上海"保险码"平台是由上海保交所牵头承建的普惠保险服务平台，核心优势在于直联上海医保就诊 数据，能够在客户授权、确保信息安全与隐私保护的前提下，实现医保电子诊疗数据与商业健康保险 理赔的高效衔接。为顺利入驻该平台，长生人寿内部紧密协作、高效推进，从系统对接、数据核验到 服务流程优化，全程严格把控，最终确保平台入驻工作顺利落地，成功打通数字化理赔服务"最后一 公里"。 即日起，符合条件的长生人寿客户可便捷享受平台理赔服务：一是参保上海社会基本医疗保险，且在 上海地区医保定点医疗机构就医并完成医保实时结算的个险保单被保人；二是在上海地区承保，且已 开通微信理赔服务的团险保单被保人。客户无需提交纸质发票、费用清单等传统材料，只需通过"随 申办"APP、微信/支付宝 "随申办" 小程序，或长生人寿官方微信服务号"长生人寿客户服务"，即 可轻松完成医疗险理赔申请与进度查询，真正实现 "足不出户，一键理赔"。 作为始终践行"以客户为中心"服务宗旨的保险机构，长生人寿一直秉持"数据多跑路，群众少跑 腿"的服务理念，持续探索数字化技术在保险服务中的创新应用。此次入驻上海"保险码"一码通赔平 台，是长生人寿深化数字化理赔转型的 ...

Core Insights - The insurance industry is experiencing a significant increase in claim payouts and service efficiency, with digital and intelligent claims processing becoming standard practice [1][2][4] Group 1: Claim Performance - Major insurance companies reported substantial claim volumes in the first half of 2025, with China Life Insurance processing over 12.14 million claims totaling over 30.2 billion yuan, and Ping An Life handling 2.377 million claims amounting to 20.62 billion yuan [2] - The industry maintains a high claim approval rate, with several companies exceeding 99%, including China Life and Citic Prudential, which both achieved 99.6% [2] - Critical illness insurance accounted for a significant portion of claims, with China Pacific Insurance reporting 5.23 billion yuan in critical illness claims, representing 52.7% of their total payouts [2] Group 2: Medical Insurance Trends - Medical insurance claims are the most frequent, with Ping An Life reporting that 92% of their claims were for medical insurance, while Sunshine Insurance reported 83.7% [3] - The prevalence of medical claims highlights the close connection between insurance products and public health needs [3] Group 3: Technological Advancements - Insurance companies are leveraging technology to enhance claims efficiency, with Ping An Life achieving 93% of automated claims processed within 60 seconds using their DeepSeek model [4][5] - China Life's claims processing time has improved significantly, with small medical claims being settled in an average of 0.37 days [4] Group 4: Direct Payment Services - The industry is focusing on "direct payment" services, allowing for seamless integration between hospitals, health insurance, and commercial insurance, enabling patients to settle claims upon discharge [6][7] - China Life has pioneered direct payment initiatives, processing over 3.91 million direct payment claims worth over 2.13 billion yuan in the first half of 2025 [7] - Other companies, such as Ping An Life and Taikang Life, have also introduced similar direct payment services, enhancing customer convenience [7]