China-Singapore Jingwei Client, January 23 (Wei Wei) After taking out the insurance, everyone is most concerned about claims.
Many people muttered in their hearts, is it difficult to settle claims?
Will it be denied?
A reporter from Sino-Singapore Jingwei has sorted out the 2020 claims reports of 40 life insurance companies. Let's take a look at which insurance companies have the highest claims?
Which diseases have a high risk rate?
Four family life insurance companies claim over 10 billion claims
First, let’s take a look at the amount of claims. According to statistics from China-Singapore Jingwei reporters, the cumulative amount of claims for 40 life insurance companies in 2020 reached 153.515 billion yuan.
Among them, four insurance companies have claims over 10 billion yuan, including China Life 47 billion yuan, Ping An Life 35.2 billion yuan, Pacific Life Insurance 16.4 billion yuan, and Xinhua Life Insurance 11.7 billion yuan.
Data source: Life insurance company's 2020 claims report tabulation: Wei Wei, Sino-Singapore Jingwei
In terms of the statute of limitations, most of the 30 companies that announced the statute of limitations for claim settlement applications are within 1-2 days.
Five companies announced the statute of limitations for small claims, and four of them are all within 0.2 days, which is within five hours.
Consumers may be confused about how the insurance claims settlement time in their own impression is longer than that announced by the insurance company.
Here I want to popularize related concepts.
The time limit for claims announced by insurance companies usually refers to the time limit for applying for payment, that is, the natural day length from the time the insurance company collects all claims data to the completion of the payment of the claims.
Another concept is the time limit for insurance payment, that is, the time from the time a customer accident is reported to the actual payment of the claim.
In the claims report, Agricultural Bank of China Life, Qianhai Life, and Bohai Life announced the time limits for insurance payment, which were 50.6 days, 57.2 days and 63.79 days, respectively.
In addition, a reporter from Sino-Singapore Jingwei found that among the 40 life insurance companies, 27 have announced the odds data, all of which have reached more than 97%. The odds of 16 companies are not less than 99%, accounting for about 60%. ; Among them, the odds of Pearl River Life's small claims even reached 100%.
This is in sharp contrast to the "difficulty in claim settlement" in the public's impression. In this regard, Wei Li, director of the China Insurance Institute of Renmin University of China, told the Sino-Singapore Jingwei client that this is mainly related to the claim settlement experience in the claim settlement process, such as claims Response time, materials required for claim settlement, etc.
Customers not only care about whether they get the compensation in the end, but also pay attention to the experience of the entire claims service. In this regard, insurance companies need to improve.
High proportion of medical insurance claims
Which insurance customers have the highest probability of using it?
From the perspective of the composition of compensation types, the number of medical insurance claims accounts for a large proportion. Among the 26 life insurance companies that released this data, 23 medical insurance claims have more than 80% of the number.
However, in terms of the amount of claims, critical illness insurance accounts for a relatively large proportion. Of the 29 life insurance companies that released this data, 19 companies (that is, more than 60% of the companies) accounted for the amount of critical illness claims. most.
“Medical insurance products, as expense reimbursement protection, have the largest number of claims and are also the most commonly used protection for customers. As a benefit-type insurance, critical illness insurance products have the largest amount of claims. After the customer is diagnosed with a serious illness, it can give customers strong financial support. "Tian An Life Insurance wrote in the claims report.
Data source: Life insurance company's 2020 claims report tabulation: Wei Wei, Sino-Singapore Jingwei
Judging from the largest claim cases of 40 companies, the single highest claim case in 2020 is China Merchants Cigna Life, with a claim amount of 20 million yuan.
In addition, there are Ping An Life, Everyone Life, China Life, and Bank of Communications Kanglian Life's single-piece maximum claim amount not less than 10 million yuan.
Top thyroid cancer risk rate
In critical illness insurance claims, which diseases have the highest incidence?
Although the data of various insurance companies are slightly different, from the perspective of major illness compensation reasons, malignant tumors, heart disease, and cardiovascular and cerebrovascular diseases are becoming the "three killers" that threaten health.
"From the data of the past five years, the risk of malignant tumors has always accounted for about 73% of the total number of critical illnesses, which is relatively stable." Taikang Life wrote in the claims report.
From the perspective of age at risk, the occurrence of serious illnesses is showing a younger trend.
According to statistics from GCL, the average ages for critical illness, medical treatment, death, and disability are 45, 28, 51 and 43 years old.
Among them, the age of critical illness claims customers is concentrated between 31 and 50 years old.
Peking University Founder Life's data also shows that the incidence of serious illness claims for middle-aged and young people (31-50 years old) exceeds 60%.
So, which malignant tumors have a higher risk rate?
Ping An Life, China Life and other companies' 2020 claims reports all show that men are concentrated in lung cancer, thyroid cancer and bowel cancer, while women are concentrated in thyroid cancer, breast cancer, and lung cancer.
Judging from the data released by major companies, the risk rate of thyroid cancer is in the forefront, and it is a well-deserved "cancer king."
TOP5 Malignant Tumors by Gender Source: Ping An Life
Once upon a time, due to the high cure rate and low treatment cost, thyroid cancer was once jokingly called "carcinoma-like" by netizens.
On November 5, 2020, the Insurance Industry Association of China and the Chinese Medical Doctor Association issued the "Regulations for the Use of the Definition of Critical Illness Insurance (2020 Revised Edition)" (hereinafter referred to as the New Regulations for Critical Illness Insurance). It is the graded compensation for thyroid cancer.
The Insurance Association of China stated that the revision did not exclude thyroid cancer, but classified it according to the severity of the disease, and grading the compensation according to the degree of importance.
According to the revised content, thyroid cancer with TNM staging (note: currently the most universal tumor staging system in the world) is stage I or less is not classified as "malignant tumor-severe" and is not covered by "severe disease".
Thyroid cancer with TNM stage I is reclassified as "Malignant Tumor-Mild" under "Mild Disease", which means it is covered by "Mild Disease".
According to the new regulations, a certain proportion of compensation can be obtained for mild illness, which is not higher than 30% of severe illness.
Wei Li believes that thyroid cancer will not have a substantial impact on insurance companies and policyholders after grading compensation.
"In fact, the degree of thyroid cancer varies greatly. If it is a milder thyroid cancer, the cost of treatment is not high. If a serious illness is included, the compensation rate will increase, which will inevitably lead to an increase in the rate." Wei Li said.
Right now, there are only less than ten days left before the new regulations on critical illness insurance are officially implemented, and some consumers are also entangled in whether to pay the last time to insure.
In this regard, Wei Li pointed out that there is no need for policyholders to panic in insuring. Insurance is priced according to the expected compensation. After thyroid cancer is classified, the compensation for insurance companies will be relatively reduced, which will cause the price of critical illness insurance to be lowered.
Therefore, policyholders still have to purchase suitable insurance products according to their risk requirements.
(Zhongxin Jingwei APP)
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