At present, with the improvement of the digitalization of claims, consumers' expectations for insurance claims have also increased from "compensation received" to "fast compensation and good experience". In the claims report released by insurance industry companies in 2023, the speed of claims service has been constantly refreshed, and "flash claim", "second claim", "direct claim" and "intelligent pre-claim" have become hot words, providing consumers with a faster and warmer service experience. As an insurance technology company that uses AI algorithm models to drive all business scenarios, Yuanbao has performed more prominently in this regard, and it is all in the recently released "2023 Yuanbao Health Insurance Claims Annual Report".
First of all, with the gradual application of AI models in the insurance field, the efficiency and quality of claims have been significantly improved, and Yuanbao has made great progress in terms of core claims data. Among them, the average claim amount of medical insurance per person reached 27,199 yuan, and the average compensation per person who successfully claimed compensation was 16 times, the average arrival time of claims below 10,000 yuan < 5 days, and the maximum cumulative amount of claims for a single person is 8650,000 yuan, a single person has a maximum of 53 cumulative claims, and the satisfaction rate of intelligent customer service is nearly 95%. In addition, compared with last year, the health protection provided by Yuanbao is more inclusive, the efficiency is more significant, and the service is better.
Compared with ordinary insurance, Internet insurance has the characteristics of being more inclusive. According to the Yuanbao claim report, in the past three years, Yuanbao medical insurance has been expanding the scope of protection, and the proportion of claims reimbursement in total medical expenditure has increased year by year, and the proportion of commercial insurance reimbursement expenses in total medical expenditure in 2023 will increase by 75% compared with 2020. In 2023, after the reimbursement of medical insurance and commercial insurance, the proportion of users' out-of-pocket medical expenses will be reduced to 187%, compared with 46% in 2022, continue to "reduce the burden" of people seeking medical treatment, further demonstrating the inclusive value of insurance.
With the help of the improvement of AI capabilities, Yuanbao has not only improved the speed of claims settlement, but also improved its innovation ability and launched many value-added services to meet the diverse needs of users. For example, the Green Pass service for critical illness insurance is a special access to medical treatment that provides patients with convenient and high-quality medical services. According to the report, in 2023, Yuanbao's critical illness green pass service will cover 293 prefecture-level cities and 2,694 medical institutions across the country, of which 100% of the tertiary hospitals will be covered. The data of the "Yuanbao Medical Advance Payment Service" in the report shows that in 2023, the maximum advance payment of the Yuan insurance policy is 100,000 yuan, and multiple advance payment services are provided for many users, with a maximum advance payment of 210,000 yuan for a single person, which effectively reduces the financial burden of patients and provides a solid guarantee for them to obtain necessary medical treatment**.
Looking back at 2023, Yuanbao will continue to upgrade its claims service by adhering to the inclusive insurance business, using AI to convey temperature, and guarding hope with "compensation". In the new year, Yuanbao will continue to increase scientific and technological innovation, drive the development of insurance business with AI algorithm models, and bring consumers a better and more efficient claims service experience.