Bei Jing Shang Bao·2026-01-04 11:56Core Insights - The insurance claims service is a crucial aspect of insurance value and a key touchpoint for consumers to experience insurance services [1] - As insurance density continues to expand, claims data is increasingly becoming an important metric for evaluating the service capabilities of insurance companies and the practicality of insurance products [3] Claims Data Overview - Most insurance companies reporting claims data have a claim approval rate above 99%, with some companies like China Life Insurance achieving a claim approval rate of 99.18% and CMB Life reaching 99.8% [3] - China Life Insurance reported a total claims payout of 100.4 billion yuan for 2025, reflecting a year-on-year growth of 10% [3] Technological Advancements - The application of artificial intelligence in claims processing has led to significant digital transformation, with some companies achieving claim payouts in as little as one second [4] - Companies like Taikang Life and Cigna have implemented technologies such as OCR and big data models to streamline the claims process, resulting in faster payouts and reduced manual intervention [4] Claims Composition - Medical insurance claims are the most frequent, while critical illness insurance has the highest payout amounts. For instance, Xinhua Insurance reported that critical illness claims amounted to 6.13 billion yuan, accounting for over 40% of their total claims [5] - Medical insurance claims accounted for 90.4% of the total claims at Zhonghong Life, indicating a high frequency of claims in this category [5] Consumer Guidance - Consumers are advised to understand claims data and select core insurance products effectively, with a recommended configuration of "medical insurance as a base and critical illness insurance as a supplement" [6] - For families with significant financial responsibilities, it is suggested to have both types of insurance, ensuring that the critical illness insurance coverage is adequate to cover income loss and essential family expenses during treatment [7]