金改前沿|实地走访看大病保险十年成效 :百元保费托举“因病致贫”底线

Core Insights - The article highlights the significant role of critical illness insurance in alleviating the financial burden of medical expenses for families in Gansu Province, particularly in the impoverished areas of Linxia Prefecture [1][2]. Group 1: Impact of Critical Illness Insurance - The critical illness insurance has provided substantial financial relief to families like that of Ma Yang, whose two sons require regular dialysis, resulting in a total reimbursement of over 210,000 yuan from basic medical insurance and 90,000 yuan from critical illness insurance [2]. - The insurance system in China is structured in a tiered manner, with basic medical insurance forming the foundation, critical illness insurance serving as a supplementary layer, and medical assistance providing a safety net, collectively reducing the financial burden on the populace [2]. Group 2: Implementation and Management - As of September 2025, the critical illness insurance in Linxia has compensated 788,300 individuals, with total payouts reaching 1.428 billion yuan, including 722 million yuan for impoverished populations [3]. - The management of critical illness insurance has been delegated to commercial insurance companies, which has enhanced service levels and market vitality. China Pacific Life Insurance has been managing this insurance since 2017, focusing on improving claim processing times and increasing public awareness of the policies [4]. Group 3: Challenges and Innovations - The implementation of critical illness insurance in remote areas faces challenges such as lengthy claim processes and low policy awareness. China Pacific Life Insurance has addressed these issues by establishing a one-stop claims system that reduces processing time from 3-15 days to just 2-3 minutes [4][6]. - The company has also deployed outreach teams to educate local populations about the insurance policies, distributing over 160,000 informational materials in local dialects to ensure understanding [4][7]. Group 4: Future Outlook - The critical illness insurance program has evolved from basic protection to precise service, becoming a crucial safety net for millions. It aims to continue enhancing service mechanisms and increasing coverage to further support families and combat poverty caused by medical expenses [5][7].