90% of claims can be paid in 2 days. What new attempts has PICC Health made in digital services？

Keep watch | focus on insurance innovation

Driven by the market trend and customer demand, the digital transformation of the insurance industry has entered a new stage.

On September 7th, Ant Insurance released the first digital operation platform "Xingyun 1" in the industry, and it was fully open to cooperative insurance institutions. This means that insurance institutions can realize the online and digital operation of the whole process of sales, operation and service on Ant Insurance, greatly improving operational efficiency and service experience.

In the insurance industry, PICC Health has always been a pioneer in digital management. Since 2018, it has been in contact with the Internet and launched the first "good medical insurance and long-term medical care" in China to guarantee 6-year renewal, which quickly became an explosion. In the face of the rapid influx of Internet users, PICC has realized digital operation healthily and quickly, and online the whole process of policy processing and claims processing.

Today, for the digital operation of PICC Health, it is no longer the digitization of basic processes, but the need to enhance customer service experience through more intelligent tools. In May this year, the "Good Medical Insurance" series of products took the lead in accessing Ant Insurance’s "Peace of Mind Compensation". Through scientific and technological capabilities, more than 90% of cases can be settled within 2 days, and digital operations are optimized in service experience.

Digital transformation: keeping people healthy and entering a bumper harvest period

Among the insurance companies undergoing digital transformation, PICC Health has to be mentioned, and its recently released financial report also shows that the company’s digital transformation has begun to show results.

The financial report of PICC Health in the first half of 2022 showed that the company’s operating performance reached a record high, achieving a net profit of 742 million yuan, an increase of 186.5% year-on-year; The original insurance premium income was 30.383 billion yuan, an increase of 18.8% year-on-year, and the premium scale ranked first in professional health insurance.

It is particularly noteworthy that PICC Health’s Internet business accounts for 30% of the total, and it has served more than 60 million customers nationwide, which reflects PICC Health’s leading position in digitalization based on Internet channels.

As a professional health insurance company under the People’s Insurance Company of China, People’s Insurance Company of China and Ant Insurance Co., Ltd. have developed Internet inclusive products with relatively high security and relatively appropriate prices, and at the same time realized the combination of long and short insurance, covering medical, serious illness, accidents and other insurance products. At the same time, through the advantages of Ant Insurance Platform, the service scope has been extended further and further.

In addition to products, another advantage brought by ant insurance is channels. It can be seen from the data of PICC that 78% of its customers come from third-tier and below cities, which is of great significance to PICC health and to expand the customer base in third-and fourth-tier cities and vast rural areas.

In terms of service, Ant Insurance’s Internet attribute promotes PICC health and continuously optimizes Internet online services, providing 7*24-hour all-weather service capacity, meeting the needs of a large influx of customers at night and strengthening night service capacity. According to the data of People’s Insurance, thousands of consultations flow in every day for 12 hours at night, which really meets the immediate needs of users.

In other services, the two parties jointly launched family mutual aid and "peace of mind compensation" to deepen users’ service experience and claim perception. From the data point of view, PICC Health’s online claims rate can reach 98%, and customer satisfaction can also reach 98%.

Digital transformation and upgrading services: 90% of claims can be paid within 2 days.

On May 16, 2018, PICC Health and Ant Insurance launched the first "Good Medical Insurance Long-term Medical Care" insurance with a six-year guarantee in China. In a short time, the number of insured users reached the order of one million, which became an explosive online celebrity product of their cooperation.

In the early stage of the launch of good medical insurance products, claims are made by offline mailing materials. The service limitation is relatively insufficient, and the biggest appeal of Internet insurance products is to settle claims quickly and not polish them well, which will have an impact on the healthy development in the future.

Since then, PICC Health has set up a special operation center and started to cooperate with Ant Insurance to solve the user’s claim experience. In recent years, PICC Health has used the "claims brain" developed by Ant Insurance to intelligently identify 107 kinds of medical and claims vouchers through AI smart camera identification, OCR identification, bill direct connection, risk control entry and other technologies, with an identification accuracy rate of over 95%, helping insurance institutions to improve their claims efficiency by over 70%, and at the same time improving the convenience and limitation of claims for users.

In May this year, PICC Health "Good Medical Insurance and Long-term Medical Insurance" took the lead in accessing Ant Insurance "Peace of Mind Compensation", and more than 90% of the cases were settled within 2 days. At present, the online claims rate of good medical insurance has accounted for 98% of the total claims.

In the final analysis, for people’s health, the next stage of digitalization will be digital intelligence with "service" as the core.

Digital management of insurance industry enters the fast lane

Digitalization has been engraved into the genes of insurance companies, and it is also true for people’s health. In the business philosophy of keeping people healthy, service technology innovation is the key development direction in the future.

In the next stage, PICC Health will attract and retain customers with better professional digital construction, focusing on user demand mining, product richness, specialization of service team and technical iteration to enhance user experience and satisfaction. For example, PICC Health will enhance the service experience of the elderly through exclusive services for the elderly. In terms of online customer service, PICC Health will continue to deepen its cooperation with Ant Insurance, and use digital technology to actively introduce direct compensation and other methods to provide more intimate claims service.

For insurance companies, digital operation is more important to enhance their core service capabilities. Behind this, it is necessary for insurance companies and insurance agency platforms such as Ant Insurance to cooperate closely in science and technology to better meet the actual needs of users.

The ant insurance "Xingyun 1" platform launched this time can be synchronized to insurance companies through users’ search needs, providing users with more insurance products that meet their needs.

Secondly, in terms of service, insurance companies can realize the online service of the whole process from pre-insurance, insurance to after-sales through the "Xingyun 1" platform. Insurance institutions can open an exclusive "business hall" in Ant Insurance to carry out product sales, content education and rights and interests services, and help insurance institutions establish online self-operating positions directly connected to users. In addition, through AI technical capabilities, insurance institutions can provide users with services such as policy management and claims settlement.

In addition, in terms of intelligence, many traditional insurance companies seek experience from the Internet technology industry. "Xingyun 1" has opened up the technical capabilities accumulated by Ant Insurance in the fields of risk control and claims, improved the accuracy of underwriting and claims, and improved the operating efficiency of insurance companies. Really enter the fast lane of digital management with insurance companies.

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This article first appeared on WeChat WeChat official account: Bao Guan. The content of the article belongs to the author’s personal opinion and does not represent Hexun.com’s position. Investors should operate accordingly, at their own risk.