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It tracks millions of companies around the world and provides insight on the latest market trends, the startups and scaleups reshaping the industry, and intelligence on how other big insurers are innovating.

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中国医疗保险业中的公私合作伙伴关系。

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1.基于区块链的反欺诈机制:

长期以来,从多家保险公司提取重复保单然后进行多重索赔的做法,一直困扰着中国的保险公司。清华大学已经牵头建立了一个基于区块链的平台,成员包含7家人寿保险公司以及万向区块链实验室。根据该计划,保险公司需向清华大学这一管理和验证数据的仲裁者,提供部分客户信息和保单细节;而万向区块链实验室则提供区块链底层基础设施,以促进保险公司之间的匿名数据交换。该项目展示了区块链的合法性,以及公营和私营利益相关方共同应对中国国内系统性挑战的能力。

2.员工福利规定:

长期以来,全民公共医疗保险为中国员工福利的政策鼓励蒙上了一层阴影。然而,公共医疗资金成本的提高促进了中国首个可免税健康保险计划的推出,该计划旨在减轻政府的医疗负担,并使当地企业能够与那些可提供更多优渥员工福利待遇的西方企业进行竞争。该倡议于2016年提出之后,近期正由热衷于扩张商业健康部门的监管机构加速推行。

3.政府支持的承保和理赔处理服务:

公立医院可见性的缺乏导致了中国医疗保险公司不可持续的损失率。缺乏可见性意味着精算部门将设计出影响盈利能力的低价产品,或是由于定价过高而丧失竞争力。这种情况促使政府提供资金支持初创企业,例如正在应对这一双重挑战的和金在线。和金可向人寿/医疗保险公司提供额外数据,以帮助其更好地了解定价工作的相关信息。

4.基于人工智能的操作:

中国的保险监管机构并未忽视人工智能的前景,其制定了人工智能的应用指南,从而促使了多家人寿保险公司接受基于人工智能的使用案例。其中,泰康人寿已达到领先地位,并且计划到2020年,能够利用人工智能解决提交给泰康在线单位的大部分索赔。泰康还借力于政府对面部识别技术的支持,以验证和核准客户交互。

结论:

在不到10年的时间里,全中国约有9亿人参加了各种医疗保险计划。然而,如果没有政府的支持,这一切都不可能实现,同时,公私合营伙伴关系将继续在中国医疗保健的发展中发挥至关重要的作用。

 

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