In the Chinese medical insurance industry, the assessor's role is essential and requires significant efforts to converse with the claimant. This is a highly professional job that involves many parts, such as identifying personal information, collecting related evidence, and making a final insurance report. Due to the coronavirus (COVID-19) pandemic, the previous offline insurance assessment has to be conducted online. However, for the junior assessor often lacking practical experience, it is not easy to quickly handle such a complex online procedure, yet this is important as the insurance company needs to decide how much compensation the claimant should receive based on the assessor's feedback. In order to promote assessors' work efficiency and speed up the overall procedure, in this paper, we propose a dialogue-based information extraction system that integrates advanced NLP technologies for medical insurance assessment. With the assistance of our system, the average time cost of the procedure is reduced from 55 minutes to 35 minutes, and the total human resources cost is saved 30% compared with the previous offline procedure. Until now, the system has already served thousands of online claim cases.
翻译:在中国医疗保险行业,评估员的作用至关重要,需要做出重大努力才能与申请人沟通,这是一项高度专业的工作,涉及许多部分,如识别个人信息、收集相关证据和提出最后保险报告。由于冠状病毒(COVID-19)大流行,以前的离线保险评估必须在网上进行,然而,对于低级评估员来说,对于往往缺乏实际经验的初级评估员来说,迅速处理这样一个复杂的在线程序并非易事,但这一点很重要,因为保险公司需要根据评估员的反馈决定索赔人应得到多少赔偿。为了提高评估员的工作效率并加快总体程序,我们在本文件中提议建立一个基于对话的信息提取系统,将先进的NLP技术纳入医疗保险评估。在我们系统的帮助下,程序的平均时间从55分钟减少到35分钟,总人力资源费用比以前的离线程序节省了30%。到目前为止,该系统已经处理了数千个在线索赔案件。