Insurance companies compete to seize the new blue ocean of the silver economy by breaking the notion that "one person's disability unbalances the entire family."

“One person’s disability leads to an imbalance for the whole family.” — This statement reflects the bitter reality faced by countless families and is becoming increasingly common in daily life as China’s population ages rapidly. As an important institutional arrangement to address this dilemma, long-term care insurance is being rolled out nationwide. In this process, commercial insurance institutions are leveraging their professional advantages in actuarial science, risk control, and service networks to seize opportunities in this new blue ocean of the silver economy.

China Life recently disclosed at its 2025 annual performance conference that since 2016, the company has participated in over 70 pilot projects for long-term care insurance. “China Life will contribute its strength to the stable and orderly implementation of long-term care insurance with a responsible corporate attitude, high-quality service supply, and professional operational management,” said Hou Jin, assistant president and chief actuary of the company.

The practices of China Life are a microcosm of how insurance institutions are deeply involved in the management of long-term care insurance. In the policy-oriented long-term care insurance sector, a new mechanism of social-commercial cooperation has been widely established, characterized by “government management as the basis, supplemented by social forces,” and employing a separation of management and operation model, where health insurance departments oversee and commercial insurance companies undertake. For example, the Jiangsu branch of China Life has undertaken 23 long-term care insurance projects across the province, covering nearly 11 million people. PICC Property and Casualty, on the other hand, has expanded its involvement in 32 national long-term care insurance pilot city projects and further developed supplementary care insurance projects for economically disadvantaged groups in collaboration with various local civil affairs departments, initially establishing a multi-tiered caregiving protection system.

There are mainly two pathways for insurance institutions to participate in long-term care insurance: one is the service provision model, which offers complete process services like disability assessment, cost auditing, and payment settlement; the other is the product supplement model, which develops commercial long-term care insurance to bridge with social security. However, while deeply involved, commercial insurance institutions also face challenges such as insufficient operational sustainability and inadequate implementation of the principle of cost recovery. Zhou Yanfang, director of the Strategic Research Center at China Pacific Insurance, suggests that tax reductions and exemptions should be implemented for insurance institutions handling long-term care insurance, referencing the mature experience of urban and rural residents’ serious illness insurance, and proposing separate accounting, evaluation, and regulation for long-term care insurance to achieve strict separation between policy-oriented and commercial insurance businesses.

If the sustainability of the service model is an “internal circulation” issue for the operation of the system, then controlling service quality is the “last mile” that determines whether long-term care insurance can truly benefit the disabled population. In response to the national condition where “over 90% of elderly people choose home-based care,” many large insurance companies are vigorously developing home nursing services, training professional caregivers to provide regular services for disabled individuals, supplemented by smart nursing beds and pressure sore prevention mattresses to alleviate the burden of family care.

However, the service chain involves multiple parties, including commercial insurance companies, assessment institutions, and nursing service providers, making quality control challenging. There have been previous cases of fraudulent billing to defraud health insurance funds. Gao Chengyuan, deputy secretary-general of the Guangdong Social Policy Research Association, stated that the lack of uniform standards for disability assessments and frequent fraud necessitate the establishment of national-level assessment standards, as well as the introduction of technologies like smart wearables and remote monitoring to achieve a fully digitized and traceable process. In terms of breakthrough pathways, the experience of Zhejiang’s “co-insurance body” can be referenced, where multiple insurance companies jointly undertake to disperse risks, forming a new governance pattern of “government sets rules, market provides services, insurance controls risks.”

In the face of challenges on the management end, insurance institutions are transitioning from being mere “operators” to “ecosystem builders,” extending their reach into the innovation of commercial long-term care insurance products and the integration of health and wellness services. The reporter noted that some domestic insurance companies are actively trying commercial long-term care insurance, offering not only insurance payouts but also a variety of service benefits such as outpatient appointments, accompaniment during hospital visits, home care assessments, coordination of home care, guidance on care hardware, rehabilitation nutrition guidance, and coordination with disability care institutions, extending support from simple financial compensation to full-process caregiving support.

A relevant person from China Pacific Life Insurance stated that the positioning of policy-oriented long-term care insurance is to “ensure basic coverage and wide accessibility,” achieving a safety net function. However, the demand for high-quality, personalized caregiving protection and services from disabled elderly individuals is growing, which is precisely where commercial long-term care insurance can make an impact. China Pacific Life Insurance has launched a series of commercial long-term care insurance products with higher coverage amounts and more flexible designs, effectively dispersing the risk of “one person’s disability leading to an imbalance for the whole family.”

Industry experts generally believe that as long-term care insurance gradually moves toward universal coverage, future insurance institutions will not only serve as payers but should also become builders of the health and wellness ecosystem. Insurance institutions can collaborate with housekeeping companies, elderly care agencies, community service centers, etc., to establish a full-process management system and take the lead in formulating service standards and operational specifications. At the same time, they should explore the application of age-friendly technological products, such as fall prevention devices and remote monitoring, to reduce the labor intensity of caregivers while enhancing care safety and efficiency.