Zheng Quan Ri Bao·2026-01-13 17:12Core Insights - The insurance industry is showcasing its claims service reports for 2025, highlighting the effectiveness of service and the current gaps in critical illness coverage for consumers [2] Claims Efficiency and Timeliness - China Life Insurance Company reported over 62.24 million claims in 2025, a 7% increase year-on-year, with total claims amounting to over 100.4 billion yuan, up 10% [3] - Other insurers also reported significant claims, with Ping An Life processing 4.958 million claims totaling 41.51 billion yuan, and Xinhua Insurance handling 5.01 million claims amounting to 14.7 billion yuan [3] - The digital transformation in the insurance sector has significantly improved claims efficiency, with China Life's "Digital Guo Life" strategy enabling 8.17 million direct claims payments totaling over 4.3 billion yuan [4] Medical Insurance Claims Dominance - Medical insurance claims are increasingly dominating the claims structure, with Ping An Life reporting that 92% of claims were for medical insurance, while critical illness insurance accounted for only 5% [5] - Despite the high volume of claims, there remains a significant gap in critical illness coverage, with 80% of claims being under 100,000 yuan, indicating insufficient coverage for actual treatment costs [5] Market Dynamics and Recommendations - The rapid growth of medical insurance, due to its affordability and high leverage, is causing a diversion from the critical illness insurance market, which may slow down growth and lead to customer segmentation [6] - Experts suggest that consumers should utilize medical insurance to cover high medical expenses while relying on critical illness insurance for income loss compensation, emphasizing the complementary nature of both products [6]