiment includes an event information acquisition unit 100a that acquires event information related to an event that is the subject of an insurance claim from a first terminal device, a storage unit 102 that stores process information including one or more processes required to determine the compensation content for the event and a process progress condition that must be satisfied by predetermined information including the event information in order to progress the process, a progress control unit 100c that progresses or stops the process based on the process progress condition, a notification unit 100d that notifies a second terminal device different from the first terminal device in response to the process being stopped by the progress control unit, and an additional information acquisition unit 100a that acquires additional information for progressing the process from the notified second terminal device, and the progress control unit 100c progresses the process based on the additional information.

The support device 1 can make the granting of compensation more efficient. Specifically, among the steps required for granting compensation, those that can be routinely processed by a computer are executed by the support device 1, and other non-routine steps are executed by the second user, thereby reducing the burden on the second user and shortening the time required from receiving a notice of an accident to granting compensation.

For example, in the above operation example, for the first process, second process, and fourth process that are determined to be progressed in the initial progress condition determination (S308, S314, and S325) for each process, the support device 1 progresses the process, and the second user does not operate the second terminal device 12. In other words, the effort required for the second user to progress the process is reduced, and the lead time until the first user receives compensation is shortened.

On the other hand, for example, for a third process that is determined to be stopped in the first progress condition determination (S315) for that process, the second user collects additional information required to progress the process and inputs it into the support device 1 (S318, S320, and S322). Depending on the type of accident or the content of the event information, it may not be possible for a computer to perform standard processing. In such cases, the second user can partially intervene in the process, enabling a flexible response to the accident.

4. Hardware Configuration
An example of a hardware configuration in which the above-described support device 1 is realized by a computer 20 will be described with reference to Fig. 6. Note that the functions of each device can also be realized by dividing them into a plurality of devices.

As shown in FIG. 6, the computer 20 includes a processor 200, a storage device 202, an input I/F 204, a data I/F 206, a communication I/F 208, and a display device 210.

The processor 200 controls various processes in the computer 20 by executing programs stored in the storage device 202. For example, each functional unit of the control unit 100 of the support device 1 can be realized by the processor 200 executing a program stored in the storage device 202.

The storage device 202 is a storage medium such as a RAM (Random Access Memory). The RAM temporarily stores the program code of the program executed by the processor 200 and data required when the program is executed.

The storage device 202 may also be a non-volatile storage medium such as a hard disk drive (HDD) or flash memory. The storage device 202 stores an operating system and various programs for implementing the above-mentioned configurations. The storage medium storing the various programs may be a non-transitory computer readable medium. In addition, the storage device 202 may store a table for registering various information such as business information, and a DB for managing the table. Such programs and data are loaded into the storage device 202 as necessary and referenced by the processor 200.

The input I/F 204 is a device for receiving input from a user. Specific examples of the input I/F 204 include a keyboard, a mouse, a touch panel, various sensors, and a wearable device. The input I/F 204 may be connected to the computer 20 via an interface such as a Universal Serial Bus (USB).

The data I/F 206 is a device for inputting data from outside the computer 20. A specific example of the data I/F 206 is a drive device for reading data stored in various storage media. The data I/F 206 may be provided outside the computer 20. In that case, the data I/F 206 is connected to the computer 20 via an interface such as a USB.

The communication I/F 208 is a device for performing data communication via the communication network 16, either wired or wirelessly, with devices external to the computer 20. The communication I/F 208 may be provided external to the computer 20. In that case, the communication I/F 208 is connected to the computer 20 via an interface such as a USB.

The display device 210 is a device for displaying various types of information. Specific examples of the display device 210 include a liquid crystal display, an organic EL (Electro-Luminescence) display, and a display of a wearable device. The display device 210 may be provided outside the computer 20. In that case, the display device 210 is connected to the computer 20 via, for example, a display cable. Furthermore, when a touch panel is used as the input I/F 204, the display device 210 can be configured as an integral part of the input I/F 204.

Note that this embodiment is an example for explaining the present invention, and is not intended to limit the present invention to this embodiment alone. Furthermore, the present invention can be modified in various ways without departing from the gist of the invention. Furthermore, a person skilled in the art can adopt an embodiment in which each element described below is replaced with an equivalent, and such an embodiment is also included in the scope of the present invention.

The components of the support device 1 described in the above embodiment are assumed to be implemented in cooperation with other hardware by the processor 200 executing a program stored in the storage device 202. In other words, these components are assumed to be software or firmware, and also corresponding hardware, and in both concepts, they are also described as "functions," "means," "parts," "processing circuits," "units," or "modules," and can be interpreted as each of these.

5. Modifications
Although the present invention has been described based on the above embodiment, the following cases are also included in the present invention.

In the above embodiment, the support device 1, the first terminal device 10, the second terminal device 12, and the external storage device 14 are each described as being one device, but this is not limited to the above. For example, the support device 1 and the second terminal device 12 may be one device, and the functions of the support device 1 may be realized by multiple devices.

In the above embodiment, an example was described in which the automatic process execution determination (S304) was judged as "yes" and the first process (P1) was allowed to proceed, but if the automatic process execution determination was judged as "no," the support device 1 may not proceed with the process, and the second user may manually execute the first to fourth processes.

In addition, in the above embodiment, the process progress conditions are as shown in FIG. 4, but are not limited to this. Items of the process progress conditions are, for example, "account information," "target insurance product," "vehicle type," "whether road assistance is implemented," "agency type," "date and time of accident," and "age of the insured person," and conditions may be set according to each item.

The process progress conditions are typically conditions that determine that no human intervention is required, and may vary depending on the functionality of the system. Specifically, if the system is multifunctional, intervention by the second user is often not required, so using broad process progress conditions (i.e., conditions that are less likely to be notified to the second user) can provide greater efficiency.

In the above embodiment, the event information, external information, additional information, and process progress conditions are all expressed in table format, but this is not limited to the above. In other words, the information and conditions may be expressed in any format. Each piece of information and condition may be expressed, for example, in a file format such as JSON (Javascript Object Notation) format or XML format, or in a data structure such as a tree structure, list, or structure. Furthermore, the process progress conditions may be generated by machine learning.

In the above embodiment, the event information, external information, and additional information are all described as being text-based data, but this is not limited to this. In other words, the various data may include true/false values, numerical values, dates and times, image data, 3D model data, and video data.

In the above embodiment, after the process is stopped in the progress condition determination (S315) of the third process, the process is resumed from the third process again, but this is not limited to the above. That is, the support device 1 may resume from the stopped process, or may resume from a process different from the stopped process. In this case, the additional information may include process designation information that designates the process to be progressed by the progress control unit.

By specifying the same process as the stopped process as the process to be resumed, the support device 1 can determine whether the additional information satisfies the progress condition judgment of that process. This makes it possible to prevent the second user from making an input error in the additional information from affecting subsequent processes.

On the other hand, it may be possible to provide compensation quickly by specifying a process to be resumed that is different from the stopped process. For example, if the additional information is only a very minor correction, it may not be necessary to check the progress conditions again when resuming a process. In such cases, it is possible to provide compensation quickly by resuming the process that is next to the stopped process.

In the above embodiment, the second user does not perform any operation in the fourth process, but this is not limited to the above. For example, the support device 1 that receives a response from the first user (S328) may notify the second user to request approval for the payment of the insurance money, regardless of the result of the progress condition determination (S325).

In this case, the second terminal device 12 may display an approval screen. The approval screen typically displays information regarding the basis for approval. For example, the approval screen includes information such as the items that were subject to judgment in the progress condition judgment for each process (S308, S315, and S323) and the judgment results for those items. After checking the approval screen, the second user approves the payment. Approval of the payment is performed, for example, by pressing an approval button displayed on the approval screen.

In the above embodiment, the insurance payment amount is calculated by AI based on an image file of the damaged area, but this is not limited to this. For example, instead of calculating the payment amount by itself, the support device 1 may place an order to a person who assesses damages (also called an adjuster) to calculate the payment amount.

The support device 1 may further include a fraud detection unit 100e that detects the presence of fraud in the event information based on the specified information, and the process progress condition may include a condition that the fraud detection unit 100e does not detect the presence of fraud. In other words, if fraud is detected in the accident report from the first user, the support device 1 may stop the process.

Fraud detection may be performed using either a rule-based method or a machine learning model. The rule-based method detects fraud by assuming that the risk of fraud is high when a specific rule is satisfied and that the risk of fraud is low when the rule is not satisfied. Fraud may also be detected by assuming that the risk of fraud is low when a specific rule is satisfied and that the risk of fraud is high when the rule is not satisfied. One example of a fraud detection method is to estimate that "if the event information is related to a car accident and the location information of the first terminal device 10 at the time of the accident significantly differs from the location of the accident entered by the first user in the accident report, then there is a high risk of fraud."

The method of using a machine learning model is a method of detecting fraud by using a machine learning model that has been trained with data on a large number of past compensation claims and data on whether or not each compensation claim was actually fraudulent.

The accuracy of fraud detection varies depending on the point in the entire process at which it is detected. For example, immediately after an accident is reported (corresponding to S302), the support device 1 does not have enough information and therefore cannot guarantee sufficient accuracy. On the other hand, for example, at the time when the insurance payment is made (corresponding to S334), the support device 1 has enough information and can detect fraudulent claims with sufficient accuracy.

The fraud detection unit 100e may detect the presence of fraud when the numerical value of the risk of fraud in the event information indicates a magnitude equal to or greater than a predetermined threshold. The numerical value of the risk of fraud in the event information is typically a value that corresponds to the probability that the event information contains fraud, calculated by the fraud detection unit 100e. In other words, the numerical value is calculated to be high when the risk is high and low when the risk is low.

The fraud detection unit 100e may include a first fraud detection unit that is performed at a specific process stage, and a second fraud detection unit that is performed at a process stage different from the specific process and has a higher reliability of fraud detection than the first fraud detection unit. For example, the first fraud detection unit may perform fraud detection when an accident notification is received (corresponding to S302), and the second fraud detection unit may perform fraud detection when a response confirming the intention to make a claim is received (corresponding to S328).

If the first fraud detection unit can detect a fraudulent charge, the second user can take measures at an early stage. On the other hand, the second fraud detection unit can detect a fraudulent charge with higher accuracy. In this way, by estimating the reliability at multiple points in time, it is possible to achieve both early detection and highly accurate detection.

In addition, in the above embodiment, the external storage device 14 is inside the support system, but this is not limited to the above. For example, the support device 1 may obtain various information using an API (Application Programming Interface) provided by an external system.

The support device 1 according to one embodiment of the present invention includes an event information acquisition unit 100a that acquires event information related to an event that is the subject of an insurance claim from a first terminal device, a storage unit 102 that stores process information including one or more processes required to determine the compensation content for the event and a process progress condition that must be satisfied by predetermined information including the event information in order to progress the process, a progress control unit 100c that progresses or stops the process based on the process progress condition, a notification unit 100d that notifies a second terminal device different from the first terminal device in response to the process being stopped by the progress control unit 100c, and an additional information acquisition unit 100a that acquires additional information for progressing the process from the notified second terminal device, and the progress control unit 100c progresses the process based on the additional information.

In the above aspect, the process progress conditions may include multiple conditions corresponding to multiple items belonging to the process, and the progress control unit 100c may progress or stop the process based on whether the specified information satisfies the multiple conditions.

In the above embodiment, the progress control unit 100c may proceed with the process if the specified information satisfies all of the multiple conditions, and may stop the process if any one or more of the multiple conditions are not satisfied.

In the above aspect, the additional information may be information regarding a condition among the multiple conditions that the specified information does not satisfy.

In the above aspect, the additional information may include process specification information that specifies the process that the progress control unit will progress based on the additional information.

In the above embodiment, the process designation information may be information that designates the same process as the process stopped by the progress control unit 100c.

In the above embodiment, the process designation information may be information that designates a process different from the process stopped by the progress control unit 100c.

In the above aspect, the system may further include a fraud detection unit 100e that detects the presence of fraud in the event information based on the specified information, and the process progress condition may include a condition that the fraud detection unit 100e does not detect the presence of fraud.

In the above aspect, the fraud detection unit 100e may detect the presence of fraud when the numerical value of the risk of fraud in the event information indicates a value equal to or greater than a predetermined threshold value.

In the above aspect, the one or more processes may include a first process and a second process subsequent to the first process, and the fraud detection unit 100e may include a first fraud detection unit that is performed at the stage of the first process, and a second fraud detection unit that is performed at the stage of the second process and has a higher reliability of fraud detection than the first fraud detection unit.

In the above embodiment, the event may be an accident involving a motor vehicle.

In the above aspect, the one or more processes may include at least one of a liability determination for determining whether or not the user of the first terminal device is eligible for compensation, an initial response for obtaining event information, a damage assessment for determining compensation, and a compensation grant for granting compensation to the user of the first terminal device.

Another embodiment of the support method of the present invention has a computer execute an acquisition step of acquiring event information related to an event that is the subject of an insurance claim from a first terminal device, a progress control step of progressing or stopping the process based on a process progress condition that must be satisfied by predetermined information including the event information in order to progress one or more processes necessary to determine the compensation content for the event, a notification step of notifying a second terminal device different from the first terminal device in response to the process being stopped by the progress control step, and an additional information acquisition step of acquiring additional information for progressing the process from the second terminal device that has received the notification, and the progress control step progresses the process based on the additional information.

1 Support device 10 First terminal device 12 Second terminal device 100 Control unit 100a Acquisition unit 100c Progress control unit 100d Notification unit 100e Fraud detection unit 102 Storage unit

Claims (13)

an event information acquisition unit that acquires event information relating to an event that is the subject of an insurance claim from a user's terminal device;
a storage unit that stores process information including one or more processes necessary to determine the compensation content for the event, and a process progress condition that a predetermined information including the event information should satisfy in order to determine that an intervention by a person in charge of the insurance claim is not required to progress the process;
a progress control unit that progresses or stops the process based on whether the predetermined information satisfies the process progress condition;
a transmission unit that, in response to the process being stopped by the progress control unit, transmits a notification to a terminal device of the person in charge that the process has been stopped and the notification includes information regarding a condition that caused the process to be stopped ;
an additional information acquisition unit that acquires additional information input by the person in charge from the terminal device of the person in charge that has received the notification;
The progress control unit determines whether the specified information has been supplemented with the additional information to satisfy the process progress condition, progresses the stopped process based on the result of the determination , and further progresses or stops one or more processes after the stopped process regardless of the operation of the person in charge based on whether the specified information supplemented by the additional information satisfies the process progress condition. the process progress conditions include a plurality of conditions corresponding to a plurality of items belonging to the process;
The support device according to claim 1 , wherein the progress control unit progresses or stops the process based on whether the predetermined information satisfies the plurality of conditions. The support device according to claim 2, wherein the progress control unit allows the process to proceed if the predetermined information satisfies all of the plurality of conditions, and stops the process if the predetermined information does not satisfy any one or more of the plurality of conditions. The support device according to claim 2, wherein the additional information is information about a condition among the plurality of conditions that is not satisfied by the specified information. The support device according to claim 1, wherein the additional information includes process specification information that specifies a process that the progress control unit will progress based on the additional information. The support device according to claim 5, wherein the process designation information is information that designates the same process as the process stopped by the progress control unit. The support device according to claim 5, wherein the process designation information is information that designates a process different from the process stopped by the progress control unit. a fraud detection unit that detects fraud in the event information based on whether the event information matches an actual situation of the event,
The support device according to claim 1 , wherein the process progress condition includes a condition that the fraud detection unit does not detect the presence of fraud. a calculation unit that calculates a numerical value according to a degree of consistency between the event information and an actual situation of the event, the numerical value being lower as the degree of consistency increases and being higher as the degree of consistency decreases;
The support device according to claim 8 , wherein the fraud detection unit detects the presence of fraud when the numerical value is equal to or greater than a predetermined threshold value. the one or more processes include a first process and a second process subsequent to the first process,
The support device described in claim 8, wherein the fraud detection unit includes a first fraud detection unit performed at the first process stage and a second fraud detection unit performed at the second process stage and having a higher reliability of fraud detection than the first fraud detection unit. The support device according to any one of claims 1 to 10, wherein the event is an automobile accident. The one or more processes include at least one of a liability determination, an initial response, a damage assessment, and a compensation grant;
The liability determination is a process of obtaining information for determining whether the user is eligible for compensation;
the initial response is a process of causing the event information acquisition unit to additionally acquire the event information;
The damage assessment is a process of determining compensation details according to the damage suffered by the user due to the event based on the event information,
The assistance device according to claim 1 , wherein the compensation is a process of making an insurance payment to the user. On the computer,
An acquisition step of acquiring event information related to the event that is the subject of the insurance claim from a terminal device of the user;
a progress control step of progressing or stopping one or more processes required for determining compensation details for the event based on whether or not predetermined information including the event information satisfies a process progress condition for determining that intervention by a person in charge of the insurance claim is not required in progressing the one or more processes required for determining compensation details for the event;
a sending step of sending a notice to a terminal device of the person in response to the process being stopped by the progress control step, the notice including information on the fact that the process has been stopped and the condition that caused the process to be stopped ;
and acquiring additional information input by the person in charge from the terminal device of the person in charge that has received the notification.
The progress control step determines whether the specified information has been supplemented with the additional information to satisfy the process progress condition, and progresses the process that was stopped based on the result of the determination, and further progresses or stops one or more processes following the stopped process regardless of the operation of the person in charge based on whether the specified information supplemented by the additional information satisfies the process progress condition.

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