The 2024 Insurance Claims Annual Report is released: Six life insurance companies paid out more than

Since January this year, more than 40 life insurance companies have disclosed their annual claims reports.

The compensation scale of 6 life insurance companies exceeded 10 billion

From the perspective of life insurance companies, among the top seven large insurance companies in my country, China Life Insurance continued to rank first in terms of compensation amount, reaching 60.39 billion yuan, with an average daily compensation of more than 160 million yuan and 24.885 million compensation cases, an increase of more than 12% year-on-year; Ping An Life Insurance paid 41.94 billion yuan, ranking second; Pacific Life Insurance paid 20.5 billion yuan, ranking third. In addition, Ping An Life Insurance, New China Life Insurance, Taikang Life Insurance, and Taikang Life Insurance paid 18 billion, 15.2 billion, 10.14 billion, and 9.5 billion yuan respectively.

Jiemian News reporters noticed that, except for China Life, Taikang Life and Taikang Pension, the other four insurance companies all showed a slight downward trend in their claims. The high amount of claims paid by the four leading life insurance companies is mainly related to their underwriting scale, while the amount of claims paid by the two large professional pension insurance companies, Ping An Pension and Taikang Pension, was also as high as more than 10 billion yuan, which was related to their underwriting of large-scale short-term medical insurance.

In addition, Interface News reporters also noticed that in terms of compensation rates, the compensation rates generally announced by my country's insurance companies are all above 98%, which means that most insurance companies' policies can obtain compensation; and the very few cases where no compensation is received are often due to non-compliance with health declarations, being within the scope of exemption, etc.

The scale of commercial medical insurance claims has been increasing year by year

For a long time, critical illness insurance and medical insurance have been two important types of insurance operated by life insurance companies.

Interface News reporters noticed that in the claims reports released by many insurance companies, although the claim rate of critical illness insurance is not high, the claim amount accounts for a high proportion, and there are even cases of critical illness insurance claims of millions or even tens of millions of yuan.

Among the critical illness claims announced by many insurance companies, malignant tumors are still the main reason for critical illness claims, accounting for more than 70%. In addition, cardiovascular and cerebrovascular diseases, such as acute myocardial infarction and cerebral stroke, are also high-incidence critical illnesses.

According to data released by Ping An Life Insurance and others, the average compensation amount for critical illness insurance in my country is less than 100,000 yuan. However, according to the "National Health Education Textbook for Prevention of Major Diseases" issued by my country in 2019, the treatment cost of critical illness insurance is generally between 220,000 yuan and 800,000 yuan, which means that the critical illness insurance configuration of most consumers in my country is still insufficient.

In terms of medical insurance, the number of claims is far greater than that of critical illness insurance. Taking Ping An Life as an example, in 2024, the number of critical illness insurance claims was 257,000 with a compensation amount of 20.7 billion yuan, while the number of medical insurance claims was 4.857 million with a compensation amount of 12.8 billion yuan.

In addition, the scale of medical insurance claims is rising rapidly. Although the current claims data of large insurance companies show that the scale of medical insurance claims has not yet exceeded that of critical illness insurance, the number of medical insurance claims is on the rise. China Life Insurance disclosed in its 2024 claims annual report that the amount of medical insurance claims in 2024 has increased by more than 50% compared with five years ago.

A senior insurance agent told Interface News reporters that obvious changes can be seen in the critical illness insurance and medical insurance claims trends announced by various insurance companies in 2024.

She said that the trend of serious diseases becoming younger has become a significant trend. The claims data for the 30-40 and 40-50 age groups have increased significantly. This may be due to the greater mental and life pressures faced by young people in my country, as well as the fact that their poor lifestyles lead to earlier onset of serious diseases. In addition, the current detection methods are more abundant, and serious diseases such as cancer can be detected earlier.

In addition, she said that in the claims reports of many large insurance companies in 2024, the proportion of lung cancer has increased significantly, replacing the previous ranking of thyroid cancer and occupying the first place, which may be related to the high incidence of respiratory diseases in recent years.

The industry's claims settlement period has been shortened to less than two days

Small and high-frequency medical insurance claims also place higher demands on the digitalization of claims processing by my country's insurance companies.

Interface News reporters noticed that in the insurance companies' annual claims reports, intelligence, automation, and claims settlement in seconds have become key words for the upgrade of claims services.

According to the claims report of Xinhua Insurance, in 2024, the company's online claims applications accounted for 96.76%; the AI settlement engine pushed 52.77% of cases to be automatically closed with a review speed of seconds; in the claims payment link, since December 11, 2024, the real-time payment limit of Xinhua Insurance's individual insurance claims has been increased to 50,000 yuan, and nearly 87% of cases can be credited in real time upon case closure.

China Life Insurance Company has settled more than 9.09 million claims with a total amount of 9.09 billion yuan through electronic invoices, with an overall claims settlement period of 0.27 days for electronic invoice claims. The "One-Day Claim for Serious Illness" service has completed claims settlement for eligible cases within one day, with more than 240,000 claims paid in 2024 with a total amount of nearly 11 billion yuan.

Ping An Life's claims report also shows that its "flash compensation" service paid 2.16 million claims in 2024, with a total compensation amount of 4.7 billion yuan; "Smart Pre-compensation" can realize early payment of claims and reduce customers' financial pressure. The service completed a total of 50,000 claims throughout the year, with a compensation amount of 4.8 billion yuan; another special claims service "Direct and Fast Compensation for Hospitalization" can realize automatic uploading of customer discharge materials, and direct compensation can automatically offset medical expenses. The number of claims paid throughout the year was 1.21 million, with a compensation amount of 4.3 billion yuan.