Zhong Guo Zheng Quan Bao·2026-01-19 23:17Core Insights - The insurance industry has shown a stable claims scale for 2025, with major insurers enhancing their protection capabilities and many small to medium-sized insurers experiencing significant business growth [2][3] Claims Scale Stability - The total number of claims for China Life exceeded 62.24 million, a year-on-year increase of 7%, with total claims amounting to over 100.4 billion yuan, up 10% [2] - Ping An Life reported 4.958 million claims with a total payout of 41.51 billion yuan, while Xinhua Insurance had 5.01 million claims totaling 14.7 billion yuan [2] - Smaller insurers like Zhongyou 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% [2] - The claims acceptance rates for several insurers remained high, with China Life, CITIC Prudential, and Ping An Life at 99.8%, 99.7%, and 99.2% respectively [2] High Payouts 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 [3] - The average payout for critical illness and death claims was notably high, with Zhonghong Insurance reporting average payouts of 181,500 yuan and 184,500 yuan respectively [3] - There exists a substantial coverage gap between critical illness payouts and treatment costs, with Zhongyou Insurance indicating an average payout of 100,000 yuan against an average treatment cost of 400,000 yuan for malignant tumors [3] Growth Potential in Critical Illness Insurance - Analysts predict that the aging population and increasing demand for better medical resources will expand the potential customer base for critical illness insurance, leading to a sales growth period [4] - Medical claims accounted for the highest proportion of total claims for China Life at 60.6%, and over 65% for Cigna Life [4] Technological Empowerment in Claims Services - The integration of information technology has significantly accelerated claims processing times, with Xinhua Insurance reporting an average processing time of 0.5 days for small medical claims under 5,000 yuan [5] - Ping An Life's "111 Fast Claims" service has improved efficiency, with 93% of automated claims being processed within 60 seconds [5] - China Life has implemented a "one-day claim" service for critical illness claims, allowing for same-day processing for eligible cases [6] - The focus on IT in the insurance sector has shifted towards intelligent underwriting and claims systems, with major insurers adopting digital solutions to replace manual processes [6]