金融监管总局近日发布的三季度保险业主要监管指标数据显示，前三季度，保险公司原保险保费收入 5.2万亿元，同比增长8.5%；赔款与给付支出1.9万亿元，同比增长7.6%；新增保单件数846亿件，同比 增长7.9%。 随着行业整体运行态势向好，保险业务的结构性变化日益显现，互联网保险正加快融入行业运行体系。 规模持续扩大 近年来，互联网保险进入稳步增长区间。元保集团和清华大学五道口金融学院中国保险与养老金融研究 中心联合发布的《中国互联网保险发展报告（2024）》（以下简称《报告》）显示，2013年至2023年 间，我国互联网保险保费规模由290亿元增长至约4949亿元，年均复合增长率超过30%。未来5年，互联 网保险年均增速将稳定在15%到20%之间。 对此，中央财经大学中国精算科技实验室主任陈辉表示，从长期趋势看，互联网保险确实推动了保险业 规模扩张和结构变化，但其发展并非简单的线性上行。回顾过去，互联网保险增速呈现出一定波动性， 与监管政策和业务合规要求的调整高度相关。这也说明，互联网保险仍处在创新与稳健发展不断磨合的 阶段，其增长质量和制度适配性同样值得关注。 从公司主体看，目前开展互联网业务的人身险公司 ...

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]

Core Insights - The report highlights the growing demand for insurance among individuals with pre-existing conditions due to rising treatment costs and a significant protection gap [1][2] - The health insurance sector in China is facing challenges in product restructuring and meeting the needs of the aging population and younger individuals with chronic diseases [1][2] Group 1: Market Trends - The average treatment cost for individuals with pre-existing conditions in China is 87,000 yuan, which is 2.1 times the annual disposable income of residents [2] - Over 60% of severe disease patients incur out-of-pocket expenses exceeding 100,000 yuan, indicating a clear protection gap [2] - The growth rate of health insurance from property insurance companies reached 9.08% in the first half of 2025, while life insurance companies only saw a growth of 0.15% [1] Group 2: Product Development - Waterdrop Insurance has launched 214 new insurance products for individuals with pre-existing conditions by 2025, averaging one new product every 1.14 days [3] - The use of AI technology has significantly improved efficiency, reducing the average processing time for complex health insurance underwriting by 80% and achieving a 99.8% accuracy rate [3] Group 3: Industry Recommendations - The report suggests that government departments should enhance policy support and integrate pre-existing condition insurance into the inclusive insurance framework [3] - Companies are encouraged to invest more resources into the development of pre-existing condition insurance, leveraging big data and AI to improve risk assessment and underwriting capabilities [3] - A "Inclusive Product Alliance" has been initiated by Waterdrop Insurance in collaboration with 18 insurance companies to promote the implementation of inclusive insurance [3]

Core Insights - The report highlights the growing challenge of providing insurance for individuals with pre-existing conditions in the context of an aging population and increasing chronic diseases among younger people [1][2] - The average treatment cost for this group is approximately 90,000 yuan, which is 2.1 times the annual disposable income of residents, indicating a significant financial burden [1] - The insurance industry is viewing insurance for individuals with pre-existing conditions as a key area for innovation and inclusive health insurance solutions [1][6] Group 1: Market Demand and Challenges - Nearly 30% of individuals with pre-existing conditions are denied coverage due to health disclosures, and many are unaware that they can obtain insurance despite their conditions [2][3] - Over 75% of this group desires insurance products that cover their existing conditions and are willing to pay extra premiums for such targeted coverage, indicating a substantial unmet demand in the market [2] - Medical insurance has become a necessity for 44.5% of individuals with pre-existing conditions, with specialized products for cancer recurrence and disability risks emerging as important supplements [2][3] Group 2: Differentiated Needs Among Subgroups - Older individuals with pre-existing conditions have a stronger demand for long-term stable coverage due to higher treatment costs and longer illness duration [3] - Younger individuals are more affected by sub-health and chronic diseases, preferring insurance products with lower entry barriers and flexible coverage [3] - There is a significant demand for insurance that covers pregnancy-related health issues among the mother and baby demographic [3] Group 3: Role of AI in Insurance Innovation - AI is driving systemic changes across the insurance service chain, addressing the challenges faced by individuals with pre-existing conditions [4][5] - Waterdrop Insurance has launched 214 insurance products for individuals with pre-existing conditions, with 34 being first-of-their-kind in China, and an average of 1.14 days to launch a new product [4] - AI has improved user experience and operational efficiency, with AI customer service achieving an average response time of 1.5 seconds and significantly reducing underwriting processing time [4][5] Group 4: Industry Collaboration and Ecosystem Development - Waterdrop Insurance has initiated a "Universal Product Alliance" with 18 insurance companies to scale up inclusive insurance solutions through industry collaboration [6] - The former vice-chairman of the China Insurance Regulatory Commission emphasized the need for policy, industry, and technology to work together to promote high-quality development of insurance for individuals with pre-existing conditions [6] - The insurance service chain requires enhanced collaboration among institutions to build a more robust and open insurance future, ensuring that inclusive coverage reaches all who need it [6] Group 5: Future Development Path - The development path for insurance for individuals with pre-existing conditions is becoming clearer, representing a new growth curve for the insurance industry and a commitment to inclusive and technology-driven values [7]

Core Insights - The conference highlighted the importance of "chronic illness insurance" as a critical topic in the insurance industry, emphasizing the significant treatment costs faced by individuals with chronic conditions in China [1][2][3] - The report indicates that the average treatment cost for chronic illness patients is 87,000 yuan, which is 2.1 times the average disposable income of residents, revealing a substantial protection gap [1] - The development of chronic illness insurance aligns with national goals of high-quality development and expanding insurance coverage to better serve public welfare [1][2] Group 1: Market Demand and Challenges - The youth demographic is increasingly facing health risks, with the prevalence of sub-health and chronic diseases being twice that of the elderly, indicating a shift in disease patterns that necessitates product innovation [2][3] - Despite the growing insurance demand among the chronic illness population, they encounter barriers such as high costs, lack of awareness, and stringent underwriting requirements [2][3] - Nearly 30% of individuals are denied coverage due to health disclosures, and 20% are unaware that they can apply for insurance despite having chronic conditions [2][3] Group 2: Technological Innovations - The integration of AI and smart underwriting technologies is transforming the insurance product development and pricing models, allowing for a more inclusive approach to risk acceptance [6][7] - Waterdrop Insurance has launched 214 chronic illness insurance products in the past year, with 34 being first-of-their-kind in China, indicating a rapid evolution in product offerings [6] - The AI underwriting system "KEYI.AI" significantly enhances the efficiency of the underwriting process, reducing processing time by 80% and achieving a 99.8% accuracy rate [6][7] Group 3: Industry Collaboration and Future Directions - The establishment of the "Inclusive Product Alliance" by Waterdrop Insurance and 18 insurance companies aims to create affordable and accessible insurance products for the public [8][9] - The shift from a risk exclusion model to a risk acceptance model is being driven by policy changes and technological advancements, marking a new era in the insurance industry [9] - The focus is now on improving claims processing transparency and speed, which is crucial for ensuring that chronic illness insurance serves its intended purpose of providing real protection [10][11]

Core Insights - The report highlights a significant protection gap for individuals with pre-existing conditions in China, particularly among the younger population, where the prevalence of chronic diseases is twice that of the elderly [1] - The development of insurance products for individuals with pre-existing conditions is essential for expanding coverage and improving public welfare, necessitating innovation in product offerings and the use of AI and big data for better risk assessment and management [1][2] Group 1 - The report indicates that the chronic disease incidence among the youth is twice that of the elderly, signaling a shift in disease patterns that demands innovative insurance solutions [1] - Individuals with pre-existing conditions face challenges such as limited product options, increased premiums, and insufficient coverage, highlighting the need for tailored insurance products [1] - The former vice chairman of the China Insurance Regulatory Commission emphasized that developing insurance for individuals with pre-existing conditions is crucial for enhancing the insurance industry's coverage and service capabilities [1] Group 2 - The assistant secretary-general of the Beijing Insurance Industry Association noted that the insurance sector must evolve to meet changing consumer demands, focusing on proactive service integration and improved accessibility and satisfaction [2] - The CEO of Waterdrop Company stated that AI is not only a tool for efficiency but also a key driver for achieving universal insurance coverage, particularly for underserved groups such as the elderly and those with pre-existing conditions [2] - Waterdrop has launched 214 insurance products for individuals with pre-existing conditions by 2025, with 34 being first-of-their-kind in China, demonstrating a commitment to innovation and accessibility in insurance offerings [2] Group 3 - At the conference, Waterdrop and 18 insurance companies formed the "Inclusive Product Alliance" to address the insurance needs of specific demographics, including those with pre-existing conditions, the elderly, and mothers and infants [3] - The alliance aims to leverage AI and collaborative product development to promote inclusive insurance services, aligning with the strategy of leading new supply through new demand [3]

Core Insights - The core message emphasizes the transformation of the insurance industry from a supply-driven model to a demand-driven model, focusing on understanding user needs and providing tailored services [1][4][14] Group 1: Service Ecosystem Development - Waterdrop Insurance has launched the "Three Good Service Alliance" with 18 insurance companies to address the protection gaps for underrepresented groups such as those with pre-existing conditions, the elderly, and mothers [2][5] - The "Three Good Service" framework focuses on providing good products, good services, and good claims processes, aiming to enhance user experience and satisfaction [1][11] Group 2: Focus on Pre-existing Conditions - A report released at the conference highlights that the average treatment cost for individuals with pre-existing conditions is 87,000 yuan, which is 2.1 times the average disposable income, indicating a significant protection gap [4][5] - The report also notes that over 60% of critical illness patients face out-of-pocket expenses exceeding 100,000 yuan, underscoring the urgent need for better insurance products tailored to this demographic [4][5] Group 3: Product Innovation and AI Integration - Waterdrop has introduced 214 insurance products for individuals with pre-existing conditions, with 34 being first-of-their-kind in China, and an average of 1.14 days to launch a new product [5][12] - The company invests 300 million yuan annually in AI research, resulting in over 100 technology patents and the development of a proprietary AI model to enhance product customization, underwriting, and claims processing [8][9] Group 4: Claims Processing Enhancement - The "Help Help Claim" service has processed over 200,000 claims, with a nearly 98% success rate for first-time submissions, demonstrating the effectiveness of integrating AI with human support in claims management [11][12] - The average processing time for general claims has been reduced by 43.3% through the AI and human collaboration model, improving overall efficiency in claims handling [12][13]

Core Insights - The report highlights the growing challenge of providing insurance for individuals with pre-existing conditions in the context of an aging population and increasing chronic diseases among younger people [1][2] - The average treatment cost for this group is approximately 90,000 yuan, which is 2.1 times the annual disposable income of residents, indicating a significant financial burden [1] - The insurance industry is viewing the development of insurance products for individuals with pre-existing conditions as a key area for innovation and inclusive coverage [1][4] Group 1: Market Demand and Challenges - Nearly 30% of individuals with pre-existing conditions are denied coverage due to health disclosures, while others face exclusions or significantly higher premiums [2] - Over 75% of this group desires insurance that covers their existing conditions and is willing to pay extra for such targeted coverage, indicating a substantial unmet demand in the market [2] - Medical insurance has become a necessity for 44.5% of individuals with pre-existing conditions, with specialized products for cancer recurrence and disability risks emerging rapidly [2] Group 2: Differentiated Needs Among Subgroups - The elderly with pre-existing conditions have a stronger demand for long-term stable coverage due to higher treatment costs and longer illness duration [3] - Younger individuals are more affected by sub-health and chronic diseases, preferring insurance products with lower entry barriers and flexible coverage [3] - There is a significant need for insurance covering pregnancy-related health issues among certain segments of the mother and baby demographic [3] Group 3: Role of AI in Insurance Innovation - AI is driving systemic changes across the insurance service chain, addressing the challenges faced by individuals with pre-existing conditions [4][6] - The integration of AI and big data has accelerated product innovation, with 214 insurance products for individuals with pre-existing conditions launched by Waterdrop Insurance by 2025, including 34 first-of-their-kind products [4] - AI has improved user experience and operational efficiency, with AI-driven customer service and underwriting processes significantly reducing response times and increasing accuracy [6] Group 4: Industry Collaboration and Future Directions - The establishment of the "Inclusive Product Alliance" by Waterdrop Insurance and 18 other insurance companies aims to transform isolated innovations into scalable inclusive coverage [7] - The collaboration emphasizes the need for policy, industry, and technology to work together to enhance the quality of insurance for individuals with pre-existing conditions [7] - The insurance sector is encouraged to expand from mere compensation to comprehensive risk management, integrating prevention and recovery services [7][8]

Core Insights - The second "Gathering Strength, Achieving Common Good" Waterdrop Insurance Service Ecosystem Conference was successfully held, where the "Research Report on Innovative Insurance for People with Pre-existing Conditions (2025)" was released, highlighting the protection status and demand pain points of the pre-existing condition population in China [1][5][12] - Waterdrop Insurance, in collaboration with 18 insurance companies, established the "Inclusive Product Alliance" to focus on the insurance needs of specific groups such as those with pre-existing conditions, the elderly, and mothers and infants, aiming to promote inclusive insurance services through AI empowerment and product co-creation [1][18] Group 1: Conference Highlights - The conference featured notable figures from the insurance industry, including former officials from the China Insurance Regulatory Commission and representatives from various insurance companies and media [4] - The development of insurance for people with pre-existing conditions is seen as a key measure for expanding coverage and serving public welfare, aligning with national development goals [5][7] Group 2: Research Findings - The average annual medical expenditure for individuals with pre-existing conditions is approximately 87,000 yuan, which is 2.1 times the average disposable income of residents, indicating a significant protection gap [12] - Over 60% of severe disease patients incur out-of-pocket expenses exceeding 100,000 yuan, highlighting the urgent need for better insurance solutions [12] - Young adults are experiencing a rising prevalence of sub-health and chronic diseases, with rates twice that of the elderly, necessitating innovative insurance products [12] Group 3: Product and Service Innovations - Waterdrop Insurance has launched 214 innovative insurance products for people with pre-existing conditions, with 34 being first-of-their-kind in the country, and an average of 1.14 days to launch a new product [14] - The introduction of AI-driven services, such as the AI customer service "Bao Xiaohui," has significantly improved service efficiency, achieving a response time of 1.5 seconds and a 40-fold increase in service capacity [17] - The establishment of the "Inclusive Product Alliance" aims to create affordable and accessible insurance products for the public, with participation from 18 insurance companies [18]

Core Insights - The second "Gathering Strength, Achieving Common Good" Waterdrop Insurance Service Ecosystem Conference was successfully held, where a report on the innovation of insurance for individuals with pre-existing conditions was released, highlighting the current protection status and demand pain points for this demographic [1][9] - Waterdrop Insurance established the "Inclusive Product Alliance" with 18 insurance companies to focus on the protection needs of specific groups such as individuals with pre-existing conditions, the elderly, and mothers and infants, aiming to promote inclusive insurance services through AI empowerment and product co-creation [1][16] Group 1 - The average annual medical expenditure for individuals with pre-existing conditions is nearly 90,000 yuan, indicating a significant protection gap that needs to be addressed [3][9] - The development of insurance for individuals with pre-existing conditions aligns with the national "14th Five-Year Plan" principles of prioritizing people's needs and high-quality development, and is essential for expanding coverage and improving service in the insurance industry [3][5] - The report indicates that over 60% of critical illness patients incur out-of-pocket expenses exceeding 100,000 yuan, and the prevalence of chronic diseases is increasing among younger populations, necessitating innovation in insurance products [9][10] Group 2 - Waterdrop Insurance has launched 214 insurance products for individuals with pre-existing conditions, with 34 being industry firsts, and has introduced innovative products such as a medical insurance plan that does not require health declarations [10][12] - The "Three Good Services" initiative, focusing on "Good Products," "Good Services," and "Good Claims," aims to enhance the overall service experience through AI and big data technology [13][14] - The establishment of the "Inclusive Product Alliance" aims to develop affordable and accessible insurance products for the public, with participation from various insurance companies to strengthen collaboration and trust within the industry [16]