Why Is KangAi Commune Stricter Than Insurance Companies in Some Respects?

This also shows how the Commune differs from insurance—a difference determined by the characteristics of the two models.

Insurance is a capital model: premiums are collected in advance, premiums are managed, and there is a large capital pool. The use of funds, the intensity of review, and the standard for payouts are decided by the insurance company itself. Even if there are wrongful claims here, the company does not need to explain to other policyholders, so insurance companies have much greater flexibility.

For example: insurance companies have a practice of "ex gratia payment." For cases that could be paid or not, that are disputed, the company may pay if it wants to protect its image or to accommodate a relationship. If an insurance company is not strict about cost control, its payout standard may be a bit looser.

Of course, paying more means the insurance company earns less; paying less means earning more.

But the Commune model is in fact an information intermediary that charges afterward. This determines that everything must be clearly accounted for to members. Where things are unclear, members will object, affecting the payment rate. So in many places the Commune must be cautious; a case like an ex gratia payment simply cannot happen. If the Commune decided on its own to aid a disputed case, it would then inevitably face questions from all members. Whether it pays more or less, the Commune's operators gain nothing.

An insurance company's position is like that of the house in a game of chance: it bets against policyholders, can influence the odds to some extent, and has flexibility. KangAi Commune, by contrast, is only an intermediary—an intermediary of information and funds. It cannot influence the odds, and beyond the published rules it has no flexibility whatsoever. The conditions for establishing such flexibility would be members fully trusting the Commune and the existence of a certain amount of flexible funds, and those conditions do not currently exist.

This determines why this situation arises. It is not what we want, but there is nothing we can do about it.

At the same time, it shows that an insurance company and KangAi Commune are essentially two different things. They cannot be lumped together; they complement each other. Don't choose only one.