近日，张女士向南都记者反映，其父亲投保2025年度"健康·佛医保"后理赔遭拒，并要求"退保"，原因 为"不符合参保条件"。 张女士对此不解：投保成功还生成了保单，为什么理赔时才说"不能生效"？ "健康·佛医保"相关工作人 员答复称，被保人不属于"佛医保"适用的几类人群，投保时有相关说明。有保险行业资深人士告诉记 者：保险业遵循"最大诚信原则"，投保时默认用户承诺真实，理赔时若发现不符合条件，保单可能无 效。 健康·佛医保宣传页面。 手持保单，被告知"合同无效" 据了解，被保人张叔今年64岁，户籍广东肇庆，多年间一直在佛山市南海区桂城街道居住、生活，近5 年在桂城做小区保安工作。 今年2月19日，张叔的儿子通过官方微信小程序给张叔购买"佛医保" 。6月份，张叔被查出腹部主动脉 瘤，先后在南海桂城医院和佛山市第一人民医院住院，产生约12万元医疗费用，经肇庆居民医疗保险 （420元/年）出院理赔结算后，个人支付6万余元。 "医生说，如果购买了'佛医保'，个人支付超过两万以上出院时就能自动理赔报销。"张女士说。不过， 理赔并未随出院到账，张女士一家经线下网点咨询得知，需提交"3月31日前持有的有效佛山居住证"等 相关 ...

"小保单"托举民生"大保障"。在国家大力推进普惠金融与消费升级的战略背景下，在粤港澳大湾区建设 纵深推进的关键阶段，国务院《关于做好金融"五篇大文章"的指导意见》犹如及时春雨，为金融业服务 实体经济、服务百姓民生指明方向。普惠保险作为普惠金融的重要构成部分，正以其独特的保障功能和 社会价值，为增进民生福祉、提升保障水平、服务高质量发展注入强劲动能。 近年来，中国人寿保险股份有限公司（以下简称"中国人寿寿险公司"）始终践行"金融为民"初心，充分 发挥综合金融优势与业务协同效应，以"一个国寿 一生守护"为理念，创新构建多层次医疗保障"广东模 式"，努力打造破解民生保障难题的"国寿样本"。 守护全生命周期，构建普惠金融服务体系 金融是国民经济的血脉，关系中国式现代化建设全局。作为我国普惠金融的重要组成部分，发展普惠保 险是践行金融工作政治性、人民性的必然要求，是服务中国式现代化建设的重要任务，亦是保险业高质 量发展的内在需要。中国人寿始终践行"国之大者"的使命担当，以创新为驱动，构建起覆盖全生命周期 的普惠金融服务体系。 从广州"穗岁康"到珠海"大爱无疆"，从江门"邑康保"到佛山"佛医保"、中山"博爱康"..... ...

南方财经全媒体记者林汉垚 北京报道 普惠金融是指立足机会平等要求和商业可持续原则，以可负担的成本为有金融服务需求的社会各阶层和 群体，尤其是中小企业、农民以及城镇低收入人群等特殊群体提供适当、有效的金融服务。 在金融服务日益普及的今天，普惠金融正深刻改变着亿万民众的生活。而普惠保险作为我国普惠金融的 重要组成部分，更是承担着满足社会各界多层次保障需求和引领服务保险业高质量发展的重要使命。 广东作为经济总量领跑全国的排头兵，有着全国最多的经营主体，既是普惠金融的需求热土，更是金融 创新的实践高地。近日，记者在广东调研了解到，近三年来，中国人寿寿险广东省分公司（以下简 称"广东国寿"）已为广东全省17个地市超3500万人提供城市定制型商业医疗保险保障，累计赔付155.72 万人次，赔付金额15.92亿元，并打造出了广州"穗岁康"、珠海"大爱无疆"、江门"邑康保"、佛山"佛医 保"、中山"博爱康"等普惠保险品牌。 监管指引推动普惠保险发展 现实生活中，最需要保险保护的人群，往往是收入有限、积蓄单薄、抵御风险能力相对脆弱的群体。一 场意外或疾病可能轻易击碎他们平静的生活。然而，现实常显得颇为矛盾——恰恰是这部分最需要 ...

新华财经北京6月13日电（记者张千千）做好普惠金融，事关广大人民群众民生福祉。近年来，保险行业结合百姓健康、养老等实际需要，积极参与政府主 导的各类普惠保险项目，向百姓提供买得到、买得起的保险服务。普惠保险如何更好助力兜住兜牢民生底线、实现可持续健康发展？记者在广东等地进行了 采访。 广覆盖确保百姓"买得到" 临近退休时，广州市民鲁先生确诊淋巴瘤，其对症的一种抗癌药品价格高达上百万元且未纳入医保。"住院产生的自费药品和检查费用超过140万元，我购买 的'穗岁康'保险提供了近100万元费用补偿，缓解了就医压力。"鲁先生说。 "穗岁康"是政保合作普惠保险的一个缩影。近年来，全国多地推出城市定制型商业医疗保险，也就是"惠民保"。不同地区的产品名称不同，但却拥有同样的 特点——由政府指导、保险机构运作，投保门槛低、保费低、保额高，具有普惠性质。 "要做好普惠保险，首先要解决的就是可及性问题，确保让更多人买得到。"中国人寿寿险总公司战略规划部总经理洪梅表示，一是要更好服务以往因渠道触 达不到而被排除在金融服务之外的人群，二是要将因风险难以计量而被传统金融服务排除在外的人群纳入保险服务对象。 "老年人、带病人群和既往症患 ...

Core Viewpoint - The article highlights the development and impact of inclusive insurance products, particularly the "Hui Min Bao" initiative in various cities, which aims to provide affordable healthcare coverage to a broader population, especially vulnerable groups like the elderly and low-income individuals [1][2][4]. Group 1: Hui Min Bao Overview - "Hui Min Bao" is a government-guided, commercially operated insurance initiative that integrates with basic medical insurance, forming a multi-tiered medical security system [2]. - The "Sui Sui Kang" insurance product, launched in Guangzhou, has seen over 14.71 million participants and generated premiums exceeding 2.6 billion yuan, with total claims amounting to 2.14 billion yuan [2][4]. - The product is characterized by low entry barriers and high coverage levels, with minimal restrictions on residency, age, or pre-existing conditions, effectively reducing the financial burden on insured individuals [2][3]. Group 2: Targeted Services and Innovations - The "Yi Kang Bao" initiative in Jiangmen combines medical and nursing care, providing insurance benefits for elderly individuals with severe disabilities, with over 56,300 beneficiaries and total payouts around 24.8 million yuan [3]. - The "Da Ai Wu Jiang" project in Zhuhai extends medical insurance to include diverse health management services, saving approximately 42 million yuan in healthcare costs through early diagnosis and treatment initiatives [4]. - The "Yin Ling An Kang" program, initiated in Guangzhou, offers accident insurance for the elderly, with over 18.36 million participants and total claims exceeding 370 million yuan [5][6]. Group 3: Challenges and Future Directions - The insurance industry faces challenges in promoting inclusive insurance, including low consumer awareness and limited access in rural areas, which hinder the uptake of insurance products [8][9]. - The company is exploring various strategies to enhance the reach and effectiveness of inclusive insurance, such as leveraging technology for streamlined claims processes and increasing public awareness through educational initiatives [8][9]. - Future development of inclusive insurance will require stronger collaboration between government and enterprises, as well as improved data support to expand the insurable population [9].

Core Viewpoint - The development of inclusive insurance in China is transitioning from mere availability to quality improvement, with a focus on providing broad coverage and equitable access to insurance services for various vulnerable groups [3][5][12] Group 1: Policy and Framework - Recent national policies have clarified the role of inclusive insurance, identifying personal, agricultural, and pension insurance as the three pillars of this initiative [3] - By the end of the 14th Five-Year Plan, a high-quality inclusive insurance system is expected to be established, marking a new phase of quality enhancement and expansion [3][4] Group 2: Current Achievements - Inclusive insurance has made significant strides in agriculture, health, disaster, and pension sectors, with the central government allocating 54.7 billion yuan in subsidies for agricultural insurance in 2024, supporting a premium scale of 152.1 billion yuan, which is a 6% increase year-on-year [4] - China Life Insurance has issued over 250 million policies covering new citizens, disabled individuals, women, children, and special occupational groups, providing risk coverage for approximately 270 million rural residents [4] Group 3: Innovative Practices - Guangdong province has emerged as a key testing ground for inclusive insurance innovations, with various projects tailored to meet the needs of farmers, the elderly, and migrant workers [5][6] - Projects like "Sui Sui Kang" in Guangzhou and "Da Ai Wu Jiang" in Zhuhai exemplify successful models that balance inclusivity and sustainability, with significant participation from local governments and commercial insurers [6][7] Group 4: Challenges and Solutions - Despite progress, challenges remain in service accessibility, operational efficiency, and collaborative governance, particularly in rural and remote areas [9] - Guangdong authorities are actively exploring innovative solutions to enhance service delivery and operational efficiency, including the establishment of a diverse collaborative mechanism among government, enterprises, and social organizations [10][11] Group 5: Future Directions - The future of inclusive insurance in Guangdong involves enhancing top-level design, promoting government-enterprise collaboration, and leveraging technology to improve service delivery and operational efficiency [12]

较高的老年人口抚养比将给广州的社保体系带来挑战。 人口老龄化是今后我国较长一段时期的基本国情，也是推进中国式现代化必须面对的重大课题。党的二 十届三中全会提出"积极应对人口老龄化，完善发展养老事业和养老产业政策机制"。健全社会保障体系 是应对人口老龄化的重要举措，也是改善民生、增进人民福祉的重要手段。近年来广州市医疗保险制度 运行平稳，为广大市民提供了可靠的医疗保障。但随着老龄化程度的逐渐加深，广州的医保体系也将面 临挑战。 广州市老龄化趋势发展迅速 广州市老年人口规模大，老龄化速度快。根据广州市老龄办公布的数据，2023年广州市60岁及以上户籍 人口占比明显提升。2023年底，广州市户籍人口1056.61万人，其中60岁及以上老年人口204.77万人，占 户籍人口的19.38%，比2022年（195.21万人）增加9.56万人；65岁及以上老年人口147.15万人，占户籍 人口的13.93%，比2022年（142.31万人）增加4.84万人。按照有关标准，广州市即将进入中度老龄化社 会。 以60岁作为老年人口的界定年龄，广州老年人口抚养比为32.10%；以65岁作为老年人口的界定年龄， 广州老年人口抚养比为 ...