Introduction: From Product-Centric to Scenario-Centric – A New Logic for Medical Insurance
Traditionally, medical insurance products have been designed around disease categories or claim amounts, resulting in high standardization and lack of relevance. However, healthcare itself is a complex and dynamic service process. What patients care about is not just the disease name, but whether they are protected in real clinical scenarios.
Scenario-based medical insurance has emerged to meet this need. It focuses on key risk points within the medical journey—before, during, and after surgery, during recovery, and in cases of medical liability. Yihuibao is a pioneer and practitioner of this model.
I. Industry Trends: Three Forces Driving the Shift to Scenario-Based Insurance
1. Rising demand for medical liability protection: As tensions in doctor-patient relationships increase, hospitals look to insurance not only for compensation but also for prevention.
2. Increasing complexity in clinical workflows: New technologies and surgical techniques introduce dynamic risks that traditional disease-based policies can't cover.
3. Changing patient behavior: Modern patients focus more on immediate procedural risks than end-stage diagnosis, shifting demand from outcome-based to process-based protection.
II. Core Strategy: Building Protection Around Medical Touchpoints
Yihuibao has built a five-scenario framework that addresses real-life risk events:
- Preoperative: Ensuring informed consent through the 'Surgical Consultation Witnessing System'.
- Intraoperative: Providing fixed compensation for anesthetic and surgical risks via 'Surgical Accident Insurance'.
- Postoperative: Covering complications like infections, pulmonary embolism, or functional disorders.
- Recovery: Combining hospitalization benefits with post-surgery follow-up.
- Medical liability: Dual-layer protection for both patients and hospitals through accident and liability insurance.
This framework not only improves patient experience but also enhances hospital-level compliance and risk control.
III. Implementation Model: The Three Dimensions of Scenario-Based Delivery
1. Product: Designing policies based on surgical risk scoring models and aligning with clinical pathways.
2. Service: On-site sales + pre-op signing + direct claims settlement embedded into hospital workflows.
3. Technology: Full-process digital platform enabling 'enrollment—recording—reporting—claiming' integration.
Yihuibao has successfully deployed this model in multiple tertiary hospitals, achieving over 15% participation rates and 90%+ patient satisfaction, significantly increasing the visibility and value of medical insurance in real-world care.
IV. Future Outlook: From Insurance Product to Healthcare Service Infrastructure
Scenario-based insurance is not just about selling policies—it’s about integrating insurance into the healthcare ecosystem. This evolution will transform:
- Insurance companies: From claim processors to active scenario participants.
- Hospitals: From passive policyholders to collaborative risk managers.
- Patients: From policy buyers to informed participants in scenario-based protection.
Yihuibao will continue advancing its closed-loop 'product + technology + service' operation, creating a protection model that is truly impactful, usable, and trustworthy.
Conclusion: Scenarios Are Not Concepts – They Are Operational Logic
Scenario-based medical insurance is not a buzzword—it is a response to real medical challenges. Only by stepping into hospital workflows, understanding department needs, and embedding into day-to-day clinical processes can insurance become truly valuable. Yihuibao remains committed to finding the optimal balance between risk and protection through grounded, professional innovation.