Guo Ji Jin Rong Bao·2026-01-14 15:17Group 1 - The core focus of the article is on the rising trend of insurance claims in China, highlighting the increasing number of claims and payout amounts across various insurance companies, with a high claim approval rate maintained above 99% [1][2] - In the first eleven months of 2025, the insurance industry reported a premium income of 5.76 trillion yuan, a year-on-year increase of 7.56%, while claims paid out reached 2.21 trillion yuan, up 5.95% [2] - Major players like China Life and Ping An Life have shown significant growth in claims, with China Life processing over 62.24 million claims and a total payout exceeding 100.4 billion yuan, marking a 10% increase [2] Group 2 - The improvement in claims processing efficiency is attributed to technological advancements, with companies utilizing AI and data analytics to streamline the claims process, resulting in faster payouts [3] - Despite advancements, there are still concerns regarding the perception of "difficult claims," primarily due to issues such as incomplete health disclosures by consumers and misunderstandings of policy terms [3][4] - The disparity between the high incidence of critical illnesses and the inadequate coverage provided by critical illness insurance is highlighted, with significant gaps in protection against high medical costs [5][7] Group 3 - The report indicates that medical insurance claims are the most frequent, while critical illness insurance accounts for the highest payout amounts, revealing a structural difference in their functions [6] - The average treatment cost for cancer ranges from 220,000 to 800,000 yuan, while the average payout for critical illness claims is only 100,000 yuan, indicating a substantial coverage gap [7] - Recommendations for consumers include prioritizing critical illness insurance for family breadwinners and considering medical insurance for younger individuals to mitigate large medical risks [7]