Exploring proactive claims, with over 4.5 million people participating in the "Shanghai Benefit Insurance" for centenarians | Age | Newborns
Shanghai Huibao is exploring and promoting proactive claims settlement to help the public access services more quickly and conveniently. On June 20th, the Shanghai Insurance Industry Association and the Shanghai Insurance Society held a media research conference with the theme of "Focusing on One Old, One New, and One Youth 'Shanghai Huibao' to Continuously Optimize and Benefit the People". The reporter learned from the meeting that since the launch of "Shanghai Huibao" in 2023, a new record has been set for the renewal appointment of urban customized commercial medical insurance. As of now, more than 4.5 million people have participated in the insurance, with a participation rate of about 23%. About one in four Shanghai basic medical insurance participants has taken out the insurance.
Li Yingjie, representative of Pacific Life Insurance, the chief underwriting company of the "Shanghai Huibao" co insurance body, introduced that over the past two years of operation, "Shanghai Huibao" has accumulated compensation of over 1.1 billion yuan, accepted over 390000 cases, and benefited hundreds of thousands of families, with an average settlement time of 2.4 days.
From the insurance data, it can be seen that the ratio of employee medical insurance to resident medical insurance in the "Shanghai Hui Insurance" is nearly 6:1, reflecting an increased awareness of insurance among employed individuals in the Shanghai region. The number of insured individuals on a household basis exceeds 3.47 million, accounting for over 78%, indicating that "Shanghai Hui Bao" is more conducive to family assistance and provides comprehensive health protection for families. 3.52 million people used their personal medical insurance account balance to make payments, accounting for 79% of the total number of people, indicating that medical insurance personal account payment is the preferred payment channel.
From the claims data, it can be seen that the specific hospitalization self payment liability compensation is 948.49 million yuan, the specific high-value drug liability compensation is 135.12 million yuan, the proton and heavy ion medical liability compensation is 48.52 million yuan, the overseas special drug expense insurance is 1.25 million yuan, and the CAR-T treatment drug expense insurance is 17.5 million yuan. The maximum compensation age is 102 years old, and the minimum compensation age is 0 years old. From newborns to centenarians, "Shanghai Huibao" provides protection for citizens of all ages.
Professor Xu Xian, Vice President of the Shanghai Insurance Society and Director of the Department of Risk Management and Insurance at Fudan University, stated that "Shanghai Huibao" is one of the many welfare insurance products in China. From the distribution of the age distribution of compensation in Shanghai Huibao in 2022, the group aged 51 and above accounted for 62% of the total compensation. These groups are the ones with an increase in disease incidence and far less coverage of commercial insurance. "Shanghai Huibao" can effectively compensate for the shortcomings of traditional commercial insurance.
