Group 1 - The core idea of the news is the launch of the "Commercial Insurance Calculator" by the Shanghai Medical Insurance Bureau, which aims to help consumers select tailored commercial health insurance products using intelligent technology [1][2] - The "Commercial Insurance Calculator" utilizes a data foundation based on "personal medical expense burden profiles," ensuring consumer privacy and data security while creating multidimensional population profiles [1] - The profiles categorize medical expense burdens into three main categories (high, medium, low) and nine subcategories, dynamically generating a "health insurance matching model" to recommend specific products [1] Group 2 - The "Commercial Insurance Calculator" is now available in the "Suishenban" personal account section, allowing users to receive intelligent insurance recommendations after granting authorization [2] - Currently, 11 insurance products are recommended, including hospitalization medical insurance, comprehensive medical insurance, critical illness insurance, outpatient emergency insurance, and specific disease insurance, covering essential protection needs [2] - The Shanghai government has adopted a "government-led, market-driven" approach to attract more insurance institutions, resulting in over 20 products launched in the personal account section, with more than 50,000 policies issued and premiums exceeding 30 million yuan, of which 93% were paid from personal accounts [2]

Core Viewpoint - Ant Insurance has demonstrated significant advancements in health insurance claims processing, showcasing the effectiveness of its "Anxin Pei" service in enhancing user experience and resolving disputes [1][3][7]. Group 1: Claims Data - In 2024, Ant Insurance's platform facilitated health insurance claims totaling 9.2 billion yuan, serving 7.25 million claimants [1]. - The average claim amount for critical illness insurance on the platform was 77,920 yuan, with the highest single payout reaching 1.6 million yuan [1]. - The average claim amount for hospitalization medical insurance was 6,586 yuan, primarily due to conditions like breast cancer, lung cancer, and pneumonia [1]. Group 2: Anxin Pei Service - The "Anxin Pei" service has been upgraded since 2022, covering 85 products from 11 insurance companies, providing comprehensive support throughout the claims process [3][4]. - The service includes AI interpretation of claims conclusions, one-on-one expert assistance, and mediation by trained personnel, enhancing communication between users and insurance companies [3][4]. Group 3: Dispute Resolution - In 2024, 162,000 health insurance claim users utilized the AI interpretation service, achieving a self-resolution rate of 96% [4]. - For complex claims disputes, the Ant Mediation Studio successfully mediated 955 cases, assisting users in recovering 4.97 million yuan [2][4]. - The mediation process has a high resolution rate, with over 98% of disputes resolved through AI interpretation and expert assistance, leaving less than 2% of cases requiring mediation [8]. Group 4: Industry Impact - The introduction of a neutral third-party platform like Ant Insurance enhances communication between insurers and users, providing a new model for resolving claims disputes [7][8]. - The focus on improving claims services aligns with the industry's goal of protecting consumer rights and enhancing user satisfaction [7][8].