Xinhua Life Insurance said that the company always adheres to the concept of "finding the reasons for compensation for customers", relies on technology empowerment to optimize claims services, pays attention to claims every minute, and is committed to providing customers with temperature claims services.
The average daily compensation exceeds 38.4 million yuan.
In 20021year, Xinhua life insurance paid a total of 654.38+04 billion yuan, up about 654.38+09.7% year-on-year, and the average daily compensation exceeded 38.4 million yuan. The accumulated premium is exempted by 789 million yuan, and about 65.438+0.2 million policies still enjoy protection without payment. The time limit for each claim from application to settlement is only 0.55 days.
Among the types of claims, medical insurance accounts for over 90%. The company raised the limit of claims, and paid a small amount of medical insurance within 5000 yuan. The time limit for the case from application to closing is 0.27 days, and the five-day closing rate is about 99.4%, and the odds are about 99.3%. The second is critical illness insurance, which accounts for less than 10% of the total compensation, but the compensation amount of 5.44 billion yuan is close to 40% of the total compensation, and the number of people paying compensation is about 63,000. This shows the importance of raising risk awareness and strengthening the protection of critical illness.
According to the report, the oldest customer is 97 years old and the youngest is only 3 months. Therefore, it is particularly necessary to configure insurance products covering the whole life cycle. The maximum single payment for millions of medical insurance products is 620,000 yuan, and the maximum number of payments is 34 times; In terms of critical illness insurance products, Ms. Z, a customer from Henan, has been paid 1 for minor illness and two serious illness, which highlights the guarantee advantages of high insurance coverage and multiple compensation.
Malignant tumor accounts for a high proportion of serious diseases.
The report specifically analyzes the composition of compensation for serious illness. In 20021,the company paid 5.44 billion yuan for critical illness insurance, up about 35.8% year-on-year.
Judging from the gender composition of compensation for serious illness, the proportion of women is about 59.5%, which is 19 percentage points higher than that of men, indicating that women have a strong sense of risk and the probability of serious illness is slightly higher than that of men. In terms of age distribution, the age group of seriously ill patients is between 40 and 59 years old. Therefore, it is strongly recommended to take critical illness insurance as the "standard" for middle-aged people and make health planning in advance. Judging from the degree of illness, 3402 cases were mild, with a compensation amount of 97.08 million yuan and a free premium of 654.38+0.25 billion yuan; There are about 60,000 claims for serious illness, with a compensation amount of 5.34 billion yuan and a premium-free of 664 million yuan.
Malignant tumor still occupies the first place in serious illness claims, and female malignant tumor claims are relatively concentrated, accounting for about 74%. The main reason for male serious illness claims is malignant tumor, accounting for about 48%, followed by cardiovascular disease, accounting for about 16%. From the site of occurrence, the high incidence sites of malignant tumors in men are lung, thyroid and liver, while in women, thyroid, breast and lung. The causes of compensation for high incidence and serious diseases of minors are leukemia, epilepsy and thyroid malignant tumor in turn. It can be seen that it is necessary to allocate critical illness insurance or cancer insurance in a targeted manner.
The report also pointed out that traffic accidents, falls and drowning are the main causes of accidental deaths.
Science and technology help to claim that quality and efficiency go hand in hand.
While AI, big data and other scientific and technological forces have entered the claims service and rapidly improved the efficiency of claims, Xinhua Life has continuously optimized the temperature of claims service and improved the customer's claims experience. In 20021year, there were about 447,000 AI intelligent claims, and the compensation amount was 970 million yuan.
The company's first direct payment project landed in Zhengzhou, Henan Province 202 1, 1.0 1. Direct payment of claims has realized one-stop settlement of medical insurance commercial insurance when discharged from hospital, and truly realized "zero waiting for claims". In the future, the company will continue to increase service innovation and open up the "last mile" of claims service in more fields.
"Gradually Kanghuazun Medical Insurance" products support medical first-aid services and help customers alleviate the funding gap for medical treatment. 202 1, * * * provided hospitalization deposit advance service for 74 customers, of which the maximum advance payment was 6 times for a single hospitalization, and the maximum advance amount was 2 1 10,000 yuan.
The first payment service for serious illness continued to release professionalism and warmth, with a total of 4,282 claims, and the amount of compensation was about 330 million yuan, so that customers who unfortunately suffered from malignant tumors received home condolences and compensation guidance at the initial stage of illness, and paid quickly, reducing the financial pressure on customers to seek medical treatment.
The company practices the initial intention of "paying for customers to find reasons", and employs the chief physician and above experts from domestic authoritative 3A hospitals to conduct consultation on difficult and controversial cases, and provides 124 external expert consultation throughout the year.
At the scene of major accidents, Xinhua Life Insurance always has claim service personnel. The company has launched emergency response to major emergencies for 83 times, and the compensation amount is 7.33 million yuan.
The settlement credit bill transparently presents key data such as the settlement amount and the number of claims handled by the salesman during the year, which enhances the professionalism and enthusiasm of customer service, covering more than 6.5438+0.4 million person-times and reading more than 6.5438+0.000 million times.
Actively serve the national economy and people's livelihood
While providing professional claims service for customers, the company actively fulfills its social responsibilities, stands forward in the fields of insurance poverty alleviation, anti-epidemic and disaster relief, and actively plays the role of social "stabilizer" of insurance enterprises.
By the end of 2002 12, Xinhua Life Insurance had carried out a series of precision poverty alleviation projects in 36 deep poverty-stricken areas in12 provinces, among which the insurance poverty alleviation projects had provided insurance protection schemes for more than 50,000 poor people, including filing cards, with a total insurance coverage of over 5 billion yuan. Large-scale public welfare activities of caring for sanitation workers in China continued. By the end of 20021,the project had covered 58 cities in China, handled accident insurance for more than 900,000 sanitation workers, and made 284 claims, with a total compensation amount of 25135,000 yuan.
In order to help fight the epidemic, the company developed the product of "Vaccine Guarding Medical Accident Insurance" to ensure the abnormal reaction after vaccination, and to escort the vaccination in COVID-19.
Based on the company's achievements in claims service, at the end of 20021,Xinhua Life won the title of "Outstanding Claims Service Insurance Company of the Year" in the "20021Outstanding Financial Enterprise Festival" held by Economic Observer. Xinhua Life said that the company will stick to the initial intention of "returning to the source of protection", constantly hone its professional management ability, supply products and services leading the market, and closely weave a "protection network" for the people throughout their life cycle.