In 2003, Chinese Life Insurance Co., Ltd. *** hereinafter referred to as "Chinese Life Insurance Company") successfully listed overseas after shareholding reform, setting a record for the world's largest IPO project that year, marking the company's new stage of development.
In 2023, today's Chinese life insurance company has steadily grown into the leader of China's life insurance industry, and is striding forward towards the goal of building a world-class life insurance company. Twenty years of trials and hardships, twenty years of hard work. Generations of China Life people have always adhered to the concept of "customer-centric", constantly innovated the claims service model, provided customers with a fast and warm claims service experience, and carefully guarded the people's better life.
Respond quickly to customer claims
Claims service is an important point of contact for customers to perceive insurance. When it comes to insurance, people are most concerned about whether it is difficult to settle claims and whether the business is handled quickly. Since its listing in 2003, Chinese Life Insurance Company has always paid attention to customer service experience, with the goal of "first-class experience", responding to customer demands, solving customer pain points, and starting from the heart, changing the claims operation mode. Time has witnessed the three stages of development of Chinese Life Insurance Company's claims service, and recorded the progress of China Life Claims Adjusters.
In the era of pure handwork, the claims process is simplified from the customer's point of view. Twenty years ago, before the arrival of the wave of informatization, all claims settlement links of insurance companies were paper-based handover and manual processing. After the accident, customers need to go back and forth to the insurance company's outlets to report the case, fill in paper documents, submit claim materials, and sometimes need to travel many times to supplement the information. Although the technical means are limited, the claims staff of Chinese Life Insurance Company stand in the perspective of customers, in response to customer pain points such as "many claim procedures" and "long waiting time", first reform from the operational practice, establish the "active, timely, accurate and reasonable" claims service eight-character policy in the whole system, and compile the industry's first claims practice manual. Every time a customer comes to handle a claim, we strive to make it the easiest way for the customer to get a claim. On the basis of unified operating standards, after continuous exploration, Chinese Life Insurance Company has successively launched a series of claims settlement convenience measures, such as claim claim exemption service, simplified customer application procedures, improved business document samples, and counter claims settlement is desirable, etc., the customer service experience of the counter has improved year by year, and the convenience measures have been recognized by customers.
In the early stage of electronicization, the efficiency of claims settlement was improved with the help of new technological developments. The timeliness of claims is a matter of great concern to customers. With the popularization and application of computers and the rapid development of the Internet, the claims department of Chinese Life Insurance Company has acted quickly and continued to make efforts to solve the pain points of customers who want to "quickly obtain claims". An electronic operating system has been established, and the application of claims and materials has been changed from offline acceptance of paper documents to online processing, which has greatly improved service efficiency. Since 2000, Chinese Life Insurance Company has realized all computer processing of claims operations, opening the era of electronic claims management. In 2013, the unified claim operation platform was launched nationwide, and the real-time data interaction of multiple systems realized the "customer-centric" claims processing, which became an important milestone in the automation of claims operations. At the same time, we will implement the universal payment of claims in the national system, comprehensively promote the service of "convenient claims, fast claims, and transparent claims", and vigorously expand Internet service channels. At this stage, Chinese Life Insurance Company promoted the innovation of claims service through technological innovation, broke free from the limitations of manual operation ability, embraced technology, created many precedents in the history of insurance claims service, and realized online claims, nationwide claims, and small quick claims. The company has established a systematic service system, strived to improve the efficiency and quality of claims services, and provided customers with more convenient and high-quality claims services, which has won the respect and trust of customers.
With the advent of intelligence, we will enhance the customer experience with a diversified service model. With the development of the times, technologies such as the Internet, big data, cloud computing, artificial intelligence, and blockchain have accelerated innovation and are increasingly integrated into the whole process of economic and social development. On the basis of improving the timeliness of claims, "how to make customers get more convenient claims services" has become a research topic for China Life claimers. In 2016, Chinese Life Insurance Company subverted the traditional claims service model and began to build a new full-chain claims service model of "multi-channel online acceptance + intelligent processing + real-time payment". On the front end, customers can apply for claims through channels such as the Chinese Life Insurance app, WeChat mini program, China Life e-store, 95519 contact center, counter, etc., to achieve "anytime, anywhere, at your fingertips".On the back end, Chinese Life Insurance Company promotes the deep integration of claims settlement and new technology applications, and realizes the whole process intelligent operation of the industry's largest medical liability claims case by building an intelligent calculation rule engine, applying an intelligent risk control model, building a four-layer insurance liability structured model of "element-rule-liability-scheme", building a medical basic database, and embedding OCR intelligent image quality inspection.
In 2022, Chinese Life Insurance Company provided mobile claims services for more than 16 million customers, accounting for more than 70% of all claims cases in the whole process, and the overall compensation time limit was only 043 days.
Claims are at the heart of insurance services. From manual processing to system management to mobile and whole-process intelligent operation, from a single case compensation to a multi-scenario and diversified active service of "thinking about what customers think and knowing what customers need", the ways and means of service are changing, but the core of the service remains the same, and the love and responsibility for customers always run through every moment of the claims service. Through the application of cutting-edge technologies such as mobile Internet, big data, cloud computing, and artificial intelligence, Chinese Life Insurance Company focuses on customer claims experience, continuously expands content-rich digital ** services, refreshes the speed of claims service, and provides customers with a simple, high-quality and warm service experience.
Promote service innovation with customers as the center
Behind the transformation of life insurance services, there needs to be a strong customer driving force. The most important thing for an insurance company to continue to operate is to manage its customers well. Therefore, changes in customer demand will continue to drive changes in the service model of insurance companies.
Adhering to the "customer-centric" service concept, Chinese Life Insurance Company has built a strong and attractive service system through continuous innovation of service processes and models, and established a sincere connection with customers with ingenious services. Innovate the service model with customer needs, measure the service level with customer satisfaction, realize the accurate matching of the supply of claims service and customer needs, and even think of the front of customers, create a "fast and warm" claims service brand, and strive to exceed customer expectations, so that "good service" has become a wide evaluation of customers.
Chinese Life Insurance Company actively carries out a series of claim settlement services such as "one-day compensation for major diseases", "direct payment of claims and convenient compensation", "express compensation for emergencies" and "door-to-door compensation for special customers", and practices the service commitment of "Chinese Life Insurance Company by your side".
Direct payment of claims and convenient compensation: Open up the background to create convenient claims without travel. In the traditional claim, the hospitalized customer needs to pay all the medical expenses at the end of the discharge, and then report to the insurance company, submit complete information, and only after the approval can the insurance claim be obtained from the insurance company. In response to the pain points of customers having difficulty in collecting claims information and time-consuming and laborious travel to insurance companies, Chinese Life Insurance Company began to think about how to help customers avoid the inconvenience of collecting information and going back and forth to the counter as early as 2004, and took the lead in actively exploring and trying in Sichuan Province. In the payment hall of Chengdu 363 Hospital, there is a counter specially marked with the words "Chinese Life Medical Insurance Settlement Counter". "The total amount of medical expenses is 774362 yuan, you only need to pay 104838 yuan. Ms. Wang (not her real name) was hospitalized in the hospital and had a gallbladder removal operation, and when her family went through the discharge procedures for her, the cashier at the counter prompted her. The less than 6,700 yuan of expenses was completed in real time through the "Mediinsurance Pass" of Chinese Life Insurance Company, and the claim payment was directly offset against part of the hospitalization expenses, and Ms. Wang only needed to pay the remaining small amount of self-payment.
At that time, the real-time compensation system of the "medical insurance pass" hospital realized the synchronous settlement of social security medical insurance and commercial insurance, and the customer could get the claim after the discharge procedure, which could truly realize the zero-time and zero-distance compensation, and no longer need to run around for the compensation after discharge, and at the same time, it could also effectively reduce the advance expenses when the customer was sick and hospitalized.
This service model accelerates the service response to customers, simplifies the claim procedures, realizes real-time compensation, and fundamentally solves the problem of "difficult claims" by putting the claim process in front. At that time, the domestic insurance industry was an innovative practice, and domestic and foreign insurance companies followed suit. This service model has also become the prototype of the "direct payment of claims" model.
In 2016, after more than ten years of polishing, Chinese Life Insurance Company comprehensively promoted the direct payment service of claims, and actively provided customers with convenient services without reporting, submitting information and running to the company's outlets through docking with medical institutions, medical insurance and third-party data company systems, and opened a "one-stop" direct payment service for claims settlement and direct deduction of medical expenses when customers are discharged from the hospital. In 2022, Chinese Life Insurance Company provided direct payment services for more than 6.7 million claims, with a cumulative compensation of 36500 million yuan.
One-day compensation for critical illness: improve efficiency, and pay compensation to the account for treatment. According to the traditional claims process, the time limit for critical illness is about 5 to 20 days, from the customer report, the insurance company collects materials, manual review, claim investigation to the final payment of compensation, and the process is relatively cumbersome. The pain point of patients with critical illnesses and their families is that once they get sick, high fees and fees are imminent.
It's easy to put the icing on the cake, but it's hard to send charcoal in the snow. The customer's problem is the problem of China Life's claimant. In 2019, starting from the most urgent needs and pain points of customers, Chinese Life Insurance Company launched the "Critical Illness One-Day Compensation" service, providing eligible customers who apply for critical illness compensation with a fast service to complete claim processing within one working day. In the following years, the service of "one-day compensation for critical illness" has been continuously upgraded and strived to provide warm services to more customers.
Mr. Mao (pseudonym), who lives in Zhejiang, was unfortunately diagnosed with a malignant tumor of the colon, and his physical pain and heavy medical expenses continued to consume the body and mind of Mr. Mao and his family. When the sales staff of Chinese Life Insurance Company visited the customer, after learning of Mr. Mao's illness, they immediately informed him that he could apply for critical illness insurance benefits and instructed his family to collect the information required for the claim. After the information is complete, the claims adjuster will go to Mr. Mao's home as soon as possible to assist in promoting the "one-day compensation for critical illness" claim service. The case was closed on the day of submitting the claim, and Mr. Mao received 250,000 yuan of critical illness insurance, and he said excitedly, "This money has solved my urgent need, and the insurance claim payment has guaranteed my follow-up **!"”
"Critical Illness One-Day Claim" provides eligible customers with the "Claim on Diagnosis" service by actively visiting and assisting customers to collect all information, solving customers' urgent needs, so that customers will not be delayed due to funding gaps**, and effectively improving the efficiency of claims service and customer experience. From the beginning of its launch to the end of 2022, Chinese Life Insurance Company has sent a total of 600,000 customers with "one-day compensation for critical illness", with a compensation amount of more than 26 billion yuan. Today, "one-day compensation for critical illness" has become a resounding business card of China Life's claims service.
Express compensation for emergencies: put the people first and be a "retrograde" in disasters. The emergency response to claims emergencies often requires high timeliness, affects a wide range of groups, and has a large social impact, which forms a major test for the service ability of insurance companies, and is an important embodiment of the insurance industry's fulfillment of social responsibility and acting as a social stabilizer.
In 2008, 8Level 0 is strong**, and the personnel ** are miserable. Chinese Life Insurance Company immediately activated the emergency response mechanism and issued ten "Chinese Life 5."12** Insurance Claims Service Commitment". More than 300 claims experts from more than 30 provinces (autonomous regions and municipalities directly under the central government) traveled thousands of miles to help, braved the danger of aftershocks, went against the grain, carried out earthquake claim assistance, and established 69 claim service stations in Yingxiu Town, Beichuan County and other disaster areas to provide fast and warm services for customers who came to consult. After more than two months of arduous struggle, the Chinese Life Insurance Company sent a front-line claims assistance team to the disaster area to handle more than 1 case60,000 pieces, and the compensation paid is more than 1With 500 million yuan, it is the life insurance company with the largest claim volume in Wenchuan.
In this series of claims rescue work, Chinese Life Insurance Company takes "initiative" as the main tone of claims settlement services, changes "waiting for customer claims" to "actively claims for customers", simplifies procedures, extends services, and ensures that claims are handled quickly and properly.
Since Wenchuan**, Chinese Life Insurance Company has continuously summed up a set of efficient and three-dimensional "emergency express compensation" service system with "system + management + service" as the core based on practical experience, covering efficient response, organizational system, division of responsibilities, service measures, data control and other related content of emergency response to claims emergencies, organizational system, division of responsibilities, service measures, data control and other related content with relevant departments, so that the company can respond to emergencies quickly, scientifically and orderly, and provide all-round, One-stop integrated services to effectively protect the interests of customers.
Applying this emergency claims service system, at the beginning of the outbreak of the new crown epidemic in 2020, Chinese Life Insurance Company immediately activated the claims emergency mechanism, comprehensively promoted the "contactless service" of claims, opened a 7 24-hour online claim application channel, simplified claims procedures and processes, and accelerated the processing timeliness. During the epidemic, the "Two Ones" initiative was launched: "contact the customer within one hour after reporting the case, and in principle, the processing will be completed within one day after receiving all the information". The company's honest and heart-warming claims service has won high praise from customers. A family member sent a letter of thanks, praising "Chinese Life is a trustworthy insurance company that sends warmth and love to customers when they need help." ”
With the heart of "the great man of the country", it aims to benefit the people and serve the people. In the face of unexpected emergencies, Chinese Life Insurance Company has always been undaunted by difficulties, charged ahead, and bravely assumed the responsibilities of central enterprises and fulfilled the mission of central enterprises. Over the past 20 years, it has taken the initiative to respond to more than 1,000 emergencies, and practiced the insurance nature of helping the poor, helping the poor and reassuring the people with practical actions at the critical moment.
Escort the people's better life with an enterprising attitude
Every policy carries love and responsibility to customers, and every compensation is a silent wait for customers.
Over the past 20 years, Chinese Life Insurance Company has always adhered to the claims service concept of "honesty and trustworthiness, customer first", continuously improved the claims business, improved the level of claims service, and continuously increased the scale of claims. From 2003 to 2022, the total number of cumulative claims exceeded 16.5 billion cases, with a total claim amount of 485.5 billion yuan, ranking first in the industry. In 2022, the number of claims increased by 24 times compared with 2003, and the total amount of claims increased by 17 times, of which the average daily claim for critical illness increased by nearly 30 times.
Don't forget the original intention, but encourage new people to serve. Chinese Life Insurance Company adheres to technology-driven, promotes the innovation and upgrading of claims service with digital technology, and provides customers with faster and more accurate digital claim settlement services. The online service capability has been continuously upgraded, and the newly launched medical electronic bill claim settlement has effectively released the value of data elements, greatly improved the efficiency of claims settlement operations, and won the 2022 China Banking and Insurance Industry Service Innovation CaseThrough the deep integration with the application of new technologies, Chinese Life Insurance Company has realized intelligent claims service from 10 to 3The iterative upgrade of 0 is continuing to promote intelligent claim verification 40 construction, the claim automation rate has reached a new level, and the whole process of claims settlement without manual intervention has also achieved an important breakthrough in continuous exploration.
In the future, Chinese Life Insurance Company will continue to practice the corporate mission of "serving the overall development of the country and protecting the people's better life", accelerate the intensive, intelligent and digital process of claims service, provide customers with a fast and warm service experience, and strive to make the people's sense of gain, happiness and security more secure.
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