Zhong Guo Zheng Quan Bao·2026-01-19 21:11Core Insights - The insurance industry has shown a stable claims scale for 2025, with major insurers enhancing their protection capabilities and small to medium-sized insurers experiencing significant business growth [1][2] - Critical illness insurance and medical insurance exhibit complementary characteristics, with high claim amounts and high frequency of claims respectively [1] Claims Scale Stability - In 2025, China Life Insurance reported over 62.24 million claims, a year-on-year increase of 7%, with total claims exceeding 100.4 billion yuan, up 10% [1] - Ping An Life had 4.958 million claims totaling 41.51 billion yuan, while Xinhua Insurance reported 5.01 million claims with a payout of 14.7 billion yuan [1] - Smaller insurers like China Post Insurance saw customer service numbers exceed 2.49 million, a growth of over 370%, with claims amounting to 3.2 billion yuan, up over 90% [1] High Claim Amounts in Critical Illness Insurance - Critical illness claims accounted for a significant portion of total payouts, with Ping An Life reporting 261,000 claims totaling over 20.86 billion yuan, representing over 50% of total claims [2][3] - Other insurers like Xinhua Insurance and Zhonghong Insurance also reported critical illness claims as the highest payout category in 2025 [2] High Average Payouts - Zhonghong Insurance reported average payouts for critical illness and death claims at 181,500 yuan and 184,500 yuan respectively [3] - Sunshine Life indicated average payouts for death and critical illness claims at 143,000 yuan and 90,000 yuan respectively [3] - There exists a significant protection gap between critical illness payouts and treatment costs, with China Post Insurance noting an average payout of 100,000 yuan against an average treatment cost of 400,000 yuan for malignant tumors [3] Technology Empowering Claims Service Upgrades - Many insurers have significantly accelerated payout speeds due to technological advancements, with Xinhua Insurance reporting an average processing time of 0.5 days for small medical claims under 5,000 yuan [4] - Ping An Life's "111 Fast Claim" service has improved, with 93% of automated claims being processed within 60 seconds, and the fastest payout occurring in just 8 seconds [4] - China Life Insurance has implemented a "one-day payout" green channel for critical illness claims, allowing eligible cases to be processed on the same day [4] IT Developments in Insurance - Analysts note that insurers are increasingly focusing on IT developments in smart underwriting and claims systems, with leading insurers adopting digital employees and intelligent audits to replace manual processes [5]