ZhongAn Insurance launches AI-powered group insurance integrating claims and health data

Group health insurance is a high-growth segment within China's multi-tiered medical security system, and the widespread adoption of AI technology is reshaping the entire service process for group insurance.

On September 23, ZhongAn Insurance officially launched its "Enterprise Smart Group Insurance" solution, offering intelligent capabilities across four dimensions: employee service experience, employee health companionship, HR digital health management, and employee benefit extension. The solution leverages AI and digital capabilities to reconnect group insurance products, services, and employee experience.

AI Adoption in Enterprises

In recent years, the wave of AI applications has accelerated across enterprise operations, with new use cases emerging in recruitment, office collaboration, finance, and customer service. Data shows that 83% of Chinese enterprises have already integrated generative AI into at least one business process on a regular basis.

However, the digital transformation of group insurance within corporate benefits systems has lagged behind. According to relevant surveys, the actual AI application rate among HR professionals in China for scenarios such as estimating benefit costs and supporting employee physical and mental health remains well below 10%.

Challenges in Group Insurance Management

Industry insiders note that for enterprises, group insurance extends far beyond policy activation. After a policy is issued, companies must continue investing in personnel management, claims processing, health management, and benefits administration. Reducing management costs, making benefits more accessible to employees, and enabling companies to better understand employee needs have become new challenges in group insurance management.

How Smart Group Insurance Works

Lin Yijing, Head of Multi-Channel and Group Insurance Business at ZhongAn Insurance, pointed out that smart group insurance fundamentally changes how group insurance understands and connects with employees.

Within the smart group insurance system, ZhongAn has introduced "OK仔" (OK Boy), an intelligent assistant that serves as a unified service entry point for employees. Previously, when employees encountered group insurance issues such as medical treatment, claims, or health services, they typically had to first contact HR or customer service, who would then determine the appropriate channel for resolution. Now, this process can be handled by "OK仔." Employees can ask questions directly in natural language, and "OK仔" interprets the request based on the company's specific insurance plan, provides corresponding answers, determines coverage eligibility, and connects to follow-up services.

This capability is built on the integration of insurance domain knowledge and AI technology. In traditional group insurance services, claims processing and health management often operate separately. While enterprises can access a large amount of data, this data is scattered across different processes, making it difficult to form a complete picture of health risks. Under the ZhongAn smart group insurance system, and subject to compliance authorization and data anonymization, claims and health management data are connected to identify high-incidence diseases and key health risks among employee groups. Based on this analysis, services such as disease prevention, targeted screenings, online consultations, and rehabilitation management are configured accordingly.

Strategic Value of Group Insurance

Li Gaofeng, Vice President and Chief Investment Officer of ZhongAn Insurance, believes that group health insurance is becoming an important link between enterprise operational needs and employee health needs. As the role of group insurance evolves, its value will extend from traditional employee benefits to strategic corporate assets, with intelligence serving as a key enabler of this transformation.

Supporting Ecosystem

For smart group insurance to truly integrate into daily enterprise management, it requires support not only from AI applications but also from products, technology, and service systems:

• Product side: ZhongAn continues to enhance its ability to rapidly customize group insurance products and build diversified combinations to meet the needs of different industries, enterprises, and employee groups.
• Technology side: ZhongAn is advancing AI integration into insurance operations through its "One AI" strategy, connecting models, data, and business processes.
• Service side: ZhongAn is continuously building its healthcare service ecosystem, which has served over 150 million users cumulatively and includes more than 330 healthcare partners.

Market Reach

According to its annual report, in 2025, ZhongAn's enterprise group insurance served over 13,000 enterprises and more than 3.8 million employees, covering industries including internet, finance, healthcare, and automotive.