Table of Contents
Preface
Section 1 Big Data Insights into Legal Services for Insurance Claims I. Trend of Insurance Demand: Strong Market Demand and High Compensation Amounts II. Trend of Insurance Cases: Sustained High Case Volume III. Status of Insurance Cases: High Win Rate for Consumers IV. Difficulties in Insurance Cases: High Professional Barriers and Unequal Bargaining Power V. Common Voices from Clients VI. Analysis of Client Pain Points
Section 2 Catalogue of Insurance Legal Services I. Insurance Legal Consultation II. Assistance in Claim Application and Preparation of Supporting Documents III. Issuance of Lawyer’s Legal Opinion on Insurance Claims IV. Participation in Negotiations and Alternative Dispute Resolution for Insurance Claims V. Issuance of Lawyer’s Letter Urging Insurance Settlement VI. Representation in Litigation and Arbitration over Insurance Claims VII. Diagnosis of Insurance Portfolio Allocation VIII. Insurance Policy Custodian Service
Section 3 Introduction to Baopeiban Legal Service Program I. Service Overview II. Core Service 1: Insurance Consultation and Planning Service III. Core Service 2: Legal Rights Protection for Insurance Claims IV. Core Service 3: Insurance Policy Custody and Annual Review Service V. Service Flowchart
Section 4 Successful Cases Contact Person
Preface
Insurance is supposed to serve as solid support and financial safeguard when risks emerge. In reality, however, policyholders, insured persons and beneficiaries (hereinafter referred to as “insurance consumers”) often encounter difficulties during claim settlement. Faced with insurance companies’ claim rejection notices, complicated clause interpretations and unequal professional status, consumers may feel helpless and treated unfairly.
The service product “Baopeiban” is developed to address such challenges. We fully understand that every insurance policy embodies the security and trust of a family or enterprise. Developed by a professional team of insurance lawyers, this product aims to break the “black box” of insurance claim settlement and provide insurance consumers with full-process, professional and considerate legal services.
From now on, you can firmly say no to the following troubles:
Overwhelming and confusing claim documents;
Unreasonable claim rejection by insurers with inadequate explanations;
Incomprehensible arbitrary compensation amounts;
Messy management of scattered insurance policies.
We strive to enable insurance to deliver its intended protection function and safeguard your legitimate rights and interests.
01 Big Data Insights into Legal Services for Insurance Claims
Section 1
On February 28, 2025, the National Bureau of Statistics released the 2024 National Economic and Social Development Statistical Communiqué of the People’s Republic of China. According to the document, original premium income of insurance companies reached RMB 5.6963 trillion for the whole year, representing a year-on-year increase of 5.7% under comparable statistical standards. Breakdown of premium income:
Original premium income from life insurance business: RMB 3.1917 trillion
Original premium income from health insurance and accident insurance business: RMB 1.0715 trillion
Original premium income from property insurance business: RMB 1.4331 trillion
Total payments and benefits reached RMB 2.3005 trillion:
Benefit payments for life insurance: RMB 874.7 billion
Indemnities and benefits for health insurance and accident insurance: RMB 444.9 billion
Indemnities for property insurance: RMB 981.0 billion
II. Trend of Insurance Cases: Sustained High Case VolumeDespite adjustments to the policy on open access to judgment documents, available data demonstrates persistently high volumes of insurance disputes. In recent years, tens of thousands of insurance dispute cases have entered judicial proceedings annually. Disputes mainly centre on claim settlement under personal insurance (critical illness insurance, medical insurance, accident insurance) and property insurance (motor vehicle insurance). This indicates that insurance consumers generally face major obstacles when seeking to enforce policy rights.
III. Status of Insurance Cases: High Win Rate for ConsumersClaim amount distribution visualized from case data:
Cases involving claims below RMB 100,000 account for over 61%
Cases with claims ranging from RMB 100,000 to RMB 500,000 account for approximately 35%
The figures reflect that most claim disputes relate to vital interests of ordinary families.
Table 1 Civil disputes concerning companies, securities, insurance, negotiable instruments and related cases collected by Alpha Case Database (21 August 2022 – 21 August 2025)
The data reveals a crucial finding: consumers enjoy a high rate of successful claims in court litigation. In particular, the support rate for claims below RMB 100,000 stands at 88.3%. This strongly suggests that many grounds relied on by insurance companies to reject claims cannot withstand judicial scrutiny. Insurance consumers stand a high chance of succeeding in rights protection through legal channels.
Table 2 Same data scope as Table 1
IV. Difficulties in Insurance Cases: High Professional Barriers and Unequal Bargaining PowerInsurance claim disputes involve complex insurance law principles, interpretation of specific policy clauses, medical or accident expertise, as well as insurance industry regulatory rules. When negotiating with insurance companies, consumers suffer from three core disadvantages: information asymmetry, insufficient professional knowledge and inferior bargaining position. It is extremely difficult for them to defend rights independently.
V. Common Voices from Clients
Claim requirements are complicated and confusing with no clear direction.
It seems everything is covered at the time of purchase, yet numerous exclusions emerge once an accident occurs.
Insurance companies arbitrarily determine compensation amounts which consumers cannot understand.
Insurance is recognised as important, yet often fails to meet expectations when needed.
Insurance products are diverse with lengthy, complicated clauses that are hard to comprehend.
Consumers lose track of their policies and do not know when to take relevant actions.
VI. Analysis of Client Pain Points(I) Lack of insurance literacy; mismatch between coverage and actual needsDue to complicated clauses and abundant professional jargon, consumers struggle to fully understand coverage scope, exclusions and claim conditions when buying insurance. This results in policies inconsistent with real needs. After an insured incident, they find coverage unsuitable or unavailable, and expected protection cannot be realised. Furthermore, a household’s multiple policies may be issued by different insurers, leading to overlapping liabilities or coverage gaps without systematic sorting. Protection effectiveness is severely undermined once risks materialise.
(II) Disadvantaged position in claim settlement; arduous rights protectionAfter an incident, unfamiliarity with procedures leaves consumers confused by extensive and stringent documentary requirements from insurers (medical records, accident certificates, financial documents etc.). Multiple rounds of supplementary submissions consume massive time and energy. Upon receiving claim rejection notices or low settlement offers based on “policy exclusions”, “non-disclosure of material facts” or “failure to satisfy insurance liability conditions”, consumers lack the expertise to assess the reasonableness of insurers’ arguments, with limited negotiation leverage and communication skills. Many feel wronged without effective channels to appeal. Even where insurers agree to pay compensation, settlement amounts often fall far short of expectations with opaque calculation methodology. Consumers cannot obtain reasonable explanations and have limited capacity to pursue higher compensation.
(III) Disorganised policy management; unsustainable protection efficiencyWithout systematic management of household policies, information regarding coverage, insured amounts, expiry dates and beneficiaries tends to be forgotten or muddled over time. Consequences include interrupted protection due to missed premium payments, or uncertainty over which policy applies and how to claim upon an incident, preventing full utilisation of coverage. In addition, continuous changes to family structure, financial status and external circumstances may render existing insurance portfolios unable to match updated risk exposures. Without regular reviews and dynamic adjustments, insurance as a long-term financial plan cannot reliably protect families.
02 Catalogue of Insurance Legal Services
Section 2
I. Insurance Legal Consultation
Consultation on critical illness insurance
Consultation on accident insurance
Consultation on medical insurance
Consultation on life insurance
Consultation on property insurance
Consultation on liability insurance
Consultation on integrated insurance planning for families and enterprises
II. Assistance in Claim Application and Preparation of Supporting Documents
Guide preparation of documents tailored to different insurance types
Highlight key considerations for application materials by insurance category
Represent or attend investigation interviews arranged by insurance companies
III. Issuance of Lawyer’s Legal Opinion on Insurance Claims
Analysis of claim eligibility
Assessment of recoverable compensation amount
Recommendation of optimal path to obtain compensation
IV. Participation in Negotiations and Alternative Dispute Resolution for Insurance Claims
Prepare case retrieval reports of similar precedents
Conduct on-site consultation and negotiation
V. Issuance of Lawyer’s Letter Urging Insurance Settlement
Document and confirm the submission date of claim application
Illustrate losses arising from delayed settlement
VI. Representation in Litigation and Arbitration over Insurance Claims
First-instance representation 1.1 Prepare statement of claim and supporting evidence 1.2 Lodge court filing materials 1.3 Formulate court hearing outlines 1.4 Compile reference document lists for trial 1.5 Prepare similar case retrieval reports 1.6 Represent clients in entrusted appraisal procedures 1.7 Attend court hearings
Second-instance representation 2.1 Prepare appeal statements and defence submissions 2.2 Collate new evidence for second instance 2.3 Formulate court hearing outlines 2.4 Attend court hearings
Representation in commercial arbitration
Representation in enforcement proceedings
Representation in retrial applications
VII. Diagnosis of Insurance Portfolio Allocation
Review and diagnose arrangement of relevant parties under insurance policies
Issue insurance portfolio analysis report
Provide guidance on adjustment of insurance arrangements
Review insurance contracts
Interpret insurance policy clauses
VIII. Insurance Policy Custodian Service
Collation of insurance policies
Reminders for critical time nodes
Annual insurance value analysis
03 Introduction to Baopeiban Legal Service Program
Section 3
Service OverviewTargeting your challenges and pain points, “Baopeiban” integrates legal services into three core modules. We deliver customised solutions according to your actual situation and demands to eliminate confusion and provide reliable support. • Professional Insurance Consultation: Clarify policy clauses and design tailored protection plans, preventing mismatched coverage from the outset. • Full-Process Claim Support: Provide strong professional legal representation. We adopt non-litigation measures including document guidance and negotiation, alongside strategic litigation and arbitration, to strive for entitled compensation. • Continuous Policy Custody Service: Systematically manage your policies and conduct annual reviews with dynamic adjustments to ensure protection always aligns with your needs, bringing peace of mind.
Core Service 1: Insurance Consultation and Planning Service
(I) Applicable Scenarios & Target Clients
Scenarios: Planning to purchase insurance without knowing how to select and allocate coverage; Holding existing policies but failing to understand coverage scope and exclusions; Seeking to understand potential claim procedures and risks after insured incidents.
Target Clients: All insurance consumers, especially individuals, families and small & medium enterprise owners with basic insurance awareness yet limited professional knowledge.
(II) Core Objectives & Service Value
Core Objective: Help clients “understand insurance, purchase appropriate insurance and establish rational insurance arrangements”. Prevent future claim disputes caused by mismatched products, flawed structural design and misinterpreted clauses, enabling risk prevention in advance.
Service Value: Break information asymmetry, equip clients with capabilities to make informed insurance decisions, ensure every premium paid delivers valid protection and eliminate potential claim risks beforehand.
(III) Service Content & Deliverables
Service Content 1.1 Specialised consultation by insurance type: In-depth legal interpretation for critical illness insurance, medical insurance, accident insurance, life insurance, motor vehicle insurance, non-motor property insurance, liability insurance etc., clarifying covered risks and exclusion boundaries. 1.2 Insurance contract review: Professionally review existing or prospective insurance contracts, mark key clauses, unfair provisions and potential risks. 1.3 Insurance portfolio diagnosis: Comprehensively assess client’s family structure, asset status and risk exposure, review existing policies and identify coverage gaps and redundant protection. 1.4 Legal analysis opinion: Issue Legal Analysis Opinion for specific insurance plans or emerging dispute risks, analysing claim feasibility and core controversial points.
Deliverables 2.1 Family / Enterprise Insurance Portfolio Analysis Report2.2 Interpretation of Core Insurance Clauses and Risk Notice2.3 Legal Feasibility Opinion on Insurance Plan
Core Service 2: Legal Rights Protection for Insurance Claims
(I) Applicable Scenarios & Target Clients
Scenarios: Uncertain about required documents before submitting a claim; Claim submitted yet facing settlement delay, rejection or insufficient compensation; Receipt of Claim Rejection Notice or Partial Settlement Notice and disagreeing with the insurer’s decision.
Target Clients: Insurance consumers entering or about to enter claim settlement procedures requiring professional legal guidance and representation.
(II) Core Objectives & Service Value
Core Objective: With professional lawyer representation, adopt the strategy prioritising non-litigation negotiation supplemented by litigation and arbitration, efficiently resolve claim disputes and secure full and reasonable compensation for clients.
Service Value: Reverse consumers’ disadvantaged position during claim settlement. Leverage professional legal expertise, negotiation skills and judicial remedy capacity to maximise the probability and efficiency of successful claims, acting as the most powerful tool to resolve insurance disputes.
(III) Service Content & Deliverables
Service Content 1.1 Claim guidance and document preparation: Guide clients to prepare complete claim materials for different insurance categories; represent or accompany clients in insurer investigation interviews to ensure standard applications and solid evidence. 1.2 Professional legal document drafting: Prepare Lawyer’s Legal Opinion on Insurance Claims to accurately assess claim prospects and recoverable amounts; draft and issue Lawyer’s Letter Urging Settlement to formally state positions and preserve evidence. 1.3 Participation in negotiation: Represent clients to negotiate with insurers supported by detailed similar case retrieval reports and legal arguments, pursuing prompt compensation. 1.4 Litigation and arbitration representation: Provide full representation for litigation and arbitration including first instance, second instance, retrial and enforcement if negotiation fails, and protect rights via judicial procedures.
Deliverables 2.1 Claim Document Checklist and Guidance Notes2.2 Lawyer’s Legal Opinion on Insurance Claims2.3 Similar Case Retrieval Report2.4 Lawyer’s Letter 2.5 Negotiation Plan and Review Report2.6 Closing documents including effective court judgments, arbitration awards or settlement agreements
Core Service 3: Insurance Policy Custody and Annual Review Service
(I) Applicable Scenarios & Target Clients
Scenarios: Lack of clear overview of overall protection; holding numerous scattered household or corporate policies; Protection demands evolving with changes in family structure and income requiring dynamic adjustment; Concerns over missed renewal and premium deadlines leading to lapsed coverage.
Target Clients: Clients seeking hassle-free, continuous and professional policy management, especially high-net-worth families and enterprise owners with multiple policies.
(II) Core Objectives & Service Value
Core Objective: Deliver professional digital and ongoing policy management services, ensure protection schemes continuously match client demands and achieve dynamic optimisation for long-term peace of mind.
Service Value: Outsource complex insurance administration to specialists, freeing clients from disorganised policy management. Ensure rational arrangement of relevant insured parties and continuous protection to realise long-term security and wealth preservation.
(III) Service Content & Deliverables
Service Content 1.1 Policy collation and digital custody: Establish confidential electronic policy archive, systematically sort core information of all policies (insurance type, insured amount, term, designated beneficiaries), provide consolidated overview and risk alerts. 1.2 Reminders for critical time nodes: Proactively notify clients of renewal, premium payment and survival benefit collection deadlines to avoid unintended lapse of coverage. 1.3 Annual review and optimisation suggestions: Issue Annual Insurance Review Report each year, comprehensively analyse coverage gaps and redundancies, and propose adjustment recommendations aligned with life stage changes.
Deliverables 2.1 Consolidated Schedule of Family / Enterprise Insurance Policies2.2 Annual Insurance Review and Optimisation Report2.3 Continuous reminder service for critical time nodes
04 Section 4 Successful Cases
Cases where insurers rejected claims on the ground of “non-disclosure of material facts”, and clients obtained compensation after legal representation Yang v. PICC Property & Casualty; Zhou v. Huatai Property & Casualty; Zheng v. China Merchants Renhe Life; Zhang v. Ping An Life; Zhang v. Fosun United Insurance; Zhang v. China Life; Xie v. PICC Health; Mo v. Anxin Insurance
Cases where insurers rejected claims on the ground of “incident occurring within waiting period” or “non-first occurrence”, and clients obtained compensation after legal representation Zeng v. PICC Health; Wang v. PICC Property & Casualty; Li v. Pacific Property & Casualty
Cases where insurers rejected claims on the ground that “incident does not fall within insurance liability”, and clients obtained compensation after legal representation Wang et al. v. Ping An Life Insurance; Wu v. Hexie Health Insurance; Shao v. Bainian Life Insurance; Sanming Company v. Guoren Property & Casualty; Lü v. Pacific Life Insurance
Cases where insurers rejected claims relying on “exclusion clauses”, and clients obtained compensation after legal representation Liu et al. v. Ping An Property & Casualty; Yin et al. v. China Life; Ye v. PICC Health; Yang v. Ping An Life; Tan v. PICC Health; Si et al. v. China Life; Lu v. Pacific Life Insurance
Lawyer Luo Chao
Partner Lawyer Member, Insurance Law Committee of Guangdong Lawyers Association Former Member, Insurance Law Committee of the 6th Changchun Lawyers Association Staff Member, Nanshan District Lawyers Working Committee Commercial Mediator, Luohu District
Practice AreasInsurance law litigation and non-contentious legal services; dispute resolution
Practice BackgroundSince admission in 2018, he has participated in over 300 civil and commercial dispute cases, covering: Contract disputes (sales, leasing, lending, financial leasing, contracting, construction projects); Real right disputes (recovery of possessed property); Unjust enrichment disputes; Labour disputes (enterprise employment compliance, labour contract disputes, work injury benefit disputes); Intellectual property and competition disputes (copyright ownership and infringement, trademark infringement, passing-off); Insurance disputes (personal insurance contract disputes, property loss insurance disputes, liability insurance disputes, insurer subrogation disputes); Negotiable instrument disputes; Tort liability disputes (personal injury arising from labour service, product liability); Marital and family disputes (divorce, maintenance claims); Corporate credit and debt disposal; enforcement proceedings. He has accumulated extensive experience in civil and commercial legal services across contentious and non-contentious matters.
In recent years, he has focused mainly on contentious and non-contentious work relating to insurance claim rejection, handling hundreds of insurance cases. When representing insurers in insurance contract disputes, he has helped clients achieve significant loss mitigation via negotiation and secured judgments dismissing all opposing claims on multiple occasions. When representing policyholders, insured persons or beneficiaries, he has successfully recovered denied insurance benefits or secured continued policy performance through judgments, mediation and settlement. He possesses profound practical experience in resolving insurance contract disputes and excels at combining non-litigation and litigation strategies to resolve insurance-related legal issues for clients.