Core Viewpoint - The current state of short-term health insurance in China shows a low comprehensive claims ratio, indicating insufficient consumer protection and trust in insurance companies [2][3][8]. Group 1: Claims Ratio Analysis - The median comprehensive claims ratio for short-term health insurance among 120 insurance companies is only 42.12%, with an average of 45% after excluding extreme values [2][5]. - A claims ratio between 50% and 70% is considered reasonable for both consumer satisfaction and sustainable insurance company operations [4][10]. - The claims ratio for life insurance companies has increased from 38.83% in 2023 to 42.12% in the first half of 2025, while property insurance companies saw an increase from 38.70% to 42.30% [5]. Group 2: Company Performance - Few insurance companies achieve a claims ratio above 60%, with only 23 out of 120 companies falling within this range [5]. - Companies like China Life, Ping An Health, and Taikang Life have claims ratios above 50%, while others like Zhong An Insurance have a significantly lower ratio of 30.7% [8][9]. - Some companies report negative claims ratios due to low business volume, while others exceed 100% due to specific claims situations [6]. Group 3: Market Dynamics - The high operational costs associated with online customer acquisition and marketing are squeezing the claims payout space for insurance companies [9][14]. - The shift towards digital marketing has increased competition and customer acquisition costs, impacting the overall claims ratio [9][15]. - The importance of commercial health insurance is growing as basic medical insurance faces increasing financial pressure, highlighting the need for better integration and product offerings [11][12]. Group 4: Future Outlook - There is a recognized need to improve the claims ratio by at least 20 percentage points to enhance consumer experience and trust [13]. - Expanding the range of coverage and improving service efficiency are seen as critical paths to increasing the claims ratio and consumer satisfaction [15]. - Recent policy changes in Shanghai encouraging the use of personal medical accounts for group health insurance may open new avenues for growth in the commercial health insurance sector [15].

Core Viewpoint - The comprehensive claim ratio of short-term health insurance in the industry is low, with a median of 42.12% and an average of 45%, indicating insufficient consumer protection and trust in insurance companies [1][3][4]. Summary by Sections Comprehensive Claim Ratio - The comprehensive claim ratio is a crucial indicator of insurance product protection, with a higher value indicating more payouts to consumers [4]. - The current ratio of around 45% is considered low, with industry professionals suggesting a more reasonable range of 50%-70% for better consumer experience and sustainable operations [4][11]. Trends Over Time - From 2023 to the first half of 2025, the median claim ratio for life insurance companies increased from 38.83% to 42.12%, while for property insurance companies, it rose from 38.70% to 42.30% [6]. - Among the insurers reporting data, 11 had negative claim ratios, and 9 exceeded 100%, with 44 companies falling between 0%-40% and 33 between 40%-60% [6]. Company Performance - Major insurers like China Life, Ping An Health, and others have claim ratios above 50%, while companies like Zhong An Insurance and Tai Kang Online have significantly lower ratios [11]. - The disparity in claim ratios among companies is influenced by their product focus, with those offering broader coverage typically having higher ratios [14]. Cost Structure and Profitability - Low claim ratios do not necessarily equate to high profits for insurance companies, as high operational costs can offset potential gains [13]. - The competitive landscape for acquiring customers, especially through digital channels, has led to increased costs, impacting claim ratios [13]. Market Dynamics - The importance of commercial health insurance is growing, especially with reforms in payment methods that open new opportunities for development [16]. - The current short-term health insurance products primarily cover out-of-pocket expenses after basic insurance reimbursements, often with high deductibles [16]. Future Outlook - There is a recognized need to improve the claim ratio by at least 20 percentage points to enhance consumer satisfaction and trust [16]. - Strategies to increase consumer engagement and expand coverage are being explored, including targeting sub-healthy and sick populations [18][19]. - Government initiatives to support group health insurance purchases may provide a significant boost to the commercial health insurance market [20].

Core Viewpoint - The current state of short-term health insurance in China shows a low comprehensive claims ratio, indicating insufficient consumer protection and trust in insurance companies [2][3][8]. Claims Ratio Analysis - The median comprehensive claims ratio for short-term health insurance from 2023 to mid-2025 has increased from 38.83% to 42.12% for life insurance companies, and from 38.70% to 42.30% for property insurance companies [4]. - A total of 120 insurance companies reported a median claims ratio of 42.12%, with an average of 45% after excluding outliers [2][4]. - Only 19.1% of the companies reported a claims ratio between 60% and 100%, indicating that achieving a higher claims ratio is challenging [4]. Company Performance - Companies like China Life, Ping An Health, and Taikang Life have reported claims ratios above 50%, while others like ZhongAn Insurance and Taikang Online have much lower ratios, indicating a disparity in performance among insurers [8][9]. - Some companies reported negative claims ratios due to low business volume, while others exceeded 100% claims ratios, highlighting the variability in the market [5][8]. Market Dynamics - The low claims ratios are attributed to high operational costs, including online marketing and distribution expenses, which compress the space for actual claims payouts [9][10]. - The insurance market is seeing a shift towards digital marketing and the need for companies to adapt to changing consumer behaviors and expectations [9][14]. Future Outlook - There is a consensus among industry experts that the ideal claims ratio for short-term health insurance should be between 50% and 70% to ensure consumer satisfaction and company sustainability [3][12]. - The increasing pressure on basic medical insurance funds highlights the growing importance of commercial health insurance, especially with the implementation of new payment methods [10][11]. - Innovations in insurance products and expanding coverage to include more health-related services are seen as necessary steps for improving claims ratios and consumer trust [13][14].