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国内首款6年保证续保百万医疗险问世

日前,国内健康保险与互联网金融的龙头企业联合发力百万医疗保险市场,以一款6年保证续保的创新产品,开行业先河,为新时代的美好生活提供更加丰富的健康风险保障。

5月10日,中国人民保险集团旗下专业子公司——中国人民健康保险公司(以下简称“中国人保健康”)与蚂蚁金服联合举办新闻发布会,在支付宝平台推出国内首款6年保证续保的“好医保·长期医疗”保险,这也是目前保证续保期限最长的互联网百万医疗产品,在加快健康保险供给侧改革,回归保险保障本源,发挥专业优势推动产品创新方面迈出了实实在在的一步。

保障更长期 续保不担心

针对大众需求痛点和市场现状,中国人保健康结合多年来在专业健康保险领域的数据积累、分析和应用,在行业内率先开发了6年保证续保的互联网长期医疗险产品,为客户提供更加全面的医疗健康保障。

此前,市场上的百万医疗保险产品通常都是一年期短期险产品,停售即不再接受续保。而中国人保健康在支付宝上推出的“好医保·长期医疗”保险,明确规定投保人首次投保本保险,自合同生效日起每6年为一个保证续保期间,保证续保期间内,被保险人保费不调价、不因健康状况或理赔状况被拒绝续保,从根本上保障被保险人的长期利益。同时,条款还明确说明,若因不可控因素导致本保险统一执行停售,投保人可以以续保方式(没有等待期且无需重新填写健康告知)投保本公司其他医疗保险产品。

与市场上绝大多数的“百万医疗”产品每年1万元免赔额不同,“好医保·长期医疗”免赔额为6年合计1万元,客户会获得更多实在好处。例如,康先生在支付宝上投保了“好医保·长期医疗”,2018年发生住院医疗费8000元,2019年发生住院医疗费8000元,保证续保期间内累计超过1万元,则康先生可获赔8000元+8000元-10000元=6000元。若康先生投保的是不保证续保且年度免赔额1万元的保险产品,很显然,两个保险年度内均未超过1万元,所以,不能获得任何理赔。

产品与健康管理深度融合

“好医保·长期医疗”保险产品依托中国人保健康《健康金福悠享保个人医疗保险2018款》,具有保费价格低、保障范围广、保障额度高等特点,同时,将健康管理服务与产品深度融合,推出垫付医疗费、代约好医生、送绿色通道等,可极大地缓解投保人的家庭医疗支出压力,真切地感受到专业健康险公司的特色服务。

在保费价格方面,该产品费率实惠,适合全家投保。以31-35岁人群为例,在有社保的情况下,该产品每人每年保费为299元或305元(续保)。凡出生满28天至60周岁身体健康的个人均可作为被保险人,可续保至100周岁。

在保障范围方面,该产品覆盖范围广,保障很安心。社保用药、自费药、进口药、靶向药等都在保障范围内;疾病种类涵盖齐全,若发生条款约定的百种重疾,限额额外增加200万元。住院治疗、化疗透析和门诊手术等都可获得报销费用补偿。

在保障额度方面,该产品总保险金400万元,其中,一般医疗保险责任为200万元,重大疾病医疗保险责任200万元,赔付比例(不区分社保内外)为100%。值得指出的是,若被保险人以参加社会医疗保险身份投保,但未以参加社会医疗保险身份就诊并结算的,保险公司将按照赔付金额的60%进行给付。

在理赔服务方面,该产品垫付医疗费,理赔超省心。公司在全国78个城市支持垫付,全国支持在线理赔,客户出险后,可按照流程申请垫付医药费服务,专人帮付医药费,流程审核后,将于1个工作日服务上门完成。

依托中国人保健康在健康管理领域内多年深耕细作的资源优势,“好医保·长期医疗”保险提供就医绿色通道服务。通过PICC人民健康APP、支付宝保险平台、支付宝PICC人民健康生活号,可实现5个工作日安排专家门诊,10个工作日安排专家病房,名医资源涵盖31个省市自治区,超过990家医院、700家三甲医院,让客户就医不用排队,看病效率更高,全程专享贴心服务。

科技创新引领产品变革

4月28日,国务院办公厅正式印发《促进”互联网+医疗健康”发展的意见》,就促进互联网与医疗健康深度融合发展做出部署,优化资源配置,创新服务模式,提高服务效率,降低服务成本,满足人民群众日益增长的医疗卫生健康需求。

中国人保健康有关负责人介绍,顺应宏观政策导向与保险科技迅猛发展势头,中国人保健康将以创新为第一动力,在产品创新、服务创新、运营创新等不同层面全面发力,借助新兴科技,提升服务质量和服务内涵,实现公司质量变革、效率变革、动力变革。

据了解,中国人保健康联合蚂蚁保险在支付宝上推出的互联网中端医疗产品“好医保·住院医疗”保险,上线仅短短几个月就成为一款深受网民欢迎的“网红”产品。此次“好医保·长期医疗”上线,首发选择蚂蚁金服保险平台,并经产品专家论证优选为蚂蚁保险精选产品,正是看中该平台以保险科技为核心的功能体现,进而利用蚂蚁保险保民公社等渠道,及时收集反馈用户意见,分析评价用户需求,不断为用户提供最适合的产品和服务。

此外,中国人保健康还顺应消费者需求变化,积极开发“个人+企业、短期+长期、特定疾病+综合疾病、保险+服务”的多样化互联网产品,通过互联网产品的持续创新,公司电子商务渠道保费收入呈现出强劲的增长势头。同时,中国人保健康新一代的电商平台也正式上线运营,该系统成功引入成熟的金融级分布式交易架构,从底层基础设施到上层应用架构进行了全面更新换代,出单能力由每秒0.2单提升到每秒1000单,达到了国内人身险领域的顶尖水平,可为公司电子商务各项业务发展提供强大支撑。

中国人保健康还与蚂蚁金服等国内顶尖互联网公司深度合作,在移动互联、区块链、大数据、人工智能、互联网保险产品创新等领域进行全面合作,在精准定价、精准控费、精准健康管理等领域研发专业产品。此外,还将引入智能客服系统,以智能自助服务逐渐取代大部分人工服务,以智能引导和智能决策的机器人辅助人工服务,让客户享受到方便、快捷、贴心以及个性化的服务,大幅提高用户满意度。

 

 

来源:人民健康网

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