Core Insights - The insurance industry in China has shown stable growth in premium income and claims payout in the first half of the year, with total premium income reaching 3.74 trillion yuan, a year-on-year increase of 5.3%, and claims payout amounting to 1.35 trillion yuan, up 9.41% [2] Group 1: Claims Data and Health Risks - The most claimed insurance type by China Life Insurance was medical insurance, with 2.26 million claims and a payout of 3.467 billion yuan, where respiratory diseases, bodily injuries, and digestive system diseases accounted for 52.69% of the claims [2] - The most claimed insurance type by China Pacific Life Insurance was critical illness insurance, with 1.947 million claims and a payout of 9.92 billion yuan, where the highest claims were for malignant tumors, minor strokes, and acute myocardial infarctions [3] - Chronic diseases significantly contribute to medical expenses, with the top five chronic diseases being coronary artery disease, hypertension, hyperlipidemia, thyroid nodules, and chronic gastritis [3] Group 2: Technological Advancements in Claims Processing - Insurance companies are leveraging technology to enhance claims processing efficiency, with Ping An Life introducing an intelligent review engine that can process 93% of claims within 60 seconds [6] - Xinhua Insurance has implemented a direct connection service for seamless claims processing, covering 12 provinces and serving approximately 993 clients with a payout of 3.09 million yuan [7] - The insurance industry has activated emergency claims procedures in response to major disasters, with Tai Ping Life initiating 65 emergency plans in the first half of the year [7] Group 3: Evolving Insurance Landscape - Advances in medical diagnostics and treatment are reshaping the insurance landscape, particularly in life and health insurance, with early diagnosis leading to better treatment outcomes and a shift in risk assessment [8] - The Munich Re report indicates that while cancer remains a leading cause of death claims, the mortality rate has improved significantly over the past few decades, suggesting a need for insurance companies to adapt their policies accordingly [9] - The complexity of critical illness insurance products is increasing, necessitating continuous updates in medical knowledge for insurance professionals to effectively manage claims [9]
人身险理赔服务质效提升
Jing Ji Ri Bao·2025-08-03 21:57