2025带病体保险创新研究报告：近七成风险敞口未覆盖，三成投保曾“被拒”丨银行与保险

Core Insights - The report highlights a significant health insurance gap for the "sick population" in China, driven by aging demographics, the younger onset of chronic diseases, and advancements in medical technology that extend patient lifespans [1][3][18] Group 1: Health Insurance Gap - The average medical expenditure for the sick population is 87,625 yuan, which is 2.1 times the annual disposable income of residents [5] - Nearly 30% of the sick population is denied insurance coverage due to health disclosures [1][8] - By the end of 2024, the population aged 60 and above in China is expected to exceed 300 million, accounting for 22% of the total population, with 75% of this group suffering from at least one chronic disease [3][4] Group 2: Rising Chronic Diseases - The incidence of type 2 diabetes among individuals aged 15-39 has doubled from 1990 to 2021, making it difficult for many young people to obtain health insurance at standard rates [4][11] - The five-year survival rate for cancer patients has improved from 33.3% a decade ago to 43.7%, indicating a growing need for insurance among long-term survivors [4][14] Group 3: Financial Burden and Willingness to Pay - Over 60% of major disease patients pay more than 100,000 yuan out-of-pocket for medical expenses, with the average monthly medication cost for the sick population at 526.85 yuan [7][8] - 75.4% of the sick population is willing to pay additional premiums for coverage of existing conditions, with an average annual willingness to pay around 4,049 yuan [6][8] Group 4: Insurance Product Insights - The report indicates a significant gap in insurance products for specific demographics, such as young adults and mothers, with many expressing a clear need for coverage but facing limited options [10][12] - Innovations in insurance products are emerging, including simplified health disclosures and coverage for pre-existing conditions, which are becoming trends in the market [14][15] Group 5: Recommendations for Development - The report suggests that government policies should support the inclusion of sick population insurance in inclusive insurance categories and promote data sharing for precise pricing [17] - Companies are encouraged to invest resources into developing targeted products for the sick population and to leverage big data and AI for underwriting and risk management [17][18]