中国人寿理赔答卷：五年赔付超2.4亿件、4195亿元

Core Viewpoint - The insurance industry is transitioning from rapid growth to high-quality development, with claims service capability becoming a key measure of core competitiveness and a crucial part of brand differentiation for companies like China Life Insurance [1] Group 1: Claims Data and Trends - China Life's claims data during the 14th Five-Year Plan period shows significant growth, with the number of claims increasing from 37 million in 2021 to 62.24 million by 2025, and the claims amount rising from 81.9 billion yuan to 100.4 billion yuan [1] - Cumulatively, the company processed 240 million claims with a total payout of 419.52 billion yuan, averaging about 2.3 billion yuan in daily payouts [1] Group 2: Targeted Service Innovations - The company has shifted its claims service from general to precise, optimizing service details for different customer groups, including the elderly, women, and children [2] - In 2025, the company served 15.17 million elderly clients with claims exceeding 11.3 billion yuan, while claims for women's cancer insurance reached 33,000 cases, and services for students and children exceeded 5.02 million cases with a total payout of over 5.2 billion yuan [2] Group 3: Service Quality and Technology Integration - Medical insurance claims accounted for 60.6% of total claims in 2025, with payouts exceeding 60 billion yuan, highlighting the importance of service experience in customer evaluations [3] - The company has implemented a one-stop direct claim service, allowing for immediate settlement at the point of care, significantly enhancing customer experience [5] Group 4: Operational Innovations - China Life introduced the "Smart Operation" model in 2019, integrating digital connections and intelligent models for centralized management, which has provided "smart services" to over 100 million customers [4] - The company has developed a complementary service matrix with multiple online and offline channels, achieving a revolutionary breakthrough in claims processing with a seamless service experience [5]