Guoshou life insurance push “direct payment of claims”, discharge of the compensation speed, temperature


In recent years, the Party and the country have attached great importance to the digital economy, elevating it into a national strategy.Governments at all levels are also actively promoting the development of the digital economy, fostering new industries, new forms of business and new models, such as emerging online services and the sharing economy, to create a more convenient and better life for the people.As a state-owned financial insurance enterprise, China Life Insurance Company Limited (hereinafter referred to as “China Life Insurance Company”) has been continuously strengthening theoretical research and application innovation in the development of digital economy.Give full play to the insurance company in the modern finance, social security, the important role of social risk management, is committed to meet the demand of the multi-level and diversified insurance people, active practice of “take the customer as the center” the service idea, the promotion of digital technology and insurance claims service depth fusion, assigned to the traditional service mode transformation and upgrading,We will continue to explore a new service model of “Internet plus insurance”, and develop and launch a direct payment service for claims.Direct claim settlement is a new claim settlement service mode in which China Life Insurance Company directly obtains the customer’s medical data under the premise of customer authorization and legal compliance through cooperation with medical insurance institutions and other units, and provides customers with fast claim processing and insurance benefits payment.Up to now, China Life Insurance Company has launched direct claim settlement service in more than 200 cities, serving more than 15 million customers and paying nearly 10 billion yuan in compensation.It is understood that through the direct payment service of claims, customers can get a faster, more efficient and warm insurance experience.The claim settlement procedure is easier. After the customer is hospitalized and reported to the hospital, China Life Insurance Company will take the initiative to provide the customer with hospital visit service, and directly obtain the customer’s medical data through the medical institution, simplifying the procedure and reducing the customer’s claim application data to a greater extent.In most areas where direct claim settlement is carried out, China Life Insurance companies can provide real-time settlement of insurance benefits after discharge and direct deduction of diagnosis and treatment costs, realizing the “zero prescription” service of claim settlement upon discharge.Mr. Yang, a registered poverty household in Guangdong Province, was diagnosed with severe pneumonia in December 2019 due to lung discomfort.When Mr. Yang was worried about the medical expenses, the hospital staff took the initiative to inform him that he had poverty alleviation insurance in China Life Insurance Company and could directly settle the poverty alleviation insurance money at the discharge window to offset the medical expenses.When Mr. Yang was discharged from hospital, according to the provisions of poverty alleviation insurance, he directly adjusted the insurance premium of more than 20,000 yuan and directly deducted the medical expenses.Direct payment of claims effectively breaks through the data barrier between social security and commercial insurance, realizing the sharing and application of medical big data. On the basis of law and compliance, the direct payment of medical big data fully demonstrates the supplementary value of commercial insurance to basic medical insurance, and better alleviates the difficulties of the masses of people.Since China Life Insurance Companies have achieved remarkable results in direct payment of claims, the National Health Commission, The National Medical Insurance Administration and the State Administration of Traditional Chinese Medicine jointly issued the Notice on Furthering the “Internet + Medical Health” and “Five One” Service Action (National Health Planning (2020) No. 22) in 2020, highlighting the experience of direct payment of claims in Ningxia Autonomous Region.It highly praised ningxia Medical Insurance and China Life Insurance Company for their direct claim settlement mode of “letting data run more and ordinary people run less, establishing the interconnection mechanism between commercial supplementary insurance and basic medical insurance, and realizing the settlement of medical expenses for all people and the whole range”.China life insurance company says it will actively participate in and promote the development of the digital economy, pay close attention to the governments at all levels of medical application of relevant policies, data sharing and innovation on the premise of legal compliance, take the customer as the center, insist on innovation drive, continue to promote “claims direct pay”, dedicated to provide customers with fast, warm claims service, the good life for the people.

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