The Breakthrough in Yuanbao Year 6: The Road to Reconstructing User Value in Internet Insurance

In 2021, it was a gray year for Sister Cai. While accompanying a friend to get an ultrasound, she was found to have a breast lump. She was then diagnosed with mid-to-late-stage triple-positive breast cancer and needed surgery as soon as possible. For anyone, “cancer” is a terrifying disease—especially when it is mid-to-late stage.

At a critical moment, a medical insurance policy from Yuanbao gave Sister Cai the courage to get through it. This Yuanbao policy provided reimbursement for 12 claims in total, reimbursed 56,7000 yuan in total, and when combined with reimbursements from other channels, she almost had no out-of-pocket expenses.

A similar story also happened to Ms. Niu, a mother of three and a “post-90s” generation. She and her husband, Brother Ge, run a hotel and a bathhouse. While they were working, Brother Ge happened to notice her face looked yellow. The hospital’s initial diagnosis was severe anemia. They had never expected that, after taking medicine for a long time, her condition would not improve. Eventually, she was diagnosed with a “malignant sigmoid colon tumor,” and it had already metastasized.

It was also because she purchased Yuanbao’s Million Medical Insurance and Yuanbao’s Premium Million Medical Insurance. Her total treatment cost was nearly 900,000 yuan, including over 200,000 yuan reimbursed by social insurance and more than 60,000 yuan paid by herself. To date, her Yuanbao policy has paid out 69 times in total, and reimbursed about 630,000 yuan in total.

In a time full of change and uncertainty, more and more people, like Sister Cai and Ms. Niu, urgently need reliable protection to support their lives. In this process, internet insurance technology groups represented by Yuanbao are becoming an important bridge linking protection and demand.

Besides Sister Cai and Ms. Niu, more people have obtained full protection through Yuanbao, received satisfactory payouts, and smoothly made it through their hardest times……

Uncertain times****Call for reform on the insurance supply side

Sister Cai is a strong woman who loves life. Her eldest daughter has an intellectual disability; her younger daughter is still in school. She is a full-time caregiver, but she encountered a midlife divorce. Without a stable source of income or savings, Sister Cai managed to get through it by working odd jobs and receiving social assistance. Now that her eldest daughter has married and her younger daughter is about to graduate, and her life is about to get better, an unexpected turn of events struck.

In her impression, breast cancer only happens to people who are depressed. Before, when Sister Cai tried to buy suitable insurance, the price would be relatively expensive and might exceed her budget—just like the 4:4:2 investment structure widely circulated online: four tenths for preserving value, four tenths for upgrading, and two tenths of insurance as the final line of defense.

For a long time, the public’s understanding of insurance has generally been biased. When they are healthy and safe, they think insurance is far away and are unwilling to set it up. When risks arrive, they want to buy insurance again, but the opportunity has already been missed. Yet in Yuanbao’s many cases, we can see a brand-new picture brought by internet insurance: more and more people are starting to prepare ahead of time—like bringing an umbrella on a sunny day—so they can protect themselves for life in advance.

Behind their foresight is Yuanbao’s use of digital-intelligence capabilities to lower the insurance barrier, broaden the boundaries of its service coverage, and enable more ordinary families like Sister Cai and Ms. Niu to buy insurance with high cost performance.

In recent years, technology has driven industrial transformation, and population mobility and changes in lifestyles have accelerated. People are even more eager for protection with certainty. When reflected in insurance, what is needed are products with high cost-effectiveness, precise coverage, and convenient services.

As the internet and AI penetrate every industry, they are also reshaping consumption habits. Today’s users are accustomed to comparing prices, “liking” recommendations, conducting independent research, and making decisions online. They are good at using tools to compare products and analyze policy terms. In insurance, this shows up as proactively learning about coverage after abnormal checkups or seeing health-related news, and then quickly placing orders after AI consultation and online comparisons. This requires the insurance industry to build richer consumer scenarios and provide a smarter, more autonomous service experience.

In summary, in an era of more refined demand and intelligent decision-making, users’ insurance needs are showing changes toward diversified needs and consumer-driven purchases. This puts higher demands on the supply side.

Yuanbao has been operating for six years, and its users cover the whole country. It has deeply cultivated cities such as Beijing, Shanghai, and Guangzhou, and also reaches wide areas where traditional insurance is difficult to move into. Countless users find suitable products here and receive reimbursements smoothly. Why can this “new wave” in the insurance industry break through in a short time? And how has it reformed the product supply side?

Buyable, affordable, and claims you’re satisfied with

When Sister Cai recalls buying Yuanbao’s Million Medical Insurance, it feels as if her life opened a window. After contacting Yuanbao’s claims experts, she quickly received the reply: “The situation meets the claims requirements, and it has been successfully entered into the claims process.”

Brother Ge, Ms. Niu’s husband, submitted his claim materials online with guidance from Yuanbao customer service. Within just a few days, he received the first claim payment of 41,763.06 yuan. After the incident, Brother Ge successfully renewed his policy the following year. Less than a month after submitting the claim materials, he received, on the same day, the first claim payment after renewal.

“Buyable, affordable, and claims you’re satisfied with” is the intuitive experience Yuanbao provides. However, achieving such an experience requires real hard work.

First, it is “buyable.” The core is expanding the coverage area of insurance so that it reaches more people. Yuanbao relies on AI and internet technology, focusing on broader markets that traditional insurance services struggle to reach, and connecting users with protection needs at lower cost and higher efficiency. At the same time, it tailors exclusive insurance products for “non-standard” groups, new residents, and flexible workers, so that more people can “be able to apply for insurance and buy the right coverage.” For example, for new residents and flexible workers, Yuanbao launched “Yuanbao Guard • Workers’ Peace of Mind Insurance,” relaxing occupational restrictions.

Second, it is “affordable.” That means providing as comprehensive coverage as possible within a price range people can afford. To do so, Yuanbao uses a product-customization approach to comprehensively innovate on coverage scope, payment methods, and other aspects, significantly lowering the barrier for users to obtain protection. In addition, Yuanbao keeps upgrading its coverage responsibilities such as critical illness hospitalization allowance, hospitalization deposit advance, and accompanying medical visit services. Taking the critical illness hospitalization allowance as an example, for some of Yuanbao’s products, this responsibility has been gradually upgraded from 100 yuan/day with cumulative payout of 18,000 yuan in 2021 to 800 yuan/day with cumulative payout of up to 144,000 yuan by 2025.

Further, it is “claims you’re satisfied with.” Yuanbao has built an intelligent claims service that allows users to handle claims entirely online. Yuanbao applies AI to speed up the claims process. The “one-click upload” feature allows users to upload various medical receipts together; the system can automatically recognize, categorize, and extract key information. It transforms the previously cumbersome manual handling process for claims into efficient and convenient intelligent computing, greatly lowering the operational threshold for users.

In addition, Yuanbao has also launched a concierge-style claims service called “Ruyi Claims.” Through three major mechanisms—“assisting, following up, and coordinating”—it creates a one-stop claims service system. While safeguarding claims efficiency, it improves the quality of claims services and provides users with a faster and warmer claims experience. 《Yuanbao 2025 Claims Annual Report》 shows that with technological empowerment, the fastest time to close Yuanbao’s medical insurance claims has been shortened to 3.4 minutes.

With innovative business models as the framework and technological innovation as the underlying support, Yuanbao adheres to long-termism and keeps refining products and services. And the fundamental reason it can break through quickly is that it always stands on the side of users—seeing ordinary people’s real needs, and addressing the pain points that ordinary people wrestle with—so users can “buyable, affordable, and claims you’re satisfied with.”

The future of commercial health insurance****is hidden in user value

The stories of Sister Cai and Ms. Niu happen every day, and behind them is the enormous and real demand for commercial health insurance.

The 《2024 Statistical Bulletin on the Development of China’s Health and Health Services》 shows that in 2024, China’s total health expenditure was about 9.09 trillion yuan. Of this, personal health expenditure was 2.5 trillion yuan, still accounting for 27.5% of total health expenditure. Based on data from the OECD report 《Health at a Glance 2023》, if we refer to the OECD countries’ average out-of-pocket ratio of about 20%, China’s personal spending could drop to 1.8 trillion yuan. A gap of 700 billion yuan could be covered by health insurance claims. Those claims correspond to an estimated health insurance premium scale of about 1.5 trillion yuan. At present, China’s health insurance premium scale is still below 1 trillion yuan, leaving huge room for development.

For the broad public, to tap the long-tail market and provide products that fit it—this is the growth potential of commercial health insurance in the future. Yuanbao focuses on the inclusive health insurance segment. By using “insurance + AI” to reconstruct the service experience, it offers end-to-end online processes, fast claims, and a lighter experience. With case after case proving it, good insurance, at its core, is about letting users buy it cheaply and get claims they’re satisfied with.

Whether it is the golden track of commercial health insurance or the industry trend of technology-driven service upgrades, none of it happens overnight. Yuanbao has spent six years cultivating the field and has always upheld the philosophy of taking steady steps while staying grounded in users. It continues to invest in product innovation, technology iteration, and service upgrades. Industry breakthroughs and maturity require long-term commitment. In the future, Yuanbao will also continue to put users first, use technology to make insurance more inclusive and more human, steadily move forward along the path of internet insurance, and build solid protection barriers for more families.

Source｜Legal Daily

Edited by｜Han Yuting, Zhu Yuchen, Liu Xuyu