医保、商保数据互通点评：商业模式重塑，医疗险空间望打开

Investment Rating - The investment rating for the industry is "Outperform the Market" (maintained) [1]. Core Viewpoints - The integration of medical insurance and commercial insurance data is expected to significantly benefit various business segments of commercial health insurance, enhancing pricing accuracy, underwriting risk identification, and claims settlement efficiency, thereby improving profitability and customer experience [2][17]. - The commercial health insurance sector in China is projected to experience substantial growth, with premium income expected to reach 1.4 trillion yuan by 2028 under neutral assumptions [2][21]. Summary by Sections Industry Overview - The commercial health insurance is a crucial component of China's multi-tiered medical security system, addressing the diverse medical protection needs of the population. As of October 2024, the premium income for commercial health insurance reached 873.86 billion yuan, reflecting an 8.5% year-on-year growth, with expectations to exceed 980 billion yuan for the entire year [3][21]. Market Challenges - The commercial health insurance sector faces challenges in pricing, underwriting, and claims processing due to limited data accumulation and the separation of medical data platforms. These challenges hinder accurate pricing and increase the risk of claims [11][12]. Policy Support - Systematic policies are being implemented to facilitate the integration of medical insurance and commercial insurance data, with several key documents released since 2020 to support this initiative. These include the "Opinions on Deepening the Reform of the Medical Security System" and the "14th Five-Year Plan for National Medical Security" [13][16]. Future Projections - The report anticipates that the measures to enhance data integration will further increase the value contribution of commercial health insurance, leading to improved market acceptance of products and a continuous rise in per capita insurance density in China [17][21].