Technology reshaping the mix of social and private health insurance

Technology will empower the synergy of social and commercial health insurance and reshape the entire insurance value chain, industry experts said during a forum on Thursday.

China is building a multi-level medical security system and technology will play a big role in the process, said Hong Juan, deputy general manager and chief operation officer of Ping An Medical and Healthcare Management Co Ltd (Ping An HealthKonnect), at the two-day Insurance Analytics and AI Innovation Asia Pacific 2019 Summit from June 26 to 27.

China has established one of the world’s largest basic medical safety nets, covering more than 95 percent of people.

As of end-2018, the number of people insured under the social health insurance program was 1.34 billion and the accumulated balance of the fund stood at 2.3 trillion yuan (US$330 billion), according to the National Healthcare Security Administration.

Premiums for commercial health insurance, which functions as a supplement to the national basic protection scheme, grew rapidly to hit 544.8 billion yuan during the same period.

Coinsurance still accounted for a large share of the protection system, with 28 percent of medical expenses borne by individuals, above the proportion of out-of-pocket payments recommended by the WHO of 20 percent for preventing poverty due to illness, Hong said.

To address people’s changing and diversified protection needs, China needs to promote the synergistic development of basic and supplementary private health insurance, which calls for the help of advanced technologies like Big Data and artificial intelligence , Ping An HealthKonnect said.

The Shanghai-based company is lending support to that integration by exporting its systems, service platforms and expertise in insurance product development, data analysis and risk management.

With the help of the tech firm, people in Chongqing and Henan Province, for example, can access one-stop services immediately online or nearby without repetitive applications.

Policy-holders can search for, purchase products and make payment for both social and private health insurance on a shared platform template offered by Ping An HealthKonnect.

Ping An HealthKonnect also enables underwriters to have more marketing channels on its interconnected platforms, spot protection gaps through its Big Data analysis and strengthen their anti-fraud capabilities to better control claims risks.