平均赔付率45%，你买的短期健康险真的赔到了吗？

Core Viewpoint - The current state of short-term health insurance in China shows a low comprehensive claims ratio, indicating insufficient consumer protection and trust in insurance companies [2][3][8]. Group 1: Claims Ratio Analysis - The median comprehensive claims ratio for short-term health insurance among 120 insurance companies is only 42.12%, with an average of 45% after excluding extreme values [2][5]. - A claims ratio between 50% and 70% is considered reasonable for both consumer satisfaction and sustainable insurance company operations [4][10]. - The claims ratio for life insurance companies has increased from 38.83% in 2023 to 42.12% in the first half of 2025, while property insurance companies saw an increase from 38.70% to 42.30% [5]. Group 2: Company Performance - Few insurance companies achieve a claims ratio above 60%, with only 23 out of 120 companies falling within this range [5]. - Companies like China Life, Ping An Health, and Taikang Life have claims ratios above 50%, while others like Zhong An Insurance have a significantly lower ratio of 30.7% [8][9]. - Some companies report negative claims ratios due to low business volume, while others exceed 100% due to specific claims situations [6]. Group 3: Market Dynamics - The high operational costs associated with online customer acquisition and marketing are squeezing the claims payout space for insurance companies [9][14]. - The shift towards digital marketing has increased competition and customer acquisition costs, impacting the overall claims ratio [9][15]. - The importance of commercial health insurance is growing as basic medical insurance faces increasing financial pressure, highlighting the need for better integration and product offerings [11][12]. Group 4: Future Outlook - There is a recognized need to improve the claims ratio by at least 20 percentage points to enhance consumer experience and trust [13]. - Expanding the range of coverage and improving service efficiency are seen as critical paths to increasing the claims ratio and consumer satisfaction [15]. - Recent policy changes in Shanghai encouraging the use of personal medical accounts for group health insurance may open new avenues for growth in the commercial health insurance sector [15].