"普惠"正在成为我国金融领域被提及最多的高频词之一。作为普惠金融的关键支柱与保险业践行社会责任的核心载体，普惠保险始终以服务国计民生、促进 社会公平为初心，从田间地头的农业保障到新业态从业者的权益守护，从银发族的专属医疗保障到小微企业的经营风险护盾，用"小保费"撬动"大保障"的民 生智慧，在中华大地上织密一张兼具广度与温度的全民风险防护网。 如今，这张防护网正从"广覆盖"的规模扩张迈向"深耕耘"的质量升级，在政策护航、产品创新中回应多元诉求，也在破解发展瓶颈的探索中，向着更精准、 更可持续的高质量发展之路稳步前行。 从新业态从业者到"一老一小"，从快递小哥到慢病人群，普惠保险正以"精准滴灌"的方式回应不同群体的差异化保障需求。 在新市民与新业态保障领域，普惠保险产品创新亮点纷呈。具体来说，福建省实施新业态人员综合保险方案，结合当地气候炎热特点，不仅为新市民人群提 供急需的医疗、住院津贴以及交通意外、残疾、疾病身故等保险服务，还将因热射病导致的保险责任纳入保障范围。江苏省建立新市民金融保险服务中心， 为建筑工程项目、企业用工中的新业态就业人员提供保险保障，进一步完善工伤保险责任。 针对"一老一小"，慢病人群等传 ...

"普惠"正在成为我国金融领域被提及最多的高频词之一。作为普惠金融的关键支柱与保险业践行社会责任的核心载体，普惠保险始终以服务国计民生、促进 社会公平为初心，从田间地头的农业保障到新业态从业者的权益守护，从银发族的专属医疗保障到小微企业的经营风险护盾，用"小保费"撬动"大保障"的民 生智慧，在中华大地上织密一张兼具广度与温度的全民风险防护网。 如今，这张防护网正从"广覆盖"的规模扩张迈向"深耕耘"的质量升级，在政策护航、产品创新中回应多元诉求，也在破解发展瓶颈的探索中，向着更精准、 更可持续的高质量发展之路稳步前行。 精准滴灌 从新业态从业者到"一老一小"，从快递小哥到慢病人群，普惠保险正以"精准滴灌"的方式回应不同群体的差异化保障需求。 在新市民与新业态保障领域，普惠保险产品创新亮点纷呈。具体来说，福建省实施新业态人员综合保险方案，结合当地气候炎热特点，不仅为新市民人群提 供急需的医疗、住院津贴以及交通意外、残疾、疾病身故等保险服务，还将因热射病导致的保险责任纳入保障范围。江苏省建立新市民金融保险服务中心， 为建筑工程项目、企业用工中的新业态就业人员提供保险保障，进一步完善工伤保险责任。 针对"一老一小"，慢 ...

"普惠"正在成为我国金融领域被提及最多的高频词之一。作为普惠金融的关键支柱与保险业践行社会责 任的核心载体，普惠保险始终以服务国计民生、促进社会公平为初心，从田间地头的农业保障到新业态 从业者的权益守护，从银发族的专属医疗保障到小微企业的经营风险护盾，用"小保费"撬动"大保障"的 民生智慧，在中华大地上织密一张兼具广度与温度的全民风险防护网。 如今，这张防护网正从"广覆盖"的规模扩张迈向"深耕耘"的质量升级，在政策护航、产品创新中回应多 元诉求，也在破解发展瓶颈的探索中，向着更精准、更可持续的高质量发展之路稳步前行。 精准滴灌 金融是国民经济的血脉，保险是经济的减震器和社会的稳定器，普惠保险更是保险业服务国家战略、增 进民生福祉、保障社会稳定的关键一环。 产品创新背后，是普惠保险从"量"到"质"的深刻转变。浙大城市学院副教授林先平表示，与3—5年前相 比，我国普惠保险在覆盖范围、服务质量、制度建设方面取得了显著进步。 两大难题 尽管普惠保险近年来在产品丰富度和覆盖范围上取得了一定进展，但供需错配、结构失衡的问题依然突 出。 正如中国人寿战略规划部总经理洪梅分析，普惠保险面临两大世界性难题：一是服务覆盖难题，即 ...

中国太保 20251126 摘要 太保积极响应监管对非车险应收保费的规范，推行见费出单制度，旨在 优化综合成本率和提升盈利能力，但短期内可能对保费增长带来压力。 此举有利于规范市场竞争，头部公司将更专注于定价和服务。 太保 2025 年综合成本率受自然灾害、市场竞争和业务结构调整影响。 车险方面，监管趋严和行业自律降低费用率，但新能源车赔付率上升。 非车险复杂性高，公司逐步退出高成本、高风险业务如个性宝，长期有 助盈利。 太保退出个人新保业务（个性宝）是主动调整，虽未出现重大亏损，但 为应对市场不确定性，选择停止新业务以确保经营稳健，预计 2026 年 底完成清退。 普惠金融是太保业务增长点，农险等受政府补贴，长期保本微利，但规 模上具有基石作用，分散风险，与法人单位大型项目互补，平衡利润和 稳定性。 太保寿险强调收关开门一体化，不提前预收。个险渠道通过提升代理人 产能实现高个位数增长，银保渠道通过拓展网点和提升产能实现 20%- 30%增速，保持价值率稳定。 Q&A 非车险报行合一政策对行业的影响如何？ 非车险报行合一政策是逐步落地的，预计到 2026 年将全面执行。该政策要求 重新梳理险种条款和费率，并严 ...

Core Viewpoint - The implementation of the "reporting and operation integration" policy for non-auto insurance, effective November 1, is expected to profoundly impact the industry and reshape the competitive landscape [1]. Group 1: Industry Overview - The insurance industry is a crucial part of the financial system, with a market size in the trillions, serving as a "social stabilizer" and participating in social governance [1]. - The essence of insurance is to provide risk protection for society, helping enterprises, families, and individuals transfer unknown risks [1]. Group 2: Policy Implications - The core of the "reporting and operation integration" policy is to compel insurance companies to operate in compliance, ensuring consistency between what is reported and what is practiced, thereby enhancing professional capabilities and service levels [1][2]. - This policy aims to shift companies from low-level competition based on resource grabbing and price wars to a competition based on comprehensive strength [1]. Group 3: Industry Challenges - Historically, insufficient regulatory oversight has led to a lack of self-discipline in the industry, resulting in companies ignoring compliance and engaging in practices such as splitting coverage and misreporting expenses [2]. - The chaotic competition has posed risks of losses for insurance companies, affecting their profitability and solvency, which in turn impacts the income of industry professionals and the overall health of the sector [2]. Group 4: Market Potential and Reform - The Chinese insurance market has significant potential and is calling for regulation, with ongoing financial reforms moving towards deeper integration of reporting and operations [3]. - The "reporting and operation integration" policy restricts speculative behaviors in the market, signaling a shift towards more structured operations [3]. Group 5: Future Directions - The insurance market in China is still developing and faces challenges that need to be addressed through ongoing development [4]. - Companies must accurately grasp policy changes, adhere to regulations, enhance risk management, and innovate service models to thrive in a competitive environment [4].

Core Insights - The article discusses the significance of non-auto insurance and the recent regulatory initiative known as "reporting and execution consistency" in the insurance industry [1][2][3][4] Group 1: Non-Auto Insurance - Non-auto insurance encompasses various types of insurance products, including home property insurance, enterprise property insurance, liability insurance, accident insurance, short-term health insurance, travel insurance, and return shipping insurance [1] - The share of non-auto insurance in total property insurance premiums has increased from 37.1% in 2019 to 50.8% in the first eight months of this year, indicating a growing market [1] Group 2: Reporting and Execution Consistency - "Reporting and execution consistency" mandates that the insurance terms and rates submitted for regulatory approval must match those used in actual sales, preventing discrepancies that could mislead consumers [2][3] - This initiative aims to eliminate unethical competitive practices, such as underreporting fees or altering coverage terms post-approval, which can distort the cost structure and pressure underwriting profits [2] - The regulatory body has issued guidelines to enhance supervision of non-auto insurance, focusing on optimizing assessment mechanisms, standardizing product development, managing premium income, and improving claims services [2] Group 3: Impact on Consumers and Market - The policy is designed to protect consumers by ensuring fair market practices and maintaining the financial stability of insurance companies, which is crucial for timely and adequate claims payments [3][4] - By enforcing strict adherence to approved terms, the initiative promotes transparency and reduces sales misrepresentation, allowing consumers to make informed comparisons [3] - The shift in competitive focus from price wars to value-based competition is expected to lead to better product offerings and enhanced customer experiences in the insurance market [3][4]

Group 1 - The comprehensive payout ratio is an important indicator of the protection level of insurance products, with higher values indicating more compensation received by consumers [1] - Companies such as China Life, PICC Health, Taiping Property & Casualty, Taiping Life, PICC Life, and AXA Tianping have short-term health insurance comprehensive payout ratios exceeding 50% [1] - The median comprehensive payout ratio for short-term health insurance among 120 insurance companies is only 42.12%, with an average of 45% after excluding extreme values, which is considered low by industry professionals [2] Group 2 - Industry professionals suggest that a comprehensive payout ratio between 50% and 70% for short-term health insurance is more reasonable, as it ensures consumer experience and supports the stable operation of insurance companies [2]

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].