On September 21, 2023, the first-year live broadcast event “Four Years of Protection, Longer Companion” was successfully held on September 21, 2023. The one-hour live event attracted nearly 30,000 viewers and over 15,000 interactions in the comment area. As the last step in the insurance business process, insurance claims are the core part of implementing the insurance protection function, and it is also the most important concern of users who purchase insurance. Through this live event, many netizens said, “At last, they have some understanding of the complicated and mysterious work of claims settlement. This live broadcast is very meaningful.”

Water Drop Insurance “Help Claim” Service Upgrade Press Conference

The reasonable rights and interests of users should be protected for every point

In November 2022, when Ms. Wang, a water drop protection user, was brushing a bowl at home, a glass bowl suddenly broke and her right hand was severely cut, and her index finger was unable to move. The family quickly called 120, did a simple bandage on the ambulance, and then sent them to the hospital for suture surgery. Because of this sudden accident, the tendon and nerve in the user's right hand were broken, and the treatment cost more than 10,000 yuan. The user applied for one million medical insurance claims, but soon received the conclusion that the claim could not be settled. The reason for refusing the claim was that “the hospital the user is visiting is a private hospital and does not meet the requirements of a 'public hospital level II or higher' as stipulated in the insurance agreement.”

“When users came to me for advice, we carefully communicated the entire accident and the circumstances of being taken to the hospital. We found that in November of last year, during the COVID-19 control period, patients were all decided by 120 to decide which hospital they were sent to, and they had no power to pick and choose at all. Moreover, Ms. Wang had a serious accident at the time. The hospital performed surgery within 30 minutes of receiving the treatment before the injury was promptly controlled, so the 120 first aid arrangement was reasonable. Considering these actual circumstances, we helped the user negotiate with the insurance company, and in the end, Ms. Wang obtained a normal claim of 3,418 yuan.” Gao Yang, senior claims consultant at Water Drop Insurance's “Help Claim”, introduced a claim case he has handled to netizens.

Goyang joined the insurance industry in 2010 and has been working in insurance services for 13 years with various insurance entities. In 2019, Goyang chose to join Shuidi Insurance, a leading insurance technology platform in China. Its main responsibility is to handle consultation and complaints arising from the claims process and handle all kinds of complex claims disputes. Over the past 4 years, Goyang has led the team to help users resolve more than 400,000 claims. Since the beginning of 2023, it has legally and reasonably obtained 520,000 yuan in claims for users.

“It's easy to see from my gray hair that filing a claim is really a complicated job.” In an interaction with netizens, Gao Yang said, “Claims processing itself is a highly specialized job. It's not mysterious, but it does involve many aspects of expertise and has certain process requirements. It is impossible for every ordinary user to become a medical expert or insurance expert, so the best way is to leave professional matters to professional people. Please also believe that we are the ones who can resolve your claims and questions in the most efficient way.”

“User first” is not a slogan; it must be implemented through action

“As an insurance brokerage platform, why does Shuidi Insurance do claims processing services, and it also spent a lot of money to establish its own professional team to provide free services to users.” Teng Hui, chief actuary of Shuidi, said during the live broadcast that he was often asked this question in the early days. “In the early days of the establishment of Water Drop Insurance, our position was a 'preferred platform for health insurances'. Adhering to the corporate values of “putting users first”, we continued to provide quality services to users. Claims processing is the most important service link for users. We must play a good role as a bridge, efficiently communicate with insurance companies on behalf of users, provide good service, and protect users' rights and interests. This is fundamental to the development of the Water Drop Insurance business.”

According to reports, many insured users report that electronic insurance policies lack a sense of security, so Waterdrop Insurance pays out of their own pockets. On average, 1.4 million paper policies are printed for users and mailed to their homes for free every year, making it easy for everyone to save and view; users have concerns about Internet financial security and personal information security, so Shuidi Insurance has given users more than 90 million free account security insurances; in July of this year, Shuidi Insurance obtained the “Personal Financial Information Protection Capability Certification” certificate issued by the National Fintech Certification Center, making it one of the first insurance institutions to pass national certification, so that more users can use it You can apply for insurance and pay with confidence, and have no worries.

“For every policy sold, pair it with a claim assistance service”

In order to solve users' pain points of “difficult and slow claims settlement”, Shuidi Claims Business began upgrading its claims service system in September 2022, and the service brand was officially named “Help Claim.”

During the service process, Water Drop Insurance's “Help Claim” team noticed that many users did not know how to apply when they needed to file a claim, so Water Drop Insurance has launched an online claim application function. Insured users can fill in the report information and submit claim materials online. The “Help Claim” team will help users review the submitted materials, find problems and communicate in a timely manner, avoiding situations where users are affected by their inability to read medical documents or the insurance company's requirements. The “Help Claim” team will also give detailed explanations to users in response to claims conclusions made by insurance companies, so that users can clearly and clearly understand every penny. If the claim cannot be settled, the “Help Claim” team will patiently explain the law and review basis to the user until the user understands it. Once there is a dispute, the “Help Claim” team will also assist the user to communicate with the insurance company, resolve the dispute, and protect the legal rights and interests of the claimant based on the terms.

In addition, “Help Claim” has also launched a series of claim assistance services for the elderly, offline claims cooperation services, and counter services at the Beijing Claims Service Center for elderly users. For example, users over the age of 60 can leave a phone number on the Claim Assistance Service homepage to make an appointment for a claim service to help the elderly. There is no need to worry about not being able to report cases on mobile phones or uploading data on mobile phones. Claims advisors will call back users who have successfully made an appointment within 1 working day, provide one-on-one guidance and assistance, track the progress of claims, and answer all of the users' claims questions.

In May 2023, Shuidi Insurance opened the country's first offline claims service center in Beijing, so that “help with claims” can be “seen and touched”. Users can go to the door to inquire about insurance liabilities, claim procedures, prepare claims materials in person, and complete reports on site. Over the past year, “Help Claim” has focused on the four “help apply, help review, help interpret, and help mediate”. Through online and offline services, it has provided services for 79,377 claims cases, and helped Shuidi Insurance users receive a total of 318 million yuan in compensation (the data caliber is from September 29, 2022 to September 11, 2023).

Ma Jing, head of Water Drop Insurance's “Help Claim” business, said, “In the future, we will continue to expand the scope of 'help with claims service'. We hope to fulfill the promise of 'every policy sold, paired with a claim service' as soon as possible, and expand the scope of claims consulting services to users' family insurance policies. As long as you are a Waterdrop Insurance user, you and your family buy health insurance policies on any platform, 'Help Claim' will provide claim advice and assistance with the highest service standards, and keep a lifetime of service promises together for a long time.”