新华财经上海1 月 30日电（记者 王淑娟）平安健康险最新发布的2025年理赔年度报告显示，2025年平 安健康险累计理赔案件达622万个，理赔客户171万人，赔付总金额达79亿元，人均赔付4次，单客户最 高赔付金额456万元。其中，最快理赔仅需3秒，实现了理赔效率的再提速，单客户最长赔付年限跨越17 年，见证了治疗周期中的持续守护，赔付年龄跨度从13天到103岁，实现了全生命周期的保障覆盖。 值得关注的是，截至2025年底，平安健康险的肿瘤全病程服务已累计服务39.6万人次，精准就医引导达 1.4万人次，就医服务达35万人次，特药使用14.4万人次，康复服务1.1万人次。报告显示，肿瘤全病程 服务最长时长记录达1460天，单人最多特药使用46次，单笔特药赔付金额最高达129万元。 理赔数据也是健康风险趋势的晴雨表，平安健康险2025年理赔年报揭示了三大趋势，不仅关乎个体保障 规划，也为产品与服务创新指明方向。年报显示，院外药品费用持续攀升。2025年，客户特药使用人次 涨幅达105%，特药账单总金额同比增长50%，人均账单同比上涨10%。 此外，跨省异地就医人数逐年增长。2025年客户异地就诊人数占比已达8 ...

Core Viewpoint - The article discusses the launch of Ping An's "Years of Peace" specific disease insurance, which aims to provide comprehensive health protection throughout the life cycle, addressing diverse consumer needs in the evolving health insurance market [1]. Group 1: Product Features - The "Years of Peace" specific disease insurance offers optional general medical insurance benefits, allowing policyholders to receive medical funds annually, which can be enjoyed for many years depending on the payment method, and is valid for life [2]. - The insurance has a low entry threshold with only two health disclosures required, making it accessible to a wide range of individuals aged from 28 days to 70 years [6][7]. - The policy is designed to meet the varying protection needs at different life stages, providing educational funds for children, health protection for young adults, and enhanced security for the elderly [7]. Group 2: Coverage and Benefits - The insurance covers ten specific diseases, including six neurological disorders and four common critical illnesses, with a significant focus on diseases prevalent among the elderly, such as severe strokes and Alzheimer's disease [8]. - For individuals aged 80 and above, the insurance offers a higher level of coverage for the specified diseases, enhancing the protection significantly [8]. Group 3: Flexibility and Usability - The general medical insurance benefit is highly flexible, with no restrictions on diseases, hospitals, or treatment methods, and can be used both online and offline with valid receipts for reimbursement [11]. - The coverage includes a wide range of scenarios such as home care, child health, traditional Chinese medicine, maternity protection, and health check-ups, making it applicable in various contexts [14]. Group 4: Service Quality - The integration of health services with insurance products is emphasized, with the "Years of Peace" insurance providing 14 exclusive value-added services worth over 18,000, covering multiple healthcare scenarios [15]. - The "Ping An Happy Health" service brand has been upgraded to enhance the health insurance service system, focusing on health promotion, quality medical services, digital healing, and long-term protection [18]. Group 5: Company Strengths - Ping An Health Insurance has a strong brand presence, recognized for its service capabilities and financial stability, with a brand value of $33.6 billion, ranking first in the global insurance brand value list for nine consecutive years [21]. - The company has provided insurance protection to over 77 million customers, with total claims exceeding 50 billion, and maintains a high customer satisfaction rate of 99.4% [22]. - The company has shown consistent profit growth, achieving a net profit of nearly 2 billion in 2024 and 17.84 billion in the first three quarters of 2025, indicating a robust financial performance [24][26].

Core Insights - China Ping An's health insurance subsidiary, Ping An Health Insurance, launched the first "Twin Peaks Starry Music Festival" in Shanghai as part of its 2025 "Customer Carnival" series, aiming to integrate modern customer demands for "natural nourishment + artistic cultivation + healthy living" with diverse customer engagement activities [1][2] - The event marks the first large-scale offline activity since the rebranding of the "Ping An Le Health" brand at the end of October, showcasing the company's commitment to high-value services and customer appreciation [1][2] Group 1 - The Shanghai Twin Peaks series of activities is a significant initiative by Ping An Health Insurance to promote its core brand concepts of "health promotion" and "health assets," contributing to the "Healthy China" strategy [2] - The rebranding of "Ping An Le Health" includes four core service areas: vibrant living, quality medical care, digital healing, and long-term protection, aiming to connect customers' health journeys through a digital account [2] - The company has organized various online and offline health activities, such as the "Ping An Le Health Public Welfare Sports Relay" and the Twin Peaks walking event, to advocate health concepts and enhance public health awareness [2] Group 2 - Ping An Health Insurance plans to continue innovating customer-centric brand activities to enhance residents' sense of gain and happiness, positioning "Ping An Le Health" as a key contributor to the well-being of the public [2]

Core Viewpoint - Ping An Health Insurance has officially launched its operations in Jiangxi, aiming to provide a digital health management platform called "Ping An Le Health" to enhance the health and well-being of local residents [1][2]. Group 1: Company Initiatives - The establishment of the Jiangxi branch is a strategic move to meet local health service demands and contribute to regional economic development [1]. - The "Ping An Le Health" service system includes four main service areas: Vitality Life, Quality Medical Care, Digital Healing, and Long-term Protection, designed to create a comprehensive health management experience [2]. - The company has introduced a "Le Health" station at the launch event, offering various health management services and interactive experiences for attendees [2]. Group 2: Community Engagement - The "Yi Qi Ai" health assistance program has been initiated to support vulnerable groups, particularly the elderly and children, with an expected investment of 500,000 yuan in a special public welfare fund [2]. - Previous initiatives have included care for special children and health assistance in multiple provinces, demonstrating the company's commitment to community health [2]. Group 3: Future Outlook - The Jiangxi branch plans to enhance local health services through professional products, innovative services, and strong public welfare commitments, contributing to the high-quality development of the local healthcare industry [3]. - The goal is to make "Ping An Le Health" a significant part of the residents' quality of life, promoting overall well-being in Jiangxi [3].

Core Insights - A strategic cooperation framework agreement was signed among Ping An Health Insurance, Peking University Health Management Group, and Roche Pharmaceuticals China to launch the "Pharmaceutical Insurance" ecosystem by 2025 [1][4] Group 1: Strategic Cooperation - The signing ceremony was attended by key executives from all three companies, highlighting the collaborative effort in the healthcare sector [3] - The partnership aims to leverage each company's strengths: Roche's innovative drug development, Peking University's medical service network, and Ping An's insurance and health management services [4][5] Group 2: Policy Alignment - The initiative aligns with China's 14th Five-Year Plan, which emphasizes deepening healthcare reform and enhancing insurance support for the health industry [4] - The collaboration focuses on critical disease areas such as oncology, aiming to create a comprehensive health service system that spans disease prevention, precise diagnosis, innovative treatment, and health insurance services [4] Group 3: Value-Based Healthcare - The partnership seeks to establish a new paradigm of value-based healthcare, contributing to the "Healthy China" strategy by providing integrated health services throughout the customer lifecycle [5][7] - Ping An Health Insurance has recently upgraded its "Ping An Happy Health" platform, which integrates various health management services to support the new "Pharmaceutical Insurance" model [7]

Core Insights - The concept of "health" is evolving into a valuable asset, with insurance companies transitioning from traditional "post-claim" models to a new phase of "medical-insurance integration" [1][3][6] - Ping An Health Insurance has introduced the concept of "family health assets," creating a quantifiable and operational system for health asset management, setting a benchmark for industry transformation [1][4] Market Demand - The prevalence of chronic diseases in China, such as hypertension and diabetes, is driving the transformation of the health insurance industry [2] - Lifestyle factors contribute significantly to the occurrence of chronic diseases, indicating that proactive health management is more effective than mere risk compensation [2] Policy Environment - Regulatory bodies are encouraging the health insurance industry to extend into health management, promoting a fusion of "health insurance + health management" [2] - The positioning of basic medical insurance as "basic coverage" leaves room for commercial health insurance to address specific needs, such as critical illness treatments and high-end medical services [2] Industry Challenges - Traditional health insurance faces challenges such as high claim rates and low customer loyalty due to a lack of intervention in user health behaviors [3] - The shift in public perception towards "active health management" necessitates a new approach in the health insurance sector [3] Innovative Solutions - Ping An Health Insurance's upgraded "Ping An Le Health" platform integrates health management into a family-oriented health asset management system, allowing shared health accounts and collective health behavior tracking [4][5] - The platform incentivizes healthy behaviors through a points system, where positive actions accumulate points that can enhance insurance coverage and redeem services [5] Medical-Insurance Integration - The "medical-insurance integration" model encompasses a full-cycle health service approach, addressing prevention, management, and coverage [6] - Ping An Health Insurance is leading this trend by offering services that promote healthy lifestyles and provide access to quality medical resources [6] Future Outlook - The medical-insurance integration model is expected to become mainstream in the next 3-5 years, driven by advancements in technology and the rising demand for family health management [7]

Core Insights - The commercial health insurance market in China is steadily growing, with premium income reaching 759.9 billion yuan in the first eight months of 2025, marking a year-on-year increase of 2.38%, approaching a trillion yuan scale [1][8] - The industry is undergoing a transformation from a "risk compensation" model to a "health management-driven" approach, driven by the "Healthy China" strategy and the acceleration of population aging [1][3] - Leading companies like Ping An Health Insurance are pioneering this shift by integrating health services into their product offerings, creating a positive feedback loop between health behavior, rewards, and insurance coverage [3][4] Industry Challenges - Despite growth, the industry faces persistent issues such as "easy to insure, difficult to service," and significant data barriers, indicating a need for deeper transformation [1][8] - The traditional economic compensation model is insufficient to meet the comprehensive health needs of residents throughout their life cycles, necessitating a shift in operational strategies [3][8] Policy Support - The "14th Five-Year Plan" outlines a clear direction for the development of the health insurance system, emphasizing the integration of health management with insurance services [6][11] - Recent regulatory guidelines from the National Financial Supervision Administration aim to enhance the quality of health insurance, focusing on a new service system that includes prevention, management, and post-coverage [6][7] Market Innovations - Companies are enhancing service depth and density, with initiatives such as direct payment channels between public hospitals and commercial insurance, AI-driven service systems, and immediate claims processing upon discharge [5][7] - The introduction of health points systems encourages customers to engage in healthy behaviors, transforming these actions into accumulative health assets [4][10] Future Outlook - The commercial health insurance market is expected to play a crucial role in the multi-tiered healthcare system, supported by policy incentives, technological advancements, and collaborative ecosystem development [11]

Core Insights - The commercial health insurance market in China is steadily growing, with premium income reaching 759.9 billion yuan in the first eight months of 2025, marking a year-on-year increase of 2.38%, approaching a trillion yuan scale [1][8] - The industry is undergoing a transformation from a "risk compensation" model to a "health management-driven" approach, driven by the "Healthy China" strategy and the acceleration of population aging [1][4] - Major companies like Ping An Health Insurance are leading the way in this transformation by integrating health services into their product offerings and creating a positive feedback loop between health behavior, rewards, and insurance coverage [4][5] Industry Challenges - Despite growth, the industry faces long-standing issues such as "easy to insure, difficult to service," and significant data barriers that hinder the integration of health management services with core insurance products [1][8] - The traditional economic compensation model is increasingly inadequate to meet the comprehensive health needs of residents throughout their life cycles, necessitating urgent transformation [4][8] Policy Support - The "14th Five-Year Plan" outlines clear directions for the construction of a health security system, emphasizing the integration of health insurance with health management [6][10] - Recent regulatory guidelines from the National Financial Supervision Administration aim to promote the development of health insurance, focusing on a new health service guarantee system that includes prevention, management, and post-coverage [6][10] Market Innovations - Leading companies are innovating by enhancing service density and depth, utilizing AI technology for comprehensive service systems, and offering immediate claims processing and digital chronic disease management solutions [5][7] - The introduction of health points mechanisms encourages customers to engage in healthy behaviors, which can lead to increased insurance coverage and reduced deductibles [5][9] Future Outlook - The commercial health insurance market is expected to play a crucial role in the multi-tiered health security system, supported by ongoing policy incentives, technological advancements, and collaborative ecosystem development [10] - The industry is positioned for significant growth as it adapts to the evolving needs of consumers and integrates health management into its core operations [7][10]

Core Insights - The core innovation of the "Ping An Happy Health" brand upgrade is the establishment of a "Family Health Asset" account system [1] - This system consists of three components: health points, health insurance, and health rights, allowing users to gain more health protection through earned points [1] - The model aims to integrate short-term incentives with long-term health improvements, promoting lifestyle changes and supporting the construction of a healthy China [1] Company Strategy - The brand upgrade reflects a strategic shift towards a digital platform that enhances user engagement and health management [1] - By focusing on family health assets, the company is positioning itself to meet evolving consumer needs in health insurance [1] - The initiative aligns with corporate social responsibility goals, emphasizing the company's commitment to public health [1]

Group 1 - The core innovation of the "Ping An Happy Health" brand upgrade is the establishment of a "Family Health Asset" account system, which consists of health points, health protection, and health rights [2] - Users can earn points to obtain more health protection, integrating short-term incentives with long-term health [3] - The model aims to change users' lifestyles and fulfill corporate social responsibility, contributing to the construction of a healthy China [3]