China Life Insurance Company Limited has been recognized with the Insurance Industry Outstanding Claims Case Award at the 2026 Golden Stone Awards for Financial Consumer Protection Excellence. The company earned this distinction for its innovative case submission titled "Intelligent Connectivity, Simplicity and Warmth – A Digital-Intelligent Claims System Based on Multi-Dimensional Data Fusion."
The following is a summary of the award-winning case: To address common industry challenges such as cumbersome claim documentation, lengthy procedures, the need for in-person visits, and inefficient information verification in commercial health insurance, China Life has broken down barriers to single-source data application. The insurer has integrated multi-dimensional external data, including medical insurance settlements, electronic invoices, and government service data, establishing cross-domain, cross-platform data interoperability. This initiative has created a comprehensive, multi-layered, and user-friendly digital-intelligent claims service system, driving the transformation of claims processing from a document-driven to a data-driven model and setting a benchmark for innovative claims practices powered by multi-dimensional data.
Adhering to a principle of pilot programs leading broader implementation, China Life has focused on the integrated application of multi-dimensional external data. Through direct system connections, process optimization, and model innovation, and by leveraging fully automated, human-free claims processing capabilities, the company has developed a fast-claims service model. This has resulted in a digital-intelligent claims system built on a "national unified standard with regional customization," simplifying procedures and enhancing service efficiency.
First, the system establishes data connectivity, creating a new foundation for multi-dimensional data integration. To tackle industry issues like inconsistent对接 standards and insufficient adaptability for third-party data across different regions and types, China Life has innovated its technical architecture. The company built a flexible, configurable, and highly scalable multi-dimensional data integration platform that specifically supports the对接 needs of various third-party data, including medical insurance settlements, medical diagnoses, electronic invoices, and hospital charges. By developing standardized data接入 interfaces and a modular adaptation system, the platform can be personalized based on the data formats, transmission standards, and update frequencies of different partner organizations, enabling "front-end customer self-authorization and back-end system rapid integration" for all types of external data.
Second, the system enhances risk control by constructing a multi-layered risk prevention framework. Leveraging fully automated claims processing, China Life has incorporated technologies like large AI models and cloud computing. Throughout the entire claims handling chain, the company has established an intelligent scheduling, identification, and review system centered around an AI claims brain, facilitating intelligent workflow management, smart risk identification and control, and self-iterative model learning. This approach significantly improves claims efficiency while building a robust, multi-level risk防控 system.
Third, the system upgrades the customer experience by introducing a new model for document-free fast claims. For complex medical insurance cases, China Life has piloted an "instant settlement with no documents required" service. Relying on multi-dimensional external data integration, customers no longer need to submit medical records or invoices after receiving treatment. Claims can be applied for in as little as 8 seconds and settled within 5 seconds, delivering a genuine "second-level claims" experience.
Fourth, the system strengthens security defenses by establishing a comprehensive data protection framework for the entire process. Covering the full lifecycle of multi-dimensional external data integration and application, China Life has implemented an end-to-end, multi-tiered, and精细化 data security system. Technologically, multiple measures such as encrypted transmission, data desensitization, and access control are employed to provide graded protection for sensitive information like personal details, medical data, and claims information. The principle of collecting only necessary data and ensuring it remains invisible without authorization safeguards the security, accuracy, and real-time nature of data interactions.
In terms of project outcomes, claims efficiency has seen a leap forward. In 2025, the "instant settlement with no documents required" service was successfully rolled out in multiple provinces and cities including Shanghai, Zhejiang, and Henan. Supported by direct connections to multi-dimensional external data and the intelligent review system, the efficiency of the entire claims process improved dramatically. Overall claims processing time was reduced by over 90% compared to traditional models, with the average case resolution time controlled within 10 minutes. This shift has transformed the traditional multi-day review process, eliminating long waits for customers and providing a truly efficient and convenient financial service experience.
Furthermore, service coverage continues to expand. Guided by the "national unified standard with regional customization" principle, the digital-intelligent claims system has been rapidly deployed at qualified branches nationwide. In 2025, it provided fast-claims services to over 240,000 customers across the country, covering various client groups such as group insurance and individual policyholders. This enables customers from different regions and with different policy types to enjoy document-free, online claims services.
Customer operational costs have also been significantly reduced. With the document-free application model, customers are no longer required to collect, organize, and upload traditional claim materials like medical records, invoices, and expense lists. They need only complete an online authorization and select their treatment records to initiate a claim. Nationwide in 2025, this approach eliminated the need for customers to upload over 660,000 document images, addressing the common pain points of extensive effort and communication traditionally associated with claims and substantially lowering the time burden and operational difficulty for clients.
Finally, intelligent operational capabilities have been continuously strengthened. Relying on fully automated processing and the multi-layered risk防控 system, the digital-intelligent claims system achieves a dual balance of efficiency and security. The end-to-end risk prevention framework not only reduces manual operational costs but also minimizes human error, enhancing the standardization of claims handling operations.
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